We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Trypanocide Treatment of Women Infected with Trypanosoma cruzi and Its Effect on Preventing Congenital Chagas.
- Authors
Fabbro, Diana L.; Danesi, Emmaria; Olivera, Veronica; Codebó, Maria Olenka; Denner, Susana; Heredia, Cecilia; Streiger, Mirtha; Sosa-Estani, Sergio
- 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. Author Summary: Congenital infection with Trypanosoma cruzi is the most common mode of transmission in countries where the vectorial and transfusional routes have been controlled. We evaluated the efficacy of trypanocidal therapy in preventing congenital Chagas disease and compared the clinical and serological changes between treated and untreated mothers. From medical records of infected women with and without trypanocidal treatment, we studied their children to detect congenital infection. Among 222 children of untreated mothers, we detected 34 cases of congenital transmission. The 132 children of previously treated women were born without infection. In 117 mothers followed for more than eight years, we observed negative serology for Chagas in 43.7% of the treated women and none in untreated mothers. Regarding their clinical course, there was also a positive difference for treated women (2.2%), compared with untreated ones (15.4%). These results indicate the benefit of providing etiologic treatment to young people with chronic infection. This recommendation would have a major health impact both in primary prevention, preventing further cases of congenital Chagas disease, and in secondary prevention, reducing the risks of morbidity and mortality that can cause infection.
- Subjects
TRYPANOSOMA cruzi; YOUNG adults; CHAGAS' disease; CONGENITAL disorders; SECONDARY prevention; TRICHOMONIASIS
- Publication
PLoS Neglected Tropical Diseases, 2014, Vol 8, Issue 11, p1
- ISSN
1935-2727
- Publication type
Article
- DOI
10.1371/journal.pntd.0003312