Research Article: Negativation of Trypanosoma cruzi PCR within Six Months after Treatment of a Child with Nifurtimox

Date Published: May 7, 2015

Publisher: Public Library of Science

Author(s): Lauren Pull, Feriel Touafek, Luc Paris, Guillaume Le Loup, Laurent Brutus, Jean-Yves Siriez, Carlos Franco-Paredes. http://doi.org/10.1371/journal.pntd.0003667

Abstract: None

Partial Text: This case report concerns a male child born in 2002 in Santa Cruz, Bolivia. His parents had been positive for T. cruzi since 1999 and had never been treated until they moved to France with their children in 2004. The boy has two sisters, both negative for Chagas disease. In March 2009, after a confirmation of the diagnosis of Chagas disease in both parents at Tenon Hospital (Paris), the boy tested positive for anti-T.cruzi antibodies by indirect immunofluorescence (IIF) (200–400, Table 1) (Slide Immunofluor Chagas, Biocientifica SA, Buenos Aires, Argentina) and enzyme-linked immunosorbent assay (ELISA) (Chagatest Elisa rec v 3.0, Wiener lab, Rosario, Argentina) (index 7.6, Table 1).

In Europe, Chagas disease can be considered as an emerging problem, and several cases have been identified in children. Spain in particular sees significant immigration from Latin America; e.g., 1,800,000 immigrants estimated in 2009. One study in that country found three cases of congenital infection among 1,350 pregnant women of Latin American origin [2], but another found no cases in a cohort of 108 children aged 0 to 14 years and either from Latin America or born in Spain to mothers coming from endemic areas for Chagas disease [3]. In Switzerland, congenital transmission was diagnosed in four newborns and five children between 1 and 11 years of age at the early indeterminate phase of the chronic stage of Chagas disease [4]. In Italy, five children adopted from Bolivia were found to be seropositive for T. cruzi, as were a number of children among 266 migrants tested for T. cruzi [5]. Methods of diagnosis and adverse effects of treatment were rarely detailed in these studies. 45 cases of Chagas disease in children have been recently reported from Spain and Switzerland. The diagnostic procedure included microscopic blood examination, in-house real-time polymerase chain reaction, and serological testing. 35 children received benznidazole, five received nifurtimox, and one received both drugs consecutively. At 2 years, five patients presented negative serology, 17 showed a serological titer reduction <50%, and seven had a ≥50% titer reduction [6]. According to recent estimations, there may be as many as 1,500 T. cruzi-infected individuals living in France. Between 1980 and 2007, there were an estimated 20 to 70 cases of congenital infection annually and potentially 235 adopted children who had Chagas disease [7]. To our knowledge, the case that we report here is the first one diagnosed in France and reported in the literature. Source: http://doi.org/10.1371/journal.pntd.0003667

 

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