Trypanosoma cruzi infection in Latin American pregnant women living outside endemic countries and frequency of congenital transmission: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Valeria Colombo ◽  
Andrea Giacomelli ◽  
Giovanni Casazza ◽  
Laura Galimberti ◽  
Cecilia Bonazzetti ◽  
...  
Keyword(s):  
Trypanosoma Cruzi ◽  
Pregnant Women ◽  
Chagas Disease ◽  
Latin American ◽  
Transmission Rate ◽  
Congenital Infection ◽  
Health Concern ◽  
Congenital Transmission ◽  
Global Rate ◽  
Cruzi Infection

Abstract Background Chagas disease, as a consequence of globalization and immigration, is no more restricted to Central and Latin America. Therefore, congenital transmission represents a growing public health concern in non-endemic countries. Methods The aim of this study was to assess the prevalence of Trypanosoma cruzi infection in pregnant Latin American (LA) women living outside endemic countries and the rate of congenital transmission. Data were extracted from studies indexed in PubMed, Scopus, Embase, Lilacs and SciELO databases without language restriction. Two investigators independently collected data on study characteristics, diagnosis, prevalence of infection in pregnant women and congenital infection rate. The data were pooled using a random effects model. Results The search identified 1078 articles of which 29 were eligible regarding prevalence of T. cruzi infection among pregnant women and 1795 articles of which 32 were eligible regarding the congenital transmission rate. The estimated pooled prevalence of T. cruzi infection in LA pregnant women was 4.2% [95% confidence interval (CI): 3.0–5.5]. The prevalence of T. cruzi infection in pregnant women from Bolivia was 15.5% (95% CI: 11.7–19.7) and 0.5% (95% CI: 0.2–0.89) for those coming from all other LA countries. The estimated global rate of congenital transmission was 3.5% (95% CI: 2.5–4.5); excluding poor-quality studies, the rate of congenital transmission was 3.8% (95% CI: 2.4–5.1). Conclusions Prevalence of Chagas disease among LA pregnant women living outside endemic countries is high, particularly in Bolivian women. The rate of vertical transmission of T. cruzi infection is similar to the rate reported in South and Central American countries.

scholarly journals Chagas disease prevalence in pregnant women: migration and risk of congenital transmission

2016 ◽  
Vol 10 (09) ◽  
pp. 895-901 ◽  
Author(s):  
Rodolfo A Kolliker-Frers ◽  
Ivan Insua ◽  
Gabriela Razzitte ◽  
Francisco Capani
Keyword(s):  
Pregnant Women ◽  
Chagas Disease ◽  
Latin American ◽  
The United States ◽  
Serological Tests ◽  
Cross Sectional ◽  
Congenital Transmission ◽  
The Public ◽  
Endemic Areas ◽  
The Impact

Introduction: Argentina has been a preferential target for Bolivian immigrants for decades. The relatively recent migratory flux includes Germany, France, the United States, Australia, Japan, and some Latin American countries. The aim of this cross-sectional study was to describe the prevalence of Chagas disease in pregnant women, analyzing the Bolivian-specific Chagas prevalence as the main contributor of migratory populations from Chagas disease-endemic areas to Buenos Aires city, Argentina, and to evaluate the impact of these migrant influxes on the process of the "urbanization" of the disease in reference hospital José Maria Ramos Mejia (JMRM). Methodology: Overall, 21,332 pregnant women (100%) between 15 and 49 years of age derived from the public maternity service of JMRMH were studied. Serology data was obtained from registered serological diagnosis data, consisting of three different serological tests performed at the Public Parasitology Unit. Results: Although general prevalence decreased during the analyzed period, the specific prevalence of pregnant women from Bolivian origin showed a sustained growth during 1983–2013. Solely 5% of the total pregnant women population from Bolivia contributed to one third of the total Chagas prevalence. Conclusions: This study showed that a cohort of pregnant women from Bolivia who attended JMRMH during the period 1983–2007 constituted a population at risk for congenital transmission. Increased migration from endemic areas of Bolivia might potentially increase the prevalence of Chagas disease among pregnant women. In addition, this study highlights the importance to analyze specific prevalence according to endemic areas to determine the profiles of potential hidden prevalence.

