Risk factors and consequences of congenital Chagas disease in Yacuiba, south Bolivia.
OBJECTIVE
To determine the risk factors of congenital Chagas disease and the consequences of the disease in newborns.


METHODS
Study of 2712 pregnant women and 2742 newborns in Yacuiba, south Bolivia. Chagas infection was determined serologically in mothers and parasitologically in newborns. Consequences of congenital Chagas disease were assessed clinically.


RESULTS
The prevalence of Chagas disease in pregnant women was 42.2%. Congenital transmission was estimated at 6% of infected mothers leading to an incidence rate of 2.6% among newborns. Main risk factors of congenital transmission were mothers' seropositivity and maternal Trypanosoma cruzi parasitaemia. Parity was higher in infected than in non-infected mothers, but it was not associated with the risk of congenital transmission. The rate of congenital infection was significantly higher in newborns from multiple pregnancies than in singletons. However, we did not observe statistically significant consequences of Chagas disease in newborns from single pregnancies or among twins.


CONCLUSIONS
The main risk factors for congenital transmission were infection and parasitaemia of mothers. Consequences of the disease seemed mild in newborns from single pregnancies and perhaps more important in multiple births.
Salas
N A
NA
IRD UR010, Team Mother's and Child's Health in Tropical Environments, Institut de Recherche pour le Développement, La Paz, Bolivia.
Cot
M
M
Schneider
D
D
Mendoza
B
B
Santalla
J A
JA
Postigo
J
J
Chippaux
J P
JP
Brutus
L
L
D000328:Adult; D000818:Animals; D001838:Bolivia / Q000453:epidemiology; D014355:Chagas Disease / Q000151:congenital / Q000453:epidemiology / Q000635:transmission*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D010298:Parity; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000453:epidemiology*; D011272:Pregnancy, Multiple / Q000706:statistics & numerical data; D015995:Prevalence; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D014349:Trypanosoma cruzi / Q000302:isolation & purification*