Mother-to-child transmission of Chagas' disease in North America: why don't we do more?
OBJECTIVE
Mothers with Chagas' disease can transmit Trypanosoma cruzi to their fetuses, who often become carriers of the infection and are then at risk of developing severe cardiac disease later in the course of their lives. If identified early enough after birth, the infected newborns can be treated and cured. Our objective was to review the data available in Canada, Mexico, and the United States and to discuss the need for prevention programs.


METHODS
We reviewed the literature and estimated the number of seropositive mothers and newborns infected by T. cruzi.


RESULTS
We estimate that about 40,000 pregnant women and 2,000 newborns are likely to be infected by T. cruzi in North America. We have not identified any ongoing prevention programs.


CONCLUSIONS
Mother-to-child transmission of T. cruzi has all the characteristics required to be a public health priority, as it is relatively frequent, severe, identifiable, and treatable. In reality, it is a neglected disease and a missed opportunity. It is urgent to better understand the epidemiology of mother-to-child transmission of T. cruzi in North America and to develop effective prevention programs.
Buekens
Pierre
P
School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, Suite 2430, New Orleans, LA 70112, USA. pbuekens@tulane.edu
Almendares
Olivia
O
Carlier
Yves
Y
Dumonteil
Eric
E
Eberhard
Mark
M
Gamboa-Leon
Rubi
R
James
Mark
M
Padilla
Nicolas
N
Wesson
Dawn
D
Xiong
Xu
X
D000818:Animals; D014355:Chagas Disease / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D015997:Neonatal Screening; D009656:North America / Q000453:epidemiology; D011247:Pregnancy; D011295:Prenatal Care; D012307:Risk Factors; D014349:Trypanosoma cruzi / Q000302:isolation & purification*