A National Survey to Determine Prevalence of Trypanosoma cruzi Infection Among Pregnant Women in Ecuador

Jaime A. Costales Center for Infectious Disease Research, Pontificia Universidad Católica del Ecuador, Quito, Ecuador; Pan American Health Organization, Quito, Ecuador; National School of Public Health, Havana, Cuba; National STI/HIV-AIDS Program, Ministry of Public Health, Quito, Ecuador; Pan-American Health Organization, Bogotá, Colombia; Instituto Nacional de Salud Pública e Investigación (INSPI), Guayaquil, Ecuador; Biomedical Center, Central University of Ecuador, Quito, Ecuador; Department of Biomedical Sciences, Tropical Disease Institute, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio

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Amaya Sánchez-Gómez Center for Infectious Disease Research, Pontificia Universidad Católica del Ecuador, Quito, Ecuador; Pan American Health Organization, Quito, Ecuador; National School of Public Health, Havana, Cuba; National STI/HIV-AIDS Program, Ministry of Public Health, Quito, Ecuador; Pan-American Health Organization, Bogotá, Colombia; Instituto Nacional de Salud Pública e Investigación (INSPI), Guayaquil, Ecuador; Biomedical Center, Central University of Ecuador, Quito, Ecuador; Department of Biomedical Sciences, Tropical Disease Institute, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio

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Luis C. Silva-Aycaguer Center for Infectious Disease Research, Pontificia Universidad Católica del Ecuador, Quito, Ecuador; Pan American Health Organization, Quito, Ecuador; National School of Public Health, Havana, Cuba; National STI/HIV-AIDS Program, Ministry of Public Health, Quito, Ecuador; Pan-American Health Organization, Bogotá, Colombia; Instituto Nacional de Salud Pública e Investigación (INSPI), Guayaquil, Ecuador; Biomedical Center, Central University of Ecuador, Quito, Ecuador; Department of Biomedical Sciences, Tropical Disease Institute, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio

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William Cevallos Center for Infectious Disease Research, Pontificia Universidad Católica del Ecuador, Quito, Ecuador; Pan American Health Organization, Quito, Ecuador; National School of Public Health, Havana, Cuba; National STI/HIV-AIDS Program, Ministry of Public Health, Quito, Ecuador; Pan-American Health Organization, Bogotá, Colombia; Instituto Nacional de Salud Pública e Investigación (INSPI), Guayaquil, Ecuador; Biomedical Center, Central University of Ecuador, Quito, Ecuador; Department of Biomedical Sciences, Tropical Disease Institute, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio

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Susana Tamayo Center for Infectious Disease Research, Pontificia Universidad Católica del Ecuador, Quito, Ecuador; Pan American Health Organization, Quito, Ecuador; National School of Public Health, Havana, Cuba; National STI/HIV-AIDS Program, Ministry of Public Health, Quito, Ecuador; Pan-American Health Organization, Bogotá, Colombia; Instituto Nacional de Salud Pública e Investigación (INSPI), Guayaquil, Ecuador; Biomedical Center, Central University of Ecuador, Quito, Ecuador; Department of Biomedical Sciences, Tropical Disease Institute, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio

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César A. Yumiseva Center for Infectious Disease Research, Pontificia Universidad Católica del Ecuador, Quito, Ecuador; Pan American Health Organization, Quito, Ecuador; National School of Public Health, Havana, Cuba; National STI/HIV-AIDS Program, Ministry of Public Health, Quito, Ecuador; Pan-American Health Organization, Bogotá, Colombia; Instituto Nacional de Salud Pública e Investigación (INSPI), Guayaquil, Ecuador; Biomedical Center, Central University of Ecuador, Quito, Ecuador; Department of Biomedical Sciences, Tropical Disease Institute, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio

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Jerry O. Jacobson Center for Infectious Disease Research, Pontificia Universidad Católica del Ecuador, Quito, Ecuador; Pan American Health Organization, Quito, Ecuador; National School of Public Health, Havana, Cuba; National STI/HIV-AIDS Program, Ministry of Public Health, Quito, Ecuador; Pan-American Health Organization, Bogotá, Colombia; Instituto Nacional de Salud Pública e Investigación (INSPI), Guayaquil, Ecuador; Biomedical Center, Central University of Ecuador, Quito, Ecuador; Department of Biomedical Sciences, Tropical Disease Institute, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio

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Luiggi Martini Center for Infectious Disease Research, Pontificia Universidad Católica del Ecuador, Quito, Ecuador; Pan American Health Organization, Quito, Ecuador; National School of Public Health, Havana, Cuba; National STI/HIV-AIDS Program, Ministry of Public Health, Quito, Ecuador; Pan-American Health Organization, Bogotá, Colombia; Instituto Nacional de Salud Pública e Investigación (INSPI), Guayaquil, Ecuador; Biomedical Center, Central University of Ecuador, Quito, Ecuador; Department of Biomedical Sciences, Tropical Disease Institute, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio

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Caty A. Carrera Center for Infectious Disease Research, Pontificia Universidad Católica del Ecuador, Quito, Ecuador; Pan American Health Organization, Quito, Ecuador; National School of Public Health, Havana, Cuba; National STI/HIV-AIDS Program, Ministry of Public Health, Quito, Ecuador; Pan-American Health Organization, Bogotá, Colombia; Instituto Nacional de Salud Pública e Investigación (INSPI), Guayaquil, Ecuador; Biomedical Center, Central University of Ecuador, Quito, Ecuador; Department of Biomedical Sciences, Tropical Disease Institute, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio

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Mario J. Grijalva Center for Infectious Disease Research, Pontificia Universidad Católica del Ecuador, Quito, Ecuador; Pan American Health Organization, Quito, Ecuador; National School of Public Health, Havana, Cuba; National STI/HIV-AIDS Program, Ministry of Public Health, Quito, Ecuador; Pan-American Health Organization, Bogotá, Colombia; Instituto Nacional de Salud Pública e Investigación (INSPI), Guayaquil, Ecuador; Biomedical Center, Central University of Ecuador, Quito, Ecuador; Department of Biomedical Sciences, Tropical Disease Institute, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio

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A nationwide survey was conducted to obtain an estimate of Chagas disease prevalence among pregnant women in Ecuador. As part of a national probability sample, 5,420 women seeking care for delivery or miscarriage at 15 healthcare facilities were recruited into the study. A small minority of participants reported knowing about Chagas disease or recognized the vector. A national seroprevalence of 0.1% (95% confidence interval [95% CI] = 0.0–0.2%) was found; cases were concentrated in the coastal region (seroprevalence = 0.2%; 95% CI = 0.0–0.4%). No cases of transmission to neonates were identified in the sample. Seropositive participants were referred to the National Chagas Program for evaluation and treatment. Additional studies are necessary to determine if areas of higher prevalence exist in well-known endemic provinces and guide the development of a national strategy for elimination of mother-to-child transmission of Chagas disease in Ecuador.

Author Notes

* Address correspondence to Mario J. Grijalva, Tropical Disease Institute, Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, 333 Irvine Hall, Athens, OH 45701. E-mail: grijalva@ohio.edu

Financial support: This project was supported by funds from the Pan-American Health Organization/Latin American Center for Perinatology and Human Development (PAHO/CLAP), the United Nations Children's Fund (UNICEF), and the Ecuadorian Ministry of Health.

Authors' addresses: Jaime A. Costales and César A. Yumiseva, Centro de Investigación en Enfermedades Infecciosas, Pontificia Universidad Católica del Ecuador, Quito, Ecuador, E-mails: jacostalesc@puce.edu.ec and cayumiseva@puce.edu.ec. Amaya Sánchez-Gómez, Pan-American Health Organization, Quito, Ecuador, E-mail: amayasgomez@gmail.com. Luis C. Silva-Aycaguer, National School of Public Health, Havana, Cuba, E-mail: lcsilvaa@yahoo.com. William Cevallos, Biomedical Center, Universidad Central del Ecuador, Quito, Ecuador, E-mail: wcevallos@uce.edu.ec. Susana Tamayo, National STI/HIV-AIDS Program, Ministry of Public Health, Quito, Ecuador, E-mail: st_suzette@hotmail.com. Jerry O. Jacobson, Pan-American Health Organization, Bogota, Colombia, E-mail: jerryojacobson@gmail.com. Luiggi Martini and Caty A. Carrera, Instituto Nacional de Salud Pública e Investigación, Guayaquil, Ecuador, E-mails: luiggimartini8@hotmail.com and c_carrera2008@hotmail.com. Mario J. Grijalva, Tropical Disease Institute, Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, E-mail: grijalva@ohio.edu.

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