Mother-to-Child Transmission of Trypanosoma cruzi

Gebrekristos, Hirut T.; Buekens, Pierre

doi:10.1093/jpids/piu059

Cited by 20 publications

(7 citation statements)

References 49 publications

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“…In the Valencian protocol, the retest at 1 month is optional. The disadvantages of microscopic examination are low sensitivity and high subjectivity, since it depends on the ability and training of the observer to detect the parasite in the blood sample (39,56). Both factors could lead to parasites being missed in congenitally infected newborns (57).…”

Section: Discussionmentioning

confidence: 99%

Towards a New Strategy for Diagnosis of Congenital Trypanosoma cruzi Infection

et al. 2017

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The immigration of Latin American women of childbearing age has spread the congenital transmission of Chagas disease to areas of nonendemicity, and the disease is now a worldwide problem. Some European health authorities have implemented screening programs to prevent vertical transmission, but the lack of a uniform protocol calls for the urgent establishment of a new strategy common to all laboratories. Our aims were to (i) analyze the trend of passive IgG antibodies in the newborn by means of five serological tests for the diagnosis and follow-up of congenital infection, (ii) assess the utility of these techniques for diagnosing a congenital transmission, and (iii) propose a strategy for a prompt, efficient, and cost-effective diagnosis of infection. In noninfected newborns, a continuous decreasing trend of passive IgG antibodies was observed, but none of the serological assays seroreverted in any the infants before 12 months. From 12 months onwards, serological tests achieved negative results in all the samples analyzed, with the exception of the highly sensitive chemiluminescent microparticle immunoassay (CMIA). In contrast, in congenitally infected infants, the antibody decline was detected only after treatment initiation. In order to improve the diagnosis of congenital infection, we propose a new strategy involving fewer tests that allows significant cost savings. The protocol could start 1 month after birth with a parasitological test and/or a PCR. If negative, a serological test would be carried out at 9 months, which if positive, would be followed by another at around 12 months for confirmation.

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Section: Discussionmentioning

confidence: 99%

Towards a New Strategy for Diagnosis of Congenital Trypanosoma cruzi Infection

et al. 2017

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“…16 A better knowledge of the risk of congenital transmission is a prerequisite to the establishment of universal screening programs for T. cruzi infection among pregnant women and infants. 17,18 Institutional delivery is almost universal in Latin America, allowing for hospital recruitment of study populations. 19 The objective of this study was to compare T. cruzi congenital transmission rates in Argentina, Honduras, and Mexico, using a common methodology.…”

Section: Introductionmentioning

confidence: 99%

Congenital Transmission of Trypanosoma cruzi in Argentina, Honduras, and Mexico: An Observational Prospective Study

Buekens

Cafferata²,

Alger³

et al. 2018

The American Journal of Tropical Medicine and Hygiene

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Compared with South America, there is a lack of epidemiologic studies about the risk of congenital transmission of in Central America and Mexico. It has been suggested that genotypes might differ by region and that congenital transmission might vary according to the parasite's genotype. Our objective was to compare congenital transmission rates in three countries. We performed an observational prospective study in 2011-2014 enrolling women at delivery in one hospital in Argentina, two hospitals in Honduras, and two hospitals in Mexico. Congenital infection was defined as the presence of one or more of the following criteria: presence of parasites in cord blood (direct parasitological microscopic examination) with positive polymerase chain reaction (PCR) in cord blood, presence of parasites in infant's blood at 4-8 weeks (direct parasitological microscopic examination), and persistence of -specific antibodies at 10 months, as measured by at least two tests. Among 28,145 enrolled women, 347 had at least one antibody rapid test positive in cord blood and a positive enzyme-linked immunosorbent assay in maternal blood. PCR in maternal blood was positive in 73.2% of the cases, and genotyping identified a majority of non-TcI in the three countries. We found no (0.0%; 95% confidence interval [CI]: 0.0, 2.0) confirmed congenital case in Honduras. Congenital transmission was 6.6% (95% CI: 3.1, 12.2) in Argentina and 6.3% (95% CI: 0.8, 20.8) in Mexico. non-TcI predominated and risks of congenital transmission were similar in Argentina and Mexico.

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“…67,68 Nevertheless, false positives have been observed due contamination of IgM antibodies from the mother to the fetus, coming from damage to the integrity of the placenta and through maternal blood during childbirth. 67,71,72 Despite the diagnostic advances and the fact that serological methods are in many cases sensitive and specific, it's necessary to perform complementary tests (xenodiagnostic, PCR, electrocardiogram, echocardiogram, etc.) for the validation of the serological results.…”

Section: Serological Diagnosismentioning

confidence: 99%

Chagas disease: an overview of diagnosis

Rodea¹,

Cuevas²,

Ramos³

et al. 2018

JMEN

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Abbreviations: IF, indirect immuno fluorescence; ELISA, enzyme-linked immuno-sorbent assay; IH, indirect hemagglutination; SAPA/TS, shed acute-phase antigens/transsialidase; TESA: trypomastigote excreted and secreted antigen; IA: immunoagglutination assay; Ab, antibodies; Ag, antigens; PCR, polymerase chain reaction J Microbiol Exp. 2018;6(3):151-157. 151 AbstractChagas disease, caused by the flagellated protozoan Trypanosoma cruzi, afflicts millions of people, mainly affecting poor and neglected populations. The different transmission routes, the high genetic variability of the parasite, the different detection methods as well as the distinct phases of the disease, influence negatively the diagnosis accuracy of the disease. Diagnostic tests can range from simple parasitological techniques to complex molecular and serological techniques that can be used for early diagnosis in the acute phase of the disease, the determination of congenital transmission, to determine the epidemiological behavior of the disease, to detect the presence of the parasite, both in blood transfusions, as in organ transplantation, among others. This review addresses some of the most widely used tools to detect T. cruzi infection in different scenarios.

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Mother-to-Child Transmission of Trypanosoma cruzi

Cited by 20 publications

References 49 publications

Towards a New Strategy for Diagnosis of Congenital Trypanosoma cruzi Infection

Towards a New Strategy for Diagnosis of Congenital Trypanosoma cruzi Infection

Congenital Transmission of Trypanosoma cruzi in Argentina, Honduras, and Mexico: An Observational Prospective Study

Chagas disease: an overview of diagnosis

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