CONGENITAL CHAGAS DISEASE: CHALLENGES IN NEONATAL DIAGNOSIS IN NON-ENDEMIC AREAS

Abstract

ngenital Chagas disease is a relevant route of transmission of Trypanosoma cruzi and has gained increasing importance in non-endemic areas due to the increase in international migration flows. This study presents a narrative review of the main challenges related to neonatal diagnosis in these contexts, considering epidemiological aspects, technical limitations, and organizational barriers of health systems. The analysis shows that low clinical suspicion, the nonspecificity of neonatal manifestations, and the limited availability of sensitive diagnostic methods, such as polymerase chain reaction (PCR), contribute significantly to the underreporting of the infection. In addition, the absence of systematic prenatal screening protocols and the fragmentation of follow-up of exposed newborns hinder early detection, compromising the effectiveness of treatment, which shows better results when instituted in the first months of life. It is concluded that improving neonatal diagnosis of Chagas disease in non-endemic regions requires an integrated approach, encompassing active surveillance, professional training, expansion of laboratory infrastructure, and implementation of specific public policies for populations in situations of epidemiological vulnerability.