Fumadó Victoria, Juncosa Teresa, Posada Elizabet, Fisa Roser, Gállego Montserrat, Gascón Joaquim
Servicio de Pediatría, Unidad de Medicina Importada, Hospital Universitari Sant Joan de Déu, Esplugues de Llobregat, Barcelona, España.
Servicio de Microbiología, Hospital Universitari Sant Joan de Déu, Esplugues de Llobregat, Barcelona, España.
Enferm Infecc Microbiol Clin. 2014 May;32(5):293-6. doi: 10.1016/j.eimc.2013.04.024. Epub 2014 Jan 31.
Immigration has introduced new diseases into Spanish society, one of which is Chagas disease. Young women of childbearing age and children infected with Trypanosoma cruzi from endemic areas are at risk of developing the disease years later, and pregnant women can transmit the infection through the placenta.
Serological screening for anti-T.cruzi antibodies was performed on all immigrant children coming from a Chagas endemic area and seen in our Pathology Unit between 2003 and 2008, as well as on newborns of T.cruzi positive infected pregnant women coming from Latin America. Two ELISA tests were used (bioelisa Chagas Biokit® with recombinant antigens, and an 'in house' ELISA with crude antigen). Patients with sufficient sample were also screened by nested PCR (TCZ3/Z4).
A total of 202 children, aged 1 day to 14 years old were included in the study, of whom 22 (10.8%) were diagnosed with asymptomatic infection, 5 of which were congenital as they were born in this country. All infected patients received treatment with benznidazole, with three of them currently with a serologically negative result after treatment.
Chagas disease is a new imported paediatric disease that can affect children from endemic countries, but can also be acquired in our country by vertical transmission. Therefore, we believe that it is essential to perform serological screening on all children and pregnant women in the prenatal care from endemic areas, and provide specific treatment for those infected patients, given the good results observed in the paediatric population.
移民将新疾病引入西班牙社会,其中之一便是恰加斯病。来自流行地区的感染克氏锥虫的育龄年轻女性和儿童,数年后有患病风险,且孕妇可通过胎盘传播感染。
对2003年至2008年间在我们病理科就诊的所有来自恰加斯病流行地区的移民儿童,以及来自拉丁美洲的克氏锥虫阳性感染孕妇的新生儿进行抗克氏锥虫抗体的血清学筛查。使用了两种酶联免疫吸附测定法(使用重组抗原的恰加斯生物试剂盒生物酶联免疫吸附测定法,以及使用粗抗原的内部酶联免疫吸附测定法)。对有足够样本的患者也通过巢式聚合酶链反应(TCZ3/Z4)进行筛查。
共有202名年龄在1天至14岁的儿童纳入研究,其中22名(10.8%)被诊断为无症状感染,其中5名是先天性感染,因为他们在本国出生。所有感染患者均接受了苯硝唑治疗,其中3名患者治疗后目前血清学结果为阴性。
恰加斯病是一种新的输入性儿科疾病,可影响来自流行国家的儿童,但也可在我国通过垂直传播获得。因此,鉴于在儿科人群中观察到的良好效果,我们认为对来自流行地区的所有儿童和产前护理中的孕妇进行血清学筛查,并为那些感染患者提供特异性治疗至关重要。