In 329 newborns examined by the method of Strout and/or histopathological sections of the placenta, Trypanosoma cruzi was observed in 25 cases. The serological prevalence of Chagas' disease in mothers was 51%. A greater risk of congenital transmission was observed in newborns ranging between 1,001 and 2,500 g (21%), compared to 2% in newborns weighing more than 2,500 g. Congenital transmission occurred predominantly in newborns with a gestational age of 26 to 37 weeks. Histopathological examination of placentae disclosed T. cruzi in 6.3%. In areas with a high prevalence of Chagas' disease, congenital transmission is a real hazard.
Eight hundred and twenty newborn babies with a mean weight of < or = 2500g from the Maternity Hospital P Boland in Santa Cruz- Bolivia were examined in 1988-1989 by different methods to diagnose Chagas disease, (placental pathology, serology, parasitologically and clinically) to determine the efficiency and cost of these methods. The histopathological exam detected 87 cases of placenta infection. Out of this total 43 (49%) newborns were positive on the parasitological exam of the chord blood. This number increased by repeating the blood test during the first month of the baby's life, reaching the same level as the histopathology. With the serology, only 2 cases were detected as positive. The clinical sign with a high specificity in children infected with Chagas disease is the hepatosplenomegaly. The advantages and disadvantages regarding the cost and feasibilty of two strategies to detect congenital Chagas disease are being discussed. The first in based on the histopathology and the other over on parasitology. It is concluded that the control programs for this non vectorial form of Chagas' disease cannot be uniform since the aspects to consider are: prevalence of the disease, existence of the vector and availability to laboratory techniques.
In order to know the significance of placental infection by T. cruzi 820 newborn infants (NB) weighing less than or equal to 2500 grs were examined both clinically and by the Strout method and histopathological sections of the placenta in order to detect congenital infection with Chagas' disease. Thirty five (4.26%) NB presented a placentary infections by T. cruzi, but having a negative direct parasitological examination in the cord blood, these NB were followed up parasitologically (microhematocrit), in order to detect an eventual positive change in the post-partum period. The follow-up was done at 7, 15, 30 and 60 days after birth, and with xenodiagnosis 15 days later. In 27 newborn (3.29%) it was possible to complete their follow-up with detection of T. cruzi in every case. In the control group, constituted by NB which were negative to both methods, there was no positivisation at all during the follow-up period. These observations show a high frequency of congenital T. cruzi infection in Santa Cruz.
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