Prevalence of Trypanosoma cruzi infection in Latin American pregnant women and level of compliance of the Valencian Health Programme in the city of Alicante

Abstract Background Chagas disease, as a consequence of globalization and immigration, is no more restricted to Central and Latin America. Therefore, congenital transmission represents a growing public health concern in non-endemic countries. Methods The aim of this study was to assess the prevalence of Trypanosoma cruzi infection in pregnant Latin American (LA) women living outside endemic countries and the rate of congenital transmission. Data were extracted from studies indexed in PubMed, Scopus, Embase, Lilacs and SciELO databases without language restriction. Two investigators independently collected data on study characteristics, diagnosis, prevalence of infection in pregnant women and congenital infection rate. The data were pooled using a random effects model. Results The search identified 1078 articles of which 29 were eligible regarding prevalence of T. cruzi infection among pregnant women and 1795 articles of which 32 were eligible regarding the congenital transmission rate. The estimated pooled prevalence of T. cruzi infection in LA pregnant women was 4.2% [95% confidence interval (CI): 3.0–5.5]. The prevalence of T. cruzi infection in pregnant women from Bolivia was 15.5% (95% CI: 11.7–19.7) and 0.5% (95% CI: 0.2–0.89) for those coming from all other LA countries. The estimated global rate of congenital transmission was 3.5% (95% CI: 2.5–4.5); excluding poor-quality studies, the rate of congenital transmission was 3.8% (95% CI: 2.4–5.1). Conclusions Prevalence of Chagas disease among LA pregnant women living outside endemic countries is high, particularly in Bolivian women. The rate of vertical transmission of T. cruzi infection is similar to the rate reported in South and Central American countries.

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Current treatment guidelines for Trypanosoma cruzi infection in pregnant women and infants

International Journal of Antimicrobial Agents ◽

10.1016/j.ijantimicag.2012.01.014 ◽

2012 ◽

Vol 39 (5) ◽

pp. 451-452 ◽

Cited By ~ 1

Author(s):

Elizabeth J. Howard ◽

Pierre Buekens ◽

Yves Carlier

Keyword(s):

Trypanosoma Cruzi ◽

Pregnant Women ◽

Treatment Guidelines ◽

Current Treatment ◽

Cruzi Infection

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Validation of a Rapid Immunochromatographic Assay for Diagnosis of Trypanosoma cruzi Infection among Latin-American Migrants in Geneva, Switzerland

Journal of Clinical Microbiology ◽

10.1128/jcm.00774-10 ◽

2010 ◽

Vol 48 (8) ◽

pp. 2948-2952 ◽

Cited By ~ 26

Author(s):

F. Chappuis ◽

A. Mauris ◽

M. Holst ◽

P. Albajar-Vinas ◽

J. Jannin ◽

...

Keyword(s):

Trypanosoma Cruzi ◽

Latin American ◽

Immunochromatographic Assay ◽

Cruzi Infection

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Seroprevalence of Trypanosoma cruzi Infection in Pregnant Women Suggests a High Risk for Congenital Transmission in Central Veracruz, Mexico

Acta Parasitologica ◽

10.2478/s11686-020-00197-z ◽

2020 ◽

Vol 65 (3) ◽

pp. 661-668

Author(s):

Aracely López-Monteon ◽

Hilda Montero ◽

Ruth Sarahi González-Constantino ◽

Alberto Yair Limón-Flores ◽

Miguel Varela-Cardoso ◽

...

Keyword(s):

High Risk ◽

Trypanosoma Cruzi ◽

Pregnant Women ◽

Congenital Transmission ◽

Cruzi Infection

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Use of a Rapid Test on Umbilical Cord Blood to Screen for Trypanosoma cruzi Infection in Pregnant Women in Argentina, Bolivia, Honduras, and México

American Journal of Tropical Medicine and Hygiene ◽

10.4269/ajtmh.2008.79.755 ◽

2008 ◽

Vol 79 (5) ◽

pp. 755-759 ◽

Cited By ~ 60

Author(s):

Sergio Sosa-Estani ◽

Nicolás Padilla-Raygoza ◽

Luz Gibbons ◽

Eric Dumonteil ◽

Fernando Althabe ◽

...

