[Congenital Chagas disease in the city of Santa Fé. Diagnosis and treatment].
We studied 6123 pregnant women and their 341 newborn (NB), from Santa Fe city, by the following serological tests for chagasic infection: Direct Agglutination with and without 2-mercaptoethanol, Indirect Hemagglutination and Indirect Immunofluorescence test, and by identification of parasites by Fresh drops, Strout and/or by Xenodiagnosis. The prevalence of seropositivity found in pregnant women was of 14.62% with a 73% of migratory history. The parasitological studies yielded 9/341 incidence of transplacentary infection. Clinical examinations were made in the infected newborn (NB). They were treated with Benznidazol or Nifurtimox, and post-treatment evolution was evaluated. We registered connatal infection in twin-brothers. Brothers/sisters (siblings) of infected NB were also studied. Some of them were seropositive and the others seronegative. Results here obtained show that this way of transmission is important, and should be considered even in low endemicity areas. The parasitological assays proved to be decisive for the NB infection diagnosis (Table 1). The serological assays enabled us to follow the non-infected NB up to their negativization. A 6 month follow-up is recommended. It is impossible to define only one clinical outline because both symptomatic and asymptomatic infected NB may be found with gestational age at term and pre-term and when born with a weight above or below 2000 g. We obtained parasitological and serological negativization in all cases. The chagasic pregnant woman does not necessarily transmit the infection to all her descendents. Only 2.64% are infected. It is possible to systematize the diagnosis without extra resources beyond the usual ones.
Streiger
M
M
Centro de Investigaciones sobre Endemias Nacionales, Facultad de Bioquimica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina.
Fabbro
D
D
del Barco
M
M
Beltramino
R
R
Bovero
N
N
D000818:Animals; D001118:Argentina; D014355:Chagas Disease / Q000151:congenital* / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D009547:Nifurtimox / Q000008:administration & dosage; D009593:Nitroimidazoles / Q000008:administration & dosage; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic; D015995:Prevalence; D014349:Trypanosoma cruzi / Q000276:immunology
D009593:Nitroimidazoles; D009547:Nifurtimox
Chagas congénito en la ciudad de Santa Fé. Diagnóstico y tratamiento.