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Systematic review: Prevalence of Chagas disease in pregnant women and congenital transmission of Trypanosoma cruzi in Brazil: a systematic review and meta‐analysis
Author(s) -
MartinsMelo Francisco Rogerlândio,
Lima Mauricélia da Silveira,
Ramos Alberto Novaes,
Alencar Carlos Henrique,
Heukelbach Jörg
Publication year - 2014
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12328
Subject(s) - chagas disease , medicine , meta analysis , trypanosoma cruzi , transmission (telecommunications) , epidemiology , pregnancy , confidence interval , pediatrics , disease , obstetrics , immunology , biology , parasite hosting , world wide web , computer science , electrical engineering , genetics , engineering
Objective To estimate the prevalence of Chagas disease in pregnant women and the risk of congenital transmission of Trypanosoma cruzi infection in Brazil, through a systematic review and meta‐analysis. Methods We searched electronic databases, grey literature and reference lists of included publications to identify epidemiological studies on the prevalence of Chagas disease in pregnant women and on the congenital transmission rate of T. cruzi infection in Brazil published between January 1980 and June 2013. Pooled estimates and 95% confidence intervals (95% CI s) were calculated using fixed‐ and random‐effects models. Results Sixteen articles were included – 12 studies on the prevalence of Chagas disease in pregnant women (549 359 pregnant women) and nine on congenital transmission rates (1687 children born to infected mothers). Prevalence of Chagas disease in pregnant women ranged from 0.1% to 8.5%, and congenital transmission rates from 0% to 5.2%. The pooled prevalence of Chagas disease among pregnant women across studies was 1.1% (95% CI : 0.6–2.0); the pooled congenital transmission rate was 1.7% (95% CI : 0.9–3.1). In 2010, 34 629 pregnant women were estimated to be infected with T. cruzi , and 312–1073 children born (mean: 589 cases) with congenital infection. Conclusion Congenital Chagas disease is a neglected public health problem in Brazil. Systematic congenital Chagas disease control programs through routine prenatal screening for T. cruzi should be widely implemented in Brazil's endemic areas, to identify infected pregnant women and newborns at risk of congenital infection.