Seroprevalence of Trypanosoma cruzi Infection in Pregnant Women Suggests a High Risk for Congenital Transmission in Central Veracruz, Mexico

2020 ◽  
Vol 65 (3) ◽  
pp. 661-668
Author(s):  
Aracely López-Monteon ◽  
Hilda Montero ◽  
Ruth Sarahi González-Constantino ◽  
Alberto Yair Limón-Flores ◽  
Miguel Varela-Cardoso ◽  
...  
Keyword(s):  
High Risk ◽  
Trypanosoma Cruzi ◽  
Pregnant Women ◽  
Congenital Transmission ◽  
Cruzi Infection

Evaluation and Management of Congenital Chagas Disease in the United States

2019 ◽  
Vol 8 (5) ◽  
pp. 461-469 ◽  
Author(s):  
Morven S Edwards ◽  
Kelly K Stimpert ◽  
Stephanie R Bialek ◽  
Susan P Montgomery
Keyword(s):  
United States ◽  
Chagas Disease ◽  
Transmission Rate ◽  
Clinical Signs ◽  
The United States ◽  
Health Concern ◽  
Molecular Testing ◽  
Early Assessment ◽  
Childbearing Age ◽  
Cruzi Infection

Abstract Chagas disease is underappreciated as a health concern in the United States. Approximately 40 000 women of childbearing age living in the United States have chronic Chagas disease. Most of them are unaware that they have an infection that is transmissible to their offspring. The estimated US maternal-to-infant transmission rate of Trypanosoma cruzi is 1% to 5%. Ten percent to 40% of neonates with congenital T cruzi infection have clinical signs consistent with a congenital infection but no findings are unique to Chagas disease. If left untreated, 20% to 40% of infants with Chagas disease will later develop potentially fatal cardiac manifestations. Molecular testing can confirm the diagnosis in neonates. Treatment is well tolerated in infancy and usually results in cure. Screening of at-risk women during pregnancy can identify maternal infection and allow early assessment and treatment for congenital T cruzi infection.

Prevalence of Trypanosoma cruzi infection in pregnant Latin American women and congenital transmission rate in a non-endemic area: the experience of the Valencian Health Programme (Spain)

2011 ◽  
Vol 140 (10) ◽  
pp. 1896-1903 ◽  
Author(s):  
C. BARONA-VILAR ◽  
M. J. GIMÉNEZ-MARTÍ ◽  
T. FRAILE ◽  
C. GONZÁLEZ-STEINBAUER ◽  
C. PARADA ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Pregnant Women ◽  
Latin American ◽  
Transmission Rate ◽  
Newborn Infants ◽  
Congenital Infection ◽  
University Hospitals ◽  
Serological Tests ◽  
American Women ◽  
Health Programme

SUMMARYThis study describes the results of the health programme implemented in the Valencian Community (Spain) to achieve an early diagnosis of Chagas disease in pregnant Latin American women and their newborns. During 2009 and 2010, 1975 women living in the health districts of three university hospitals were enrolled via midwives or at the time of delivery. Diagnosis of disease was performed using two serological tests with different antigens. Congenital infection was diagnosed by parasitological, molecular or serological methods from blood samples obtained at birth or in subsequent controls. The overall seroprevalence of Chagas infection in pregnant women from 16 different endemic countries was 11·4%. Infection was higher in those from countries in the Gran Chaco Region (Bolivia, 34·1%; Paraguay, 7·4%; Argentina, 5·3%). Eight newborn infants from Bolivian mothers had congenital Chagas which represents a vertical transmission rate of 3·7%. In conclusion, this work supports the benefits of offering an early diagnosis to pregnant women and newborns during routine prenatal healthcare.

scholarly journals Chagas disease in European countries: the challenge of a surveillance system

2011 ◽  
Vol 16 (37) ◽  
Author(s):  
L Basile ◽  
J M Jansá ◽  
Y Carlier ◽  
D D Salamanca ◽  
A Angheben ◽  
...  
Keyword(s):  
Chagas Disease ◽  
Latin American ◽  
Annual Incidence ◽  
European Countries ◽  
Undocumented Migrants ◽  
Congenital Transmission ◽  
Potential Difficulty ◽  
Public Health Challenge ◽  
Official Sources ◽  
Cruzi Infection

