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Congenital Chagas Disease

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Chagas Disease

Part of the book series: Birkhäuser Advances in Infectious Diseases ((BAID))

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Abstract

Congenital infection with Trypanosoma cruzi is a global problem, occurring on average in 5% of children born from chronically infected mothers, with variations depending on the region. In endemic areas with inadequate vector control, Chagas disease, also known as American trypanosomiasis, is usually a vector-borne disease. In areas with effective vector control and in urban areas, the main route of new cases of CD is through mother-to-child transmission. The estimated number of new cases of congenital T. cruzi infection is 8668 cases/year [2]. This is also the case of non-endemic countries where, due to population migration, CD is increasingly becoming a public health problem in non-endemic settings. The majority of infected infants are asymptomatic, and the diagnosis is based on the microscopic observation of the parasite in the blood of newborns and by serology in infants older than 8 months of age when maternal transplacental antibodies have waned. Two drugs are available for treatment, benznidazole and nifurtimox. Treatment should be implemented immediately after diagnosis since the sooner the infection is treated, the better the prognosis. The treatment efficacy is around 95% in different cohorts with a good drug safety profile. Recent studies have shown that its transmission can be prevented through treatment of infected women before they become pregnant. Considering that etiological treatment of the child is highly effective if performed before 1 year of age, the diagnosis of infection in pregnant women and their newborns has to become the standard of care and integrated into the surveillance programs of syphilis and human immunodeficiency virus.

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Authors and Affiliations

  1. Servicio de Parasitología y Enfermedad de Chagas, Hospital de Niños “Ricardo Gutiérrez”, Buenos Aires, Argentina

    Jaime Marcelo Altcheh

  2. Instituto Multidisciplinario de Investigación en Patologías Pediátricas (IMIPP-GCBA), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina

    Jaime Marcelo Altcheh

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  1. Servicio de Parasitología y Enfermedad de Chagas, Hospital de Niños “Ricardo Gutiérrez”, Buenos Aires, Argentina

    Jaime Marcelo Altcheh

  2. Servicio de Parasitología y Enfermedad de Chagas, Hospital de Niños “Ricardo Gutiérrez”, Buenos Aires, Argentina

    Hector Freilij

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Altcheh, J.M. (2019). Congenital Chagas Disease. In: Altcheh, J., Freilij, H. (eds) Chagas Disease. Birkhäuser Advances in Infectious Diseases. Springer, Cham. https://doi.org/10.1007/978-3-030-00054-7_9

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