Detectable Trypanosoma cruzi Parasitemia during Pregnancy and Delivery as a Risk Factor for Congenital Chagas Disease

Laurent Brutus IRD UMR216, Mother and Child Facing Tropical Infections, Paris, France; Faculté de Pharmacie, Université Paris Descartes, Paris, France; IRD UMR216, Mother and Child Facing Tropical Infections, La Paz, Bolivia; Laboratory of Parasitology, Instituto Nacional de Laboratorios de Salud, Ministry of Health and Sport, La Paz, Bolivia

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Helen Castillo IRD UMR216, Mother and Child Facing Tropical Infections, Paris, France; Faculté de Pharmacie, Université Paris Descartes, Paris, France; IRD UMR216, Mother and Child Facing Tropical Infections, La Paz, Bolivia; Laboratory of Parasitology, Instituto Nacional de Laboratorios de Salud, Ministry of Health and Sport, La Paz, Bolivia

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Claudia Bernal IRD UMR216, Mother and Child Facing Tropical Infections, Paris, France; Faculté de Pharmacie, Université Paris Descartes, Paris, France; IRD UMR216, Mother and Child Facing Tropical Infections, La Paz, Bolivia; Laboratory of Parasitology, Instituto Nacional de Laboratorios de Salud, Ministry of Health and Sport, La Paz, Bolivia

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Nadin Alejandra Salas IRD UMR216, Mother and Child Facing Tropical Infections, Paris, France; Faculté de Pharmacie, Université Paris Descartes, Paris, France; IRD UMR216, Mother and Child Facing Tropical Infections, La Paz, Bolivia; Laboratory of Parasitology, Instituto Nacional de Laboratorios de Salud, Ministry of Health and Sport, La Paz, Bolivia

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Dominique Schneider IRD UMR216, Mother and Child Facing Tropical Infections, Paris, France; Faculté de Pharmacie, Université Paris Descartes, Paris, France; IRD UMR216, Mother and Child Facing Tropical Infections, La Paz, Bolivia; Laboratory of Parasitology, Instituto Nacional de Laboratorios de Salud, Ministry of Health and Sport, La Paz, Bolivia

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José-Antonio Santalla IRD UMR216, Mother and Child Facing Tropical Infections, Paris, France; Faculté de Pharmacie, Université Paris Descartes, Paris, France; IRD UMR216, Mother and Child Facing Tropical Infections, La Paz, Bolivia; Laboratory of Parasitology, Instituto Nacional de Laboratorios de Salud, Ministry of Health and Sport, La Paz, Bolivia

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Jean-Philippe Chippaux IRD UMR216, Mother and Child Facing Tropical Infections, Paris, France; Faculté de Pharmacie, Université Paris Descartes, Paris, France; IRD UMR216, Mother and Child Facing Tropical Infections, La Paz, Bolivia; Laboratory of Parasitology, Instituto Nacional de Laboratorios de Salud, Ministry of Health and Sport, La Paz, Bolivia

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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.

Author Notes

*Address correspondence Jean-Philippe Chippaux, Institut de Recherche Pour le Développement, 08 BP 841, Cotonou, Benin. E-mail: jean-philippe.chippaux@ird.fr

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.

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