Epidemiology of Chagas disease in pregnant women and congenital transmission of Trypanosoma cruzi in the Americas: systematic review and meta-analysis.

Autor: Santana KH; Center of Biological and Health Sciences, Universidade Federal do Oeste da Bahia, Barreiras, Brazil., Oliveira LGR; Center of Biological and Health Sciences, Universidade Federal do Oeste da Bahia, Barreiras, Brazil., Barros de Castro D; Fundação de Vigilância em Saúde do Amazonas, Manaus, Brazil., Pereira M; Collective Health Institute, Universidade Federal da Bahia, Salvador, Brazil.
Jazyk: angličtina
Zdroj: Tropical medicine & international health : TM & IH [Trop Med Int Health] 2020 Jul; Vol. 25 (7), pp. 752-763. Date of Electronic Publication: 2020 May 26.
DOI: 10.1111/tmi.13398
Abstrakt: Objective: To estimate the prevalence of Chagas disease in pregnant women and the vertical transmission of the disease.
Methods: Observational studies were identified from eight electronic databases, and details on study design, population and prevalence of Chagas disease were extracted. The data were pooled using a random-effects model, and choropleth maps were created based on geopolitical regions and countries.
Results: The search identified 7788 articles, of which 50 were eligible. We observed a 9% prevalence of Chagas disease among pregnant women in the Americas (95% confidence interval [CI]: 8-10, I 2  = 99.96%). High disease prevalence was identified in pregnant women in South American countries (12%, 95% CI: 11-13), while lower values were identified in pregnant women in North America (2%, 95% CI: 1-3). Countries with medium Human Development Index (HDI) had a higher prevalence of Chagas disease in pregnant women (15%, 95% CI: 13-16, I 2  = 99.98%) than countries with high HDI (3%, 95% CI: 2-3). The rate of vertical transmission in the continent was 2% (95% CI: 1-2). The statistical analysis showed that this heterogeneity was explained by the study design, region of the Americas and mean income of the country.
Conclusion: South and Central American countries have a high prevalence and vertical transmission of Chagas disease. Therefore, systematic screens for this disease during the prenatal period are necessary in addition to the diagnosis and treatment of children at risk for Trypanosoma cruzi infection.
(© 2020 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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