Spain includes Chagas disease in the national prenatal screening program

This service will be fully implemented by the regional health systems in two years for all pregnant women considered at risk.

03 July 2024

Chagas disease, caused by the Trypanosoma Cruzi parasite, is endemic in 21 Latin American countries, where the vector or triatomine that transmits it lives. But there are other routes of transmission, such as vertical transmission, or through blood transfusions, organ transplants, or ingestion of contaminated food; and some of them are a threat to other countries in the rest of the world.

Last June, Spain has officially published the incorporation of Chagas disease screening into the common services of the National Health System. Spain is not an endemic country, but in recent years public administrations and private institutions have focused on the vertical transmission of the disease, mother-to-child transmission. 

In 2023, the Barcelona Institute for Global Health reported the results after 17 years of screening at the Hospital Clínic in Barcelona. 47% of the people screened were affected, and 17% presented cardiac complications related to this tropical disease. Also, some estimates suggest that by the year 2050 there will be an incidence of around 50% of heart transplants related to complications caused by Chagas disease. In Spain, some studies estimate around 50,000 carriers, of which around 70% would not be diagnosed or treated.

Some regions, such as Catalonia, have been pioneers in the implementation of a mother-to-child screening. In 2022, the Región of Murcia became the first one in the world to eliminate congenital Chagas disease, after four consecutive years without positive cases.

Estefanía García, from the Spanish Ministry of Health, has been working for several years in this matter and has closely followed the process to fulfill this new publication for a prenatal screening in infectious diseases such as HIV, hepatitis C, Zika and, of course, Chagas disease.

In a conversation with Chagas Coalition, García considers this program a “very important step because it homogenizes the rights and access to services throughout the country. In addition, we believe that the efficiency in considering social safety as a whole is widely proven, so it should be accessible for an entire target population in conditions of equity".

The Chagas prenatal screening approved in Spain also has a protocol, or specific consensus document. It is aimed at pregnant women who were born or have been in endemic or affected areas of Latin America, but it is recommended to extend it to newborns and family members. “The target population is chosen based on a cost-effectiveness study focused on pregnant women. The 2021 standard was approved based on that data, and the protocol must adhere to that standard. However, we include requirements applied by law, and recommendations, to extend the concern to both women of childbearing age, newborns and first and second degree relatives are evaluated and diagnosed" added Garcia.

The deadline to complete the implementation of this prenatal screening in all the communities of Spain is two years. The Ministry of Health will publish an annual report and will establish protocols with the consensus of all regional stakeholders.
Photo: Alicia Petresc

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