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对感染女性后代进行克氏锥虫的扩大筛查。西班牙加泰罗尼亚巴塞罗那北部都会区,2005 - 2016年。

Extended screening of Trypanosoma cruzi among the offspring of infected women. Barcelona North metropolitan area, Catalonia (Spain), 2005-2016.

作者信息

Alcántara Román Albert, Valerio Sallent Lluís, Pérez Quílez Olga, Roure Díez Sílvia, Moreno Millán Nemesio, Villanova Sanfeliu Xavier, Martinez Cuevas Octavi

机构信息

Unidad de Salud Internacional Metropolitana Norte. PROSICS Metropolitana Norte. Universitat Autònoma de Barcelona. Institut Català de la Salut. USAI MetroN, Santa Coloma de Gramenet, Barcelona, España.

Unidad de Salud Internacional Metropolitana Norte. PROSICS Metropolitana Norte. Universitat Autònoma de Barcelona. Institut Català de la Salut. USAI MetroN, Santa Coloma de Gramenet, Barcelona, España.

出版信息

Enferm Infecc Microbiol Clin (Engl Ed). 2018 Aug-Sep;36(7):397-402. doi: 10.1016/j.eimc.2017.05.007. Epub 2017 Jul 8.

DOI:10.1016/j.eimc.2017.05.007
PMID:28689672
Abstract

INTRODUCTION

To date, very little data is available on the extensive, familiar, serological screening of Trypanosoma cruzi from infected-index cases. As it is a parasite with possibility of mother-to-child fetal transmission, the study of the offspring of chronically infected women has a special relevance.

METHODS

An observational study using a capture-recapture method that evaluates the offspring serological status of women diagnosed with T. cruzi infection (positive serology) in the northern metropolitan area of Barcelona during 2005-2016.

RESULTS

A total of 238 women with positive serology for T. cruzi were identified. Of these, 117 (49.2%) could be localized. Their offspring summarized 300 individuals, of which 192 (64%) had serology records, with 23 positive for T. cruzi (11.98%; CI95%: 8.1-17.3). Among the 53 children born within the study area, 5 (9.8%, CI95%: 4.2-20.9) cases of vertical transmission were recorded. All children born as of 2010 (the starting year of mother screening) had serological outputs.

CONCLUSIONS

Offspring of T. cruzi-seropositive women showed a high rate of seropositivity. The prevalence of vertical transmission is also remarkably high but comparable to that obtained in other European studies. The main source of loss was non-accessible women. It is reasonable to formaly include extensive, familiar, serological assessment in Chagas screening guidelines. In order to avoid losses, any eventual screening should be implemented at the time of the maternal diagnosis.

摘要

引言

迄今为止,关于对感染锥虫病的索引病例进行广泛、全面的血清学筛查的数据非常少。由于该寄生虫存在母婴垂直传播的可能性,对慢性感染女性的后代进行研究具有特殊意义。

方法

采用捕获-再捕获方法进行观察性研究,评估2005年至2016年期间在巴塞罗那北部大都市区被诊断为克鲁斯锥虫感染(血清学阳性)的女性的后代血清学状况。

结果

共识别出238名克鲁斯锥虫血清学阳性的女性。其中,117名(49.2%)能够被定位。她们的后代共有300人,其中192人(64%)有血清学记录,23人克鲁斯锥虫血清学阳性(11.98%;95%置信区间:8.1-17.3)。在研究区域内出生的53名儿童中,记录到5例垂直传播病例(9.8%,95%置信区间:4.2-20.9)。所有自2010年(母亲筛查起始年份)起出生的儿童都有血清学检测结果。

结论

克鲁斯锥虫血清学阳性女性的后代血清学阳性率很高。垂直传播的患病率也非常高,但与其他欧洲研究结果相当。主要的失访来源是无法联系到的女性。在恰加斯病筛查指南中正式纳入广泛、全面的血清学评估是合理的。为避免失访,任何最终的筛查都应在产妇诊断时实施。

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