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通过筛查母亲和监测新生儿血清学检测预防先天性恰加斯病:七年经验

Prevention of congenital Chagas disease by screening of mothers and monitoring of serological tests of neonates: the seven years' experience.

作者信息

Raglio Annibale, Clemente Libera, Guarneri Davide, Arosio Marco, Maino Marzia, Patanè Luisa, Cavallini Marco, Rodari Paola, Mangili Giovanna, Farina Claudio

机构信息

Microbiology Institute, Hospital "Papa Giovanni XXIII", Bergamo, Italy.

Division of Laboratory Medicine, University Hospital Giuliano Isontina (ASUGI), Trieste, Italy.

出版信息

Infez Med. 2023 Jun 1;31(2):243-249. doi: 10.53854/liim-3102-13. eCollection 2023.

Abstract

Approximately 14000 immigrants coming from the Cochabamba area of Bolivia, with an increased risk of congenital Chagas Disease (CD), are currently living in Bergamo, Italy. According to the World Health Organization (WHO) recommendation (2011), prevention of congenital CD involves testing all pregnant women at risk of infection and performing follow-up of their newborns. In our study, all pregnant women of Latin American origin were tested for the presence of antibodies and children, born to mothers found to be positive, were followed up after delivery. antibodies were detected using a chemiluminescence immunoassay. The test was also performed on siblings and fathers of children with CD, and women of childbearing age to prevent the congenital infection, as proposed by 2011 WHO recommendation. In the study period 1105 patients were tested for CD, using a serological test: 934 (85%) were females and 171 (15%) were males. Of the 62 newborns, from mothers who tested positive, 28 were females and 34 were males. The number of positive adults and siblings identified was 148 (14%). Among the adults and siblings born between 1991 and 2011 only 3 (2%) of females tested positive to serological test. All neonates, with the exception of one, were classified as non-infected according to the follow-up of index value of CD serology. This study confirms the usefulness of serological tests and of their index value as follow-up. The difference of positivity rate for CD antibodies between people born before and after 1990 should be further investigated to generate information that potentially improve the prevention and control of CD.

摘要

目前约有14000名来自玻利维亚科恰班巴地区、患先天性恰加斯病(CD)风险较高的移民居住在意大利贝加莫。根据世界卫生组织(WHO)2011年的建议,先天性CD的预防包括对所有有感染风险的孕妇进行检测,并对其新生儿进行随访。在我们的研究中,对所有拉丁美洲裔孕妇进行了抗体检测,对检测呈阳性的母亲所生的孩子在出生后进行了随访。使用化学发光免疫分析法检测抗体。按照WHO 2011年的建议,还对患有CD的儿童的兄弟姐妹和父亲以及育龄妇女进行了检测,以预防先天性感染。在研究期间,使用血清学检测对1105名患者进行了CD检测:934名(85%)为女性,171名(15%)为男性。在检测呈阳性的母亲所生的62名新生儿中,28名是女性,34名是男性。确定的阳性成年人和兄弟姐妹数量为148名(14%)。在1991年至2011年出生的成年人和兄弟姐妹中,只有3名(2%)女性血清学检测呈阳性。根据CD血清学指标值的随访,除一名新生儿外,所有新生儿均被归类为未感染。本研究证实了血清学检测及其指标值作为随访的有用性。1990年前后出生人群中CD抗体阳性率的差异应进一步调查,以获取可能改善CD预防和控制的信息。

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Chagas disease in Italy: updated estimates.意大利的恰加斯病:最新估计数。
Intern Emerg Med. 2020 Oct;15(7):1339-1343. doi: 10.1007/s11739-020-02387-z. Epub 2020 Jun 9.
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Chagas disease in Italy: the study's contribution of Italian researchers.意大利的查加斯病:意大利研究人员的研究贡献。
Panminerva Med. 2019 Dec;61(4):464-472. doi: 10.23736/S0031-0808.19.03723-6. Epub 2019 Jul 30.
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Chagas' disease: pregnancy and congenital transmission.恰加斯病:妊娠与先天性传播
Biomed Res Int. 2014;2014:401864. doi: 10.1155/2014/401864. Epub 2014 May 15.

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