Triagem neonatal da infecção pelo Trypanosoma cruzi em Minas Gerais, Brasil: transmissão congênita e mapeamento das áreas endêmicas

2 nd Brazilian Consensus on Chagas Disease, 2015

“…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) . In 2006, PAHO estimated that 5,000 Brazilian children would be vertically infected (17) .…”

“…Vertical transmission (from mother to child) of T. cruzi remains a reality, even with the favorable impact of vector control actions and the qualification of the transfusion process in several countries, including (104) (105) (112) (113) included in Brazil (20) (106) (107) . The existence of infected women in childbearing age, in endemic countries or not, supports this risk, which tends to be reduced over the next two decades.…”

“…In Brazil, in 2011, according to SINASC data were collected about 3 million live births. Based on the estimated prevalence of 1% of T. cruzi infection in women between 25 and 44 years of age (17) and a risk of vertical transmission estimated as maximum of 1% for the State of Minas Gerais, it is estimated that up to 300 children were born infected that year (107) . Detection of vertical transmission is complicated in practice, since the vast majority of congenital cases is totally asymptomatic (4) (10) (102) (104) (113) (114) (115) (116) .…”

“…Those with initial negative parasitologic examination or not carried out must be submitted at nine months after birth, for the research with serologic tests of anti-T. cruzi IgG antibodies or conventional serology for infection by T. cruzi (107) (117) (127) . A reactive serologic test after this age necessarily implies the need to initiate antiparasitic treatment.…”

“…In Brazil, the inclusion of serologic tests searching IgG for T. cruzi in the National Newborn Screening Program (heel prick blood test) is recommended, especially in endemic areas for T. cruzi infection, representing an useful and low cost strategy (20) (107) . The search for anti-T. cruzi IgM antibodies has a low sensitivity and there are still difficulties to standardize this technique and obtain controls.…”