Coverage of Etiological Treatment for Infection by Trypanosoma cruzi in children less than 15 years-old in Argentina. Period 2003 – 2006

Abstract

As part of the actions of the National Chagas Program (NChP) in Argentina,
the standard of care for infected chagasic children, namely early detection of
Trypanosoma cruzi infection and specific treatment, are described. The evaluation
and coverage of etiological treatment for Chagas disease in children under 1 year
of age (congenital Chagas disease), and between 1 and 14 years old (recent chronic
phase), in the period from 2003 to 2006, is described. Data were provided by the
representatives of Chagas Provincial Laboratory Network and heads of provincial
programs, and national jurisdiction of Chagas in Argentina, to the National
Coordination of Vector Control (NCVC). 13,866 children under 1 year of age,
with parasitological methods and/or serological pairs for infection by T. cruzi,
were studied. From them, 1,016 children were positive (7.33%) and, of those, 529
(52.07%) were treated. 158,640 children under 15 years of age from endemic areas
were studied through serological population-based studies. From them 4,549 positive
children were detected (2.87%) and 1,526 (33.55%) of them were treated. After a
global analysis of data from groups 1 and 2, results showed an inadequate (<50%)
coverage among the provinces. Statistical analysis showed significant differences
between groups with p<0.0001, suggesting there would be a major difficulty at the
provincial levels to improve the treatment of children infected, mainly those cases of
congenital Chagas disease. There was a relation among those provinces that harbor
a higher proportion of infected children and the gap presented between diagnosis
and treatment. We believe that these preliminary results will reinforce the need of an
analytical study to identify the causes that impede access to the etiological treatment
for infection by T. cruzi, and thus to define strategies to deal with them.