Congenital Trypanosoma cruzi Infection. Efficacy of Its Monitoring in an Urban Reference Health Center in a Non-Endemic Area of Argentina

Rissio, Ana María De; Riarte, Adelina; García, Miriam Martín; Esteva, M; Quaglino, Marta Beatriz; Ruiz, Andrés M.

doi:10.4269/ajtmh.2010.08-0383

Cited by 51 publications

(59 citation statements)

References 23 publications

(20 reference statements)

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“…This fact coincides with other studies where fluctuations can be seen in the maternal-fetal transmission rate at a specific health facility [45] and variations within the same country and between countries [18], [46]. However, in the health facilities where the transmission rate was found to be higher than 10%, or having more radical fluctuations, technical supervisions were carried out with the objective of detecting possible flaws in the technical procedures, interpretation of results, or compliance with control tests.…”

Section: Discussionsupporting

confidence: 92%

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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Section: Discussionsupporting

confidence: 92%

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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“…In Argentina, T. cruzi is vertically transmitted in ∼7-11% of pregnancies in seropositive women (6). The diagnosis of infected children, according to the Chagas National Program, relies on the visualization of the parasite by microscopy, when passively transferred maternal T. cruzi Abs can still be present.…”

mentioning

confidence: 99%

Serum Cytokines as Biomarkers of Early Trypanosoma cruzi infection by Congenital Exposure

Volta

Bustos

Cardoni

et al. 2016

The Journal of Immunology

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Trypanosoma cruzi, the causing agent of Chagas disease, leads to an activation of the immune system in congenitally infected infants. In this study, we measured a set of cytokines/chemokines and the levels of parasitemia by quantitative PCR in the circulation of neonates born to T. cruzi–infected mothers to evaluate the predictive value of these mediators as biomarkers of congenital transmission. We conducted a retrospective cohort study of 35 infants with congenital T. cruzi infection, of which 15 and 10 infants had been diagnosed by detection of parasites by microscopy in the first and sixth month after delivery, respectively, and the remaining 10 had been diagnosed by the presence of T. cruzi–specific Abs at 10–12 mo old. Uninfected infants born to either T. cruzi–infected or uninfected mothers were also evaluated as controls. The plasma levels of IL-17A, MCP-1, and monokine induced by IFN-γ were increased in infants congenitally infected with T. cruzi, even before they developed detectable parasitemia or seroconversion. Infants diagnosed between 6 and 12 mo old also showed increased levels of IL-6 and IL-17F at 1 mo of age. Conversely, infants who did not develop congenital T. cruzi infection had higher levels of IFN-γ than infected infants born to uninfected mothers. Monokine induced by IFN-γ, MCP-1, and IFN-γ production induced in T. cruzi–infected infants correlated with parasitemia, whereas the plasma levels of IL-17A, IL-17F, and IL-6 were less parasite load dependent. These findings support the existence of a distinct profile of cytokines and chemokines in the circulation of infants born to T. cruzi–infected mothers, which might predict congenital infection.

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“…Before that ChD control is mainly based on the elimination of triatomine vectors. Finally, the congenital transmission is a kind of ChD transmission that may lead to global dissemination of the disease, and hence control measures of such mode should be established as a public health priority in all endemic regions [79].…”

Section: Discussionmentioning

confidence: 99%

Epidemiological Aspects of Chagas Disease - a Review

Shyamapada¹

2014

J Anc Dis Prev Rem

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Chagas disease (ChD), also known as American trypanosomiasis, is caused by the trypanosomatid protozoan Trypanosoma cruzi (T. cruzi) that in its natural life-cycle is transmitted through triatomine vectors. Parasitological studies are useful to confirm acute cases, while the diagnosis of chronic T. cruzi infection relies on serological methods. There is no vaccine to prevent the infection, and the treatment is restricted to nifurtimox and benznidazole; and hence, new effective drugs with lower side-effects are urgently needed. The current review updates the facts and phenomena related to ChD, which is becoming an emerging health problem in non-endemic areas too, making the disease a grave global concern.

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Congenital Trypanosoma cruzi Infection. Efficacy of Its Monitoring in an Urban Reference Health Center in a Non-Endemic Area of Argentina

Cited by 51 publications

References 23 publications

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

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

Serum Cytokines as Biomarkers of Early Trypanosoma cruzi infection by Congenital Exposure

Epidemiological Aspects of Chagas Disease - a Review

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