[Congenital Chagas in Bolivia: comparative study of the effectiveness and cost of diagnostic methods]

Eight hundred and twenty newborn babies with a mean weight of < or = 2500g from the Maternity Hospital P Boland in Santa Cruz- Bolivia were examined in 1988-1989 by different methods to diagnose Chagas disease, (placental pathology, serology, parasitologically and clinically) to determine the efficiency and cost of these methods. The histopathological exam detected 87 cases of placenta infection. Out of this total 43 (49%) newborns were positive on the parasitological exam of the chord blood. This number increased by repeating the blood test during the first month of the baby's life, reaching the same level as the histopathology. With the serology, only 2 cases were detected as positive. The clinical sign with a high specificity in children infected with Chagas disease is the hepatosplenomegaly. The advantages and disadvantages regarding the cost and feasibilty of two strategies to detect congenital Chagas disease are being discussed. The first in based on the histopathology and the other over on parasitology. It is concluded that the control programs for this non vectorial form of Chagas' disease cannot be uniform since the aspects to consider are: prevalence of the disease, existence of the vector and availability to laboratory techniques.