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SEROPREVALENCE OF TRYPANOSOMA CRUZI INFECTION AMONG SCHOOL-AGE CHILDREN IN THE ENDEMIC AREA OF GUATEMALA

In support of the National Program for Chagas Disease Control, we conducted a cross-sectional study to estimate the seroprevalence rate of Trypanosoma cruzi infection across the five Departments (Chiquimula, Jalapa, Zacapa, Jutiapa, and Santa Rosa) that are believed to comprise the entire principal endemic area in Guatemala. Also, so that the results could be used to identify areas of active transmission, we conducted the survey in school-aged children. We used an experimental enzyme-linked immunosorbent assay with blood samples obtained by finger prick to estimate the seroprevalence of T. cruzi. This assay has been previously tested and showed good sensitivity and specificity. Overall, the seropositivity rate for T. cruzi infection was 5.28% (235 of 4,450). Of 173 communities evaluated, 35 (20.23%) had a seropositive rate ranging from 10% to 45%. A number of parameters, including but not limited to living conditions, were examined for possible association with seropositivity. While there are several associations, the strongest association with seropositivity is living in a house with a thatch roof. The survey results will permit the Ministry of Health to stratify T. cruzi-endemic communities, enabling local health authorities to efficiently focus on vector control operations.

Received March 5, 2002. Accepted for publication February 6, 2003.

Acknowledgments: We thank Dr. Julio C. Argueta (Ministry of Health and Social Assistance, Guatemala) for assistance, Ava Navin for her critically reviewing and editing the manuscript, Dr. Edwin C. Rowland (Ohio University, Athens, OH) for providing the T. cruzi antigen used in the ELISA, and Xiomara Munoz and Liliana Alverez for their expert technical assistance both in the field and in the laboratory.

Financial support: This investigation received financial support from the UNDP/World Bank/World Health Organization Special Program for Research and Training in Tropical Diseases (TDR).

Authors’ addresses: Nidia R. Rizzo and Byron A. Arana, Aniate Diaz, and Celia Cordon-Rosales, Center for Health Studies, Universidad del Valle de Guatemala/Medical Entomology Research and Training Unit/Guatemala, Division of Parasitic Diseases, Centers for Disease Control and Prevention, Apartado Postal No. 082, Guatemala City, Guatemala, Telephone: 502-369-0791, Fax: 502-364-0354; E-mails: nnrz{at}cdc.gov, baaz{at}cdc.gov, ad1z{at}cdc.gov and ccrz{at}cdc.gov. Robert E. Klein, Medical Entomology Research and Training Unit/Guatemala, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, American Embassy, APO, AA, Miami, FL, 34024-3321, Telephone: 502-369-0791, Fax: 502-364-0354, E-mail: reks{at}cdc.gov. Malcolm R. Powell, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Mailstop F-13, Atlanta, GA 30341, Telephone: 770-488-4529, Fax: 770-488-4108, E-mail: mrp5{at}cdc.gov.

Reprint requests: Malcolm R. Powell, Division of Parasitic Diseases, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Mailstop F-13 Atlanta, GA 30341.

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