Torrico Faustino, Vega Cristina Alonso, Suarez Eduardo, Tellez Tatiana, Brutus Laurent, Rodriguez Patricia, Torrico Mary-Cruz, Schneider Dominique, Truyens Carine, Carlier Yves
Centro Universitario de Medicina Tropical, Facultad de Medicina, Universidad Mayor de San Simon, Cochabamba, Bolivia.
Trop Med Int Health. 2006 May;11(5):628-35. doi: 10.1111/j.1365-3156.2006.01623.x.
Comparing two surveys performed in Bolivia in 1992-1994 and 1999-2001, we reported a significant decrease in the proportions of severe and mortal forms of congenital Chagas disease. This might be due to a reduction of vectorial density (VD) in maternal residence area, raising the question of a possible causal relationship between such VD, maternal parasitaemia and prognosis of congenital infection with Trypanosoma cruzi.
Comparisons of haematological and parasitological data obtained from Bolivian mothers infected with T. cruzi, and of clinical and biological data obtained from their infected and uninfected newborns, stratified according to VD in the area of maternal residence.
i) Blood hematocrit rates or hemoglobin amounts were within the normal ranges and similar in all the maternal groups, whatever the VD in their areas of residence; ii) mothers living in high VD areas displayed a higher frequency of hemocultures positive for T. cruzi; iii) newborns congenitally infected with T. cruzi, but not uninfected babies born from infected mothers, displayed higher frequencies of very low Apgar scores, low birth weights, prematurity, respiratory distress syndrome or anasarca, as well as higher mortality rates when their mothers lived in areas of high VD.
Frequent bites of blood sucking Reduvidae during pregnancy do not induce maternal anaemia, but, likely through multiple maternal re-infections with T. cruzi, increase maternal parasitemia and worsen congenital Chagas disease. Maternal dwelling in areas of high VD is associated with a serious increased risk of severe and mortal congenital Chagas disease.
通过比较1992 - 1994年和1999 - 2001年在玻利维亚进行的两项调查，我们报告了先天性恰加斯病严重和致死形式的比例显著下降。这可能是由于母亲居住地区病媒密度（VD）降低，从而引发了关于这种病媒密度、母亲寄生虫血症与克鲁斯锥虫先天性感染预后之间可能存在因果关系的问题。
比较从感染克鲁斯锥虫的玻利维亚母亲获得的血液学和寄生虫学数据，以及从她们感染和未感染的新生儿获得的临床和生物学数据，并根据母亲居住地区的病媒密度进行分层。
i）无论母亲居住地区的病媒密度如何，所有母亲组的血细胞比容率或血红蛋白量均在正常范围内且相似；ii）生活在病媒密度高的地区的母亲，克鲁斯锥虫血培养阳性的频率更高；iii）先天性感染克鲁斯锥虫的新生儿，但不是感染母亲所生的未感染婴儿，当他们的母亲生活在病媒密度高的地区时，极低阿氏评分、低出生体重、早产、呼吸窘迫综合征或全身性水肿的频率更高，死亡率也更高。
孕期频繁被吸血猎蝽叮咬不会导致母亲贫血，但可能通过母亲多次再次感染克鲁斯锥虫，增加母亲的寄生虫血症并使先天性恰加斯病恶化。母亲居住在病媒密度高的地区与严重和致死性先天性恰加斯病的风险严重增加有关。
