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. 2021 Mar 24;15(3):e0009281.
doi: 10.1371/journal.pntd.0009281. eCollection 2021 Mar.

Chagas disease screening in pregnant Latin American women: Adherence to a systematic screening protocol in a non-endemic country

Jara Llenas-García  1   2   3 , Philip Wikman-Jorgensen  2   4 , Concepción Gil-Anguita  5 , Violeta Ramos-Sesma  6 , Diego Torrús-Tendero  7   8   9 , Raquel Martínez-Goñi  10 , Mónica Romero-Nieto  2   3   11 , Javier García-Abellán  2   12 , María José Esteban-Giner  13 , Karenina Antelo  14 , María Navarro-Cots  2   15 , Fernando Buñuel  2   16 , Concepción Amador  5 , Josefa García-García  17 , Isabel Gascón  2   18 , Guillermo Telenti  2   12 , Encarna Fuentes-Campos  19 , Ignacio Torres  20 , Adelina Gimeno-Gascón  8   21 , María Montserrat Ruíz-García  2   22 , Miriam Navarro  23 , José-Manuel Ramos-Rincón  3   7   8
Affiliations

Chagas disease screening in pregnant Latin American women: Adherence to a systematic screening protocol in a non-endemic country

Jara Llenas-García et al. PLoS Negl Trop Dis. .

Abstract

Background: Chagas disease (CD) is a chronic parasitic disease caused by Trypanosoma cruzi and is endemic to continental Latin America. In Spain, the main transmission route is congenital. We aimed to assess adherence to regional recommendations of universal screening for CD during pregnancy in Latin American women in the province of Alicante from 2014 to 2018.

Methodology/principal findings: Retrospective quality study using two data sources: 1) delivery records of Latin American women that gave birth in the 10 public hospitals of Alicante between January 2014 and December 2018; and 2) records of Chagas serologies carried out in those centers between May 2013 and December 2018. There were 3026 deliveries in Latin American women during the study period; 1178 (38.9%) underwent CD serology. Screening adherence ranged from 17.2% to 59.3% in the different health departments and was higher in Bolivian women (48.3%). Twenty-six deliveries (2.2%) had a positive screening; CD was confirmed in 23 (2%) deliveries of 21 women. Bolivians had the highest seroprevalence (21/112; 18.7%), followed by Colombians (1/333; 0.3%) and Ecuadorians (1/348; 0.3%). Of 21 CD-positive women (19 Bolivians, 1 Colombian, 1 Ecuadorian), infection was already known in 12 (57.1%), and 9 (42.9%) had already been treated. Only 1 of the 12 untreated women (8.3%) was treated postpartum. Follow-up started in 20 of the 23 (87.0%) neonates but was completed only in 11 (47.8%); no cases of congenital transmission were detected. Among the 1848 unscreened deliveries, we estimate 43 undiagnosed cases of CD and 1 to 2 undetected cases of congenital transmission.

Conclusions/significance: Adherence to recommendations of systematic screening for CD in Latin American pregnant women in Alicante can be improved. Strategies to strengthen treatment of postpartum women and monitoring of exposed newborns are needed. Currently, there may be undetected cases of congenital transmission in our province.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Map of Spain and Alicante Province.
Fig 2
Fig 2. Annual number of deliveries in Latin American women, percentage of pregnant Latin American women screened for Chagas disease and percentage of women with positive screening, 2014 to 2018.
See this image and copyright information in PMC

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