Cribado de Chagas en embarazo y neonato en Andalucía (España)

espanolFundamento. Conocer la situacion de implementacion del cribado de Chagas en embarazo y neonato, en las ocho provincias andaluzas.Metodo: Se realizo un estudio descriptivo observacional, transversal, a traves de una encuesta revisada y validada por expertos del Grupo Andaluz de Infectologia e Inmunopatologia Pediatrica. Participaron dieciocho infectologos pediatricos de centros hospitalarios andaluces de referencia (catorce publicos y cuatro privados).Resultados. El cribado de Chagas durante el embarazo era conocido por diecisiete encuestados (94%), y aplicado de manera sistematica por ginecologos o matrones en siete hospitales (38,9%). El protocolo de seguimiento de neonatos hijos de madre con Chagas era conocido por dieciseis encuestados (88,9%) y aplicado en diez hospitales (55,5%), dos de los cuales no lo aplicaban a hermanos mayores y familiares de neonatos en riesgo. Solo se detectaron dos casos de transmision vertical de Chagas (11,1%) en dos centros con cribado sistematizado de Chagas a embarazadas de riesgo, en los cuales tambien se diagnosticaron dos casos en hermanos de lactantes de riesgo. Conclusion. En Andalucia el cribado de Chagas en embarazadas y neonatos de riesgo no se realiza de manera protocolaria ni uniforme en todos los hospitales de referencia, por lo que es altamente probable un infradiagnostico de Chagas congenito. La formacion de los profesionales implicados en la asistencia a la mujer embarazada y a su descendencia, y la unificacion de criterios de seguimiento serian fundamentales para realizar un correcto diagnostico y tratamiento precoz de estos casos. EnglishBackground. To determine the current state of the implementation of Chagas screening in pregnancy and newborns at risk in the eight Andalusian provinces.Methods. An observational, cross-sectional and descriptive study was carried out through a survey reviewed and validated by experts from the Andalusian Group of Pediatric Infectious Diseases and Immunology. Eighteen pediatric infectious disease specialists from Andalusian referral hospitals (fourteen public and four private) participated.Results. The Chagas screening during pregnancy was known by seventeen specialists (94%), and systema-tically applied in seven hospitals (38.9%) by gynecologists or midwives. The protocol for following-up newborns at risk was known by sixteen specialists (88.9%) and applied in ten hospitals (55.5%), two of which did not study siblings and relatives of these newborns. Only two cases of vertical transmission of Chagas (11.1%) were detected; it happened in two hospitals applying systematically the Chagas screening to pregnant woman at risk, the same ones that also diagnosed two cases in siblings of newborns at risk.Conclusion. In Andalusia screening of Chagas disease in pregnant women and newborns at risk is not carried out in a systematic and uniform way in all the reference hospitals, so an underdiagnosis of congenital Chagas disease is highly probable. The training of professionals involved in assisting pregnant women and their offspring, and the unification of the follow-up criteria for newborns at risk would be essential for carrying out both a correct diagnosis and an early treatment of these cases.