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Long-term cardiology outcomes in children after early treatment for Chagas disease, an observational study

Nicolás Leonel González1, Guillermo Moscatelli1,2, Samanta Moroni1

  • 1Servicio de Parasitología y Chagas, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina.

Plos Neglected Tropical Diseases
|December 19, 2022
PubMed

Insights

Early treatment of Chagas disease (CD) in children with benznidazole or nifurtimox significantly reduced cardiac lesions. Long-term follow-up confirmed parasiticidal treatment effectiveness and low incidence of CD cardiomyopathy in treated pediatric patients.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pediatrics

Background:

  • Parasite persistence post-Trypanosoma cruzi infection is key to Chagas disease (CD) cardiomyopathy development.
  • Evaluating CD treatment effectiveness via cardiological events in children requires long-term follow-up.
  • Pediatric ECG interpretation is complex due to age-related normal variations.

Purpose of the Study:

  • To assess cardiac involvement in pediatric Chagas disease patients after a minimum of 6 years post-treatment.
  • To evaluate the long-term clinical effectiveness of parasiticidal treatment in children with Chagas disease.

Main Methods:

  • A descriptive cohort study of 234 pediatric patients with CD treated with benznidazole or nifurtimox.
  • Follow-up duration of at least 6 years post-treatment.
  • Cardiovascular assessment included routine ECG, 24-hour Holter monitoring, and speckle-tracking 2D echocardiogram in a subset of patients.

Main Results:

  • Only 4.7% of patients showed ECG alterations, with only 4 likely related to CD (complete right bundle branch block and left anterior fascicular block).
  • 99% of treated patients achieved persistent negative parasitemia by qPCR.
  • A decrease in T. cruzi antibody titers was observed in all patients, with 52% achieving negative seroconversion.

Conclusions:

  • Early parasiticidal treatment for pediatric Chagas disease demonstrates a protective effect against cardiological lesion development.
  • Low incidence of CD-related cardiac lesions suggests the importance of prompt treatment in infected children.
  • Long-term follow-up supports the efficacy of benznidazole and nifurtimox in controlling T. cruzi infection and preventing cardiac complications.
Abstract

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