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Congenital Chagas' disease: diagnostic and clinical aspects
1Parasitology Laboratory, Ricardo Gutierrez Children's Hospital, Buenos Aires, Argentina.
Insights
Congenital Chagas
Area of Science:
- Pediatrics
- Infectious Diseases
- Parasitology
Background:
- Congenital Chagas' disease, caused by Trypanosoma cruzi, affects newborns and can lead to severe health issues.
- Early diagnosis and understanding clinical manifestations are crucial for effective management.
Purpose of the Study:
- To investigate the diagnostic methods and clinical features of congenital Chagas' disease in children.
- To evaluate the efficacy and safety of nifurtimox treatment.
Main Methods:
- Study involved 71 children (2 days to 10 years) in Buenos Aires.
- Diagnostic methods included blood Trypanosoma cruzi detection (microhematocrit) and serological tests.
- Clinical signs and human immunodeficiency virus coinfection were documented.
Main Results:
- Microhematocrit test showed 97.4% positivity in infants < 6 months.
- Serological methods were effective in children >= 6 months.
- Hepatomegaly was the most common clinical sign (18.3%); 64.8% were asymptomatic.
- Three children had HIV coinfection, severe in two cases.
- Nifurtimox treatment yielded mild adverse effects.
Conclusions:
- Microhematocrit is a rapid and reliable diagnostic tool for congenital Chagas' disease in young infants.
- Conventional serology is useful for older children.
- Congenital Chagas' disease often presents with mild or no clinical signs.
- Nifurtimox is a safe parasiticidal treatment option with minimal side effects.
Abstract:
The diagnostic and clinical aspects of congenital Chagas' disease were studied in 71 children in Buenos Aires. The children's ages ranged from 2 days to 10 years. In infants < 6 months old, the disease was diagnosed by detection of Trypanosoma cruzi in the blood; the microhematocrit test was positive in 38 (97.4%) of 39 cases. This test was the fastest and most reliable diagnostic method in this group, whereas two conventional serological methods were useful in children > or = 6 months of age. Forty-six (64.8%) of the 71 children had no clinical signs of infection. The clinical sign most frequently documented was hepatomegaly (18.3%). Three children were coinfected with human immunodeficiency virus; the latter infection was severe in two instances. Nifurtimox (10-15 mg/[kg.d] for 2 months) was used for parasiticidal treatment, and use of this drug resulted in mild adverse effects.