Department of Pediatrics, Hospital Clínico San Carlos, Complutense University of Madrid, Madrid, Spain.
Department of Pediatrics, Hospital Doce de Octubre, Madrid, Spain.
PLoS One. 2019 Jul 10;14(7):e0218491. doi: 10.1371/journal.pone.0218491. eCollection 2019.
Chagas disease (CD) is an emergent disease in Europe, due to immigration. The aims of this study are to describe the epidemiological characteristics of a cohort of Chagas infected pregnant women in Spain, to assess the vertical transmission (VT) rate and evaluate the usefulness of the PCR in the diagnosis of congenital infection in the first months of life.
A descriptive, retrospective study including Chagas seropositive pregnant women who were attended at three tertiary hospitals in Madrid, from January 2012 to September 2016. Infants were examined by PCR at birth and 1 month later and serologically studied at 9 months or later. Children were considered infected when the parasite was detected by PCR at any age or when serology remained positive without decline over the age of 9 months.
We included 122 seropositive-infected pregnant women, 81% were from Bolivia and only 8.2% had been treated before. 125 newborns were studied and finally 109 were included (12.8% lost the follow-up before performing the last serology). The VT rate was 2.75% (95% CI: 0,57-8,8%). Infected infants had positive PCR at birth and 1 month later. All of them were treated successfully with benznidazole (PCR and serology became negative later on). All non-infected children presented negative PCR. The mean age at which uninfected patients had negative serology was 10.5 months.
The VT rate is in keeping with literature and confirms the need to carry out a screening in pregnant women coming from endemic areas. PCR seems to be a useful tool to provide early diagnosis of congenital CD.
恰加斯病（CD）是一种在欧洲因移民而出现的传染病。本研究旨在描述西班牙一组感染恰加斯病的孕妇的流行病学特征，评估垂直传播（VT）率，并评估 PCR 在生命最初几个月诊断先天性感染的有用性。
这是一项描述性、回顾性研究，纳入了 2012 年 1 月至 2016 年 9 月在马德里三家三级医院就诊的 CD 血清阳性孕妇。婴儿出生时和 1 个月后进行 PCR 检查，并在 9 个月后或更晚进行血清学研究。当寄生虫在任何年龄通过 PCR 检测到或当血清学在 9 个月以上年龄仍保持阳性而无下降时，儿童被认为感染。
共纳入 122 例血清阳性感染孕妇，81%来自玻利维亚，只有 8.2%在怀孕前接受过治疗。研究了 125 名新生儿，最终纳入 109 名（12.8%在进行最后一次血清学检查前失去随访）。VT 率为 2.75%（95%CI：0.57-8.8%）。感染婴儿出生时和 1 个月后 PCR 均为阳性。所有婴儿均成功接受苯并咪唑治疗（PCR 和血清学随后转为阴性）。所有未感染儿童的 PCR 均为阴性。未感染患者血清学转为阴性的平均年龄为 10.5 个月。
VT 率与文献一致，证实有必要对来自流行地区的孕妇进行筛查。PCR 似乎是一种有用的工具，可以提供先天性 CD 的早期诊断。
