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Pediatric Chagas disease in Europe: 45 cases from Spain and Switzerland
Luciana Rodriguez-Guerineau1, Klara M Posfay-Barbe, Manuel Monsonis-Cabedo
1From the *Department of Pediatrics, University Hospitals of Geneva and University of Geneva, Switzerland; †Department of Pediatrics; ‡Laboratory of Microbiology, Sant Joan de Déu Hospital, University of Barcelona, Spain; §Department of Gynecology & Obstetrics; ¶Division of International and Humanitarian Medicine, Department of Community Medicine, Primary Care and Emergency Medicine; and ‖Division of Primary Care, Department of Community Medicine, Primary Care and Emergency Medicine, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland.
Insights
Pediatric Chagas disease is an emerging concern in Europe, with most children diagnosed in the chronic phase and asymptomatic. Early screening and pediatrician awareness are crucial for managing this parasitic infection in children.
Area of Science:
- Infectious Diseases
- Parasitology
- Pediatrics
Background:
- Chagas disease is a potentially fatal parasitic infection with increasing prevalence in Europe due to migration.
- There is a notable lack of public health attention and clinician awareness regarding Chagas disease in Europe.
- Limited data exists on the clinical characteristics of Chagas disease in pediatric populations.
Purpose of the Study:
- To describe the clinical characteristics of Chagas disease in children managed in European hospitals.
- To identify treatment outcomes and adverse events in pediatric cases of Chagas disease.
Main Methods:
- A retrospective review of medical records was conducted for children (<18 years) diagnosed with Chagas disease.
- Data was collected from two hospitals in Barcelona, Spain, and Geneva, Switzerland, between January 2004 and July 2012.
Main Results:
- Forty-five pediatric cases were identified, with 95.6% diagnosed in the chronic phase and mostly asymptomatic.
- Treatment with benznidazole or nifurtimox was completed by 97.6% of treated children, with a 4.9% interruption rate due to adverse events.
- Five out of twenty-nine children (17.2%) followed up by serology after two years showed signs of cure.
Conclusions:
- Pediatric Chagas disease is an emerging health issue in Europe requiring increased attention and awareness.
- Screening of pregnant women at risk, their newborns, and family members is recommended.
- Pediatricians play a vital role in informing families and facilitating testing for Chagas disease in at-risk individuals.
Background:
Chagas disease, a potentially fatal parasitic infection, is emerging in Europe in the context of international migration but there is little public health attention and frequent lack of clinicians' awareness. To date, there is no published information about clinical characteristics in children.
Methods:
We reviewed the medical files of all children (<18 years) with Chagas disease managed in 2 hospitals in Barcelona, Spain and Geneva, Switzerland between January 2004 and July 2012.
Results:
Forty-five cases were identified. Two children (4.4%) were diagnosed during the acute phase and the remaining 43 (95.6%) were in the chronic phase of the infection. All but 1 were asymptomatic. Of the 41 treated children, 40 (97.6%) completed 60 days of treatment. Thirty-five (85.4%) received benznidazole, 5 (12.2%) nifurtimox and 1 (2.4%) both drugs consecutively. There were 2 (4.9%) treatment interruptions due to adverse events. The most frequent adverse events were rash (24.4%), anorexia or insufficient weight gain (14.6%) and anemia (2.4%). Twenty-nine (64.4%) children were followed up by serology after 2 years. Five (17.2%) were cured.
Conclusions:
Pediatric Chagas disease is an emerging health issue in Europe that requires enhanced attention. Greater emphasis should be put on screening pregnant women at risk and their newborns in case of infection along with older children and relatives. Pediatricians have a central role to play in providing families with information and offering testing in situations of risk.
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