Volume 70, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


This work compares the results of two epidemiologic and clinical surveys on the consequences of maternal chronic infection. They were conducted in 1992–1994 and 1999–2001 in the same maternity clinic in Bolivia, a country highly endemic for infection with this parasite. In both surveys, the materno-fetal transmission of parasites occurred in 5-6% of the infected mothers. Maternal chronic infection had no effect on pregnancy outcome and health of newborns when there was no materno-fetal transmission of parasites. Comparisons between the older and the more recent surveys highlighted significant reductions in frequencies of symptomatic cases (from 54% to 45%), Apgar scores <7, and low birth weights and prematurity (from 32–50% to 6–16%) among congenitally infected babies. Neonatal mortality related to congenital Chagas disease also decreased from 13% to 2% in the interval between both studies. These results suggest that the decrease in poverty that has occurred in Bolivia between both surveys might have contributed to reduce the morbidity and mortality, but not the transmission rate of congenital infection, which remains a serious public health problem in this country.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Carlier Y, Pinto Dias JC, Luquetti AO, Hontebeyrie M, Torrico F, Truyens C. 2002. Trypanosomiase américaine ou maladie de Chagas. Encyclopedie Médico-Chirurgicale, Maladies Infectieuses. 8-505-A-20. Editions Scientifiques et Médicales. Paris: Elsevier SAS.
  2. Rubio M, Howard J, 1968. Congenital Chagas’ disease. II. Pathological findings in nine cases. Bol Chil Parasitol 23 : 113–121. [Google Scholar]
  3. Bittencourt AL, 1976. Congenital Chagas disease. Am J Dis Child 130 : 97–103. [Google Scholar]
  4. Schmuñis GA, Szarfman A, 1977. La enfermedad de Chagas congenito. Medicina (B Aires) 37 : 47–53. [Google Scholar]
  5. Freilij H, Altcheh J, 1995. Congenital Chagas’ disease: diagnostic and clinical aspects. Clin Infect Dis 21 : 551–555. [Google Scholar]
  6. Streiger M, Fabbro D, del Barco M, Beltramino R, Bovero N, 1995. Congenital Chagas disease in the city of Santa Fe. Diagnosis and treatment. Medicina (B Aires) 55 : 125–132. [Google Scholar]
  7. Moya PR, Moretti ERA, 1997. Doença de Chagas congênita. Pinto Dias JC, Coura JR, eds. Clínica e Terapêutica da Doença de Chagas - Uma Abordagem Prática para o Clínico Geral. Rio de Janeiro: Editoria Fiocruz, 383–409.
  8. Blanco SB, Segura EL, Cura EN, Chuit R, Tulian L, Flores I, Garbarino G, Villalonga JF, Gurtler 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. [Google Scholar]
  9. de Castilho EA, da Silva GR, 1976. Maternal Chagas’ infection and prematurity. Rev Inst Med Trop Sao Paulo 18 : 258–260. [Google Scholar]
  10. Hernandez-Matheson IM, Frankowski RF, Held B, 1983. Foetomaternal morbidity in the presence of antibodies to Trypanosoma cruzi. Trans R Soc Trop Med Hyg 77 : 405–411. [Google Scholar]
  11. Schenone H, Contreras MC, Borgono JM, Rojas A, Villarroel F, 1985. Congenital Chagas’ disease in Chile. Longitudinal study of the reproductivity of women with or without Chagas’ disease and of some parasitological and clinical parameters of them and their corresponding children. Bol Chil Parasitol 40 : 24–29. [Google Scholar]
  12. Oliveira FC, Chapadeiro E, Alonso MT, Lopes ER, Pereira FE, 1966. Chagas disease and pregnancy. I. Incidence of trypanosomiasis and spontaneous abortion in pregnant women with chronic Chagas disease. Rev Inst Med Trop Sao Paulo 8 : 184–185. [Google Scholar]
  13. Teruel JR, Nogueira JL, 1970. Fetal losses in a high prevalence area of chronic Chagas’ disease. Rev Inst Med Trop Sao Paulo 12 : 239–244. [Google Scholar]
  14. Bittencourt AL, 1992. Possible risk factors for vertical transmission of Chagas’ disease. Rev Inst Med Trop Sao Paulo 34 : 403–408. [Google Scholar]
  15. Schmuñis GA, 2000. A Tripanossomíase Americana e seu Impacto na Saúde Pública das Americas. Brener Z, Andrade ZA, Barral-Netto M, eds. Trypanosoma cruzi e Doença de Chagas. Second edition. Rio de Janeiro: Editora Guanabara Koogan SA, 1–15.
  16. Azogue E, La Fuente C, Darras C, 1985. Congenital Chagas’ disease in Bolivia: epidemiological aspects and pathological findings. Trans R Soc Trop Med Hyg 79 : 176–180. [Google Scholar]
  17. Azogue E, Darras C, 1991. Prospective study of Chagas disease in newborn children with placental infection caused by Trypanosoma cruzi (Santa Cruz-Bolivia). Rev Soc Bras Med Trop 24 : 105–109. [Google Scholar]
  18. Azogue E, 1993. Women and congenital Chagas’ disease in Santa Cruz, Bolivia: epidemiological and sociocultural aspects. Soc Sci Med 37 : 503–511. [Google Scholar]