Keyword(s):

Trypanosoma Cruzi ◽

Cord Blood ◽

Pregnant Women ◽

Umbilical Cord ◽

Umbilical Cord Blood ◽

Rapid Test ◽

Cruzi Infection

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Screening for Trypanosoma cruzi infection in immigrants and refugees: Systematic review and recommendations from the Spanish Society of Infectious Diseases and Clinical Microbiology

Eurosurveillance ◽

10.2807/1560-7917.es.2020.25.8.1900393 ◽

2020 ◽

Vol 25 (8) ◽

Cited By ~ 1

Author(s):

María Velasco ◽

Luis Andrés Gimeno-Feliú ◽

Israel Molina ◽

Joaquín Salas-Coronas ◽

Ivan Solà ◽

...

Keyword(s):

Trypanosoma Cruzi ◽

Latin American ◽

Cardiac Events ◽

Spanish Society ◽

Quality Of Evidence ◽

Grade Classification ◽

Screening Strategies ◽

Mother To Child ◽

Cruzi Infection

Background Chagas disease has spread beyond its original borders on the American continent with migration. It can be transmitted from mother to child, through organ transplantation and transfusion of blood and blood products. It is necessary to determine when to screen for this infection. Aim Our objective was to evaluate the appropriateness of screening for Trypanosoma cruzi infection in Latin American migrants and their descendants. Methods We reviewed the literature using rigorous criteria. The quality of evidence was ranked according to the GRADE classification. An evidence to decision framework was adopted to provide information on the most relevant aspects necessary to formulate recommendations. Results The 33 studies evaluated revealed a prevalence of T. cruzi infection among Latin American migrants in Europe of 6.08% (95% confidence interval (CI): 3.24–9.69; 28 studies). Vertical transmission occurred in three of 100 live births (95% CI: 1–6; 13 studies). The prevalence of cardiovascular disease was 19% (95% CI: 13–27; nine studies), including only 1% severe cardiac events (95% CI: 0–2; 11 studies). The overall quality of evidence was low because of risk of bias in the studies and considerable heterogeneity of the evaluated populations. The recommendations took into account economic studies on the value of screening strategies and studies on acceptability of screening and knowledge of the disease in the affected population. Conclusions We identified five situations in which screening for T. cruzi infection is indicated. We recommend screening persons from endemic areas and children of mothers from these areas.

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Prevalence of Trypanosoma cruzi infection in pregnant Latin American women and congenital transmission rate in a non-endemic area: the experience of the Valencian Health Programme (Spain)

Epidemiology and Infection ◽

10.1017/s0950268811002482 ◽

2011 ◽

Vol 140 (10) ◽

pp. 1896-1903 ◽

Cited By ~ 39

Author(s):

C. BARONA-VILAR ◽

M. J. GIMÉNEZ-MARTÍ ◽

T. FRAILE ◽

C. GONZÁLEZ-STEINBAUER ◽

C. PARADA ◽

...

Keyword(s):

Early Diagnosis ◽

Pregnant Women ◽

Latin American ◽

Transmission Rate ◽

Newborn Infants ◽

Congenital Infection ◽

University Hospitals ◽

Serological Tests ◽

American Women ◽

Health Programme

SUMMARYThis study describes the results of the health programme implemented in the Valencian Community (Spain) to achieve an early diagnosis of Chagas disease in pregnant Latin American women and their newborns. During 2009 and 2010, 1975 women living in the health districts of three university hospitals were enrolled via midwives or at the time of delivery. Diagnosis of disease was performed using two serological tests with different antigens. Congenital infection was diagnosed by parasitological, molecular or serological methods from blood samples obtained at birth or in subsequent controls. The overall seroprevalence of Chagas infection in pregnant women from 16 different endemic countries was 11·4%. Infection was higher in those from countries in the Gran Chaco Region (Bolivia, 34·1%; Paraguay, 7·4%; Argentina, 5·3%). Eight newborn infants from Bolivian mothers had congenital Chagas which represents a vertical transmission rate of 3·7%. In conclusion, this work supports the benefits of offering an early diagnosis to pregnant women and newborns during routine prenatal healthcare.

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