Congenital Chagas disease: current diagnostics, limitations and future perspectives

@article{Messenger2018CongenitalCD,
  title={Congenital Chagas disease: current diagnostics, limitations and future perspectives},
  author={L. Messenger and C. Bern},
  journal={Current Opinion in Infectious Diseases},
  year={2018},
  volume={31},
  pages={415–421}
}
Purpose of review Congenital transmission is an important route of Trypanosoma cruzi infection, both in Latin America and internationally, with considerable populations of infected women of child-bearing age residing in the United States and Europe. This review examines recent literature on congenital Chagas disease, with a focus on the changing clinical spectrum and potential new diagnostic tools. Recent findings Vertical transmission occurs in approximately 5–10% of births from T. cruzi… Expand
Congenital transmission of Chagas disease in a non-endemic area, is an early diagnosis possible?
TLDR
The VT rate is in keeping with literature and confirms the need to carry out a screening in pregnant women coming from endemic areas and PCR seems to be a useful tool to provide early diagnosis of congenital CD. Expand
Congenital Chagas disease: progress toward implementation of pregnancy-based screening
TLDR
Ongoing efforts to implement routine pregnancy-based screening for congenital Chagas disease in nonendemic regions will mutually benefit infants, their mothers and family members and can prevent potentially fatal ChagAs cardiomyopathy. Expand
Trypanosoma cruzi Infection at the Maternal-Fetal Interface: Implications of Parasite Load in the Congenital Transmission and Challenges in the Diagnosis of Infected Newborns
TLDR
Improvements in detection of this parasite, with tools that can be easily adapted to be used in remote rural areas, will make the early diagnosis of infected children possible, allowing a prompt trypanocidal treatment and avoiding the current loss of opportunities for the diagnosis of 100% of T. cruzi congenitally infected infants. Expand
Trypanocidal treatment of Chagas disease.
TLDR
This review focuses on the aspects that allow clinicians to make the best use of currently available drugs for chagas disease, and discusses new therapeutic options and ongoing research in the field. Expand
Risk Factors for Maternal Chagas Disease and Vertical Transmission in a Bolivian Hospital.
TLDR
Older maternal age, family history of Chagas disease, home conditions, lower education level, and history of living in a rural area were significantly associated with higher adjusted odds of maternal infection. Expand
Epidemiology and pathogenesis of maternal-fetal transmission of Trypanosoma cruzi and a case for vaccine development against congenital Chagas disease.
TLDR
The pathogenesis of maternal-fetal transmission of Tc is discussed, a justification for the investment in the development of vaccines against congenital CD is provided and newborns can be cured if they are diagnosed and given treatment in a timely manner. Expand
The Clinical and Parasitologic Follow-up of Trypanosoma cruzi–infected Children in a Nonendemic Country
TLDR
Effectiveness and safety of treatment were optimum in ≤1-year-old children, and increased side effects, cardiac and/or digestive disorder incidence and lower treatment effectiveness were detected in older children, highlighting the need for early screening. Expand
Congenital Chagas Disease: development and assessment of a specific IgM capture-based assay for diagnosis of transmission.
TLDR
The results indicate that this capture-based technique employing CP4 Ag can certainly improve the diagnosis of connatal infection and suggest its potential clinical relevance in term of post-test probability of infection. Expand
Chagas Disease in the United States: a Public Health Approach
TLDR
Making progress will require efforts to improve awareness among providers and patients, data on diagnostic test performance and expanded availability of confirmatory testing, and evidence-based strategies to improve access to appropriate management of Chagas disease in the United States. Expand
Congenital Chagas disease: Updated recommendations for prevention, diagnosis, treatment, and follow-up of newborns and siblings, girls, women of childbearing age, and pregnant women
TLDR
This article summarizes the recommendations of the WHO Technical Group on “Prevention and Control ofCongenital Transmission and Case Management of Congenital Infections with Trypanosoma cruzi” and updates and completes the recommendations previously published in 2011 by the Technical Group. Expand
...
1
2
3
...

References

SHOWING 1-10 OF 59 REFERENCES
Toward Improving Early Diagnosis of Congenital Chagas Disease in an Endemic Setting
  • L. Messenger, R. Gilman, +14 authors C. Bern
  • Medicine
  • Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 2017
TLDR
The proportion of T. cruzi-infected infants with clinical signs has fallen since the 1990s, but symptomatic congenital Chagas disease still represents a significant, albeit challenging to detect, public health problem. Expand
Congenital transmission of Chagas disease - Virginia, 2010.
TLDR
The first case of congenital Chagas disease in the United States confirmed by CDC is described and the importance of raising awareness of ChagAs disease among health-care providers is highlighted. Expand
Acute and congenital Chagas disease.
TLDR
A sensitive, specific and practical screening test for newborns is needed to enable Chagas disease to be added to newborn screening programs. Expand
[Screening for congenital infection by Trypanosoma cruzi in France].
The importance of congenital transmission of Chagas' disease increases with its emergence in communities infected with Trypanosoma cruzi, but where vector transmission has never existed or is fullyExpand
Risk factors and primary prevention of congenital Chagas disease in a nonendemic country.
TLDR
PCR is a useful tool for the detection of congenital CD, and the treatment of infected women of childbearing age seems to be useful for preventing vertical transmission. Expand
Between a bug and a hard place: Trypanosoma cruzi genetic diversity and the clinical outcomes of Chagas disease
TLDR
This article systematically reviews the historical literature, given the current understanding of parasite genetic diversity, to evaluate the evidence for any association between T. cruzi genotype and chronic clinical outcome, risk of congenital transmission or reactivation and orally transmitted outbreaks. Expand
Early diagnosis of congenital Trypanosoma cruzi infection, using shed acute phase antigen, in Ushuaia, Tierra del Fuego, Argentina.
TLDR
Results show that for infants younger than 30 days of age, matched blood samples from mother and infant were capable of identifying congenital transmission of infection using an enzyme-linked immunosorbent assay with SAPA, and for infants older than 3 months, congenital infection could be ruled out using the same procedure. Expand
Trypanocide Treatment of Women Infected with Trypanosoma cruzi and Its Effect on Preventing Congenital Chagas
TLDR
The trypanocidal treatment of women with chronic Chagas infection was effective in preventing the congenital transmission of Trypanosoma cruzi to their children; it had also a protective effect on the women's clinical evolution and deparasitation could be demonstrated in many treated women after over 10 years of follow up. Expand
Congenital transmission of Trypanosoma cruzi in central Brazil. A study of 1,211 individuals born to infected mothers
TLDR
This is the first report to show geographical differences in the rates of congenitals transmission of T. cruzi and the relationship between the prevalence of congenital transmission and the type of Tc prevalent in each region. Expand
Congenital Transmission of Trypanosoma cruzi in Argentina, Honduras, and Mexico: An Observational Prospective Study.
TLDR
Trypanosoma cruzi non-TcI predominated and risks of congenital transmission were similar in Argentina and Mexico, and genotyping identified a majority of non-tcI in the three countries. Expand
...
1
2
3
4
5
...