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Relationship between Chagas' disease immunoreactivity in pericardial fluid and survival of children
J A Almeida1, D F Cunha, G Olivelra
1Faculdade de Medicina do Triângulo Mineiro, Departamento de Clências Biológicas, Uberaba, Minas Cerals, Brazil.
Insights
Pericardial fluid analysis revealed a high prevalence of Chagas' disease in children in Brazil. Positive reactions correlated with age, suggesting a role for antitrypanosome antibodies in infant mortality.
Area of Science:
- Medical Parasitology
- Pediatric Pathology
- Immunology
Background:
- Pericardial fluid (PF) is utilized for studying protein content in various diseases, including infectious conditions like Chagas' disease.
- Chagas' disease, caused by *Trypanosoma cruzi*, is a significant public health concern, particularly in endemic areas.
Purpose of the Study:
- To investigate the presence and significance of Chagas' disease immunoreactivity in autopsy-obtained pericardial fluid from children.
- To correlate Chagas' disease seroreactivity in PF with age distribution and survival time in pediatric autopsies.
Main Methods:
- Retrospective analysis of 251 autopsy records from children (stillborn to 14 years) in Uberaba, Brazil (1968-1992).
- Serological testing for Chagas' disease using immunofluorescence, complement fixation, and hemagglutination assays on pericardial fluid.
- Statistical analysis to determine the relationship between immunoreactivity, age, and survival.
Main Results:
- A total of 13.5% (34 out of 251) of the children exhibited positive immunoreactivity to Chagas' disease in their pericardial fluid.
- The frequency of positive Chagas' disease reactions showed a significant association with specific age groups (chi 2 = 13.4; P < 0.005).
- Children with negative PF tests had a median survival of 13 days, while positive children had a median survival of 4 days (Z = 2.1; P = 0.02).
Conclusions:
- The findings suggest a high prevalence of Chagas' disease among pregnant women in southern Brazil, with potential vertical transmission.
- Antitrypanosome antibodies detected in pericardial fluid may serve as an indicator of infant death age.
- These antibodies might influence the disease's progression in infants born to mothers infected with Chagas' disease.
Abstract:
Pericardial fluid (PF) obtained at autopsy has been used for the study of fluid pericardium proteins in noninfectious and infectious diseases such as Chagas' disease. The aim of the present study was to determine the immunoreactivity to Chagas' disease in PF obtained at autopsy from children in an endemic area. A total of 251 autopsy records were surveyed from the files of the Medical School of Uberaba, Brazil, of children ranging in age from stillborn to 14 yr who had died between 1968 and 1992. The reactions for Chagas' disease (immunofluorescence, complement fixation, and hemagglutination) applied to PF were recorded. Thirty-four children (13.5%) showed positive reactions to Chagas' disease. The frequency of immunoreactivity was significantly related to age-group distribution (chi 2 = 13.4; P < 0.005). Children with negative PF tests who had died between 1 and 60 days of age presented a median survival time of 13 days; positive children presented a median survival time of 4 days (Z = 2.1; P = 0.02). These data indicate that the prevalence of Chagas' disease is high among pregnant women in southern Brazil. In addition, they also suggest that "antitrypanosome antibodies" detected in PF may be 1 of the indicators of age of infant death and may possibly play a role in the course of the disease in children born from mothers with Chagas' disease.