Screening for Chagas disease in Latin-American pregnant women and their newborns: A prospective observational, multicenter study in Milan, Italy

Abstract

Objectives: Chagas Disease (CD), caused by Trypanosoma cruzi, is endemic in Latin America (LA). However, due to migration, it is now present globally. We aimed to evaluate the prevalence of CD among LA pregnant women in Milan, Italy, and the incidence of T. cruzi transmission to their newborns.

Methods: A prospective multicenter observational study was conducted in five different Obstetrics and Gynecology outpatient clinics in Milan, Italy between September 2019 and October 2024. Pregnant women from endemic areas for CD were tested by means of two serological tests directed against T. cruzi antigens. Newborns from positive T. cruzi mothers were screened for T. cruzi infection at birth and at 1, 3 and 9 months.

Results: 339 women underwent screening for T. cruzi infection with a median age of 33 years [IQR 28-37 years]. Most of them came from Peru (38.3 %), followed by El Salvador (20.6 %) and Ecuador (19.5 %). Six of them tested positive for T. cruzi, accounting for an estimated prevalence of 1.77 % (95 % CI 0.37 %-3.17 %). Two of the affected women were from Bolivia, and the remaining from El Salvador, Brazil, Ecuador and Peru. All 6 children had a negative PCR for T. cruzi infection, and their serology turned negative within the first year of life.

Conclusions: The seroprevalence of T. cruzi infection among LA pregnant women in Milan is significant, underscoring the potential occurrence of congenital CD in a non-endemic area like Italy. Raising awareness of this neglected tropical disease among LA women, midwives and gynecologists is crucial.

Keywords: Chagas disease; Congenital; Italy; Pregnant women; T. cruzi; Vertical transmission.