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. 2019 Jun;24(26):1900011.
doi: 10.2807/1560-7917.ES.2019.24.26.19-00011.

Epidemiology of congenital Chagas disease 6 years after implementation of a public health surveillance system, Catalonia, 2010 to 2015

Luca Basile  1 , Pilar Ciruela  1   2 , Ana Requena-Méndez  3 , Mª José Vidal  1 , Eva Dopico  4 , Andrea Martín-Nalda  5 , Elena Sulleiro  6 , Joaquim Gascon  3 , Mireia Jané  1   2 ; Working Group of Congenital Chagas disease in Catalonia  7
Affiliations

Epidemiology of congenital Chagas disease 6 years after implementation of a public health surveillance system, Catalonia, 2010 to 2015

Luca Basile et al. Euro Surveill. 2019 Jun.

Abstract

BackgroundChagas disease is endemic in Latin America and affects 8 million people worldwide. In 2010, Catalonia introduced systematic public health surveillance to detect and treat congenital Chagas disease.AimThe objective was to evaluate the health outcomes of the congenital Chagas disease screening programme during the first 6 years (2010-2015) after its introduction in Catalonia.MethodsIn a surveillance system, we screened pregnant women and newborns and other children of positive mothers, and treated Chagas-positive newborns and children. Diagnosis was confirmed for pregnant women and children with two positive serological tests and for newborns with microhaematocrit and/or PCR at birth or serology at age 9 months.ResultsFrom 2010 to 2015, the estimated screening coverage rate increased from 68.4% to 88.6%. In this period, 33,469 pregnant women were tested for Trypanosoma cruzi and 937 positive cases were diagnosed. The overall prevalence was 2.8 cases per 100 pregnancies per year (15.8 in Bolivian women). We followed 82.8% of newborns until serological testing at age 9-12 months and 28 were diagnosed with Chagas disease (congenital transmission rate: 4.17%). Of 518 siblings, 178 (34.3%) were tested and 14 (7.8%) were positive for T. cruzi. Having other children with Chagas disease and the heart clinical form of Chagas disease were maternal risk factors associated with congenital T. cruzi infection (p < 0.05).ConclusionThe increased screening coverage rate indicates consolidation of the programme in Catalonia. The rate of Chagas disease congenital transmission in Catalonia is in accordance with the range in non-endemic countries.

Keywords: Chagas disease; Trypanosoma cruzi; congenital; public health; screening; surveillance system; vertical transmission.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Congenital Chagas disease screening programme in Catalonia, 2010–2015
Figure 2
Figure 2
Geographical distribution of Trypanosoma cruzi-positive pregnant women and cases of congenital transmission, Catalonia, 2010–2015 (n = 818)
Figure 3
Figure 3
Annual number of screened women and Trypanosoma cruzi-positive pregnant women, Catalonia, 2010–2015 (n = 33,469)
See this image and copyright information in PMC

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