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[玻利维亚母亲居住地先天性克氏锥虫感染的流行水平及先天性恰加斯病的发展]

[Endemic level of congenital Trypanosoma cruzi infection in the areas of maternal residence and the development of congenital Chagas disease in Bolivia].

作者信息

Torrico Faustino, Alonso-Vega Cristina, Suarez Eduardo, Rodríguez Patricia, Torrico Mary-Cruz, Dramaix Michele, Truyens Carine, Carlier Yves

机构信息

Centro Universitario de Medicina Tropical, Facultad de Medicina, Universidad Mayor de San Simón (U.M.S.S.), Avenida Aniceto Arce 371, casilla 3023, Cochabamba, Bolivia.

出版信息

Rev Soc Bras Med Trop. 2005;38 Suppl 2:17-20.

Abstract

In Bolivia, the prevalence of infection by T. cruzi in women in fertile age can vary between 20 and 60%. The present study made in the Maternity Germin Urquidi of Cochabamba - Bolivia, it has demonstrated, that 19.9% of the mothers who go to this hospitable center to be taken care of in the childbirth, they are carrying of the infection and that 4,6% of them, they are going to transmit, by transplacentaria route, the infection to its babies. Of the 71 children born with congenital Chagas, only 47,8 % present/display some type of alteration or of development(Apgar to 1 minute low, BPN, prematuridad, pathological dismadurez) or signs (SDR, hepatomegalia, esplenomegalia, neurological signs, cardiomegalia, anasarca, petequias). When investigating the effect of the differences in the vectorial density (low, medium and high) of the zone of maternal residence, on the transmission of the infection of the mother infected to the fetus, we concluded that the rate of transmission of the congenital infection of T. cruzi is not modified by the level of endemicidad of the zone of maternal residence. By another infected new born sides whose mothers reside in zones of high endemicidad present/display, most frequently and of significant way, Apgar to 1 minute < to 7, low weight when being born and prematuridad or an association of these alterations with respiratory syndrome of distress or anasarca, when one compares them with new born of resident mothers in the zones of loss or medium endemicidad, mortality in this group is greater. These results suggest calls to account it of the mothers, in areas of high endemicidad, she is associate with a serious increase in the risk of Disease of newborn severe and mortal congenital Chagas in.

摘要

在玻利维亚,育龄妇女中克氏锥虫感染率在20%至60%之间波动。在玻利维亚科恰班巴的Germin Urquidi妇产医院开展的本研究表明,前往该友好中心分娩的母亲中有19.9%携带感染,其中4.6%会通过胎盘途径将感染传播给其婴儿。在71例先天性恰加斯病患儿中,只有47.8%出现某种类型的发育改变或发育问题(1分钟阿氏评分低、低体重、早产、病理性发育迟缓)或体征(皮肤干燥、肝肿大、脾肿大、神经体征、心脏肥大、全身性水肿、瘀点)。在调查母亲居住地区病媒密度差异(低、中、高)对感染母亲向胎儿传播感染的影响时,我们得出结论,克氏锥虫先天性感染的传播率不受母亲居住地区流行程度的影响。另一方面,与居住在低流行或中等流行地区的母亲所生新生儿相比,母亲居住在高流行地区的感染新生儿最常且显著地出现1分钟阿氏评分<7分、出生时体重低和早产,或这些改变与呼吸窘迫综合征或全身性水肿相关联,该组死亡率更高。这些结果表明应引起母亲们的重视,在高流行地区,这与新生儿严重和致命的先天性恰加斯病风险的严重增加有关。

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