Busca retrospectiva da transmissão maternal da infecção chagásica em pacientes na fase crônica

Rassi, Anis; Neto, Vicente Amato; Rassi, Gustavo Gabriel; Amato, Valdir Sabbaga; Júnior, Anis Rassi; Luquetti, Alejandro O.; Rassi, Sérgio Gabriel

doi:10.1590/s0037-86822004000600011

Cited by 27 publications

(8 citation statements)

References 9 publications

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“…The mother-to-child T. cruzi transmission rate in different endemic areas is variable: 10% in Paraguay [3], 3.4–8.6% in Bolivia [4]–[6], 2.3% in Chile [7], 1.4% in Brazil [8], and 7–11% in Argentina [9]–[11]. Sometimes these vertical transmission rates are underestimated, as a high percentage of children do not complete the necessary one-year follow-up to confirm T. cruzi infection [3], [9], [12]–[14].…”

Section: Introductionmentioning

confidence: 99%

How to Improve the Early Diagnosis of Trypanosoma cruzi Infection: Relationship between Validated Conventional Diagnosis and Quantitative DNA Amplification in Congenitally Infected Children

et al. 2013

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BackgroundAccording to the Chagas congenital transmission guides, the diagnosis of infants, born to Trypanosoma cruzi infected mothers, relies on the detection of parasites by INP micromethod, and/or the persistence of T. cruzi specific antibody titers at 10–12 months of age.Methodology and Principal FindingsParasitemia levels were quantified by PCR in T. cruzi-infected children, grouped according to the results of one-year follow-up diagnosis: A) Neonates that were diagnosed in the first month after delivery by microscopic blood examination (INP micromethod) (n = 19) had a median parasitemia of 1,700 Pe/mL (equivalent amounts of parasite DNA per mL); B) Infants that required a second parasitological diagnosis at six months of age (n = 10) showed a median parasitemia of around 20 Pe/mL and 500 Pe/mL at 1 and 6 months old, respectively, and C) babies with undetectable parasitemia by three blood microscopic observations but diagnosed by specific anti - T. cruzi serology at around 1 year old, (n = 22), exhibited a parasitemia of around 5 Pe/mL, 800 Pe/mL and 20 Pe/mL 1, 6 and 12 month after delivery, respectively. T. cruzi parasites were isolated by hemoculture from 19 congenitally infected children, 18 of which were genotypified as DTU TcV, (former lineage TcIId) and only one as TcI.SignificanceThis report is the first to quantify parasitemia levels in more than 50 children congenitally infected with T. cruzi, at three different diagnostic controls during one-year follow-up after delivery. Our results show that the parasite burden in some children (22 out of 51) is below the detection limit of the INP micromethod. As the current trypanocidal treatment proved to be very effective to cure T. cruzi - infected children, more sensitive parasitological methods should be developed to assure an early T. cruzi congenital diagnosis.

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Section: Introductionmentioning

confidence: 99%

How to Improve the Early Diagnosis of Trypanosoma cruzi Infection: Relationship between Validated Conventional Diagnosis and Quantitative DNA Amplification in Congenitally Infected Children

et al. 2013

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“…In nonendemic areas the rate of underdiagnosis is over 90% [5]. Routine testing of older children born to seropositive mothers can identify some of these cases [75]. …”

Section: Diagnosismentioning

confidence: 99%

Chagas’ Disease: Pregnancy and Congenital Transmission

Cevallos

Hernández

2014

BioMed Research International

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Chagas disease is a chronic infection that kills approximately 12,000 people a year. Mass migration of chronically infected and asymptomatic persons has caused globalization of Chagas disease and has made nonvectorial infection, including vertical and blood-borne transmission, more of a threat to human communities than vectorial infection. To control transmission, it is essential to test all pregnant women living in endemic countries and all pregnant women having migrated from, or having lived in, endemic countries. All children born to seropositive mothers should be tested not only within the first month of life but also at ~6 months and ~12 months of age. The diagnosis is made by identification of the parasite in blood before the age of 6 months and by identification of the parasite in blood and/or positive serology after 10 months of age. Follow up for a year is essential as a significant proportion of cases are initially negative and are only detected at a later stage. If the condition is diagnosed and treated early, the clinical response is excellent and the majority of cases are cured.

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“…Overall, 60-90% of congenitally infected children are asymptomatic (Consenso, 2005). A small percentage of infected children present with clinical conditions common to other congenital infections, including hepatosplenomegaly, sepsis, myocarditis, hepatitis, meningoencephalitis, edema, fever, anemia, and jaundice 11,12 . During the acute disease phase, treatment should be given in all cases following diagnostic confi rmation regardless of the transmission route, excepting pregnant women.…”

Section: Acknowledgments Financial Support Referencesmentioning

confidence: 99%

Uneventful benznidazole treatment of acute Chagas disease during pregnancy: a case report

Corrêa¹,

Barbosa

Melo

et al. 2014

Rev. Soc. Bras. Med. Trop.

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Busca retrospectiva da transmissão maternal da infecção chagásica em pacientes na fase crônica

Cited by 27 publications

References 9 publications

How to Improve the Early Diagnosis of Trypanosoma cruzi Infection: Relationship between Validated Conventional Diagnosis and Quantitative DNA Amplification in Congenitally Infected Children

How to Improve the Early Diagnosis of Trypanosoma cruzi Infection: Relationship between Validated Conventional Diagnosis and Quantitative DNA Amplification in Congenitally Infected Children

Chagas’ Disease: Pregnancy and Congenital Transmission

Uneventful benznidazole treatment of acute Chagas disease during pregnancy: a case report

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