Luquetti Alejandro O, Dias João Carlos Pinto, Prata Aluizio
Laboratório de Pesquisa da doença de Chagas, Hospital das Clínicas, Universidade Federal de Goiás (UFG), Goânia, Brasil.
Rev Soc Bras Med Trop. 2005;38 Suppl 2:27-8.
Diagnosis of congenital infection should be performed preferentially by the search of the parasite, through microhematocrit. Nevertheless, most of the infected mothers are living now in non-endemic areas, where the expertise for identification of the parasite is low. Furthermore, transmission near delivery or even at delivery do not allow that enough parasites will be detected when the baby is at the maternity. So, if parasites are not found or not searched, it is imperative that, in serologically confirmed mothers (two positive tests), the babies are recalled at six/eight months of age, to look for IgG antibodies. If they are present, the baby is infected and should be treated. Treatment in Brazil is with benznidazol, 10 mg/Kg/day, during 60 days. Certification of cure is obtained once a negative serology is obtained, as a rule after one year. A follow up each six months is suggested.
先天性感染的诊断应优先通过微量血细胞比容法查找寄生虫来进行。然而,现在大多数受感染的母亲生活在非流行地区,那里鉴定寄生虫的专业知识水平较低。此外,临近分娩甚至分娩时的传播使得婴儿在产科时无法检测到足够数量的寄生虫。因此,如果未发现或未查找寄生虫,对于血清学确诊的母亲(两次检测呈阳性),必须在婴儿六/八个月大时召回,以检测IgG抗体。如果存在这些抗体,则婴儿受到感染,应进行治疗。在巴西,治疗方法是使用苄硝唑,10毫克/千克/天,持续60天。通常在一年后获得阴性血清学结果时才能确认治愈。建议每六个月进行一次随访。