Document Detail


The unknown risk of vertical transmission in sleeping sickness--a literature review.
MedLine Citation:
PMID:  21200416     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Children with human African trypanosomiasis (HAT) present with a range of generally non-specific symptoms. Late diagnosis is frequent with often tragic outcomes. Trypanosomes can infect the foetus by crossing the placenta. Unequivocal cases of congenital infection that have been reported include newborn babies of infected mothers who were diagnosed with HAT in the first 5 days of life and children of infected mothers who had never entered an endemic country themselves.
METHODS: This review systematically summarizes the literature on the vertical transmission of HAT, to our knowledge for the first time. To approach the broader aspects of the subject, articles considering the epidemiology of childhood HAT and HAT in pregnancy were also included. The HAT guidelines and technical reports of the World Health Organisation, Médecins Sans Frontières, Institut de Recherche pour le Développement, and of one endemic country were reviewed.
RESULTS: Publications describing congenital HAT are very limited and consist only of single case reports and small case series. Generally it is assumed to be a rare event, but it has never been systematically investigated. In two publications, it is hypothesized that congenital HAT occurs more often than suspected. Not all guidelines and not all HAT literature mention this transmission route.
CONCLUSIONS: The risk of vertical transmission is unknown. Awareness of congenital HAT is insufficient, and as a result opportunities for an early diagnosis in newborns may be missed. All HAT guidelines and local HAT protocols should stress that in endemic areas pregnant women should be systematically checked for HAT and that newborns of HAT infected mothers should be assessed for the disease as soon as possible. Studies on the impact of HAT on fertility and pregnancy and studies on congenital HAT are long overdue.
Authors:
Andreas K Lindner; Gerardo Priotto
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Publication Detail:
Type:  Journal Article; Review     Date:  2010-12-21
Journal Detail:
Title:  PLoS neglected tropical diseases     Volume:  4     ISSN:  1935-2735     ISO Abbreviation:  PLoS Negl Trop Dis     Publication Date:  2010  
Date Detail:
Created Date:  2011-01-04     Completed Date:  2011-03-15     Revised Date:  2011-07-20    
Medline Journal Info:
Nlm Unique ID:  101291488     Medline TA:  PLoS Negl Trop Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e783     Citation Subset:  IM    
Affiliation:
London School of Hygiene & Tropical Medicine, London, United Kingdom. A.K.Lindner@gmx.de
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MeSH Terms
Descriptor/Qualifier:
Female
Humans
Infant, Newborn
Infectious Disease Transmission, Vertical*
Pregnancy
Pregnancy Complications, Infectious / epidemiology*,  parasitology*
Trypanosomiasis, African / congenital*,  epidemiology,  transmission*
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