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ASSOCIATION AND EPIDEMIOLOGIC FEATURES OF TRYPANOSOMA CRUZI AND HUMAN T CELL LYMPHOTROPIC A VIRUS TYPE II IN INHABITANTS OF THE PARAGUAYAN GRAN CHACO

Serologic evidence of Trypanosoma cruzi infection was demonstrated in 43.5% of 519 Paleoamerindians and in only 2.5% of 161 non-Indians (Mennonites of German descent and Paraguayans of Spanish descent) inhabiting an area of western Paraguay that belongs to the Gran Chaco territory. These people ranged in age between two and 80 years. All were also tested for infection with the human T cell lymphotropic virus type II (HTLV-II). The prevalence of HTLV-II infection was 22.1% in Indians and 3.7% in non-Indians. As determined by a multivariate logistic regression analysis that controlled for relevant confounders, an HTLV-II-infected individual was 2.28 times more likely to be seropositive for T. cruzi than an HTLV-II negative. Possible explanations for this finding are discussed. The difference in T. cruzi prevalence between Indians and non-Indians was associated with differences between these groups in exposure to known risk factors for infection with the parasite. There were significant differences in the seroprevalence of T. cruzi among the two predominant Indian groups, even when they inhabited communities that were close to each other. These differences were associated with differences in the prevalence of HTLV-II infection but not with differences in exposure to known risk factors for T. cruzi infection. Infection with T. cruzi increased with age, was greater in males than in females, and clustered in families.

Received February 14, 2002. Accepted for publication June 20, 2002.

Acknowledgments: We thank Dr. Andres Vidovich Morales (Ministro de Salud Pública y Bienestar Social of Paraguay) and Dr. Alvin Stahl (Director Médico del Hospital Filadelfia of Paraguay) for their invaluable support and contributions to our studies. We also thank Dr. Stahl for providing us with laboratory space in the Hospital Filadelfia and for facilitating our access to the people studied. The assistance of the personnel of this hospital and of the local health clinics is also gratefully acknowledged.

Financial support: This study was supported in part by a grant from the University of Pennsylvania Research Foundation and the Barbara Kopp Cancer Research Fund.

Authors’ addresses: Jorge F. Ferrer and David Galligan, New Bolton Center, University of Pennsylvania, 382 West Street Road, Kennett Square, PA 19348, Telephone: 610-444-5800, Fax: 610-925-8123. Eduardo Esteban, Alicia Murua, Silvina Gutierrez, and Leonardo Feldman, Area de Virología, Universidad Nacional del Centro de la Provincia de Buenos Aires, Pinto 399, 7000 Tandil, Argentina, Telephone/Fax: 54-2293-441912. Syamalima Dube and Bernard J. Poiesz, Department of Medicine, Hematology/Oncology Laboratories, State University of New York, 750 East Adams Street, Syracuse, NY 13210, Telephone: 315-464-5446, Fax: 315-464-8255. Miguel A. Basombrio, Laboratorio de Patología Experimental, Facultad de Ciencias de la Salud, Universidad Nacional de Salta, Buenos Aires 177, 4000 Salta, Argentina, Telephone/Fax : 54-87-255333.

Reprint requests: Jorge F. Ferrer, New Bolton Center, University of Pennsylvania, 382 West Street Road, Kennett Square, PA 19348, e-mail: jfferrer{at}vet.upenn.edu.