An epidemiological approach to study congenital Chagas' disease

Andrade, Ana Lúcia; Zicker, Fábio; Martelli, Celina Maria Turchi

doi:10.1590/s0102-311x1994000800012

Cited by 7 publications

(7 citation statements)

References 15 publications

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“…These variations may be caused by the degree of parasitemia of the infected mother, differing parasite strains, exposure to vector‐borne re‐infections during pregnancy, occurrence of acute form of the disease during pregnancy, different origins of the population studied (Latin American immigrants in non‐endemic countries), maternal age, as well as different diagnostic techniques and study designs (Bittencourt ; Andrade et al . ; Gurtler et al . ; Hermann et al .…”

Section: Discussionmentioning

confidence: 99%

Systematic review: Prevalence of Chagas disease in pregnant women and congenital transmission of Trypanosoma cruzi in Brazil: a systematic review and meta‐analysis

Martins-Melo

Lima

Ramos

et al. 2014

Tropical Med Int Health

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Abstractobjective To estimate the prevalence of Chagas disease in pregnant women and the risk of congenital transmission of Trypanosoma cruzi infection in Brazil, through a systematic review and meta-analysis.methods We searched electronic databases, grey literature and reference lists of included publications to identify epidemiological studies on the prevalence of Chagas disease in pregnant women and on the congenital transmission rate of T. cruzi infection in Brazil published between January 1980 and June 2013. Pooled estimates and 95% confidence intervals (95% CIs) were calculated using fixed-and random-effects models.results Sixteen articles were included -12 studies on the prevalence of Chagas disease in pregnant women (549 359 pregnant women) and nine on congenital transmission rates (1687 children born to infected mothers). Prevalence of Chagas disease in pregnant women ranged from 0.1% to 8.5%, and congenital transmission rates from 0% to 5.2%. The pooled prevalence of Chagas disease among pregnant women across studies was 1.1% (95% CI: 0.6-2.0); the pooled congenital transmission rate was 1.7% (95% CI: 0.9-3.1). In 2010, 34 629 pregnant women were estimated to be infected with T. cruzi, and 312-1073 children born (mean: 589 cases) with congenital infection.conclusion Congenital Chagas disease is a neglected public health problem in Brazil. Systematic congenital Chagas disease control programs through routine prenatal screening for T. cruzi should be widely implemented in Brazil's endemic areas, to identify infected pregnant women and newborns at risk of congenital infection.

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Section: Discussionmentioning

confidence: 99%

Systematic review: Prevalence of Chagas disease in pregnant women and congenital transmission of Trypanosoma cruzi in Brazil: a systematic review and meta‐analysis

Martins-Melo

Lima

Ramos

et al. 2014

Tropical Med Int Health

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“…Since then numerous articles have been published regarding congenital Chagas disease: epidemiological and clinical studies, evaluation of different diagnostic methods [9], congenital Chagas as an imported disease (cases reported in Spain, USA, Switzerland), and above all, highlighting the importance of the disease in terms of public health and the need for health programs concerned with its diagnosis and treatment in all the endemic countries [7], [10], [11], [12], [13], [14], [15]. However, the initiatives for control and management of congenital Chagas in endemic countries are far from achieving total geographic coverage [16], [17], [18], [19], [20], [21], [22]. Such initiatives are not only necessary in endemic countries, but should, in a targeted way, also be implemented in countries that receive or have received significant migration flows from Latin America such as USA, Spain, Switzerland and others [3], [23], [24].…”

Section: Introductionmentioning

confidence: 99%

Achievements and Challenges upon the Implementation of a Program for National Control of Congenital Chagas in Bolivia: Results 2004–2009

2013

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Bolivia is one of the most endemic countries for Chagas disease. Data of 2005 shows that incidence is around 1.09‰ inhabitants and seroprevalence in children under 15 ranged from 10% in urban areas to 40% in rural areas. In this article, we report results obtained during the implementation of the congenital Chagas program, one of the biggest casuistry in congenital Chagas disease, led by National Program of Chagas and Belgian cooperation from 2004 to 2009. The program strategy was based on serological results during pregnancy and on the follow up of children born from positive mothers until one year old; if positive, treatment was done with Benznidazole, 10 mg/Kg/day/30 days with one post treatment control 6 months later. Throughout the length of the program, a total of 318,479 pregnant women were screened and 23.31% were detected positive. 42,538 children born from positive mothers were analyzed at birth by micromethod, of which 1.43% read positive. 10,120 children returned for their second micromethod control of which 2.29% read positive, 7,650 children returned for the serological control, of which 3.32% turned out positive. From the 1,093 positive children, 70% completed the 30 day-treatment and 122 returned for post treatment control with 96% showing a negative result. It has been seen that maternal-fetal transmission rates vary between 2% and 4%, with an average of 2.6% (about half of previously reported studies that reached 5%). In this work, we show that it is possible to implement, with limited resources, a National Congenital Chagas Program and to integrate it into the Bolivian health system. Keys of success are population awareness, health personnel motivation, and political commitment at all levels.

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“…2,6,7 Although much less common in the United States, it has been estimated that more than 300,000 people in the United States may have Chagas disease, 8,9 and congenital transmission occurs in 1-10% of infants born to infected mothers. 10 The majority of Chagas cases in the United States are chronically infected persons who have migrated from endemic areas where they acquired the infection; most are asymptomatic and likely unaware of their infection. 8 However, the detection of asymptomatic infections in the United States has increased after the initiation of widespread screening of the blood supply for T. cruzi in early 2007.…”

Section: Introductionmentioning

confidence: 99%