Schofield CJ, Jannin J, Salvatella R, 2006. The future of Chagas disease control. Trends Parasitol 22: 583–588.
Torrico MC, Solano M, Guzmán JM, Parrado R, Suarez E, Alonzo-Vega C, Truyens C, Carlier Y, Torrico F, 2005. Estimation of the parasitemia in Trypanosoma cruzi human infection: high parasitemias are associated with severe and fatal congenital Chagas disease [in Portuguese]. Rev Soc Bras Med Trop 38 (Suppl 2): 58–61.
Salas NA, Cot M, Schneider D, Mendoza B, Santalla JA, Postigo J, Chippaux JP, Brutus L, 2007. Risk factors and consequences of congenital Chagas disease in Yacuiba, south Bolivia. Trop Med Int Health 12: 1498–1505.
Carlier Y, 2005. Factors and mechanisms involved in the transmission and development of congenital infection with Trypanosoma cruzi [in Portuguese]. Rev Soc Bras Med Trop 38 (Suppl 2): 105–107.
Hermann E, Truyens C, Alonso-Vega C, Rodriguez P, Berthe A, Torrico F, Carlier Y, 2004. Congenital transmission of Trypanosoma cruzi is associated with maternal enhanced parasitemia and decreased production of interferon-gamma in response to parasite antigens. J Infect Dis 189: 1274–1281.
Bern C, Verastegui M, Gilman RH, Lafuente C, Galdos-Cardenas G, Calderon M, Pacori J, Del Carmen Abastoflor M, Aparicio H, Brady MF, Ferrufino L, Angulo N, Marcus S, Sterling C, Maguire JH, 2009. Congenital Trypanosoma cruzi transmission in Santa Cruz, Bolivia. Clin Infect Dis 49: 1667–1674.
Freilij H, Muller L, Gonzalez Cappa SM, 1983. Direct micromethod for diagnosis of acute and congenital Chagas' disease. J Clin Microbiol 18: 327–330.
Portela-Lindoso AA, Shikanai-Yasuda MA, 2003. Chronic Chagas' disease: from xenodiagnosis and hemoculture to polymerase chain reaction [in Spanish]. Rev Saude Publica 37: 107–115.
Storni P, Bolsi FL, 1979. Pregnancy and Trypanosoma cruzi parasitism [in Spanish]. Medicina (B Aires) 39: 193–197.
Menezes CA, Bittencourt AL, Mota E, Sherlock I, Ferreira J, 1992. The assessment of parasitemia in women who are carriers of Trypanosoma cruzi infection during and after pregnancy [in Portuguese]. Rev Soc Bras Med Trop 25: 109–113.
Torrico F, Vega CA, Suarez E, Tellez T, Brutus L, Rodriguez P, Torrico MC, Schneider D, Truyens C, Carlier Y, 2006. Are maternal re-infections with Trypanosoma cruzi associated with higher morbidity and mortality of congenital Chagas disease? Trop Med Int Health 11: 628–635.
Dickover RE, Garratty EM, Herman SA, Sim MS, Plaeger S, Boyer PJ, Keller M, Deveikis A, Stiehm ER, Bryson YJ, 1996. Identification of levels of maternal HIV-1 RNA associated with risk of perinatal transmission. Effect of maternal zidovudine treatment on viral load. JAMA 275: 599–605.
Desmonts G, Couvreur J, 1974. Toxoplasmosis in pregnancy and its transmission to the fetus. Bull NY Acad Med 50: 146–159.
Vekemans J, Truyens C, Torrico F, Solano M, Torrico MC, Rodriguez P, Alonso-Vega C, Carlier Y, 2000. Maternal Trypanosoma cruzi infection upregulates capacity of uninfected neonate cells to produce pro- and anti-inflammatory cytokines. Infect Immun 68: 5430–5434.
Truyens C, Hermann E, Alonso-Vega C, Rodriguez P, Vekemans J, Torrico F, Carlier Y, 2005. Immune responses of non-infected neonates of mothers infected with Trypanosoma cruzi [in Portuguese]. Rev Soc Bras Med Trop 38 (Suppl 2): 96–100.
