[Congenital Chagas disease: experience in the Hospital de Niños, Ricardo Gutiérrez, Buenos Aires, Argentina].
Epidemiological, clinical, diagnostic, and therapeutic data from children who were born to mothers infected with T. cruzi who came to our hospital are presented. In addition, we exhibit the preliminary results of a technique that detects the anti F2/3 antibodies: these would be able to confirm the cure earlier than conventional serology. We also show the results of PCR diagnosis. Most of the mothers (76,1%) resided in Argentina, the rest were from Bolivia and Paraguay The median average age at diagnosis of the patients was 8,5 months (range 15 days-10 years). Out of 168 children, 64,98% were asymptomatic at diagnosis. The diagnosis criteria were: T. cruzi observation by microhematocrit technique in patients less than 7 month old. Two reactive serological tests in patients older than 8 months. A nifurtimox dose used in these patients was 10-13 mg/kg/d during 60 days. Although 31% presented side effects, none of them had to be dropped from the treatment. Cure criteria was conventional serology negativization. Of the patient population, we cured 87,2% of them, 98% of those under 3 years, and 100% of those who received treatment before age 8 months. We compared the time of negativization between conventional serology and anti F2/3 in 21 children. The latter were very useful to demonstrate (p>0,001) the success of the treatment, in those that started treatment after 8 months of age. PCR testing of a group of all patients, showed a diagnostic sensibility of 80,3% and a specificity of 97,8%.
Servicio de Parasitología y Enfermedad de Chagas, Hospital de Niños R Gutiérrez, Gallo 1330 (1425), Buenos Aires, Argentina.
Jaime
J
Altcheh
M
M
Biancardi
A
A
Lapeña
G
G
Ballering
Hector
H
Freilij
D000818:Animals; D000913:Antibodies, Protozoan / Q000097:blood; D001118:Argentina; D014355:Chagas Disease / Q000097:blood / Q000151:congenital* / Q000175:diagnosis* / Q000188:drug therapy; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006400:Hematocrit; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009547:Nifurtimox / Q000627:therapeutic use; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014344:Trypanocidal Agents / Q000627:therapeutic use; D014349:Trypanosoma cruzi / Q000302:isolation & purification
D000913:Antibodies, Protozoan; D014344:Trypanocidal Agents; D009547:Nifurtimox