Protocol de cribratge, diagnòstic i tractament de la malaltia de Chagas en dones embarassades llatinoamericanes i en els seus fills
Chagas disease (CHD) continues to be a major public health problem. The WHO estimates that there are 8 million people in the world infected with Trypanosoma cruzi, the majority in Latin America. In non-endemic countries, as is the case in our environment, CHD is seen in infected people who come from endemic countries or children born in non-endemic countries, but whose mother has been infected (congenital transmission). In Catalonia, in order to control and monitor the CHD, in 2010 the Program for the Prevention and Control of Congenital Chagas' Disease in Catalonia was launched, coordinated by the Department of Health and includes diagnosis, control, follow-up and treatment of congenital CHD directed at pregnant women and their children. Within the framework of the Program, the Protocol for the Screening and Diagnosis of Chagas' Disease in Latin American pregnant women and their children was prepared, which was published in 2010. This document was the result of the joint effort of health professionals who are experts in the disease, of different scientific societies and professionals of the Department of Health of the Government of Catalonia, with the support of the Working Group of Non-endemic Countries and the Department of Control of Forgotten Tropical Diseases of WHO. The Protocol that is presented, in addition to including the same lines as the first edition, has updates on different clinical, diagnostic and epidemiological surveillance aspects based on the experience and evidence observed during these eight years of the Prevention and Control Program. Congenital Chagas disease in Catalonia. During these last years, the perspective of public health in the Program has been reinforced, in which a large number of professionals of the health care network and community health agents have participated with the aim of reducing the effect of the vertical transmission of CHD in Catalonia. The first part of the document includes the clinical characteristics of the CHD that, although it is relatively recent in our environment, thanks to the information provided both in the health field and in the community in recent years, has ceased to be a disease forgotten and unknown in Catalonia. In recent years, the advances and experience in our environment in the diagnosis of CHD have led us to reach a consensus on the use of direct molecular methods, as described in this Protocol. Likewise, the specification of epidemiological data on prevalence of infection and incidence of cases of the disease has improved greatly thanks to the monitoring and reporting of data collected within the framework of the Program for the Prevention and Control of Congenital Chagas' Disease in Catalonia by professionals. that are part of the Working Group on Congenital Chagas Disease. In this aspect and to improve their control, family doctors and community health have been incorporated, since they are one of the key professionals who are closest to patients. A fundamental aspect that emerges from this document and the operation of the Program is multidisciplinarity. The challenge of the health system and public health surveillance is the coordination and work of professionals from different health areas, such as gynecologists, microbiologists, midwives, pediatricians of primary and hospital care, family physicians and community health , nurses, infectious disease specialists, epidemiologists and community health workers who work together to achieve the stated objective. This Protocol is an eminently practical document, through which health professionals have the essential elements for carrying out screening in pregnant women. Based on this Protocol, it is also expected to achieve the detection and early treatment of cases of CHD in the pediatric population, babies and other children in Catalonia, with the ultimate goal of improving maternal and child health in Catalonia.
Chagas disease; Latin american pregnant women; Maternal and child health
Ciruela P, Basile L, Jané M, Requena A, Valls ME, Gallego M, et. al. Protocol de cribratge, diagnòstic i tractament de la malaltia de Chagas en dones embarassades llatinoamericanes i en els seus fills. Barcelona: Agència de Salut Pública de Catalunya; 2018.
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