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PLoS One. 2019 Jul 10;14(7):e0218491. doi: 10.1371/journal.pone.0218491. eCollection 2019.

Congenital transmission of Chagas disease in a non-endemic area, is an early diagnosis possible?

Author information

1
Department of Pediatrics, Hospital Clínico San Carlos, Complutense University of Madrid, Madrid, Spain.
2
Department of Pediatrics, Hospital Doce de Octubre, Madrid, Spain.
3
Department of Pediatrics, Hospital Gregorio Marañón, Madrid, Spain.
4
Department of Obstetrics and Gynaecology, Hospital Clínico San Carlos, Madrid, Spain.
5
Department of Microbiology, Hospital Clínico San Carlos, Madrid, Spain.
6
Department of Pediatrics, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, Madrid, Spain.

Abstract

BACKGROUND:

Chagas disease (CD) is an emergent disease in Europe, due to immigration. The aims of this study are to describe the epidemiological characteristics of a cohort of Chagas infected pregnant women in Spain, to assess the vertical transmission (VT) rate and evaluate the usefulness of the PCR in the diagnosis of congenital infection in the first months of life.

METHODS:

A descriptive, retrospective study including Chagas seropositive pregnant women who were attended at three tertiary hospitals in Madrid, from January 2012 to September 2016. Infants were examined by PCR at birth and 1 month later and serologically studied at 9 months or later. Children were considered infected when the parasite was detected by PCR at any age or when serology remained positive without decline over the age of 9 months.

RESULTS:

We included 122 seropositive-infected pregnant women, 81% were from Bolivia and only 8.2% had been treated before. 125 newborns were studied and finally 109 were included (12.8% lost the follow-up before performing the last serology). The VT rate was 2.75% (95% CI: 0,57-8,8%). Infected infants had positive PCR at birth and 1 month later. All of them were treated successfully with benznidazole (PCR and serology became negative later on). All non-infected children presented negative PCR. The mean age at which uninfected patients had negative serology was 10.5 months.

CONCLUSIONS:

The VT rate is in keeping with literature and confirms the need to carry out a screening in pregnant women coming from endemic areas. PCR seems to be a useful tool to provide early diagnosis of congenital CD.

PMID:
31291269
DOI:
10.1371/journal.pone.0218491
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Conflict of interest statement

The authors have declared that no competing interests exist.

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