Prevalencia de la infección por Trypanosoma cruzi y transmisión vertical en mujeres gestantes latinoamericanas en un área de salud de Vizcaya / Prevalence of Trypanosoma cruzi infection and vertical transmission in Latin-American pregnant women in a health area of Biscay

Objetivos Determinar la prevalencia de la infección por Trypanosoma cruzi, los factores epidemiológicos asociados y el riesgo de transmisión materno-fetal en las mujeres gestantes procedentes de zonas endémicas atendidas en el área de influencia del Hospital de Cruces (País Vasco, España).Métodos Estudio descriptivo. Diagnóstico de la infección por T. cruzi en las mujeres gestantes y en neonatos por serología y detección del parásito mediante PCR. Encuesta epidemiológica y análisis multivariante para identificación de los factores de riesgo asociados a la infección por T. cruzi. Resultados Se incluyeron en el estudio un total de 158 mujeres atendidas entre el 15 de diciembre de 2008 y el 15 de enero de 2010, con una edad media de 28,5 (±5,3) años. Diecinueve (12,0%) gestantes presentaban infección por T. cruzi, de las cuales 16 (84,2%) procedían de Bolivia, con una prevalencia en estas del 22,2%. Los factores de riesgo epidemiológicos que se asociaron de forma independiente con la infección por T. cruzi fueron el antecedente de residencia en casa de adobe (OR: 4,62; IC95%: 1,54-13,87; p=0,006) y el conocimiento del vector (OR: 9,07; IC95%: 1,91-43,11; p=0,006). Hubo un recién nacido infectado, lo que supone una tasa de transmisión congénita del 5,8%.ConclusionesLa elevada prevalencia detectada de infección por T. cruzi en mujeres gestantes latinoamericanas y el riesgo de transmisión vertical hacen recomendable la implantación de programas de cribado basados fundamentalmente en la identificación del origen geográfico y variables epidemiológicas (AU)

Objectives To estimate the prevalence of Trypanosoma cruzi infection, the epidemiological factors associated with it, and the risk of maternal-foetal transmission in pregnant women from endemic areas seen in the catchment area of Cruces Hospital (Basque Country, Spain).Methods Descriptive study. Diagnosis of T. cruzi infection in pregnant women and neonates by performing serological tests and parasitological diagnosis using PCR. Epidemiological survey and multivariate analysis to identify the risk factors associated with T. cruzi infection. Results A total of 158 women participated in the study between December 2008 and January 2010, with mean age of 28.5 (±5.3). Nineteen (12%) pregnant mothers were seropositive, of whom 16 (84.2%) came from Bolivia, with a prevalence, in this group, of 22.2%. Independent epidemiological risk factors associated with T. cruzi infection were a history of living in mud houses (OR: 4.62; 95%IC: 1.54-13.87; P=.006) and knowledge of the vector (OR: 9.07; 95%IC: 1.91-43.11; P=.006). There was one newborn infected, which assumed a congenital transmission rate of 5.8%ConclusionsOn the basis of the high prevalence of T. cruzi infection detected in Latin-American pregnant women and the risk of vertical transmission, a screening program would be recommended, which would be fundamentally based on the identification of geographic origin and epidemiological variables (AU)

[Recommendations for the diagnosis, treatment and follow-up of the pregnant woman and child with Chagas disease. Sociedad Española de Infectología Pediátrica. Sociedad de Enfermedades Infecciosas y Microbiología Clínica. Sociedad Española de Ginecología y Obstetricia]. / Recomendaciones para el diagnóstico, seguimiento y tratamiento de la embarazada y del niño con enfermedad de Chagas.

Congenital transmission of Chagas disease now occurs in areas where the disease is non-endemic, and also from one generation to another. According to epidemiological data from Latin America, the prevalence of the disease in pregnant women is 0.7%-54%, and the prevalence of vertical transmission is around 5%-6%. Congenital T. cruzi infection is an acute infection in newborns that should be treated with anti-parasitic therapy. The treatment of pregnant women could also have an impact on the control of the disease. This article has been prepared following the recommendations suggested by a group of experts in Infectious Diseases, Microbiology, Gynaecology and Paediatrics.

[Prevalence of Trypanosoma cruzi infection and vertical transmission in Latin-American pregnant women in a health area of Biscay]. / Prevalencia de la infección por Trypanosoma cruzi y transmisión vertical en mujeres gestantes latinoamericanas en un área de salud de Vizcaya.

OBJECTIVES: To estimate the prevalence of Trypanosoma cruzi infection, the epidemiological factors associated with it, and the risk of maternal-foetal transmission in pregnant women from endemic areas seen in the catchment area of Cruces Hospital (Basque Country, Spain). METHODS: Descriptive study. Diagnosis of T. cruzi infection in pregnant women and neonates by performing serological tests and parasitological diagnosis using PCR. Epidemiological survey and multivariate analysis to identify the risk factors associated with T. cruzi infection. RESULTS: A total of 158 women participated in the study between December 2008 and January 2010, with mean age of 28.5 (±5.3). Nineteen (12%) pregnant mothers were seropositive, of whom 16 (84.2%) came from Bolivia, with a prevalence, in this group, of 22.2%. Independent epidemiological risk factors associated with T. cruzi infection were a history of living in mud houses (OR: 4.62; 95%IC: 1.54-13.87; P=.006) and knowledge of the vector (OR: 9.07; 95%IC: 1.91-43.11; P=.006). There was one newborn infected, which assumed a congenital transmission rate of 5.8% CONCLUSIONS: On the basis of the high prevalence of T. cruzi infection detected in Latin-American pregnant women and the risk of vertical transmission, a screening program would be recommended, which would be fundamentally based on the identification of geographic origin and epidemiological variables.