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Relaciones materno-fetales en la infeccion con T. cruzi y la implementacion de un programa nacional de deteccion y tratamiento de Chagas congenito en Bolivia

par Torrico, F;Carlier, Yves ;Alonso-Vega, Cristina;Billot, Claire;Truyens, Carine
Référence Enfermedades emergentes, 9, SUPP 1, page (37-39)
Publication Publié, 2007

Article révisé par les pairs

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Résumé :

Congenital Chagas disease is caused by the transmission of Trypanosoma cruzi from an infected mother to her foetus. Although characteristically found in Latin America countries, this disease is extending to other continents due to the immigration of chronically infected women of reproductive age. The mother to foetus transmission rate varies between 1 and 12% in different regions. The significant population of infected women of child bearing age and the transmission risk during pregnancy highlight the importance of congenital transmission. In the absence of foetal infection, maternal Chagas does not appear to influence pregnancy or the foetal development. However, more than 50% of newborns with congenital Chagas are completely asymptomatic at birth. In cases where clinical disease is present, premature birth, low birth weight, hepatomegaly and splenomegally, respiratory distress syndrome, and anasarca have been observed. Diagnosis of a congenital infection can be done at birth by testing for parasites in the umbilical cord blood or bloodstream and by micromethod. Cases that are negative at birth can be followed-up with a second parasitological test between age 1 and 2 months and by serological analysis after age 6 months. Early treatment of infected infants with Benznidazol for 30 days cures almost 100% of cases. Treatment success can be confirmed by negative serological tests between 6 month and 1 year after treatment is completed. This article presents the results of a congenital Chagas detection and treatment program in three endemic areas of Bolivia. The observed prevalence of infection was more than 30% with a 2.5% transmission rate. Treatment adherence for infected infants was 83%.