Period: 2011 – 2013

This prospective observational study, funded by NIAID, aims to determine and compare the rate of congenital chagas disease of the Tc I and Tc II lineage of T. cruzi in regions of Argentina, Honduras and Mexico.

Researchers

Althabe F, Sosa Estani S, Cafferatta ML.

Summary

This prospective observational study, funded by NIAID, aims to determine and compare the rate of congenital chagas disease of the Tc I and Tc II lineage of T. cruzi in regions of Argentina, Honduras and Mexico.

For this purpose, umbilical cord blood samples are taken from all deliveries in the selected hospitals to perform a serological diagnosis of trypanosome cruzi through rapid tests. Blood samples from positive cases are studied by parasitological examination and ELISA; They are then stored and transported to a laboratory in Brussels, Belgium for a PCR test.

Babies undergo neonatal clinical examinations and are monitored with home visits at 4 weeks and 10 months of age, through reminders sent to their mothers by text message to their mobile phones. In addition to this, places of residence are mapped using GPS units. Blood samples are collected in tubes and paper filters, labeled with barcodes and stored in freezers.

Inside the freezers, temperature meters monitor the cold chain. Blood samples from children with congenital transmission are collected on filter paper and sent to the United States to measure the concentration of Benznidazole/Nifurtimox. Until 2013, at the Argentina site, 9359 women were recruited, of which 163 cases were positive in umbilical cord blood. Until October 2013, 7 cases of children with congenital transmission were reported. The follow-up rate at 4 weeks and 10 months was 93% and 85%, respectively.

Objectives

Determine the congenital transmission rate of Tc I (Mexico – Honduras) compared to that of Tc II (Argentina). Compare the characteristics and exposure to vectors of mothers infected with T. cruzi in regions where Tc I is predominant and in regions where Tc II is predominant. To describe the outcomes at birth of infected and uninfected children born to Tc I and Tc II seropositive mothers.

Finance

NIH /NIAID – National Institute of Health/National Institute of Allergy and Infectious Diseases. Tulane University School of Public Health and Tropical Medicine / National Center on Minority Health and Health Disparities (NCMHD)/NIH

Study design

Prospective observational study.