ABSTRACT
Diagnosis of congenital infection should be performed preferentially by the search of the parasite, through microhematocrit. Nevertheless, most of the infected mothers are living now in non-endemic areas, where the expertise for identification of the parasite is low. Furthermore, transmission near delivery or even at delivery do not allow that enough parasites will be detected when the baby is at the maternity. So, if parasites are not found or not searched, it is imperative that, in serologically confirmed mothers (two positive tests), the babies are recalled at six/eight months of age, to look for IgG antibodies. If they are present, the baby is infected and should be treated. Treatment in Brazil is with benznidazol, 10 mg/Kg/day, during 60 days. Certification of cure is obtained once a negative serology is obtained, as a rule after one year. A follow up each six months is suggested.
Subject(s)
Humans , Infant, Newborn , Chagas Disease/congenital , Brazil , Chagas Disease/diagnosis , Chagas Disease/therapy , Serologic TestsABSTRACT
A prevalence estimation of congenital transmission in Brazil is performed, based on several sources of recent data. From a serological survey conducted now in Brazil, with children below 5 years old, preliminary data from the state of Minas Gerais only 19/9,556 children did have antibodies against Trypanosoma cruzi. All 19 mothers were infected, but only one child persisted with antibodies on a second blood collection, hence diagnosed as congenital. The other were just passive transference of maternal antibodies. From a recent publication, 278 children born from 145 infected mothers were studied. Two cases (0.7%) were congenital. In other source, from 1,348 blood donors, 35 were born in non endemic areas. When 10 of them were called, 8 were born from infected mothers and five may be congenital. Finally, no infection was detected in 93 children born from 78 infected mothers. The reasons for this low prevalence are discussed, are lower than in other countries of the South Cone, that harbor also T. cruzi 2, but are unrecognized up to now.
Subject(s)
Humans , Animals , Female , Pregnancy , Infant, Newborn , Infant , Child, Preschool , Chagas Disease/transmission , Infectious Disease Transmission, Vertical , Pregnancy Complications, Parasitic , Antibodies, Protozoan/blood , Brazil/epidemiology , Chagas Disease/blood , Chagas Disease/epidemiology , Epidemiologic Studies , Prevalence , Trypanosoma cruziABSTRACT
Um novo estoque de Trypanosoma cruzi isolado de paciente chagásico crônico, com a forma digestiva e cardiaca da doença, foi caracterizado através de infecçäo experimental em camundongos isogênicos A/Sn suscetíveis à infecçäo chagásica. As curvas de parasitemia mostraram picos de até 1,7x10**6 parasitas/ml näo se observando mortalidade até 300 dias após infecçäo. anticorpos da classe IgM foram encontrados na fase aguda até 40 dias e também na fase crônica e IgG foi detectada nas fases aguda e crônica. O exame histopatológico mostrou miotropismo para músculo liso do tubo digestivo e cardíaco
Subject(s)
Mice , Humans , Animals , Chagas Disease/parasitology , Trypanosoma cruzi/isolation & purification , Acute Disease , Antibodies, Protozoan/blood , Chronic Disease , Chagas Disease/immunology , Mice, Inbred A , Chagas Cardiomyopathy/parasitologySubject(s)
Humans , Animals , Male , Female , Child, Preschool , Adolescent , Adult , Middle Aged , Antigens, Protozoan , Chagas Disease/diagnosis , Chagas Disease/immunology , Feasibility Studies , Reference StandardsABSTRACT
Foram analisados 240 soros de pacientes portadores de megaesôfago atendidos no Hospital das Clínicas de Goiânia, pelas técnicas de hemaglutinaçäo indireta (HAI) e de aglutinaçäo direta com pré-tratamento com 2-mercaptoetanol (AD2ME). Em 179 casos, ambas as reaçöes sorológicas foram concordantemente positivas (74,6%). Em 35 casos (14,6%) as reaçöes sorológicas foram positivas com uma técnica e negativas com a outra, sendo que a repetiçäo de ambas as técnicas e/ou a realizaçäo das técnicas de imunofluorescência indireta (IFI) e de fixaçäo de complemento (FC), demonstraram finalmente a positividade destes 35 soros "duvidosos'. Conclui-se que 89,2% dos pacientes portadores de megaesôfago na amostra estudada apresentaram anticorpos anti-Trypanosoma cruzi, confirmando a sua etiologia chagásica. Nos restantes 26 casos (10,85) ambas as reaçöes foram concordantemente negativas. Esta ausência de anticorpos específicos foi confirmada por IFI e por FC. Em oito destes 26 casos, uma nova amostra de soro confirmou estes resultados. Em 24/26 casos, existiam antecedentes epidemiológicos de doença de Chagas, e em dois destes 24 casos houve confirmaçäo parasitológica (xenodiagnóstico positivo). O encontro de dois casos sorologicamente negativos com parasitas circulantes demonstra que a etiologia chagásica näo pode ser afastada, mesmo na ausência de anticorpos específicos, se existirem antecedentes epidemiológicos e indicadores clínicos da doença de Chagas
Subject(s)
Humans , Child , Adolescent , Adult , Middle Aged , Male , Female , Esophageal Achalasia/etiology , Chagas Disease/complications , Esophageal Achalasia/diagnosis , Agglutination , Chagas Disease/diagnosis , Complement Fixation Tests , Fluorescent Antibody Technique , Hemagglutination , Mercaptoethanol , Serologic TestsABSTRACT
Estoques de tripanossomas isolados de pacientes na fase aguda da doença de Chagas foram injetados em grupos de camundongos albinos não isogênicos nas doses de 10³, 10(4) e 10(5) parasitas/camundongos. O curso da infecção foi seguido por três meses. A pctrasitemia foi em geral baixa, com picos recorrentes, na maioria das vezes os animais evoluiam para cronicidade. Somente um estoque induziu alto índice de mortalidade. Os parasitas e as lesões apesar de detectadas no pico da parasitemia e restritos ao coração estavam ausentes aos três meses. Nesta época os perfis de Igs apresentaram diferenças marcantes. Grupos de animais que foram inoculados com estes estoques foram desafiados com doses letais da cepa Y ou CL. Em alguns casos obteve-se uma parasitemia, mas patente.
Ten stocks of trypanosomes isolated from patients at the acute phase of Chagas'disease were injected into groups of outbred normal mice at the doses of 10³, 10(4) and 10s5 parasites/mouse and the course of the infections followed up for 3 months. The parasitemia was usually low, with recurrent peaks, the animals evolving to chronicity, only one of them inducing high ratio of mortality. Pattems of parasitemia and mortality were essentially different for each stock studied; only one stock did show similar pattems to well known strains (Yand CL) commonly used in experimental work. Parasites and lesions, although detected at the peak of parasitemia and restricted to heart were absent after three months. At this period the Igs profiles showed striking differences with respect to their distribution. Groups of mice that had been inoculated with one of the stocks were challenged with the Y or CL strains. In some instances low parasitemias although patent were seen after the infecting dose.