Prevention of congenital Chagas disease by Benznidazole treatment in reproductive-age women. An observational study
Prevention of congenital Chagas disease by Benznidazole treatment in reproductive-age women. An observational study
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DOI：
10.1016/j.actatropica.2017.07.004
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发表时间：
2017-10-01
期刊：
影响因子：
2.7
通讯作者：
Viotti, Rodolfo
中科院分区：
文献类型：
--
作者：
Alvarez, Maria G.;Vigliano, Carlos;Viotti, Rodolfo
由于昆虫/媒介感染的新病例减少，先天性恰加斯病在恰加斯病的传播中变得更加重要。苯并硝唑治疗可显着减少寄生虫血症，这是与垂直传播相关的重要因素。本研究的目的是评估先前对育龄妇女进行苯并硝唑治疗是否可以预防或减少先天性恰加斯病新病例的发生率。我们中心设计了一项历史队列研究，纳入了所有育龄妇女（15-45 岁）。我们纳入了 67 名患有慢性恰加斯病的母亲； 35 名妇女在怀孕前未接受过治疗，15 名妇女在怀孕前接受过治疗，17 名妇女在苯并硝唑治疗前后分娩。8 名母亲生下了 16 名患有先天性恰加斯病的孩子（8/67，12%）。先天性恰加斯病的患病率为 16/114 (14%) 未接受治疗的母亲所生的儿童和 0/42 (0%) 接受苯并硝唑治疗的母亲所生的儿童，p = 0.01。在出生患有先天性恰加斯病的孩子和未出生的孩子的母亲之间，在临床、血清学、流行病学或社会经济基线变量方面没有观察到显着差异。经过长期随访，在接受苯并硝唑治疗的女性中观察到血清学阴性的转化率为 32%。对育龄妇女进行抗寄生虫治疗可以预防先天性恰加斯病的发生。
Since the decline in new cases of infection by insect/vector, congenital Chagas disease has become more relevant in the transmission of Chagas disease. Treatment with benznidazole significantly reduces the parasitemia, which constitutes an important factor linked to vertical transmission. The objective of this study was to evaluate whether treatment with benznidazole previously administered to women of childbearing age can prevent or reduce the incidence of new cases of congenital Chagas disease. An historical cohort study that included all women in reproductive age (15-45 years) assisted in our center was designed. We included 67 mothers with chronic Chagas disease; 35 women had not been treated prior to pregnancy, 15 had been treated prior to pregnancy and 17 gave birth prior and after treatment with benznidazole.Eight mothers gave birth to 16 children with congenital Chagas disease (8/67, 12%). The prevalence of congenital Chagas was 16/114 (14%) children born to untreated mothers and 0/42 (0%) children born to benznidazole- treated mothers, p = 0.01. No significant differences were observed in clinical, serologic, epidemiological or socioeconomic baseline variables between mothers with and without children born with congenital Chagas. A 32% conversion rate to negative serology was observed in benznidazole-treated women after long-term follow up. Antiparasitic treatment administered to women in reproductive age can prevent the occurrence of congenital Chagas disease.