Paediatric Chagas' disease in a non-endemic area
Abstract number: P1487
Aguilar A.C., Juncosa T., Gené A., Fumadó V.
Objectives: Until the middle of the 20th century Chagas' disease was confined to the rural area in Central and South America, but after industrialization country people moved to the cities taking with them culture and diseases, among others Chagas' disease.
Nowadays, the increase of migration from this countries to non-endemic areas such as USA and Europe has introduced among our paediatric population some patients infected by T. cruzi, either in their original country or in ours trough vertical transmission from their mothers.
The aim of this study was to describe the cases of children with Chagas' disease admitted in our Imported Pathology Unit during the last six years (20032008).
Methods: All patients coming from endemic areas, and newborns from Chagas' disease seropositive pregnant women were studied by two ELISA tests (Bioelisa Chagas BiokitR with recombinant antigens and in-house ELISA with complete antigens). Patients with available sample were also screened by nested PCR (TCZ3/Z4). In the seroreactive patients younger than one year old the ELISA test were done again up to 12 month old, in order to demonstrate vertical transmition if antibodies persist. Confirmed cases received Benznidazol as a treatment (810 mg/Kg/day, during 60 days). Both PCR and specific antibodies must be negative in order to demonstrate the effectiveness of treatment.
Results: Screening was performed in 202 patients from one day to 14 years old (157 were immigrants and 45 were born in Spain). Forty three of them (30 younger than one year old) were seroreactive in both ELISA tests (21.2%). We performed forty PCR tests, which were positive in ten cases. In 18 patients Chagas' disease were diagnosed. In seven of them, who were born in our country, vertical transmission was demonstrated. All 18 patients were treated. In five cases the specific antibodies become negative and demonstrated the healing. Follow up is in course in eleven of the seroreactive patients. Two patients didn't continue attending our hospital.
Conclusion: Taking into account the possible severity of Chagas' disease, the effectiveness of the treatment in the first years of live and the incidence in paediatric immigrate population from Central and South America found in our study, we suggest the systematical serologic screening in this population.
|Session name:||Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Vienna, Austria, 10 - 13 April 2010|
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