Russomando G, de Tomassone MM, de Guillen I, Acosta N, Vera N, Almiron M, Candia N, Calcena MF, Figueredo A, 1998. Treatment of congenital Chagas' disease diagnosed and followed up by the polymerase chain reaction. Am J Trop Med Hyg 59: 487–491.
Blanco SB, Segura EL, Cura EN, Chuit R, Tulian L, Flores I, Garbarino G, Villalonga JF, Gürtler RE, 2000. Congenital transmission of Trypanosoma cruzi: an operational outline for detecting and treating infected infants in north-western Argentina. Trop Med Int Health 5: 293–301.
Anonymous, 1987. Essential drugs. Trypanosomiases. WHO Drug Information 1: 230–237.
Anonymous, 2009. Antitrypanosomal medicines. Stuart MC, Kouimtzi M, Hill SR, eds. American Trypanosomiasis. WHO Model Formulary 2008. Geneva: World Health Organization, 211–213.
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Vector control has led to a drastic decrease in the prevalence of acquired Chagas disease in Latin America, thus redirecting attention to congenital Chagas disease. We report results of a longitudinal study of 359 pregnant women in Yacuiba in southern Bolivia, of whom 147 (40.9%) were infected with Trypanosoma cruzi, to evaluate the relationship between the patency period of the parasitemia and the risk of congenital infection. Maternal infection was assessed by using T. cruzi-specific serologic tests, and parasitemia in mothers and newborns was diagnosed by using microscopic examination of blood in heparinized microhematocrit tubes. Parasitemia was present in 28.6% of the infected women. Its prevalence increased during the third trimester, then decreased at delivery. The likelihood of congenital infection was significantly correlated with the parasite density in the mother's blood. The risk of transmission increased during the third trimester of pregnancy and could explain premature births or low-weight newborns for infected mothers.
Financial support: This study was supported by French Institut de Recherche pour le Développement and French Institut de Médecine et d'Epidémiologie Appliquée (grant IMEA 0201).
Disclosure: None of the authors have any conflicts of interest.
Authors' addresses: Laurent Brutus, Dominique Schneider, and Jean-Philippe Chippaux, IRD UMR216, Mother and Child Facing Tropical Infections, Paris, France, and Faculté de Pharmacie, Université Paris Descartes, Paris, France, E-mails: laurent.brutus@ird.fr, dschneider@club-internet.fr, and jean-philippe.chippaux@ird.fr. Helen Castillo, Claudia Bernal, and Nadin Alejandra Salas, IRD UMR216, Mother and Child Facing Tropical Infections, La Paz, Bolivia, E-mails: helenadejavu@gmail.com, claudiabernalp@hotmail.com, and asalcla@hotmail.com. José-Antonio Santalla, Laboratory of Parasitology, Instituto Nacional de Laboratorios de Salud, Ministry of Health and Sport, La Paz, Bolivia, E-mail: josesantalla@gmail.com.
Schofield CJ, Jannin J, Salvatella R, 2006. The future of Chagas disease control. Trends Parasitol 22: 583–588.
Torrico MC, Solano M, Guzmán JM, Parrado R, Suarez E, Alonzo-Vega C, Truyens C, Carlier Y, Torrico F, 2005. Estimation of the parasitemia in Trypanosoma cruzi human infection: high parasitemias are associated with severe and fatal congenital Chagas disease [in Portuguese]. Rev Soc Bras Med Trop 38 (Suppl 2): 58–61.
Salas NA, Cot M, Schneider D, Mendoza B, Santalla JA, Postigo J, Chippaux JP, Brutus L, 2007. Risk factors and consequences of congenital Chagas disease in Yacuiba, south Bolivia. Trop Med Int Health 12: 1498–1505.
Carlier Y, 2005. Factors and mechanisms involved in the transmission and development of congenital infection with Trypanosoma cruzi [in Portuguese]. Rev Soc Bras Med Trop 38 (Suppl 2): 105–107.
