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Maternal-Fetal Transmission of Trypanosoma cruzi

par Carlier, Yves ;Truyens, Carine
Editeur scientifique Telleria, Jenny;Tibayrenc, Michel
Référence American Trypanosomiasis: Chagas disease - One hundred years of research, Elsevier, London
Publication Publié, 2010

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Résumé :

Maternal fetal transmission of T. cruzi can have severe outcomes by compromising survival and fetal/neonatal growth, and/or can lead to severe clinical forms of chronic infection later in adult life if an infant remains untreated. Congenital T. cruzi infection can be found worldwide since such transmission can occur in endemic areas, as well as nonendemic areas receiving immigrants from endemic regions. Though often asymptomatic at birth and neglected, this congenital infection must be considered an important public health problem requiring the development of reasonable prevention or control strategies, based on a deep understanding of mechanisms and multiple involved factors. Primary prevention (prophylaxis) of fetal infection with T. cruzi aims to prevent infection of pregnant women. This can be obtained by limiting the risk of contamination through vectorial contacts or blood transfusion, and by treating infected girls before they enter into their childbearing years. Secondary prophylaxis aims to avoid maternal-fetal parasite transmission from a previously infected pregnant woman using trypanocidal safe drugs. However, the potential teratogenic effects of both currently used trypanocidal drugs, benznidazole and nifurtimox, are not known. Their side effects in adults are unacceptable during pregnancy and their curative efficacy is limited in the chronic phase of infection presented by most infected pregnant women. For all these reasons, the treatment of T. cruzi infection during pregnancy is not recommended. © 2010 Elsevier Inc. All rights reserved.