Screening and congenital transmission of Chagas Disease in the user population of the Dr. Felix Bulnes Cerda Hospital and Primary Health Care Services of the Metropolitan Health Service West of Santiago, Chile

Abstract

Background: In 2016, the Hospital Dr. Felix Bulnes Cerda (HDFBC) implemented the mandatory screening of anti Ttypanosorna cruzi antibodies in pregnant women, thus complying with national regulations to detect new Chagas disease cases (CHD) in mother and child, whose early detection mediates timely pharmacological treatment. This, because the congenital transmission continues the main active transmission mechanisms of T. cruzi and a major public health problem for the country. Aim: To present the epidemiological information generated after the implementation of the ECH screening in the SSFCC HFBC, two years after its operation began. Methods: Screening test: inmunequimioluminiscence (IQLU), certification by IFI, ELISA and/or western blot. Follow up of newborn infants with PCR, IFI, ELISA and IQLU. Results: Between April 2016 and july 2018, 14.012 subject's samples were examined of which 62 resulted reactive (0.53% seropositivity) in the total studied population where 28 patients resulted positive for CHD, which corresponds to a 0.2% prevalence. Of the total population, 11.780 were pregnant. women, of these 41 were reactive and 10 were confirmed with CHD thus showing a prevalence of 0.085%. The other 18 positive cases of non-pregnant patients corresponded a prevalence of 0.81%. Also, 10 newborn and infant children of mothers with CHD were followed up. In all, congenital transmission (0%) was ruled out. Nifurtimox treatment of the mothers were completed in 30% of them. It is concluded that the implementation of the program in the HDFBC fulfills the objectives of screening, detection and diagnosis of CHD, so as the timely follow-up and phannacologic treatment of the newborn. The 0.085% prevalence of CHD in pregnant women as the 0.20% in total population are significantly lower (p-valor < 0.01) than the 0.7% reported in 2016 for the Metropolitan Region (MR), a fact that we suggest is a consequence of the national program implementation. Likewise, the 0% transpLacental transmission is accorded to the rate of 0.91 x 10.000 live births reported in 2017 for the MR. Based on the learning acquired during the development of the research, recommendations are given to contribute to the operation of the program.

Más información

Título según WOS: Screening and congenital transmission of Chagas Disease in the user population of the Dr. Felix Bulnes Cerda Hospital and Primary Health Care Services of the Metropolitan Health Service West of Santiago, Chile
Título según SCIELO: Cribado y transmisión congénita de la enfermedad de Chagas en población usuaria del Hospital Dr. Félix Bulnes Cerda y Atención Primaria de Salud del Servicio de Salud Metropolitano Occidente de Santiago, Chile
Título de la Revista: REVISTA CHILENA DE INFECTOLOGIA
Volumen: 37
Número: 2
Editorial: SOC CHILENA INFECTOLOGIA
Fecha de publicación: 2020
Página de inicio: 129
Página final: 137
Idioma: es
DOI:

10.4067/S0716-10182020000200129

Notas: ISI, SCIELO - SCIELO