Chagas disease in pregnant women from Amazon region, Brazil and control perspectives to potential vertical transmission
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Instituto Evandro Chagas, Ministério da Saúde do Brasil, Belém, Pará, Brazil
Instituto Evandro Chagas, Ministério da Saúde do Brasil, Brazil
Instituto Evandro Chagas Ministério da Saúde do Brasil, Brazil
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A1062
Chagas disease is an anthropozoonosis of tropical areas. Brazil, specially in Amazon region concentrates several cases at endemic levels and is an active focus of transmission, increased by environmental disturbances and exposure to vectors. The most frequent transmission, through the oral route provides high parasitic loads facilitating vertical transmission in affected pregnant women and, therefore, increasing the potential to vertical transmission. We describe a series of cases of pregnant women with Chagas disease (CD) and their pregnancy outcomes. This is a descriptive, cross-sectional, case series study in a clinical cohort of follow-up with pregnant women registered as confirmed cases of CD treated in the Chagas Disease Protocol of the Medical Care Department of Instituto Evandro Chagas – IEC during January 2009 to December 2019. Twenty-two pregnants with Chagas disease were included in the study, with two aproachs: 36% (8/22) of them were diagnosed in acute phase Group 1-G1) and 64% (14/22) were submitted to serological follow-up after treatment before the pregnancy and, therefore, asymptomatic actually (Group 2-G2). Among the G1 complications of mothers during pregnancy, there was one (1) threateneed miscarriage, one (1) diagnosis of acute Chagas heart disease and one (1) mother’s death was registered in the 40th week, which was not submitted to necropsy. At the end of the pregnancy, four (4/22; 18,2%) children were diagnosed with congenital Chagas disease by serological criterion. Comparatively, 75% of children with Congenital infection were born from mothers diagnosed in the acute phase (G1) and one (1) child from mother with asymptomatic infection (G2) was affected. The authors discuss the need to effort new tools for the precoucious diagnosis both in pregnant women and their new-borns and immediate access to the treatment with emphasis to pregnant women during acute phase of Chagas disease.
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