title: Trypanocide treatment of women infected with Trypanosoma cruzi and its effect on preventing congenital Chagas.
abstract: With the control of the vectorial and transfusional routes of infection with Trypanosoma cruzi, congenital transmission has become an important source of new cases. This study evaluated the efficacy of trypanocidal therapy to prevent congenital Chagas disease and compared the clinical and serological evolution between treated and untreated infected mothers. We conducted a multicenter, observational study on a cohort of mothers infected with T. cruzi, with and without trypanocidal treatment before pregnancy. Their children were studied to detect congenital infection. Among 354 "chronically infected mother-biological child" pairs, 132 were treated women and 222 were untreated women. Among the children born to untreated women, we detected 34 infected with T. cruzi (15.3%), whose only antecedent was maternal infection. Among the 132 children of previously treated women, no infection with T. cruzi was found (0.0%) (p<0.05). Among 117 mothers with clinical and serological follow up, 71 had been treated and 46 were untreated. The women were grouped into three groups. Group A: 25 treated before 15 years of age; Group B: 46 treated at 15 or more years of age; Group C: untreated, average age of 29.2 ± 6.2 years at study entry. Follow-up for Groups A, B and C was 16.3 ± 5.8, 17.5 ± 9.2 and 18.6 ± 8.6 years respectively. Negative seroconversion: Group A, 64.0% (16/25); Group B, 32.6% (15/46); Group C, no seronegativity was observed. Clinical electrocardiographic alterations compatible with chagasic cardiomyopathy: Group A 0.0% (0/25); B 2.2% (1/46) and C 15.2% (7/46). The trypanocidal treatment of women with chronic Chagas infection was effective in preventing the congenital transmission of Trypanosoma cruzi to their children; it had also a protective effect on the women's clinical evolution and deparasitation could be demonstrated in many treated women after over 10 years of follow up.
authors.affiliation: Centro de Investigaciones sobre Endemias Nacionales (CIEN) - Facultad de Bioquímica y Ciencias Biológicas- Universidad Nacional del Litoral, Santa Fe, Argentina.
authors.forename: Diana L
authors.initials: DL
authors.lastname: Fabbro
authors.affiliation: Centro Nacional de Diagnóstico e Investigaciones Endemo-epidemicas, Administración Nacional de Laboratorios e Institutos de Salud (ANLIS), Buenos Aires, Argentina.
authors.forename: Emmaria
authors.initials: E
authors.lastname: Danesi
authors.affiliation: Centro de Investigaciones sobre Endemias Nacionales (CIEN) - Facultad de Bioquímica y Ciencias Biológicas- Universidad Nacional del Litoral, Santa Fe, Argentina.
authors.forename: Veronica
authors.initials: V
authors.lastname: Olivera
authors.affiliation: Instituto Nacional de Parasitología (INP), "Dr Mario Fatala Chaben", Administración Nacional de Laboratorios e Institutos de Salud (ANLIS) Malbrán, Buenos Aires, Argentina.
authors.forename: Maria Olenka
authors.initials: MO
authors.lastname: Codebó
authors.affiliation: Centro de Investigaciones sobre Endemias Nacionales (CIEN) - Facultad de Bioquímica y Ciencias Biológicas- Universidad Nacional del Litoral, Santa Fe, Argentina.
authors.forename: Susana
authors.initials: S
authors.lastname: Denner
authors.affiliation: Centro Nacional de Diagnóstico e Investigaciones Endemo-epidemicas, Administración Nacional de Laboratorios e Institutos de Salud (ANLIS), Buenos Aires, Argentina.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Heredia
authors.affiliation: Centro de Investigaciones sobre Endemias Nacionales (CIEN) - Facultad de Bioquímica y Ciencias Biológicas- Universidad Nacional del Litoral, Santa Fe, Argentina.
authors.forename: Mirtha
authors.initials: M
authors.lastname: Streiger
authors.affiliation: Centro Nacional de Diagnóstico e Investigaciones Endemo-epidemicas, Administración Nacional de Laboratorios e Institutos de Salud (ANLIS), Buenos Aires, Argentina; Instituto Nacional de Parasitología (INP), "Dr Mario Fatala Chaben", Administración Nacional de Laboratorios e Institutos de Salud (ANLIS) Malbrán, Buenos Aires, Argentina.
authors.forename: Sergio
authors.initials: S
authors.lastname: Sosa-Estani
mesh_terms: D000293:Adolescent; D000328:Adult; D014355:Chagas Disease / Q000151:congenital / Q000188:drug therapy* / Q000276:immunology / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000188:drug therapy* / Q000276:immunology; D012189:Retrospective Studies; D014344:Trypanocidal Agents / Q000627:therapeutic use*; D014349:Trypanosoma cruzi; D055815:Young Adult
chemical_list: D014344:Trypanocidal Agents