An observational longitudinal study to evaluate tools and strategies available for the diagnosis of Congenital Chagas Disease in a non-endemic country.
OBJECTIVES
Congenital Chagas Disease (CCD) has become a global health problem. Early diagnosis and treatment is essential for the cure of the disease. Our aim was to evaluate techniques and samples used for the diagnosis of CCD in order to improve diagnostic strategies.


METHODS
A total of 181 children born in Spain from Latin American Chagas-infected mothers were consecutively enrolled and studied by microhematocrit, PCR and serology tests at 0-2, 6 and 9-12 months of age and followed up when it was required. Samples of cord blood and peripheral blood were collected for T. cruzi detection by PCR. Parasite culture was performed in patients with a positive PCR.


RESULTS
Of 181 children, 7 children (3.9%) were lost to follow-up. A total of 174 children completed follow-up, 12 were diagnosed with CCD (6.9%) and 162 (93.1%) as uninfected children (negative serology tests at the end of the follow-up). Traditional parasitological diagnosis by microhematocrit had a poor performance (sensitivity was 10%), while PCR in peripheral blood showed high sensitivity (90.9%) and specificity (100%), allowing the early diagnosis of 9 infected children during the first 6-months-old. In the other 3 congenital cases, diagnosis was only possible at 12 months by serological and molecular techniques. However, PCR in cord blood showed low sensitivity (33.3%) and less specificity (96.4%) for the diagnosis.


CONCLUSION
PCR in peripheral blood has proven to be the most adequate strategy for the diagnosis of CCD, allowing an early and reliable diagnosis.
['Simón|Marina|M|', 'Gil-Gallardo|Luis J|LJ|', 'Asunción Iborra|M|M|', 'Carrilero|Bartolomé|B|', 'López|Manuel Carlos|MC|', 'Romay-Barja|María|M|', 'Murcia|Laura|L|', 'Carmen Thomas|M|M|', 'Benito|Agustín|A|', 'Segovia|Manuel|M|']
D000293:Adolescent D000328:Adult D014355:Chagas Disease D005260:Female D005312:Fetal Blood D005500:Follow-Up Studies D014943:Global Health D006400:Hematocrit D006801:Humans D007223:Infant D007231:Infant, Newborn D008137:Longitudinal Studies D008297:Male D016133:Polymerase Chain Reaction D011247:Pregnancy D015597:Pregnancy Complications, Parasitic D012680:Sensitivity and Specificity D012698:Serologic Tests D013030:Spain D014349:Trypanosoma cruzi D055815:Young Adult
Congenital Chagas Disease Diagnostic techniques Polymerase chain reaction