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BJOG. 2014 Jan;121(1):22-33. doi: 10.1111/1471-0528.12396. Epub 2013 Aug 7.

Frequency of the congenital transmission of Trypanosoma cruzi: a systematic review and meta-analysis.

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1
Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.

Abstract

BACKGROUND:

Chagas disease is caused by the parasite Trypanosoma cruzi and is endemic in much of Latin America. With increased globalisation and immigration, it is a risk in any country, partly through congenital transmission. The frequency of congenital transmission is unclear.

OBJECTIVE:

To assess the frequency of congenital transmission of T. cruzi.

SEARCH STRATEGY:

PubMed, Journals@Ovid Full Text, EMBASE, CINAHL, Fuente Academica and BIREME databases were searched using seven search terms related to Chagas disease or T. cruzi and congenital transmission.

SELECTION CRITERIA:

The inclusion criteria were the following: Dutch, English, French, Portuguese or Spanish language; case report, case series or observational study; original data on congenital T. cruzi infection in humans; congenital infection rate reported or it could be derived. This systematic review included 13 case reports/series and 51 observational studies.

DATA COLLECTION AND ANALYSIS:

Two investigators independently collected data on study characteristics, diagnosis and congenital infection rate. The principal summary measure--the congenital transmission rate--is defined as the number of congenitally infected infants divided by the number of infants born to infected mothers. A random effects model was used.

MAIN RESULTS:

The pooled congenital transmission rate was 4.7% (95% confidence interval: 3.9-5.6%). Countries where T. cruzi is endemic had a higher rate of congenital transmission compared with countries where it is not endemic (5.0% versus 2.7%).

CONCLUSIONS:

Congenital transmission of Chagas disease is a global problem. Overall risk of congenital infection in infants born to infected mothers is about 5%. The congenital mode of transmission requires targeted screening to prevent future cases of Chagas disease.

KEYWORDS:

Chagas disease; Trypanosoma cruzi; congenital infection; meta-analysis; systematic review

PMID:
23924273
PMCID:
PMC3914719
DOI:
10.1111/1471-0528.12396
[Indexed for MEDLINE]
Free PMC Article
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