Abstract Pregnancy represents an opportunity for the health system to diagnose and treat infections that increase maternal, fetal, and neonatal morbidity and mortality. Elimination of maternal-infant transmitted diseases is a priority in the Americas region. Several efforts are taking place to reach this goal by the year 2030. This document gathers the participation of several experts from the Latin American and Caribbean Region within the Latin-American Society of Pediatric Infectious Diseases (SLIPE), presenting a practical guidance adapted to the limitations of our countries, that support the analysis and improvement in interventions to change the management of congenital infection.

Resumen El embarazo representa una oportunidad del sistema de salud para el diagnóstico y tratamiento de afecciones que aumentan la morbilidad fetal y neonatal, y la salud de la mujer gestante, siendo la eliminación de las enfermedades de transmisión materno-infantil una prioridad en la región de las Américas. En esta línea se están llevando a cabo numerosos esfuerzos en la región para alcanzar esta meta para el año 2030. El presente documento reúne la participación de expertos en la Región de América Latina y el Caribe, dentro de la Sociedad Latino-americana de Infectología Pediátrica (SLIPE), brindando una mirada práctica adaptada a las limitaciones de muchos de nuestros países, que nos ayude a analizar las mejores herramientas para detectar posibles momentos estratégicos de intervención y cambio en el manejo de las infecciones congénitas.

RESUMEN La hidatidosis pancreática representa el 0,2-0,6 % de los casos, siendo la población pediátrica la de mayor riesgo. Las lesiones suelen localizarse en cabeza del páncreas (50-58 %); la localización en cuerpo y cola del páncreas se encuentra en el 24-34 % y el 19 %, respectivamente. Dada la posibilidad de complicaciones, suele realizarse tratamiento quirúrgico. Se sugiriere indicar albendazol antes y después del acto quirúrgico por los riesgos de ruptura y diseminación de los protoescólices. Se presenta el caso de una niña de 5 años de edad con dolor abdominal progresivo y lesión quística en páncreas compatible con hidatidosis en la ultrasonografía. En la tomografía computada se observa compresión de la vía biliar. La hemoaglutinación indirecta fue negativa. Presentó elevación de la bilirrubina total, con franco predominio de bilirrubina directa, y aumento de enzimas hepáticas. Se realizó laparotomía exploradora, colecistectomía y destechamiento del quiste. Evolucionó favorablemente, continuó con albendazol durante 3 meses luego de la cirugía.

Chagas disease is a serious public health problem in Latin America and, due to migration, in other non-endemic regions. Benznidazole (BNZ) is first choice drug in pediatric therapeutics. However, little is known regarding its metabolism in humans. The aim of the study was to isolate and identify products of human BZN metabolism in urine samples obtained from a pediatric Chagas patient and a healthy adult volunteer both treated with BZN. Urine samples were collected after dose of BNZ. Urine was treated with β-glucuronidase followed by an extraction procedure under two different pH conditions and a HPLC/UV and MS/MS identification of BZN and its metabolites. BZN (m/z 260.09847) was identified in all urine extracts. Peaks from each extracted chromatograms were selected for MS and MS/MS identification. Three compounds structurally related to BZN were identified: BZN-Na+ (m/z 283.08009), N-amine-BZN (m/z 230.12307) and N-hydroxi-amine-BZN (m/z 246.11702). BNZ-Na+ was identified in all extracts, but N-amine-BZN and N-hydroxi-amine-BZN were only observed in those extracts treated with β-glucuronidase. This is the first experimental report showing elimination of BZN N-reduced metabolites in urine. As they were released after treatment with β-glucuronidase it can be suggested that glucuronization plays a role in BNZ metabolism and renal elimination.

The primary objective of this study was to estimate the prevalence of this disease in women of childbearing age and children treated at health centres in underserviced areas of the city of Buenos Aires. Demographic and Chagas disease status data were collected. Samples for Chagas disease serology were obtained on filter paper and the reactive results were confirmed with conventional samples. A total of 1,786 subjects were screened and 73 positive screening results were obtained: 17 were from children and 56 were from women. The Trypanosoma cruzi infection risk was greater in those individuals who had relatives with Chagas disease, who remember seeing kissing bugs, who were of Bolivian nationality or were born in the Argentine province of Santiago del Estero. The overall prevalence of Chagas disease was 4.08%. Due to migration, Chagas disease is currently predominantly urban. The observed prevalence requires health programme activities that are aimed at urban children and their mothers. Most children were infected congenitally, which reinforces the need for Chagas disease screening of all pregnant women and their babies in Argentina. The active search for new cases is important because the appropriate treatment in children has a high cure rate.

It is currently unknown whether treatment of Chagas disease decreases the risk of congenital transmission from previously treated mothers to their infants. In a cohort of women with Chagas disease previously treated with benznidazole, no congenital transmission of the disease was observed in their newborns. This finding provides support for the treatment of Chagas disease as early as possible.

Neurocysticercosis (NC) is a central nervous system disease caused by Cysticercus cellulosae, the larvae of Taenia solium. NC is found worldwide, and endemic in Latin America and Asia. In 1993, 11 adult patients with NC were reported in Buenos Aires, 8 from Bolivia and the rest from Argentina. Pediatric cases reported in Argentina have been from inner provinces or from rural areas. The purpose of the present article is to present the first autochthonous pediatric case, with local source of contagion in the city of Buenos Aires, and to alert regarding the possibility that the city become an endemic area, due to the migratory movements leading to establishment of asymptomatic carriers of Taenia solium in the urban area.

La neurocisticercosis es la enfermedad parasitaria del sistema nervioso central provocada por la larva de Taenia solium, denominada Cysticercus cellulosae. Es una enfermedad universal, endémica en países de Latinoamérica y Asia. En 1993, en la provincia de Buenos Aires se comunicaron 11 casos de neurocisticercosis en pacientes adultos, 8 provenientes de Bolivia y 3 del interior de nuestro país. En la Argentina, los casos pediátricos comunicados son oriundos de países limítrofes o del interior del país. El propósito del presente artículo es presentar el primer caso pediátrico autóctono, con fuente de contagio local en la Ciudad de Buenos Aires y alertar sobre la posibilidad de que una región como ésta, ingrese dentro del área endémica, producto de los movimientos migratorios internos y externos, y del asentamiento de portadores de la parasitosis en el perímetro urbano.