Implementation and evaluation of a locally sustainable system of prenatal diagnosis to detect cases of congenital Chagas disease in endemic areas of Paraguay

A locally sustainable system of prenatal screening of Trypanosoma cruzi infection has been implemented in rural health care centers of endemic areas in Paraguay A total of 61.091 women from Paraguari and Cordillera Departments were serologically evaluated, where 7.802 (12,7%) resulted to be anti-T....

Full description

Saved in:
Bibliographic Details
Published in:Revista da Sociedade Brasileira de Medicina Tropical 2005, Vol.38 Suppl 2, p.49-54
Main Authors: Russomando, Graciela, Almirón, Maria, Candia, Norma, Franco, Leticia, Sánchez, Zunilda, de Guillen, Ivalena
Format: Article
Language:Spanish
Subjects:
Adolescent
Adult
Animals
Antibodies, Protozoan - blood
Biomarkers - blood
Chagas Disease - congenital
Chagas Disease - diagnosis
Chagas Disease - epidemiology
Child
Endemic Diseases
Enzyme-Linked Immunosorbent Assay
Female
Humans
Immunoglobulin G - blood
Infant
Infant, Newborn
Middle Aged
Neonatal Screening - standards
Paraguay - epidemiology
Pregnancy
Prenatal Diagnosis - standards
Primary Health Care - organization & administration
Rural Population
Seroepidemiologic Studies
Trypanosoma cruzi - immunology
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:A locally sustainable system of prenatal screening of Trypanosoma cruzi infection has been implemented in rural health care centers of endemic areas in Paraguay A total of 61.091 women from Paraguari and Cordillera Departments were serologically evaluated, where 7.802 (12,7%) resulted to be anti-T. cruzi IgG positive. A total of 1,865 infants born to seropositive mothers were examined by parasitological techniques, such as direct microscopic observation and polymerase chain reaction, and serologically by ELISA, ELISA-SAPA and IFI. 104 infected babies were detected and treated with benznidazole. The recovery of babies born to seropositive mothers performing a single examination at the age of 6 months was significantly higher, as compared with the recommended method involving two examinations, both at birth and after 6 months of age. Although at 6 months of age in 7% of the infants maternal IgG was still detected. PCR was the most sensitive technique for early detection of T. cruzi infection in babies, but we do not recommend it use for diagnosis in high endemic areas, considering that for the screening of 815 babies, 2000 reactions were needed. We propose a strategy to detect congenital transmission of Chagas disease, based on a large-scale study, where the shortcomings of the different serological and parasitological techniques are discussed.
ISSN:0037-8682