World Health Organization, 2018. Chagas Disease (American Trypanosomiasis). Fact Sheet. Available at: http://www.who.int/news-room/fact-sheets/detail/chagas-disease-(american-trypanosomiasis). Accessed April 1, 2019.
Carlier Y, Sosa-Estani S, Luquetti AO, Buekens P, 2015. Congenital Chagas disease: an update. Mem Inst Oswaldo Cruz 110: 363–368.
World Health Organization, 2006. Estimación Euantitativa de la Enfermedad de Chagas en las Américas. Available at: http://ops-uruguay.bvsalud.org/pdf/chagas19.pdf. Accessed April 1, 2019.
Rodari P, Angheben A, Gennati G, Trezzi L, Bargiggia G, Maino M, Ruggeri M, Rampello S, Soavi L, Rizzi M, 2018. Congenital Chagas disease in a non-endemic area: results from a control programme in Bergamo province, northern Italy. Travel Med Infect Dis 25: 31–34.
Stillwaggon E, Perez-Zetune V, Bialek SR, Montgomery SP, 2018. Congenital Chagas disease in the United States: cost savings through maternal screening. Am J Trop Med Hyg 98: 1733–1742.
Gulin JEN, Bisio M, Rocco DM, Altcheh J, Solana ME, Garcia-Bournissen F, 2018. Molecular and biological characterization of a highly pathogenic Trypanosoma cruzi strain isolated from a patient with congenital infection. Exp Parasitol 186: 50–58.
Torrico F, Alonso-Vega C, Suarez E, Rodriguez P, Torrico MC, Dramaix M, Truyens C, Carlier Y, 2004. Maternal Trypanosoma cruzi infection, pregnancy outcome, morbidity, and mortality of congenitally infected and non-infected newborns in Bolivia. Am J Trop Med Hyg 70: 201–209.
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.
Altcheh J, Moscatelli G, Moroni S, Garcia-Bournissen F, Freilij H, 2011. Adverse events after the use of benznidazole in infants and children with Chagas disease. Pediatrics 127: e212–e218.
Carlier Y, Torrico F, Sosa-Estani S, Russomando G, Luquetti A, Freilij H, Albajar Vinas P, 2011. Congenital Chagas disease: recommendations for diagnosis, treatment and control of newborns, siblings and pregnant women. PLoS Negl Trop Dis 5: e1250.
Altcheh J, Moscatelli G, Mastrantonio G, Moroni S, Giglio N, Marson ME, Ballering G, Bisio M, Koren G, Garcia-Bournissen F, 2014. Population pharmacokinetic study of benznidazole in pediatric Chagas disease suggests efficacy despite lower plasma concentrations than in adults. PLoS Negl Trop Dis 8: e2907.
Mora MC, Sanchez Negrette O, Marco D, Barrio A, Ciaccio M, Segura MA, Basombrio MA, 2005. Early diagnosis of congenital Trypanosoma cruzi infection using PCR, hemoculture, and capillary concentration, as compared with delayed serology. J Parasitol 91: 1468–1473.
Grijalva MJ, Escalante L, Paredes RA, Costales JA, Padilla A, Rowland EC, Aguilar HM, Racines J, 2003. Seroprevalence and risk factors for Trypanosoma cruzi infection in the Amazon region of Ecuador. Am J Trop Med Hyg 69: 380–385.
Chico M, Sandoval C, Guevara A, Calvopina M, Cooper PJ, Reed SG, Guderian RH, 1997. Chagas disease in Ecuador: evidence for disease transmission in an Indigenous population in the Amazon region. Mem Inst Oswaldo Cruz 92: 317–320.
Amunarriz M, Chico ME, Guderian RH, 1991. Chagas disease in Ecuador: a sylvatic focus in the Amazon region. J Trop Med Hyg 94: 145–149.