A study of aggregate data collected from the literature and official sources was undertaken to estimate expected and observed prevalence of Trypanosoma cruzi infection, annual incidence of congenital transmission and rate of underdiagnosis of Chagas disease among Latin American migrants in the nine European countries with the highest prevalence of Chagas disease. Formal and informal data sources were used to estimate the population from endemic countries resident in Europe in 2009, diagnosed cases of Chagas disease and births from mothers originating from endemic countries. By 2009, 4,290 cases had been diagnosed in Europe, compared with an estimated 68,000 to 122,000 expected cases. The expected prevalence was very high in undocumented migrants (on average 45% of total expected cases) while the observed prevalence rate was 1.3 cases per 1,000 resident migrants from endemic countries. An estimated 20 to 183 babies with congenital Chagas disease are born annually in the study countries. The annual incidence rate of congenital transmission per 1,000 pregnancies in women from endemic countries was between none and three cases. The index of underdiagnosis of T. cruzi infection was between 94% and 96%. Chagas disease is a public health challenge in the studied European countries. Urgent measures need to be taken to detect new cases of congenital transmission and take care of the existing cases with a focus on migrants without legal residency permit and potential difficulty accessing care.

scholarly journals Galectins in Chagas Disease: A Missing Link Between Trypanosoma cruzi Infection, Inflammation, and Tissue Damage

2022 ◽  
Vol 12 ◽  
Author(s):  
Carolina V. Poncini ◽  
Alejandro F. Benatar ◽  
Karina A. Gomez ◽  
Gabriel A. Rabinovich
Keyword(s):  
Trypanosoma Cruzi ◽  
Chagas Disease ◽  
Tissue Damage ◽  
Protozoan Parasite ◽  
Multiple Roles ◽  
Health Concern ◽  
Global Public Health ◽  
Parasite Invasion ◽  
Socioeconomic Consequences ◽  
Cruzi Infection

Trypanosoma cruzi, the protozoan parasite causative agent of Chagas disease, affects about seven million people worldwide, representing a major global public health concern with relevant socioeconomic consequences, particularly in developing countries. In this review, we discuss the multiple roles of galectins, a family of β-galactoside-binding proteins, in modulating both T. cruzi infection and immunoregulation. Specifically, we focus on galectin-driven circuits that link parasite invasion and inflammation and reprogram innate and adaptive immune responses. Understanding the dynamics of galectins and their β-galactoside-specific ligands during the pathogenesis of T. cruzi infection and elucidating their roles in immunoregulation, inflammation, and tissue damage offer new rational opportunities for treating this devastating neglected disease.

scholarly journals Is Antibody-Dependent Enhancement of Trypanosoma cruzi Infection Contributing to Congenital/Neonatal Chagas Disease?

2021 ◽  
Vol 12 ◽  
Author(s):  
Yves Carlier ◽  
Carine Truyens ◽  
Eric Muraille
Keyword(s):  
Trypanosoma Cruzi ◽  
Pregnant Women ◽  
Chagas Disease ◽  
Viral Infections ◽  
Neonatal Morbidity ◽  
Host Cells ◽  
Antibody Dependent Enhancement ◽  
Severe Reduction ◽  
Cruzi Infection

The newborns of women infected with the parasite Trypanosoma cruzi (the agent of Chagas disease) can be infected either before birth (congenitally), or after birth (as e.g., by vector route). Congenital Chagas disease can induce high levels of neonatal morbidity and mortality. Parasite-infected pregnant women transmit antibodies to their fetus. Antibodies, by opsonizing parasites, can promote phagocytosis and killing of T. cruzi by cells expressing FcγR, on the mandatory condition that such cells are sufficiently activated in an inflammatory context. Antibody-dependent enhancement (ADE) is a mechanism well described in viral infections, by which antibodies enhance entry of infectious agents into host cells by exploiting the phagocytic FcγR pathway. Previously reported Chagas disease studies highlighted a severe reduction of the maternal-fetal/neonatal inflammatory context in parasite-transmitting pregnant women and their congenitally infected newborns. Otherwise, experimental observations brought to light ADE of T. cruzi infection (involving FcγR) in mouse pups displaying maternally transferred antibodies, out of an inflammatory context. Herein, based on such data, we discuss the previously unconsidered possibility of a role of ADE in the trans-placental parasite transmission, and/or the development of severe and mortal clinical forms of congenital/neonatal Chagas disease in newborns of T. cruzi-infected mothers.

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