Urban Chagas disease in children and women in primary care centres in Buenos Aires, Argentina

The primary objective of this study was to estimate the prevalence of this disease in women of childbearing age and children treated at health centres in underserviced areas of the city of Buenos Aires. Demographic and Chagas disease status data were collected. Samples for Chagas disease serology were obtained on filter paper and the reactive results were confirmed with conventional samples. A total of 1,786 subjects were screened and 73 positive screening results were obtained: 17 were from children and 56 were from women. The Trypanosoma cruziinfection risk was greater in those individuals who had relatives with Chagas disease, who remember seeing kissing bugs, who were of Bolivian nationality or were born in the Argentine province of Santiago del Estero. The overall prevalence of Chagas disease was 4.08%. Due to migration, Chagas disease is currently predominantly urban. The observed prevalence requires health programme activities that are aimed at urban children and their mothers. Most children were infected congenitally, which reinforces the need for Chagas disease screening of all pregnant women and their babies in Argentina. The active search for new cases is important because the appropriate treatment in children has a high cure rate.

Prevention of congenital Chagas through treatment of girls and women of childbearing age

It is currently unknown whether treatment of Chagas disease decreases the risk of congenital transmission from previously treated mothers to their infants. In a cohort of women with Chagas disease previously treated with benznidazole, no congenital transmission of the disease was observed in their newborns. This finding provides support for the treatment of Chagas disease as early as possible.

Anti-M2 muscarinic receptor autoantibodies in Trypanosoma cruzi-infected pediatric patients treated with benznidazole

La presencia de autoanticuerpos con actividad adrenérgica y colinérgica, capaces de modificar la actividad de los receptores a neurotransmisores, ha sido asociada a la patogénesis de la Miocardiopatia chagásica. Hemos investigado la existencia de autoanticuerpos contra receptores muscarínicos M2 en la fracción IgG de 14 pacientes pediátricos con Enfermedad de Chagas y en 18 controles no infectados. Encontramos una mayor frecuencia y un incremento de 6,2 mais ou menos 1,8 veces en el nivel de autoanticuerpos contra receptores cardíacos en los niños infectados con T. cruzi respecto de los controles no infectados. Luego del tratamiento parasiticida específico, los pacientes fueron evaluados prospectivamente, comprobándose una tendencia lineal descendente significativa en la reactividad de estos autoanticuerpos. Al producirse la seroconversión negativa para T. cruzi como consecuencia directa del tratamiento, los pacientes presentaron títulos de autoanticuerpos contra receptores cardíacos similares a los detectados en los niños no infectados. Concluimos que en pacientes pediátricos la respuesta de autoanticuerpos contra receptores muscarínicos M2 se manifesta tempranamente en el curso de la infección con T. cruzi y decrece después de la quimioterapia especifica. Por lo tanto, la administración de BZ a estos pacienes no sólo sería efectiva para eliminar el parásito sino también para reducir respuestas autoinmunes potencialmente patogénicas.