Carrera Vargas C, Narvaez AO, Muzzio Aroca J, Shiguango G, Robles LM, Herrera C, Dumonteil E, 2015. Seroprevalence of Trypanosoma cruzi infection in schoolchildren and in pregnant women from an Amazonian region in Orellana Province, Ecuador. Am J Trop Med Hyg 93: 774–778.
Guevara AG, Atherton RD, Wauters MA, Vicuna Y, Nelson M, Prado J, Kato H, Calvopina MH, Hashiguchi Y, 2013. Seroepidemiological study of Chagas disease in the southern Amazon region of Ecuador. Trop Med Health 41: 21–25.
Dumonteil E, Herrera C, Martini L, Grijalva MJ, Guevara AG, Costales JA, Aguilar HM, Brenière SF, Waleckx E, 2016. Chagas disease has not been controlled in Ecuador. PLoS One 11: e0158145.
Rosecrans K, Cruz-Martin G, King A, Dumonteil E, 2014. Opportunities for improved Chagas disease vector control based on knowledge, attitudes and practices of communities in the Yucatan Peninsula, Mexico. PLoS Negl Trop Dis 8: e2763.
Sanmartino M, Crocco L, 2000. Conocimientos sobre la enfermedad de Chagas y factores de riesgo en comunidades epidemiológicamente diferentes de Argentina. Rev Panam Salud Publica 7: 173–178.
World Health Organization, 2002. Control of Chagas Disease: Second Report of the WHO Expert Committee. WHO Technical Report Series. Geneva, Switzerland: WHO, 1–109.
La Fuente C, Saucedo E, Urjel R, 1984. The use of microhaematocrit tubes for the rapid diagnosis of Chagas disease and malaria. Trans R Soc Trop Med Hyg 78: 278–279.
Wincker P, Bosseno MF, Britto C, Yaksic N, Cardoso MA, Morel CM, Brenière SF, 1994. High correlation between Chagas’ disease serology and PCR-based detection of Trypanosoma cruzi kinetoplast DNA in Bolivian children living in an endemic area. FEMS Microbiol Lett 124: 419–423.
Britto C, Cardoso MA, Ravel C, Santoro A, Pereira JB, Coura JR, Morel CM, Wincker P, 1995. Trypanosoma cruzi: parasite detection and strain discrimination in chronic Chagasic patients from northeastern Brazil using PCR amplification of kinetoplast DNA and nonradioactive hybridization. Exp Parasitol 81: 462–471.
Soper DS, 2018. Poisson Confidence Interval Calculator [Software]. Available at: http://www.danielsoper.com/statcalc. Accessed October 9, 2016.
Gillaizeau F, Grabar S, 2011. Modèles de régression multiple. Sang Thromb Vaiss 23: 360–370.
Mantel N, 1967. The detection of disease clustering and a generalized regression approach. Cancer Res 27: 209–220.
R Development Core Team, 2008. R: A Language and Environment for Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing. Available at: http://www.R-project.org. Accessed January 24, 2019.
Chongsuvivatwong V, 2018. EpiDisplay V 3.5.0.1: Epidemiological Data Display Package. Available at: https://rdrr.io/cran/epiDisplay/. Accessed January 24, 2019.
Costales JA, Sanchez-Gomez A, Silva-Aycaguer LC, Cevallos W, Tamayo S, Yumiseva CA, Jacobson JO, Martini L, Carrera CA, Grijalva MJ, 2015. A national survey to determine prevalence of Trypanosoma cruzi infection among pregnant women in Ecuador. Am J Trop Med Hyg 92: 807–810.
Monge-Maillo B, Lopez-Velez R, 2017. Challenges in the management of Chagas disease in Latin-American migrants in Europe. Clin Microbiol Infect 23: 290–295.
Sicuri E, Munoz J, Pinazo MJ, Posada E, Sanchez J, Alonso PL, Gascon J, 2011. Economic evaluation of Chagas disease screening of pregnant Latin American women and of their infants in a non endemic area. Acta Trop 118: 110–117.
