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October 24, 2023
En los medios

Why diagnosis of Chagas disease among pregnant women and new-borns is crucial for preventing severe consequences.

 

Chagas disease affects nearly 8 million people in the world. One of the main transmission routes is from mother to child during pregnancy. A recent study recommends early detection to prevent this transmission mode.

El diagnóstico de Chagas en mujeres embarazadas y recién nacidos es una medida preventiva que puede salvar vidas

Chagas disease affects between 6 and 8 million people in the world, of which 1.2 million are women of childbearing age. Estimates indicate that 9,000 babies become annually infected through congenital transmission.

In Argentina, there are 1.6 million infected people, and 7 million people are at risk of becoming infected with the disease. For this reason, it is a public health problem that continues to cause concern. Approximately 1,200 babies are annually reported to be born with this disease, and most of them do not have access to proper diagnosis and treatment, according to Mundo Sano Foundation.

A study recently published in the International Journal of Gynecology & Obstetrics highlighted the need to implement monitoring protocols to reduce the risk of mother-to-child transmission of Chagas disease. The paper suggests the implementation of screening and diagnosis of both pregnant women and new-borns to avoid mother-to-child transmission.

The study was conducted by several prestigious institutions from both Argentina and Spain, including Mundo Sano Foundation and the Palacios Institute of Women’s Health, the Microbiology and Parasitology Service, University Hospital Virgen de la Arrixaca, Murcia University (Spain), Obstetrics and Gynaecology Service, University Hospital of Guadalajara, Gynaecology and Obstetrics Alcala de Henares (Spain), Centre for Microbiology, Instituto de Salud Carlos III (Spain),  Department of Obstetrics and Gynecology, Alcala de Henares University, Ramon y Cajal Hospital (Spain).

Es una enfermedad endémica en algunas regiones de América Latina, donde afecta a millones de personas. Uno de las formas de transmisión es por el insecto vector, la vinchuca

Congenital transmission of Chagas disease is currently considered the main route of spread of this disease. Research works indicate that the risk of mother-to-child transmission ranges between 5% and 12%, being particularly high in regions where the disease is endemic.

Although Chagas disease can be asymptomatic, it can be transmitted during any of its phases, either the acute or the chronic phase. Since 2002, the World Health Organization (WHO) has recommended diagnosis of Chagas disease in women and new-borns that live or come from regions with records of vector-borne transmission, i.e., through insects.

To identify asymptomatic patients, it is essential to increase visibility and education about the disease. This not only benefits the people at risk of infection, but also reinforces the formation of primary care teams. Family doctors, paediatricians and gynaecologists play a crucial role in this process.

Monitoring babies born to mothers infected with Chagas disease is key, especially if the diagnosis is negative at birth. These babies must be monitored during the first nine months of life. After the first year, it is necessary to test those children that come from endemic zones or whose mothers have Chagas disease and were not monitored before.

El Chagas es una de las consideradas enfermedades olvidadas, que necesita más atención e inversión por parte de los gobiernos y las organizaciones de salud (ProyectoChagas)

Although 80% of the new-borns infected with Chagas disease are asymptomatic, it is crucial to rule out the presence of signs and symptoms of the acute phase. If not treated properly, the disease can become chronic; 30% of the patients develop organic abnormalities, which increases the risk of premature death and severe disability.

Marcelo Abril, executive officer of Mundo Sano Foundation, highlighted the importance of focusing on women of childbearing age to make early diagnosis and provide suitable treatment.

Chagas disease, caused by the microorganism Trypanosoma Cruzi, is transmitted mainly by the bite of the triatomine insect known as vinchuca, through blood transfusion or organ transplantation, and during pregnancy or childbirth. Although it is endemic in 21 Latin American countries, of which Argentina, Bolivia, Brazil, Colombia and Mexico have the highest number of affected people, mother-to-child transmission has caused its spread to other regions and continents.

Mundo Sano stated that successful active search of asymptomatic patients requires visibility, dissemination and education to both make the potentially affected people aware of the disease and encourage the formation of primary health care teams, in which the active role of family doctors, paediatricians and gynaecologists is vital to ensure universal access to health care for people affected by this disease.

Una mujer embarazada se somete a una prueba en el marco de un control de Chagas, ya que la enfermedad puede transmitir al bebé

The mentioned study considers it essential to start treatment in new-borns as soon as Chagas disease is diagnosed. This is because of the high rate of cure demonstrated by parasitological and immunological studies, which reaches between 90% and 100% of the cases if treatment is started during the first year of life. Once a pregnant woman is diagnosed with the disease, diagnosis should be extended to the family group, siblings and parents.

“It is known that a woman that was treated before she becomes pregnant does no longer transmit Chagas disease, and there are several cases of mothers that had their first child, and even more than one, positive and that after being treated, they had a baby without Chagas disease. For this reason, it is important to focus on that woman of childbearing age who is still not planning to have a child, to make timely diagnosis and, if she tests positive, provide treatment, since it has been demonstrated that it is a control action for the potential Chagas disease cases of mother-to-child transmission”, stated Abril.

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