Women and Children, A Vulnerable Population

SOSA-ESTANI S

New Orleans, Lousiana, USA

Congreso; 57th Annual Meeting. Symposium Chagas Disease – Trypanosoma cruzi Infection; 2008

American Society of Tropical Medicine and Hygiene

Se realizó una presentación durante el symposio: Symposium Chagas Disease – Trypanosoma cruzi Infection. Women and Children, A Vulnerable Population. Presentación: Timely Diagnosis of Congenital Trypanosoma cruzi Transmission. Etiological Treatment, Possibilities and Difficulties Adicionalmente se presentó un resumen relacionado SEROPOSITIVE WOMEN AND THEIR NEWBORNS DETECTED BY ELISA WITH ANTIGENS OF A LOCAL STRAIN OF T. cruzi AND FOLLOW-UP TO IDENTIFY CASES OF CONGENITAL TRANSMISSION IN TWO MEXICAN STATES. Rubi Gamboa-León1, Claudia Ramirez1, Nicolas Padilla-Raygoza2, Sergio Sosa-Estani3, Pierre Buekens4 and Eric Dumonteil1  Laboratorio de Parasitología, Centro de Investigaciones Regionales “Dr. Hideyo Noguchi”, Universidad Autónoma de Yucatán, Mérida, Yucatán, México1; Facultad de Enfermería y Obstetricia de Celaya, Universidad de Guanajuato, Celaya, Guanajuato, México2; Instituto de Efectividad Clínica y Sanitaria, y Centro Nacional de Diagnóstico e Investigación de Endemoepidemias (CeNDIE) ANLIS Dr. Carlos G. Malbrán, Ministerio de Salud, Buenos Aires, Argentina3; School of Public Health and Tropical Medicine, Tulane University, New Orleans, Lousiana4   Mothers with Chagas’ disease can transmit Trypanosoma cruzi to their fetuses, who are then at risk of developing severe cardiac disease later in the course of their lives. There are very limited data about congenital Chagas’ disease in Mexico. In a previous study in two Mexican hospitals (Merida, Yucatan and Celaya, Guanajuato), we reported seroprevalence rates of 0.7%-0.8% in venous (IV) samples and of 0.6-0.9% in umbilical cord (UC) samples using commercial tests (Stat-Pak rapid test, Chembio, New York, USA and Chagas Test ELISA Recombinant v3.Wiener, Rosario, Argentina).   We have expanded this study by performing an additional ELISA test using whole antigens of local strains of T. cruzi. We also performed follow-up 10 months after delivery with mothers from Merida who were positive by at least two of three diagnostic tests (non-commercial ELISA, Chagas Test ELISA or Stat Pak), as well as with seropositive newborns to determine the presence of antibodies against T. cruzi as evidence of congenital infection. We also determined whether antibodies against T. cruzi were present among the infants’ siblings.   The frequency of positive ELISA tests using local antigens was 1% (10/988), which was not different from the commercial assays. Three of four women who were found to be positive at delivery by at least two tests were confirmed seropositive for T. cruzi infection at follow–up, while none of the newborns were found to be seropositive at 10-15 months of age. Similarly, none of the siblings were seropositive. One newborn from an infected mother died at two weeks of age from heart failure without confirmation of infection with T. cruzi.   We conclude that T. cruzi seroprevalence is close to one percent in our sample, and that large-scale studies are warranted to identify cases of congenital transmission in Mexico. Commercial or non-commercial ELISA tests produced similar results and could be used for future studies.