Congenital Chagas disease: Updated recommendations for prevention, diagnosis, treatment, and follow-up of newborns and siblings, girls, women of childbearing age, and pregnant women

Abstract

Targeted populations for prevention and control of congenital transmission of T. cruziIn order to eliminate congenital transmission of T. cruzi, efforts should be focused on 5 population groups living within or outside of LA (as defined previously), namely the following:Girls and female adolescents (pre-conceptional phase).Women of fertile age not yet pregnant (childbearing age), by detecting T. cruzi infection and treating those who are infected (aiming to prevent congenital transmission and reduce the pool of infected population). Control of vectors in endemic areas of LA and blood transmission in endemic as well as nonendemic areas have to be pursued to reduce the risk of infection and the reservoir of infected women.Pregnant women, by antenatal screening for infection performed before or even when entering in maternity. Among those who are infected, there is no way to identify in advance those who will transmit the infection to their offspring, and there are no means of preventing such congenital infection at that moment (antiparasitic treatment is not recommended during pregnancy. Treatment of infected girls or adults. Infected mothers should be treated after delivery and lactation period. Treatment of infected girls or adults (aiming to prevent recurrent congenital transmission in successive gestations and reduce the pool of infected population).Neonates/infants born to infected mothers by investigating congenital infection and treating and following up all detected positive cases (aiming to control congenital infection, reduce the pool of infected population, and to prevent further congenital transmission in girls). Relatives and other children born to infected mothers (siblings) by investigating their infection status and treating all positive cases (aiming to reduce the pool of infected population from index cases).