Prevalence of Trypanosoma cruzi infection in pregnant Latin American women and congenital transmission rate in a non-endemic area: the experience of the Valencian Health Programme (Spain).

This study describes the results of the health programme implemented in the Valencian Community (Spain) to achieve an early diagnosis of Chagas disease in pregnant Latin American women and their newborns. During 2009 and 2010, 1975 women living in the health districts of three university hospitals were enrolled via midwives or at the time of delivery. Diagnosis of disease was performed using two serological tests with different antigens. Congenital infection was diagnosed by parasitological, molecular or serological methods from blood samples obtained at birth or in subsequent controls. The overall seroprevalence of Chagas infection in pregnant women from 16 different endemic countries was 11·4%. Infection was higher in those from countries in the Gran Chaco Region (Bolivia, 34·1%; Paraguay, 7·4%; Argentina, 5·3%). Eight newborn infants from Bolivian mothers had congenital Chagas which represents a vertical transmission rate of 3·7%. In conclusion, this work supports the benefits of offering an early diagnosis to pregnant women and newborns during routine prenatal healthcare.

[Invasive pneumococcal disease in children in the Community of Valencia, Spain]. / Enfermedad neumocócica invasiva en la población infantil de la Comunidad Valenciana.

OBJECTIVE: Pneumococcal disease is an important cause of morbidity and mortality in children. The recent authorization of the heptavalent conjugate vaccine has increased interest in this disease. The objective of this study was to identify the epidemiological and clinical characteristics of this disease, as well as its outcome in the pediatric population of the Autonomous Community of Valencia. METHOD: Data were obtained from the medical records of children aged less than 15 years who were positive for pneumococcus isolation on admission to hospital between 1996 and 2000. All the public hospitals of the Autonomous Community of Valencia were included. Changes in incidence were evaluated by comparing rates and outcomes (sequelae and lethality) through frequency and age distribution. RESULTS: One hundred twenty-seven cases were registered, giving a mean annual rate of 3.89/105 inhabitants aged less than 15 years. The rate was 20.14 in children aged less than 2 years. A total of 29.1% of the children had previous health problems. The main clinical manifestations included sepsis/bacteremia (38%), pneumonia (31%) and meningitis (24%). At discharge sequelae were present in 10 children, 75% of whom were aged less than 2 years. Eight children died (6.3% lethality). CONCLUSIONS: In the period and region studied, pneumococcal infection was present mainly in children aged less than 2 years and in those with previous health problems. In the last few years, mortality has increased. Thus, inclusion of pneumococcal disease in the epidemiological surveillance system would be appropriate to achieve more precise estimations of its epidemiological patterns and to determine whether the conjugate vaccine represents a solution to the problems currently associated with this bacteria.

[The coverage of vaccines systematically administered and of a vaccine against Haemophilus influenzae type b prior to its inclusion in the vaccinal calendar in the Valencian Community]. / Cobertura de las vacunas administradas sistemáticamente y de la vacuna frente a Haemophilus influenzae tipo b previa a su incorporación al calendario vacunal en la Comunidad Valenciana.

OBJECTIVE: The objective of this study was to estimate the vaccine coverage among children two years of age in the Community of Valencia, Spain, in 1997. PATIENTS AND METHODS: Cluster sampling was used to assess vaccine coverage. Clusters were villages randomized according to their population < 5 years of age. At least 7 children of each of the 30 selected clusters were randomly selected from the database of newborn metabolic screening. Parents were contacted and vaccine registration cards requested by mail. RESULTS: Four hundred forty subjects were selected. Eight percent of the families had moved and were not contacted. Sixty-nine percent participated in the study. Coverage for three doses of DTP was 97.8% and 87.6% for four doses. MMR vaccine coverage was 96.6% and three doses of hepatitis B had been given in 95.1%. H. influenzae type b (Hib) vaccine coverage was 57%. In 70% of the studied cases of non-participants, vaccine coverage was known through vaccination centers and was very similar to that of the participants. CONCLUSIONS: Vaccine coverage in the Community of Valencia is high for the scheduled vaccines. Although Hib is not a scheduled vaccination, its coverage was 57%.