Requena-Mendez A, Bussion S, Aldasoro E, Jackson Y, Angheben A, Moore D, Pinazo MJ, Gascon J, Munoz J, Sicuri E, 2017. Cost-effectiveness of Chagas disease screening in Latin American migrants at primary health-care centres in Europe: a Markov model analysis. Lancet Glob Health 5: e439–e447.
Sosa-Estani S et al. 2008. Use of a rapid test on umbilical cord blood to screen for Trypanosoma cruzi infection in pregnant women in Argentina, Bolivia, Honduras, and Mexico. Am J Trop Med Hyg 79: 755–759.
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Congenital infection with Trypanosoma cruzi remains a major route for Chagas disease transmission in endemic and non-endemic regions. We evaluated an intervention strategy aimed to detect congenital Chagas disease cases at a major hospital in the Ecuadorian Amazon via cord blood analysis at the time of delivery. All women giving birth at the hospital during the study period (191) were invited to participate. Among them, two (1.0%) did not adjust to the inclusion criteria and four (2.1%) declined to participate in the study, showing the intervention had good acceptability among the mothers. It was possible to obtain cord blood samples during 146 of the deliveries, and only one woman was found to be seropositive, without evidence of transmission to the newborn at delivery or 8 months later. In addition, sociodemographic and economic characterization of the study population revealed that few women had previous knowledge about Chagas disease (16.1%) whereas more than half (62.5%) recognized the vector. Recognizing the vector and having seen it indoors were associated with women from rural families, involved in agriculture, and hunting in the forest. Interestingly, most women (87.3%) reported having easy access to Ecuador’s national health system, suggesting serological screening during prenatal visits would be of value in this province. With a proper prenatal screening system in place, cord blood screening would allow for timely detection of T. cruzi infection in newborns from both seropositive women and the minority (2.1%) of women who do not comply with prenatal care visits.
Financial support: This work received funding from the Institut de Recherche pour le Développement (IRD), France, and IdEx International 2015–2016 from the University of Bordeaux, France.
Authors’ addresses: Marion Restrepo Zambrano and Faustine Rouset, Public Health, Epidemiology and Development Institute (ISPED), University of Bordeaux, Bordeaux, France and Centro de Investigación para la Salud en América Latina (CISeAL), Escuela de Ciencias Biológicas, Pontificia Universidad Católica del Ecuador, Quito, Ecuador, E-mails: marionrestrepo85@gmail.com and faustine.rouset@hotmail.fr. Otita F. Carrasco, Hospital General Francisco de Orellana, Francisco de Orellana, Ecuador, E-mail: otita.carrasco@hfo.gob.ec. Diana Echeverría Murillo, Dirección Distrital 22D02, Orellana-Loreto-SALUD, Ministerio de Salud Pública, Francisco de Orellana, Ecuador, E-mail: diana_em55@hotmail.com. Jaime A. Costales, Centro de Investigación para la Salud en América Latina, Pontificia Universidad Católica del Ecuador, Quito, Ecuador, E-mail: jacostalesc@puce.edu.ec. Simone Frédérique Brenière, INTERTRYP, CIRAD, IRD, Université de Montpellier, Montpellier, France, E-mail: frederique.breniere@ird.fr.
These authors contributed equally to this work.
World Health Organization, 2018. Chagas Disease (American Trypanosomiasis). Fact Sheet. Available at: http://www.who.int/news-room/fact-sheets/detail/chagas-disease-(american-trypanosomiasis). Accessed April 1, 2019.
Carlier Y, Sosa-Estani S, Luquetti AO, Buekens P, 2015. Congenital Chagas disease: an update. Mem Inst Oswaldo Cruz 110: 363–368.
World Health Organization, 2006. Estimación Euantitativa de la Enfermedad de Chagas en las Américas. Available at: http://ops-uruguay.bvsalud.org/pdf/chagas19.pdf. Accessed April 1, 2019.