  19. Breniere SF, Carrasco R, Miguez H, Lemesre JL, Carlier Y, 1985. Comparisons of immunological tests for serodiagnosis of Chagas disease in Bolivian patients. Trop Geogr Med 37 : 231–238. [Google Scholar]
  20. Freilij H, Muller L, Gonzalez Cappa SM, 1983. Direct micromethod for diagnosis of acute and congenital Chagas’ disease. J Clin Microbiol 18 : 327–330. [Google Scholar]
  21. Basso B, Moretti ER, 1984. Detection of Trypanosoma cruzi by hemoculture in patients with chronic Chagas’ disease. Medicina (B Aires) 44 : 41–47. [Google Scholar]
  22. Virreira M, Torrico F, Truyens C, Alonso-Vega C, Solano M, Carlier Y, Svoboda M, 2003. Comparison of PCR methods for reliable and easy detection of congenital Trypanosoma cruzi infection. Am J Trop Med Hyg 68 : 574–582. [Google Scholar]
  23. Kliegman RM, 2002. Fetal and neonatal medicine. Behrman RE, Kliegman RM, eds. Nelson Essentials of Pediatrics. Fourth edition. Philadelphia: W. B. Saunders Company, 179–249.
  24. Ballard JL, Khoury JC, Wedig K, Wang L, Eilers-Walsman BL, Lipp R, 1991. New Ballard Score, expanded to include extremely premature infants. J Pediatr 119 : 417–423. [Google Scholar]
  25. Klein JO, Remington JS, 2001. Current concepts of infections of the fetus and newborn infant. Remington JS, Klein JO, eds. Infectious Diseases of the Fetus and Newborn Infant. Fifth edition. Philadelphia: W. B. Saunders Company, 1–23.
  26. Voller A, Bidwell D, 1982. Detection and measurement of malarial antigens and antibodies by labelled reagent methods. Strickland GT, Hunter KW Jr, eds. Immunology Parasitology: Principles and Methods in Malaria and Schistosomiasis Research. New York: Praeger, 99–107.
  27. Altman DG, 1991. Practical Statistics for Medical Research. London: Chapman & Hall.
  28. Moya PR, Villagra L, Risco J, 1979. Congenital Chagas disease: anatomopathological findings in the placenta and umbilical cord. Rev Fac Cienc Med Univ Nac Cordoba 37 : 21–27. [Google Scholar]
  29. Arcavi M, Orfus G, Griemberg G, 1993. Incidence of Chagas infection in pregnant women and newborn infants in a non-endemic area. Medicina (B Aires) 53 : 217–222. [Google Scholar]
  30. Basombrio MA, Nasser J, Segura MA, Marco D, Sanchez NO, Padilla M, Mora MC, 1999. The transmission de Chagas disease in Salta and the detection of congenital cases. Medicina (B Aires) 59 (suppl 2): 143–146. [Google Scholar]
  31. Bittencourt AL, 2000. Transmissão vertical da doença de Chagas. Brener Z, Andrade ZA, Barral-Netto M, eds. Trypanosoma cruzi e Doena de Chagas. Second edition. Rio de Janeiro: Editora Guanabara Koogan SA, 16–20.
  32. 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. [Google Scholar]
  33. Schenone H, Contreras MC, Borgono JM, Maturana R, Salinas P, Sandoval L, Rojas A, Tello P, Villarroel F, 1991. Overview of the epidemiology of Chagas’ disease in Chile. Bol Chil Parasitol 46 : 19–30. [Google Scholar]
  34. Lorca M, 2002. III. La enfermadad de Chagas congénita, transfusional y otras vías en el contexto de la interrupción de la transmisión vectorial. Rev Patol Trop 31 : 86–89. [Google Scholar]
  35. Bittencourt AL, 1988. American trypanosomiasis (Chagas’ disease). McLeod C, ed. Parasitic Infections in Pregnancy and the Newborn. First edition. Oxford, United Kingdom: Oxford University Press, 62–86.
  36. Freilij H, Altcheh J, Muchinik G, 1995. Perinatal human immunodeficiency virus infection and congenital Chagas’ disease. Pediatr Infect Dis J 14 : 161–162. [Google Scholar]
  37. Hermann E, Truyens C, Alonso-Vega C, Even J, Rodriguez P, Berthe A, Gonzalez-Merino E, Torrico F, Carlier Y, 2002. Human fetuses are able to mount an adultlike CD8 T-cell response. Blood 100 : 2153–2158. [Google Scholar]
  38. Geissler RG, Ottmann OG, Kojouharoff G, Reutzel P, Eder M, Hoelzer D, Ganser A, 1992. Influence of human recombinant interferon-alpha and interferon-gamma on bone marrow progenitor cells of HIV-positive individuals. AIDS Res Hum Retroviruses 8 : 521–525. [Google Scholar]
  39. Gelbard A, Haub C, Kent MM, 1999. World population beyond six billion. Popul Bull 54 : 1–44. [Google Scholar]
  40. Schenone H, Gaggero M, Sapunar J, Contreras MC, Rojas A, 2001. Congenital Chagas disease of second generation in Santiago, Chile. Report of two cases. Rev Inst Med Trop Sao Paulo 43 : 231–232. [Google Scholar]
  41. Hoff R, Mott KE, Milanesi ML, Bittencourt AL, Barbosa HS, 1978. Congenital Chagas’s disease in an urban population: investigation of infected twins. Trans R Soc Trop Med Hyg 72 : 247–250. [Google Scholar]

Data & Media loading...

  • Received : 14 Jul 2003
  • Accepted : 10 Oct 2003

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error