Francisco-González Laura, Gastañaga-Holguera Teresa, Jiménez Montero Beatriz, Daoud Pérez Zarife, Illán Ramos Marta, Merino Amador Paloma, Herráiz Martínez Miguel Ángel, Ramos Amador José Tomás
Servicio de Pediatría, Hospital Clínico San Carlos, Madrid, España.
Servicio de Obstetricia y Ginecología, Hospital Clínico San Carlos, Madrid, España.
An Pediatr (Engl Ed). 2018 Mar;88(3):122-126. doi: 10.1016/j.anpedi.2017.03.003. Epub 2017 Apr 12.
Chagas disease, caused by Trypanosoma cruzi (T. cruzi), is endemic in Latin-America and is emerging in Spain due to immigration. The vertical transmission rate is around 5%. A routine prenatal screening with serology of all pregnant women from endemic areas is recommended to identify infected newborns, allowing early treatment and cure.
The aim of this study was to estimate the prevalence of positive Chagas serology in a cohort of pregnant women from Latin-America and its vertical transmission.
An observational, prospective, follow-up study was conducted on women with positive serology to T. cruzi, as well as their newborns, from January 2013 to April 2015. Congenital Chagas was ruled out using a PCR technique at birth and at 1 month, and with serology at 9-12 months old. A child was considered infected when PCR was positive, and uninfected when PCR was negative, and/or it had a negative serology.
Screening was performed on 1244 pregnant women from Latin-America, and there were positive results in 40 (prevalence 3.2%, 95% CI: 2.4-4.4%), with 85% of them from Bolivia. There was only one infected newborn (rate of vertical transmission 2.8% (95% CI: 0-15%)), who had a positive PCR at birth. Relative studies enabled an 8-year-old sister with an asymptomatic disease to be diagnosed and treated. Both were treated successfully with benznidazole (later the PCR and serology were negative).
Screening during pregnancy in Latin-American women helped to detect those with Chagas disease. The rate of vertical transmission was 2.8%, in keeping with literature. Screening led to the detection and treatment of previously unidentified familial cases.
恰加斯病由克氏锥虫引起，在拉丁美洲为地方病，因移民问题在西班牙也逐渐出现。垂直传播率约为5%。建议对来自流行地区的所有孕妇进行血清学常规产前筛查，以识别受感染的新生儿，从而实现早期治疗和治愈。
本研究旨在估计拉丁美洲孕妇队列中恰加斯血清学阳性的患病率及其垂直传播情况。
2013年1月至2015年4月，对克氏锥虫血清学阳性的女性及其新生儿进行了一项观察性、前瞻性随访研究。出生时和1个月时使用聚合酶链反应（PCR）技术，9至12个月时进行血清学检测，以排除先天性恰加斯病。PCR检测呈阳性时，儿童被视为感染；PCR检测呈阴性和/或血清学检测呈阴性时，则视为未感染。
对1244名来自拉丁美洲的孕妇进行了筛查，其中40名结果呈阳性（患病率3.2%，95%可信区间：2.4 - 4.4%），其中85%来自玻利维亚。仅有一名新生儿感染（垂直传播率2.8%（95%可信区间：0 - 15%）），其出生时PCR检测呈阳性。相关研究使一名患有无症状疾病的8岁姐妹得以确诊和治疗。两人均成功接受了苯硝唑治疗（后来PCR和血清学检测均呈阴性）。
对拉丁美洲女性进行孕期筛查有助于检测出患有恰加斯病的患者。垂直传播率为2.8%，与文献报道相符。筛查导致发现并治疗了此前未被识别的家族病例。
