Catch-Up Screening to Improve Detection of Congenital Chagas Disease in a Nonendemic Setting

Mother-to-child transmission of Trypanosoma cruzi, the parasitic cause of Chagas disease, occurs in 5-10% of affected pregnancies. Congenital infection is usually asymptomatic, so if maternal infection is not suspected, the affected newborn may go undetected. As detection and antiparasitic treatment in early life result in much higher cure rates than treatment later in life, it is important to explore opportunities for catch-up testing of children born to women found to have T. cruzi infection. We piloted a multidisciplinary adult-pediatric disease referral pathway and developed a clinic to screen children of women diagnosed with Chagas disease. We evaluated the impact, acceptability, and patient experience of the pathway, including exploration of barriers to accessing prior testing. Of the 28 referred children, 23 (82%) attended the clinic, 22 (79%) were tested, and 1 child was diagnosed with congenital infection. The service was deemed effective and beneficial by both healthcare professionals and parents.