Hermann E, Truyens C, Alonso-Vega C, Rodriguez P, Berthe A, Torrico F, Carlier Y, 2004. Congenital transmission of Trypanosoma cruzi is associated with maternal enhanced parasitemia and decreased production of interferon-gamma in response to parasite antigens. J Infect Dis 189: 1274–1281.
Bern C, Verastegui M, Gilman RH, Lafuente C, Galdos-Cardenas G, Calderon M, Pacori J, Del Carmen Abastoflor M, Aparicio H, Brady MF, Ferrufino L, Angulo N, Marcus S, Sterling C, Maguire JH, 2009. Congenital Trypanosoma cruzi transmission in Santa Cruz, Bolivia. Clin Infect Dis 49: 1667–1674.
Freilij H, Muller L, Gonzalez Cappa SM, 1983. Direct micromethod for diagnosis of acute and congenital Chagas' disease. J Clin Microbiol 18: 327–330.
Portela-Lindoso AA, Shikanai-Yasuda MA, 2003. Chronic Chagas' disease: from xenodiagnosis and hemoculture to polymerase chain reaction [in Spanish]. Rev Saude Publica 37: 107–115.
Storni P, Bolsi FL, 1979. Pregnancy and Trypanosoma cruzi parasitism [in Spanish]. Medicina (B Aires) 39: 193–197.
Menezes CA, Bittencourt AL, Mota E, Sherlock I, Ferreira J, 1992. The assessment of parasitemia in women who are carriers of Trypanosoma cruzi infection during and after pregnancy [in Portuguese]. Rev Soc Bras Med Trop 25: 109–113.
Torrico F, Vega CA, Suarez E, Tellez T, Brutus L, Rodriguez P, Torrico MC, Schneider D, Truyens C, Carlier Y, 2006. Are maternal re-infections with Trypanosoma cruzi associated with higher morbidity and mortality of congenital Chagas disease? Trop Med Int Health 11: 628–635.
Dickover RE, Garratty EM, Herman SA, Sim MS, Plaeger S, Boyer PJ, Keller M, Deveikis A, Stiehm ER, Bryson YJ, 1996. Identification of levels of maternal HIV-1 RNA associated with risk of perinatal transmission. Effect of maternal zidovudine treatment on viral load. JAMA 275: 599–605.
Desmonts G, Couvreur J, 1974. Toxoplasmosis in pregnancy and its transmission to the fetus. Bull NY Acad Med 50: 146–159.
Vekemans J, Truyens C, Torrico F, Solano M, Torrico MC, Rodriguez P, Alonso-Vega C, Carlier Y, 2000. Maternal Trypanosoma cruzi infection upregulates capacity of uninfected neonate cells to produce pro- and anti-inflammatory cytokines. Infect Immun 68: 5430–5434.
Truyens C, Hermann E, Alonso-Vega C, Rodriguez P, Vekemans J, Torrico F, Carlier Y, 2005. Immune responses of non-infected neonates of mothers infected with Trypanosoma cruzi [in Portuguese]. Rev Soc Bras Med Trop 38 (Suppl 2): 96–100.
Russomando G, de Tomassone MM, de Guillen I, Acosta N, Vera N, Almiron M, Candia N, Calcena MF, Figueredo A, 1998. Treatment of congenital Chagas' disease diagnosed and followed up by the polymerase chain reaction. Am J Trop Med Hyg 59: 487–491.
Blanco SB, Segura EL, Cura EN, Chuit R, Tulian L, Flores I, Garbarino G, Villalonga JF, Gürtler RE, 2000. Congenital transmission of Trypanosoma cruzi: an operational outline for detecting and treating infected infants in north-western Argentina. Trop Med Int Health 5: 293–301.
Anonymous, 1987. Essential drugs. Trypanosomiases. WHO Drug Information 1: 230–237.
Anonymous, 2009. Antitrypanosomal medicines. Stuart MC, Kouimtzi M, Hill SR, eds. American Trypanosomiasis. WHO Model Formulary 2008. Geneva: World Health Organization, 211–213.
Past two years | Past Year | Past 30 Days | |
---|---|---|---|
Abstract Views | 288 | 202 | 21 |
Full Text Views | 377 | 19 | 1 |
PDF Downloads | 159 | 14 | 1 |