Congenital Transmission of Trypanosoma cruzi in Non-Endemic Areas: Evaluation of a Screening Program in a Tertiary Care Hospital in Barcelona, Spain

Otero, S.; Sulleiro, Elena; Molina, Israel; Espiau, María; Suy, Anna; Martin‐Nalda, Andrea; Figueras, Concepció

doi:10.4269/ajtmh.2012.12-0152

Cited by 18 publications

(7 citation statements)

References 22 publications

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“…The congenital Chagas disease prevention and control programme in Catalonia is one of few screening programmes for the control of congenital Chagas disease launched by public health authorities in a non-endemic region [9]. The observed prevalence of Chagas disease (2.8 cases/100 pregnancies) was similar to that found in other studies in pregnant women in Catalonia [33, 34]. The prevalence in Bolivian pregnant women was lower (15.8%) than in a similar programme in Bolivia (23.3%) [35].…”

Section: Discussionsupporting

confidence: 68%

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Epidemiology of congenital Chagas disease 6 years after implementation of a public health surveillance system, Catalonia, 2010 to 2015

Basile¹,

Ciruela

Requena‐Méndez

et al. 2019

Eurosurveillance

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Background Chagas disease is endemic in Latin America and affects 8 million people worldwide. In 2010, Catalonia introduced systematic public health surveillance to detect and treat congenital Chagas disease. Aim The objective was to evaluate the health outcomes of the congenital Chagas disease screening programme during the first 6 years (2010–2015) after its introduction in Catalonia. Methods In a surveillance system, we screened pregnant women and newborns and other children of positive mothers, and treated Chagas-positive newborns and children. Diagnosis was confirmed for pregnant women and children with two positive serological tests and for newborns with microhaematocrit and/or PCR at birth or serology at age 9 months. Results From 2010 to 2015, the estimated screening coverage rate increased from 68.4% to 88.6%. In this period, 33,469 pregnant women were tested for Trypanosoma cruzi and 937 positive cases were diagnosed. The overall prevalence was 2.8 cases per 100 pregnancies per year (15.8 in Bolivian women). We followed 82.8% of newborns until serological testing at age 9–12 months and 28 were diagnosed with Chagas disease (congenital transmission rate: 4.17%). Of 518 siblings, 178 (34.3%) were tested and 14 (7.8%) were positive for T. cruzi . Having other children with Chagas disease and the heart clinical form of Chagas disease were maternal risk factors associated with congenital T. cruzi infection (p < 0.05). Conclusion The increased screening coverage rate indicates consolidation of the programme in Catalonia. The rate of Chagas disease congenital transmission in Catalonia is in accordance with the range in non-endemic countries.

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Section: Discussionsupporting

confidence: 68%

“…The rate of congenital transmission in Catalonia (4.17%) was within the range detected in endemic (range: 1.7–5) [35,46-50] and non-endemic countries (range: 0–7.3) [25,33,34,36-38].…”

Section: Discussionmentioning

confidence: 60%

Epidemiology of congenital Chagas disease 6 years after implementation of a public health surveillance system, Catalonia, 2010 to 2015

Basile¹,

Ciruela

Requena‐Méndez

et al. 2019

Eurosurveillance

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“…Vertical transmission was recorded in 27 cases from 13 observational studies covering a total of 502 children born to mothers with chronic T. cruzi infection [6,[35][36][37][38][39][40][41][42][43]46,49,50]. The pooled transmission rate was three per 100 live births (95% CI: 1-6).…”

Section: Vertical Transmission Of Trypanosoma Cruzi Infectionmentioning

confidence: 99%

Screening for Trypanosoma cruzi infection in immigrants and refugees: Systematic review and recommendations from the Spanish Society of Infectious Diseases and Clinical Microbiology

et al. 2020

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Background: Chagas disease has spread beyond its original borders on the American continent with migration. It can be transmitted from mother to child, through organ transplantation and transfusion of blood and blood products. It is necessary to determine when to screen for this infection. Aim: Our objective was to evaluate the appropriateness of screening for Trypanosoma cruzi infection in Latin American migrants and their descendants. Methods: We reviewed the literature using rigorous criteria. The quality of evidence was ranked according to the GRADE classification. An evidence to decision framework was adopted to provide information on the most relevant aspects necessary to formulate recommendations. Results: The 33 studies evaluated revealed a prevalence of T. cruzi infection among Latin American migrants in Europe of 6.08% (95% confidence interval (CI): 3.24-9.69; 28 studies). Vertical transmission occurred in three of 100 live births (95% CI: 1-6; 13 studies). The prevalence of cardiovascular disease was 19% (95% CI: 13-27; nine studies), including only 1% severe cardiac events (95% CI: 0-2; 11 studies). The overall quality of evidence was low because of risk of bias in the studies and considerable heterogeneity of the evaluated populations. The recommendations took into account economic studies on the value of screening strategies and studies on acceptability of screening and knowledge of the disease in the affected population. Conclusions: We identified five situations in which screening for T. cruzi infection is indicated. We recommend screening persons from endemic areas and children of mothers from these areas.

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“…In Spain, screening for Chagas disease in all blood and organ donors coming from endemic areas has been mandatory since 2005. However, in relation to mother to child transmission, only two communities (Valencia and Catalonia) have established official prevention programmes .…”

Section: Introductionmentioning

confidence: 99%

Trypanosoma cruzi infection in a non-endemic country: epidemiological and clinical profile

Salvador

Treviño

Sulleiro

et al. 2014

Clinical Microbiology and Infection

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Chagas disease has been increasingly diagnosed in non-endemic countries. This is a prospective observational study performed at the Tropical Medicine Units of the International Health Program of the Catalan Health Institute, Barcelona (PROgrama de Salud Internacional del Instituto Catalán de la Salud, PROSICS Barcelona, Spain), that includes all patients with Chagas disease who attended from June 2007 to May 2012. Clinical and epidemiological data were collected. Overall, 1274 patients were included, the mean age of the patients was 37.7 years, 67.5% were women and 97% came from Bolivia. Thirteen patients had immunosuppressive conditions. The prevalence of cardiac involvement was 16.9%, lower than in previous studies performed in endemic areas (20-60%). Cardiac alterations were found in 33.8% of symptomatic and 14.1% of asymptomatic patients. The prevalence of digestive involvement was 14.8%. The rate of digestive involvement is very different among previous studies because of different diagnostic tools and strategies used. Barium enema alterations were found in 21.4% of symptomatic and 10.3% of asymptomatic patients, and oesophageal alterations were found in 3.7% of symptomatic and in 2.3% of asymptomatic patients. As shown in previous studies, Chagas disease in non-endemic countries affects younger patients and has lower morbidity.

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Congenital Transmission of Trypanosoma cruzi in Non-Endemic Areas: Evaluation of a Screening Program in a Tertiary Care Hospital in Barcelona, Spain

Cited by 18 publications

References 22 publications

Epidemiology of congenital Chagas disease 6 years after implementation of a public health surveillance system, Catalonia, 2010 to 2015

Epidemiology of congenital Chagas disease 6 years after implementation of a public health surveillance system, Catalonia, 2010 to 2015

Screening for Trypanosoma cruzi infection in immigrants and refugees: Systematic review and recommendations from the Spanish Society of Infectious Diseases and Clinical Microbiology

Trypanosoma cruzi infection in a non-endemic country: epidemiological and clinical profile

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