Trypanosoma cruzi seroprevalence in pregnant women and screening by PCR and microhaematocrit in newborns from Guanajuato, Mexico

Montes-Rincón, Laura Mayela; Galaviz‐Silva, Lucio; González-Bravo, Francisco Ernesto; Molina-Garza, Zinnia Judith

doi:10.1016/j.actatropica.2016.08.029

Cited by 20 publications

(17 citation statements)

References 38 publications

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“…38 Another recent study found 20.0% positive PCR on cord blood among T. cruzi seropositive mothers in Guanajuato, Mexico. 7 In Argentina, PCR positive rates as high as 30.8% in Jujuy and 27.2% in Formosa have been recently reported. 39 PCR on cord blood is not universally accepted for diagnosing congenital Chagas disease at birth.…”

Section: Discussionmentioning

confidence: 99%

“…5 Other Mexican studies relied mostly on polymerase chain reaction (PCR) on cord blood to diagnose congenital transmission of T. cruzi. [6][7][8] A recent study identified one case of congenital Chagas disease among 32 infected mothers in El Salvador. 9 It has been suggested that the congenital transmission rate might vary according to the parasite's genotype, but available data are inconclusive.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

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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“…The higher sensitivity of the micromethod in sick infants compared to asymptomatic ones is the direct result of these higher parasite burdens. Most recent studies have not included clinical data [21,22], or have described all infected infants as asymptomatic [8,23]; however, the lack of findings may reflect the small numbers of infected infants in most studies (usually <10). A recent large study included 125 infected infants, but did not report clinical status data [24].…”

Section: Discussionmentioning

confidence: 99%

Toward Improving Early Diagnosis of Congenital Chagas Disease in an Endemic Setting

Messenger

Gilman

Verástegui

et al. 2017

Clinical Infectious Diseases

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Summary: Congenital Trypanosoma cruzi transmission is now estimated to account for 22% of new infections. Though the proportion of T. cruzi infected infants with clinical signs has fallen from the 1990s, but symptomatic congenital Chagas disease still represents a significant, albeit increasingly challenging to detect, public health problem. 3 AbstractBackground: Congenital Trypanosoma cruzi transmission is now estimated to account for 22%

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“…During the first weeks of life, diagnosis relies on the microscopic observation of bloodstream parasites, usually with concentration techniques, like the microhematocrit method or micromethod (14). The micromethod has been used for many years in areas of endemicity for the early detection of parasites in newborn blood, although its lack of sensitivity can miss up to 50% of infected infants (34). The sensitivity of the technique varies according to the parasitemia (35).…”

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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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Trypanosoma cruzi seroprevalence in pregnant women and screening by PCR and microhaematocrit in newborns from Guanajuato, Mexico

Cited by 20 publications

References 38 publications

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

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

Toward Improving Early Diagnosis of Congenital Chagas Disease in an Endemic Setting

Towards a New Strategy for Diagnosis of Congenital Trypanosoma cruzi Infection

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