Epidemiology of congenital chagas disease 6 years after implementation of a public health surveillance system, Catalonia, 2010 to 2015
Basile, Luca (Servei Català de la Salut)
Ciruela, Pilar (Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública)
Requena-Méndez, Ana (Barcelona Institute for Global Health (ISGlobal))
José Vidal, M. A. (Servei Català de la Salut)
Dopico, Eva (Laboratori Clínic de l'Hospitalet. Hospitalet de Llobregat)
Martín-Nalda, Andrea (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Sulleiro Igual, Elena (Hospital Universitari Vall d'Hebron)
Gascon, Joaquim (Barcelona Institute for Global Health (ISGlobal))
Jané i Checa, Mireia (Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública)
Universitat Autònoma de Barcelona

Data:	2019
Resum:	Background: Chagas disease is endemic in Latin America and affects 8 million people worldwide. In 2010, Catalonia introduced systematic public health surveillance to detect and treat congenital Chagas disease. Aim: The objective was to evaluate the health outcomes of the congenital Chagas disease screening programme during the first 6 years (2010-2015) after its introduction in Catalonia. Methods: In a surveillance system, we screened pregnant women and newborns and other children of positive mothers, and treatedChagas-positive newborns and children. Diagnosis was confirmed for pregnant women and children with two positive serological tests and for newborns with microhaematocrit and/or PCR at birth or serology at age 9 months. Results: From 2010 to 2015, the estimated screening coverage rate increased from 68. 4% to 88. 6%. In this period, 33,469 pregnant women were tested for Trypanosoma cruzi and 937 positive cases were diagnosed. The overall prevalence was 2. 8 cases per 100 pregnancies per year (15. 8 in Bolivian women). We followed 82. 8% of newborns until serological testing at age 9-12 months and 28 were diagnosed withChagas disease (congenital transmission rate: 4. 17%). Of 518 siblings, 178 (34. 3%) were tested and 14 (7. 8%) were positive for T. cruzi. Having other children with Chagas disease and the heart clinical form of Chagas disease were maternal risk factors associated with congenital T. cruzi infection (p < 0. 05). Conclusion: The increased screening coverage rate indicates consolidation of the programme in Catalonia. The rate of Chagas disease congenital transmission in Catalonia is in accordance with the range in non-endemic countries.
Ajuts:	Instituto de Salud Carlos III RD16-0027-0004 Agència de Gestió d'Ajuts Universitaris i de Recerca 2017/SGR-924 Agència de Gestió d'Ajuts Universitaris i de Recerca 2017/SGR-1342
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Chagas disease ; Trypanosoma cruzi ; Congenital ; Public health ; Screening ; Surveillance system ; Vertical transmission
Publicat a:	Eurosurveillance, Vol. 24 Núm. 26 (2019) , p. 1900011, ISSN 1560-7917

DOI: 10.2807/1560-7917.ES.2019.24.26.19-00011
PMID: 31266591

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