ABSTRACT
A locally sustainable system of prenatal screening of Trypanosoma cruzi infection has been implemented in rural health care centers of endemic areas in Paraguay A total of 61.091 women from Paraguari and Cordillera Departments were serologically evaluated, where 7.802 (12,7%) resulted to be anti-T. cruzi IgG positive. A total of 1,865 infants born to seropositive mothers were examined by parasitological techniques, such as direct microscopic observation and polymerase chain reaction, and serologically by ELISA, ELISA-SAPA and IFI. 104 infected babies were detected and treated with benznidazole. The recovery of babies born to seropositive mothers performing a single examination at the age of 6 months was significantly higher, as compared with the recommended method involving two examinations, both at birth and after 6 months of age. Although at 6 months of age in 7% of the infants maternal IgG was still detected. PCR was the most sensitive technique for early detection of T. cruzi infection in babies, but we do not recommend it use for diagnosis in high endemic areas, considering that for the screening of 815 babies, 2000 reactions were needed. We propose a strategy to detect congenital transmission of Chagas disease, based on a large-scale study, where the shortcomings of the different serological and parasitological techniques are discussed.
Subject(s)
Humans , Animals , Female , Infant, Newborn , Infant , Child , Adolescent , Adult , Middle Aged , Pregnancy , Primary Health Care/organization & administration , Prenatal Diagnosis/standards , Chagas Disease/congenital , Chagas Disease/diagnosis , Endemic Diseases , Neonatal Screening/standards , Antibodies, Protozoan/blood , Chagas Disease/epidemiology , Enzyme-Linked Immunosorbent Assay , Immunoglobulin G/blood , Biomarkers/blood , Paraguay/epidemiology , Rural Population , Seroepidemiologic Studies , Trypanosoma cruzi/immunologyABSTRACT
Presenta un estudio alos niños menores de 5 años de edad, de ambo sexos, que consultan al servicio de urgencias de la cátedra de pediatría del hospital de clínicas e internados en la sala de lactantes, por cuadros de diarrea aguda siendo la causa más importante los los rotavirus