Acute and Congenital Chagas Disease

Caryn Bern, Diana L. Martin, Robert H. Gilman

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

The acute phase of Chagas disease lasts 4-8 weeks and is characterized by microscopically detectable parasitaemia. Symptoms are usually mild with severe acute disease occurring in less than 1% of patients. Orally transmitted Trypanosoma cruzi outbreaks can have more severe acute morbidity and higher mortality than vector-borne infection. Congenital T. cruzi infection occurs in 1-10% of infants of infected mothers. Most congenital infections are asymptomatic or cause non-specific signs, requiring laboratory screening for detection. A small proportion of congenital infections cause severe morbidity with hepatosplenomegaly, anaemia, meningoencephalitis and/or respiratory insufficiency, with an associated high mortality. Infected infants are presumed to carry the same 20-30% lifetime risk of cardiac or gastrointestinal disease as other infected individuals. Most control programs in Latin America employ prenatal serological screening followed by microscopic examination of cord blood from infants of seropositive mothers. Recent data confirm that polymerase chain reaction (PCR) is more sensitive and detects congenital infections earlier than conventional techniques. For infants not diagnosed at birth, conventional serology is recommended at at 6 to 9 months of age. In programs that have been evaluated, less than 20% of at risk infants completed all steps of the screening algorithm. A sensitive, specific and practical screening test for newborns is needed to enable Chagas disease to be added to newborn screening programs.

Original languageEnglish (US)
Title of host publicationAdvances in Parasitology
PublisherAcademic Press
Pages19-47
Number of pages29
DOIs
StatePublished - 2011

Publication series

NameAdvances in Parasitology
Volume75
ISSN (Print)0065-308X

Keywords

  • Acute phase
  • Benznidazole
  • Chagas disease
  • Congenital transmission
  • Nifurtimox
  • Trypanosoma cruzi

ASJC Scopus subject areas

  • Parasitology

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