Systematic review: Prevalence of Chagas disease in pregnant women and congenital transmission of Trypanosoma cruzi in Brazil: a systematic review and meta‐analysis

Abstract

Abstractobjective To estimate the prevalence of Chagas disease in pregnant women and the risk of congenital transmission of Trypanosoma cruzi infection in Brazil, through a systematic review and meta-analysis.methods We searched electronic databases, grey literature and reference lists of included publications to identify epidemiological studies on the prevalence of Chagas disease in pregnant women and on the congenital transmission rate of T. cruzi infection in Brazil published between January 1980 and June 2013. Pooled estimates and 95% confidence intervals (95% CIs) were calculated using fixed-and random-effects models.results Sixteen articles were included -12 studies on the prevalence of Chagas disease in pregnant women (549 359 pregnant women) and nine on congenital transmission rates (1687 children born to infected mothers). Prevalence of Chagas disease in pregnant women ranged from 0.1% to 8.5%, and congenital transmission rates from 0% to 5.2%. The pooled prevalence of Chagas disease among pregnant women across studies was 1.1% (95% CI: 0.6-2.0); the pooled congenital transmission rate was 1.7% (95% CI: 0.9-3.1). In 2010, 34 629 pregnant women were estimated to be infected with T. cruzi, and 312-1073 children born (mean: 589 cases) with congenital infection.conclusion Congenital Chagas disease is a neglected public health problem in Brazil. Systematic congenital Chagas disease control programs through routine prenatal screening for T. cruzi should be widely implemented in Brazil's endemic areas, to identify infected pregnant women and newborns at risk of congenital infection.

2 nd Brazilian Consensus on Chagas Disease, 2015

“…According to data from the Brazilian Live Birth Information System [Sistema de Informações sobre Nascidos Vivos (SINASC)], 2,861,868 live births were recorded in the country in 2010. From these data it was estimated that 34,629 pregnant women would be infected with T. cruzi this year; the number of congenitally infected children would thus range from 312 to 1,073 (average: 589 cases) (106) . These data are consistent with those of an epidemiological survey conducted in the State of Minas Gerais in 1998, extrapolated to the Brazilian population (107) , and with the global estimate provided by the WHO of 571 Brazilian children infected by vertical transmission in 2010 (5) .…”

“…A systematic review with meta-analysis of studies conducted in Brazil estimated the prevalence of infection in pregnant women to be 1.1% with a vertical transmission rate of 1.7% (106) . According to data from the Brazilian Live Birth Information System [Sistema de Informações sobre Nascidos Vivos (SINASC)], 2,861,868 live births were recorded in the country in 2010.…”

Caracterização molecular e bioquímica das enzimas envolvidas na biossíntese de prolina em <i>Trypanosoma cruzi</i>.

“…Outras formas de transmissão não vetoriais ocorrem por transplante de órgãos proveniente de pacientes infectados (KRANSDORF; ZAKOWSKI; KOBASHIGAWA, 2014), via placentária (de mãe a filho) (MARTINS-MELO et al, 2014;TORRICO et al, 2004) e via oral, através da ingestão de alimentos contaminados (ROBERTSON et al, 2016;RUEDA et al, 2014 …”

Enfermedad de Chagas del sistema nervioso central en un paciente con SIDA demostrada por métodos cuantitativos moleculares

“…Además de la infección vectorial, puede transmitirse en forma vertical durante el embarazo, por transfusión sanguínea en ausencia de tamizaje, por órganos trasplantados o por ingestión de alimentos contaminados [2][3][4][5][6] . Esta infección ocurre sólo en el continente americano pero ha sido observada en otros continentes por migraciones humanas, trasplantes de órganos o donaciones de sangre 5,7 .…”