Towards a new strategy for diagnosis of congenital Trypanosoma cruzi infection

Alba Abras, Carmen Muñoz, Cristina Ballart, Pere Berenguer, Teresa Llovet, Mercedes Herrero, Silvia Tebar, María Jesús Pinazo, Elizabeth Posada, Carmen Martí, Victoria Fumadó, Jordi Bosch, Oriol Coll, Teresa Juncosa, Gemma Ginovart, Josep Armengol, Joaquim Gascón, Montserrat Portús, Montserrat Gállego

Research output: Contribution to journalArticleResearchpeer-review

13 Citations (Scopus)

Abstract

Copyright © 2017 American Society for Microbiology. All Rights Reserved. The immigration of Latin American women of childbearing age has spread the congenital transmission of Chagas disease to areas of nonendemicity, and the disease is now a worldwide problem. Some European health authorities have implemented screening programs to prevent vertical transmission, but the lack of a uniform protocol calls for the urgent establishment of a new strategy common to all laboratories. Our aims were to (i) analyze the trend of passive IgG antibodies in the newborn by means of five serological tests for the diagnosis and follow-up of congenital Trypanosoma cruzi infection, (ii) assess the utility of these techniques for diagnosing a congenital transmission, and (iii) propose a strategy for a prompt, efficient, and cost-effective diagnosis of T. cruzi infection. In noninfected newborns, a continuous decreasing trend of passive IgG antibodies was observed, but none of the serological assays seroreverted in any the infants before 12 months. From 12 months onwards, serological tests achieved negative results in all the samples analyzed, with the exception of the highly sensitive chemiluminescent microparticle immunoassay (CMIA). In contrast, in congenitally infected infants, the antibody decline was detected only after treatment initiation. In order to improve the diagnosis of congenital T. cruzi infection, we propose a new strategy involving fewer tests that allows significant cost savings. The protocol could start 1 month after birth with a parasitological test and/or a PCR. If negative, a serological test would be carried out at 9 months, which if positive, would be followed by another at around 12 months for confirmation.
Original languageEnglish
Pages (from-to)1396-1407
JournalJournal of Clinical Microbiology
Volume55
Issue number5
DOIs
Publication statusPublished - 1 May 2017

Keywords

  • Congenital chagas disease
  • Countries of endemicity
  • Europe
  • Flowchart
  • Immigrant population
  • Serology
  • Spain

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