Rodari P, Angheben A, Gennati G, Trezzi L, Bargiggia G, Maino M, Ruggeri M, Rampello S, Soavi L, Rizzi M, 2018. Congenital Chagas disease in a non-endemic area: results from a control programme in Bergamo province, northern Italy. Travel Med Infect Dis 25: 31–34.
Stillwaggon E, Perez-Zetune V, Bialek SR, Montgomery SP, 2018. Congenital Chagas disease in the United States: cost savings through maternal screening. Am J Trop Med Hyg 98: 1733–1742.
Gulin JEN, Bisio M, Rocco DM, Altcheh J, Solana ME, Garcia-Bournissen F, 2018. Molecular and biological characterization of a highly pathogenic Trypanosoma cruzi strain isolated from a patient with congenital infection. Exp Parasitol 186: 50–58.
Torrico F, Alonso-Vega C, Suarez E, Rodriguez P, Torrico MC, Dramaix M, Truyens C, Carlier Y, 2004. Maternal Trypanosoma cruzi infection, pregnancy outcome, morbidity, and mortality of congenitally infected and non-infected newborns in Bolivia. Am J Trop Med Hyg 70: 201–209.
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.
Altcheh J, Moscatelli G, Moroni S, Garcia-Bournissen F, Freilij H, 2011. Adverse events after the use of benznidazole in infants and children with Chagas disease. Pediatrics 127: e212–e218.
Carlier Y, Torrico F, Sosa-Estani S, Russomando G, Luquetti A, Freilij H, Albajar Vinas P, 2011. Congenital Chagas disease: recommendations for diagnosis, treatment and control of newborns, siblings and pregnant women. PLoS Negl Trop Dis 5: e1250.
Altcheh J, Moscatelli G, Mastrantonio G, Moroni S, Giglio N, Marson ME, Ballering G, Bisio M, Koren G, Garcia-Bournissen F, 2014. Population pharmacokinetic study of benznidazole in pediatric Chagas disease suggests efficacy despite lower plasma concentrations than in adults. PLoS Negl Trop Dis 8: e2907.
Mora MC, Sanchez Negrette O, Marco D, Barrio A, Ciaccio M, Segura MA, Basombrio MA, 2005. Early diagnosis of congenital Trypanosoma cruzi infection using PCR, hemoculture, and capillary concentration, as compared with delayed serology. J Parasitol 91: 1468–1473.
Grijalva MJ, Escalante L, Paredes RA, Costales JA, Padilla A, Rowland EC, Aguilar HM, Racines J, 2003. Seroprevalence and risk factors for Trypanosoma cruzi infection in the Amazon region of Ecuador. Am J Trop Med Hyg 69: 380–385.
Chico M, Sandoval C, Guevara A, Calvopina M, Cooper PJ, Reed SG, Guderian RH, 1997. Chagas disease in Ecuador: evidence for disease transmission in an Indigenous population in the Amazon region. Mem Inst Oswaldo Cruz 92: 317–320.
Amunarriz M, Chico ME, Guderian RH, 1991. Chagas disease in Ecuador: a sylvatic focus in the Amazon region. J Trop Med Hyg 94: 145–149.
Carrera Vargas C, Narvaez AO, Muzzio Aroca J, Shiguango G, Robles LM, Herrera C, Dumonteil E, 2015. Seroprevalence of Trypanosoma cruzi infection in schoolchildren and in pregnant women from an Amazonian region in Orellana Province, Ecuador. Am J Trop Med Hyg 93: 774–778.
Guevara AG, Atherton RD, Wauters MA, Vicuna Y, Nelson M, Prado J, Kato H, Calvopina MH, Hashiguchi Y, 2013. Seroepidemiological study of Chagas disease in the southern Amazon region of Ecuador. Trop Med Health 41: 21–25.
Dumonteil E, Herrera C, Martini L, Grijalva MJ, Guevara AG, Costales JA, Aguilar HM, Brenière SF, Waleckx E, 2016. Chagas disease has not been controlled in Ecuador. PLoS One 11: e0158145.
