RESUMEN
INTRODUCTION AND AIM: Immigration to Spain of Latin Americans with Chagas disease in its indeterminate phase could result in vertical transmission of the disease or transmission by transfusion or organ transplantation. To ascertain the magnitude of this problem, we investigated the prevalence of bearers among women who gave birth in 3 state maternity hospitals in the Valencian Community and the incidence of vertical transmission. PATIENTS AND METHODS: An immunoprecipitation test to detect anti-Trypanosoma cruzi antibodies was carried out on 624 pregnant Latin American women. In positive cases, indirect immunofluorescence and PCR analysis were performed on mothers. In addition, a microhematocrit and PCR analysis were performed on the newborns of these mothers, and immune precipitation was carried out from age 7 months. Chagas-positive mothers were referred for outpatient care at the hospital internal medicine departments. Percentage of positive serology was calculated for the total number of patients and by country of origin. RESULTS: A total of 29 women (4.8%; 95% CI, 3.1-6.3) were Chagas-positive; all were asymptomatic and PCR-negative. None of their children were positive to the tests performed. Bolivian women were the most frequently affected: 24 out of 137 (17.5%; 95% CI, 11.2-23.9) DISCUSSION: The high prevalence of Chagas disease in the Latin American immigrant population has raised awareness of this disease among professionals involved in the study and treatment of this illness. Further epidemiological studies are needed to establish the feasibility of universal detection programs in this population.
Asunto(s)
Enfermedad de Chagas/transmisión , Emigrantes e Inmigrantes , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Tamizaje Masivo , Vigilancia de la Población , Complicaciones Infecciosas del Embarazo/prevención & control , Adolescente , Adulto , Animales , Anticuerpos Antiprotozoarios/sangre , Enfermedad de Chagas/sangre , Enfermedad de Chagas/epidemiología , Enfermedad de Chagas/inmunología , Enfermedad de Chagas/prevención & control , Estudios Transversales , ADN Protozoario/sangre , Femenino , Maternidades/estadística & datos numéricos , Humanos , Recién Nacido , América Latina/etnología , Masculino , Persona de Mediana Edad , Embarazo , Complicaciones Infecciosas del Embarazo/sangre , Complicaciones Infecciosas del Embarazo/inmunología , Complicaciones Infecciosas del Embarazo/parasitología , Atención Prenatal , Estudios Seroepidemiológicos , España/epidemiología , Trypanosoma cruzi/inmunología , Trypanosoma cruzi/aislamiento & purificación , Adulto JovenRESUMEN
INTRODUCCIÓN Y OBJETIVO. La inmigración a nuestro país de poblaciones latinoamericanas afectadas de enfermedad de Chagas en fase indeterminada abre la posibilidad de transmisión vertical y por transfusión o trasplante de órganos afectados por esta enfermedad. Para averiguar la magnitud del problema, hemos investigado la prevalencia de portadoras entre las mujeres que dan a luz en tres maternidades públicas de la Comunidad Valenciana y la tasa de transmisión vertical. PACIENTES Y MÉTODOS. A un total de 624 mujeres latinoamericanas embarazadas se les practicó una prueba de inmunoprecipitación para detectar anticuerposanti-Trypanosoma cruzi. A las madres positivas se les realizó inmunofluorescencia indirecta y reacción en cadena de la polimerasa (PCR), y a sus hijos, microhematocrito yPCR en el período neonatal e inmunoprecipitación a partir de los 7 meses de vida. Se remitieron las madres seropositivas a la consulta de medicina interna. Se calculó el porcentaje de serología positiva total y por países. RESULTADOS. Un total de 29 mujeres (4,8 %; intervalo dec onfianza [IC] del 95 %: 3,1-6,3) eran seropositivas, todas asintomáticas y con PCR negativa. Ninguno de sus hijosresultó positivo en las pruebas realizadas. Las mujeres bolivianas fueron las más frecuentemente afectadas:24 de 137 (17,5 %; IC 95 %: 11,2 a 23,9).DISCUSIÓN. La elevada prevalencia de enfermedad de Chagas en la población inmigrante latinoamericana obliga a sensibilizar a los profesionales implicados en el conocimiento de esta enfermedad. Se necesitan más estudios epidemiológicos para poder establecer la conveniencia de programas de detección universal para este colectivo (AU)
INTRODUCTION AND AIM. Immigration to Spain of Latin Americans with Chagas disease in its indeterminate phase could result in vertical transmission of the disease or transmission by transfusion or organ transplantation. To ascertain the magnitude of this problem, we investigated the prevalence of bearers among women who gave birth in 3 state maternity hospitals in the Valencian Communityand the incidence of vertical transmission. PATIENTS AND METHODS. An immunoprecipitation test to detect anti-Trypanosoma cruzi antibodies was carried out on 624 pregnant Latin American women. In positive cases, indirect immunofluorescence and PCR analysis were performed on mothers. In addition, a microhematocrit and PCR analysis were performed on the new-borns of these mothers, and immune precipitation was carried out from age 7 months. Chagas-positive mothers were referred for outpatient care at the hospital internal medicine departments. Percentage of positive serology was calculated for the total number of patients and by country of origin. RESULTS. A total of 29 women (4.8 %; 95 % CI, 3.1-6.3)were Chagas-positive; all were asymptomatic and PCR-negative. None of their children were positive to the tests performed. Bolivian women were the most frequently affected: 24 out of 137 (17.5 %;95 % CI, 11.2-23.9)DISCUSSION. The high prevalence of Chagas disease in the Latin American immigrant population has raised awareness of this disease among professionals involved in the study and treatment of this illness. Further epidemiological studies are needed to establish the feasibility of universal detection programs in this population (AU)