Congenital Transmission of Trypanosoma cruzi in Argentina, Honduras, and Mexico: An Observational Prospective Study

被引：55

作者：

Buekens, Pierre ^{[1
]}

Luisa Cafferata, Maria ^{[2
]}

Alger, Jackeline ^{[3
,13
]}

Althabe, Fernando ^{[4
]}

Belizan, Jose M. ^{[4
]}

Bustamante, Norma ^{[5
]}

Carlier, Yves ^{[1
,6
]}

Ciganda, Alvaro ^{[2
]}

del Cid, Jaime H. ^{[7
]}

Dumonteil, Eric ^{[1
]}

Gamboa-Leon, Rubi ^{[8
]}

Garcia, Jorge A. ^{[3
,13
]}

Gibbons, Luz ^{[4
]}

Graiff, Olga ^{[9
]}

Gurubel Maldonado, Jesus ^{[10
]}

Herrera, Claudia ^{[1
]}

Howard, Elizabeth ^{[1
]}

Susana Lara, Laura ^{[9
]}

Lopez, Benjamin ^{[5
]}

Luisa Matute, Maria ^{[11
]}

Jesus Ramirez-Sierra, Maria ^{[10
]}

Cecilia Robles, Maria ^{[9
]}

Sosa-Estani, Sergio ^{[4
,12
]}

Truyens, Carine ^{[6
]}

Valladares, Christian ^{[11
]}

Wesson, Dawn M. ^{[1
]}

Zuniga, Concepcion ^{[3
,14
]}

机构：

[1] Tulane Univ, Sch Publ Hlth & Trop Med, 1440 Canal St,Suite 2400, New Orleans, LA 70112 USA

[2] Unidad Invest Clin & Epidemiol Montevideo UNICEM, Montevideo, Uruguay

[3] UNAH, Fac Ciencias Med, Hosp Escuela Univ, Tegucigalpa, Honduras

[4] IECS, Buenos Aires, DF, Argentina

[5] Reg Dept Salud, Barrio Abajo, Santa Barbara, Honduras

[6] ULB, Fac Med, Lab Parasitol, Brussels, Belgium

[7] Ctr Salud Vicente Mejia Colindres, Barrio El Ctr, Intibuca, Honduras

[8] Univ Autonoma San Luis Potosi, Coordinac Acad Reg Huasteca Sur, Tamazunchale, San Luis Potosi, Mexico

[9] Inst Maternidad & Ginecol Nuestra Senora de las M, San Miguel De Tucuman, Tucuman, Argentina

[10] Univ Autonoma Yucatan, Ctr Invest Reg Dr Hideyo Noguchi, Merida, Mexico

[11] Secretaria Salud Honduras, Lab Nacl Vigilancia de la Salud, Tegucigalpa, Honduras

[12] ANLIS, CONICET, Inst Nacl Parasitol Dr Mario Fatala Chaben, Buenos Aires, DF, Argentina

[13] Inst Enfermedades Infecciosas & Parasitol Antonio, Tegucigalpa, Honduras

[14] Hosp Escuela Univ, Inst Enfermedades Infecciosas & Parasitol Antonio, Tegucigalpa, Honduras

来源：

AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE | 2018年 / 98卷 / 02期

关键词：

TO-CHILD TRANSMISSION; POLYMERASE-CHAIN-REACTION; CHAGAS-DISEASE; PREGNANT-WOMEN; HUMAN INFECTION; EARLY-DIAGNOSIS; IDENTIFICATION; BLOOD; DNA; SEROPREVALENCE;

D O I：

10.4269/ajtmh.17-0516

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Compared with South America, there is a lack of epidemiologic studies about the risk of congenital transmission of Trypanosoma cruzi in Central America and Mexico. It has been suggested that T. cruzi genotypes might differ by region and that congenital transmission might vary according to the parasite's genotype. Our objective was to compare T. cruzi congenital transmission rates in three countries. We performed an observational prospective study in 2011-2014 enrolling women at delivery in one hospital in Argentina, two hospitals in Honduras, and two hospitals in Mexico. Congenital T. cruzi infection was defined as the presence of one or more of the following criteria: presence of parasites in cord blood (direct parasitological microscopic examination) with positive polymerase chain reaction (PCR) in cord blood, presence of parasites in infant's blood at 4-8 weeks (direct parasitological microscopic examination), and persistence of T. cruzi-specific antibodies at 10 months, as measured by at least two tests. Among 28,145 enrolled women, 347 had at least one antibody rapid test positive in cord blood and a positive enzyme-linked immunosorbent assay in maternal blood. PCR in maternal blood was positive in 73.2% of the cases, and genotyping identified a majority of non-TcI in the three countries. We found no (0.0%; 95% confidence interval [CI]: 0.0, 2.0) confirmed congenital case in Honduras. Congenital transmission was 6.6% (95% CI: 3.1, 12.2) in Argentina and 6.3% (95% CI: 0.8, 20.8) in Mexico. Trypanosoma cruzi non-TcI predominated and risks of congenital transmission were similar in Argentina and Mexico.

引用

页码：478 / 485

页数：8

共 47 条

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