Rosecrans K, Cruz-Martin G, King A, Dumonteil E, 2014. Opportunities for improved Chagas disease vector control based on knowledge, attitudes and practices of communities in the Yucatan Peninsula, Mexico. PLoS Negl Trop Dis 8: e2763.
Sanmartino M, Crocco L, 2000. Conocimientos sobre la enfermedad de Chagas y factores de riesgo en comunidades epidemiológicamente diferentes de Argentina. Rev Panam Salud Publica 7: 173–178.
World Health Organization, 2002. Control of Chagas Disease: Second Report of the WHO Expert Committee. WHO Technical Report Series. Geneva, Switzerland: WHO, 1–109.
La Fuente C, Saucedo E, Urjel R, 1984. The use of microhaematocrit tubes for the rapid diagnosis of Chagas disease and malaria. Trans R Soc Trop Med Hyg 78: 278–279.
Wincker P, Bosseno MF, Britto C, Yaksic N, Cardoso MA, Morel CM, Brenière SF, 1994. High correlation between Chagas’ disease serology and PCR-based detection of Trypanosoma cruzi kinetoplast DNA in Bolivian children living in an endemic area. FEMS Microbiol Lett 124: 419–423.
Britto C, Cardoso MA, Ravel C, Santoro A, Pereira JB, Coura JR, Morel CM, Wincker P, 1995. Trypanosoma cruzi: parasite detection and strain discrimination in chronic Chagasic patients from northeastern Brazil using PCR amplification of kinetoplast DNA and nonradioactive hybridization. Exp Parasitol 81: 462–471.
Soper DS, 2018. Poisson Confidence Interval Calculator [Software]. Available at: http://www.danielsoper.com/statcalc. Accessed October 9, 2016.
Gillaizeau F, Grabar S, 2011. Modèles de régression multiple. Sang Thromb Vaiss 23: 360–370.
Mantel N, 1967. The detection of disease clustering and a generalized regression approach. Cancer Res 27: 209–220.
R Development Core Team, 2008. R: A Language and Environment for Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing. Available at: http://www.R-project.org. Accessed January 24, 2019.
Chongsuvivatwong V, 2018. EpiDisplay V 3.5.0.1: Epidemiological Data Display Package. Available at: https://rdrr.io/cran/epiDisplay/. Accessed January 24, 2019.
Costales JA, Sanchez-Gomez A, Silva-Aycaguer LC, Cevallos W, Tamayo S, Yumiseva CA, Jacobson JO, Martini L, Carrera CA, Grijalva MJ, 2015. A national survey to determine prevalence of Trypanosoma cruzi infection among pregnant women in Ecuador. Am J Trop Med Hyg 92: 807–810.
Monge-Maillo B, Lopez-Velez R, 2017. Challenges in the management of Chagas disease in Latin-American migrants in Europe. Clin Microbiol Infect 23: 290–295.
Sicuri E, Munoz J, Pinazo MJ, Posada E, Sanchez J, Alonso PL, Gascon J, 2011. Economic evaluation of Chagas disease screening of pregnant Latin American women and of their infants in a non endemic area. Acta Trop 118: 110–117.
Requena-Mendez A, Bussion S, Aldasoro E, Jackson Y, Angheben A, Moore D, Pinazo MJ, Gascon J, Munoz J, Sicuri E, 2017. Cost-effectiveness of Chagas disease screening in Latin American migrants at primary health-care centres in Europe: a Markov model analysis. Lancet Glob Health 5: e439–e447.
Sosa-Estani S et al. 2008. Use of a rapid test on umbilical cord blood to screen for Trypanosoma cruzi infection in pregnant women in Argentina, Bolivia, Honduras, and Mexico. Am J Trop Med Hyg 79: 755–759.
Past two years | Past Year | Past 30 Days | |
---|---|---|---|
Abstract Views | 395 | 330 | 28 |
Full Text Views | 748 | 10 | 0 |
PDF Downloads | 196 | 8 | 0 |