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Mother-to-Child Transmission of Chagas Disease in El Salvador

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  • Department of Biomedical Chemistry, School of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Human Development Department, Japan International Cooperation Agency (JICA), Tokyo, Japan; Department of Global Health, Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia; Sección de Epidemiología, SIBASI Sonsonate, Ministerio de Salud de El Salvador (MINSAL), Sonsonate, El Salvador; Programa de Materno Infantil, Dirección Regional de Salud Zona Occidente, Ministerio de Salud de El Salvador (MINSAL), Santa Ana, El Salvador; Unidad de Vigilancia Laboratorial, Ministerio de Salud de El Salvador (MINSAL), San Salvador, El Salvador; Unidad de Vigilancia de Enfermedades Vectorizadas, Ministerio de Salud de El Salvador (MINSAL), San Salvador, El Salvador; Dirección de Vigilancia Sanitaria, Ministerio de Salud de El Salvador (MINSAL), San Salvador, El Salvador; Consejo de Investigaciones Científicas (CIC-UES), Universidad de El Salvador, San Salvador, El Salvador; Department of International and Cultural Studies, Tsuda College, Tokyo, Japan

To estimate the incidence (any mother to child) and rate (from seropositive mother to child) of mother-to-child transmission of Trypanosoma cruzi, a serological census was conducted, targeting pregnant women and infants born to seropositive mothers, in four municipalities of El Salvador. Of 943 pregnant women, 36 (3.8%) were seropositive for T. cruzi. Of 36, 32 proceeded to serological tests of their infants when they became 6–8 months of age. Six infants seropositive at the age of 6–8 months further proceeded to second-stage serological test at the age of 9–16 months. As the result, one infant was congenitally infected. Thus, serological tests at the age of 6–8 months produced five false positives. To ensure earlier effective medication only for true positives, identification of seropositive infants at the age of 9–16 months is crucial. Incidence and rate of mother-to-child transmission were 0.14 (per 100 person-years) and 4.0%, respectively. Estimated number of children infected through mother-to-child transmission in El Salvador (170 per year) was much higher than that of human immunodeficiency virus (HIV; seven per year). It is recommended that serological testing for T. cruzi be integrated into those for HIV and syphilis as part of antenatal care package.

Author Notes

* Address correspondence to Emi Sasagawa, Department of Biomedical Chemistry, School of International Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan. E-mail: e-sasagawa@umin.ac.jp

Financial support: This work was supported by the Ministry of Health, El Salvador, and Japan International Cooperation Agency (JICA).

Authors' addresses: Emi Sasagawa and Kiyoshi Kita, Department of Biomedical Chemistry, School of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan, E-mails: e-sasagawa@umin.ac.jp and kitak@m.u-tokyo.ac.jp. Hirotsugu Aiga, Human Development Department, Japan International Cooperation Agency (JICA), Tokyo, Japan, and Department of Global Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, E-mail: aiga.hirotsugu@jica.go.jp. Edith Yanira Corado Soriano, Sección de Epidemiología, SIBASI Sonsonate, Ministerio de Salud de El Salvador (MINSAL), Sonsonate, El Salvador, E-mail: edith_corado@yahoo.es. Blanca Leticia Cuyuch Marroquín, Programa de Materno Infantil, Dirección Regional de Salud Zona Occidente, Ministerio de Salud de El Salvador (MINSAL), Santa Ana, El Salvador, E-mail: cuyuch@gmail.com. Marta Alicia Hernández Ramírez and Ana Vilma Guevara de Aguilar, Unidad de Vigilancia Laboratorial, Ministerio de Salud de El Salvador (MINSAL), San Salvador, El Salvador, E-mails: martah_ramirez@yahoo.es and anavilmadeaguilar@yahoo.es. José Eduardo Romero Chévez, Unidad de Vigilancia de Enfermedades Vectorizadas, Ministerio de Salud de El Salvador (MINSAL), San Salvador, El Salvador, E-mail: eromerochevez@yahoo.es. Hector Manuel Ramos Hernández, Dirección de Vigilancia Sanitaria, Ministerio de Salud de El Salvador (MINSAL), San Salvador, El Salvador, E-mail: el.cadejo@gmail.com. Rafael Antonio Cedillos, Consejo de Investigaciones Científicas (CIC-UES), Universidad de El Salvador, San Salvador, El Salvador, E-mail: rcedillos@navegante.com.sv. Chizuru Misago, Department of International and Cultural Studies, Tsuda College, Tokyo, Japan, E-mail: cmisago@tsuda.ac.jp.

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