[Infantile diarrhea: knowledge and attitudes of mothers at a primary care center]. / Diarrea en la infancia: conocimientos y actitudes de las madres en un centro de atención primaria.

OBJECTIVE: To study the knowledge and attitudes of mothers at a health centre to babies' diarrhoea. DESIGN: A crossover, observational and prospective study. SETTING: Paediatrics clinic at a health centre in the city of Valencia. PARTICIPANTS: 142 mothers who attended the clinic of their own accord. MEASUREMENTS AND MAIN RESULTS: The mothers themselves filled out a questionnaire on what diarrhoea was, its causes, hygiene measures to prevent it and their response when it appeared. 80.3% accurately defined diarrhoea. 94.4% recognised that micro-organisms were the cause. All mothers of unweaned babies not being breast-fed sterilised the feeding bottle adequately and had a proper water-supply. 89.4% said they washed correctly both hands and food before handling food. Although 89.4% knew they should give more liquid to their babies during diarrhoea, only 24.6% used an adequate oral rehydrating solution and 24.2% said they made their babies fast for long periods. Most said they would consult the doctor if their baby had diarrhoea (79.6%) and would go back to the doctor if they noticed complications (96.5%). CONCLUSIONS: Mothers attending a health centre in Valencia had a good attitude to diarrhoea prevention. They often committed errors in oral rehydration and feeding of a baby with diarrhoea, which might cause problems. However their frequent attendance at the doctor's may help avoid these problems.

[Ureaplasma urealyticum and Mycoplasma hominis: incidence and clinical significance of their isolation in the perinatal period]. / Ureaplasma urealyticum y Mycoplasma hominis: frecuencia y significado clínico de su aislamiento en el período perinatal.

In order to known the clinical significance of the colonization of the maternal genitalia and infant with genital mycoplasmas, we studied prospectively 219 pairs of mothers and newborns admitted for delivery to a general public hospital. U. urealyticum and M. hominis were isolated from 72 (32.9%) and 10 (4.6%) of the mothers, respectively. During the first 4 days of life. U. urealyticum and M. hominis were isolated from 23 (10.5%) and 1 (0.5%), of the newborn infants respectively. Maternal colonization by genital mycoplasmas was not associated with a longer duration of membrane rupture, nor with a shorter gestational age, nor with smaller neonatal weight and length. Neonatal colonization by U. urealyticum was not associated with shorter gestational age, nor with smaller birth weight and length, nor with the appearance of any disease during the first 3 months of life.

[Present-day status of glycogenosis Ib. Report of a new case]. / Estado actual de la glucogenosis Ib. Aportación de un nuevo caso.

A four-month-old boy affected by glycogen storage disease type I is presented. The child suffered from hepatomegaly, lactic acidosis, fasting hypoglycemia and failure to thrive. He had repeated infectious and cyclic neutropenia. Immunoglobulin and chemotactic neutrophil motility was impaired. Liver biopsy showed increased amounts of glycogen in hepatic cells as assessed by morphological and biochemical grounds. The activity of glucose-6-phosphatase as well as other glycogenolytic enzymes was normal in the frozen liver. The aforementioned characteristics suggested the diagnosis of glycogen storage disease type Ib. The child was first treated by enteral continuous feeding and later on by frequent meals during the daytime and enteral continuous feeding during the night time, improving the hypoglycemia as well as the other biochemical and metabolic abnormalities.

[Beuren-Williams syndrome: study of 20 cases]. / Síndrome de Beuren-Williams: estudio de 20 casos.

Beuren-Williams syndrome is characterized by elfin face, mental retardation in addition to cardiovascular lesions, which consist in supravalvular aortic stenosis and peripheral pulmonary stenosis. Twenty patients having this syndrome are reported with special emphasis on their cardiovascular abnormalities.