Maternal fetal transmission of Trypanosoma cruzi: a problem of public health little studied in Mexico.
The first case of neonatal Chagas was reported in Mexico in 1998, but there have been no studies since then. Therefore, we investigated the rates of congenital infection of Trypanosoma cruzi by examining the seroprevalence among 1448 pregnant women in Oaxaca, Jalisco and Mexico City. We performed ELISAs to screen for recombinant and total antigens in mothers, and examined the frequency of congenital T. cruzi transmission by PCR with cord blood and antibody testing in children when they reached two years old. Our results showed that the prevalence of infection in pregnant women was 7.32% (106/1448) overall, and 4.4% (35/794) in Oaxaca, 12.02% (67/557) in Jalisco and 4.12% (4/97) in the Mexico City. In Oaxaca, T. cruzi infection was detected by PCR in 20% (7/35) of infants born to seroreactive mothers and 11.9% (8/67) in Jalisco. No infections were identified in infants from the Mexico City. From these only eleven serological follow up their children are agree to take blood. Therefore, the maternal-fetal overall transmission rate was 4.08% (4/98) in Oaxaca and 9.1% (3/33) in Jalisco 1.5% (1/65) children with positive serology were given specific treatment Chagas. In conclusion, these are the first reports of the rates of congenital Chagas disease in Mexico. The seroprevalence was higher in mothers from Jalisco, and could be related to that there is not the periodic fumigation of the transmitting vector performed in that state. The high rates of maternal-fetal transmission found in Oaxaca could be related to the differences of pathogenicity of trypanosome. No association between both the rate of congenital transmission and the gynecologic anthropometric data was observed.
Laboratorio de Investigación en Parasitología, Dr. Márquez #162, Col. Doctores, CP 06720, Mexico. enedina@servidor.unam.mx
Enedina Jiménez
EJ
Cardoso
Guillermina Campos
GC
Valdéz
Adrián Cortes
AC
Campos
Rene
R
de la Luz Sanchez
Carlos Rivera
CR
Mendoza
Arturo Plascencia
AP
Hernández
María Hernández
MH
Ramírez
Joel Ruiz
JR
Habana
Edmundo Bonilla
EB
González
Pablo Damian
PD
Matzumura
Yves
Y
Carlier
D000293:Adolescent; D000328:Adult; D000913:Antibodies, Protozoan / Q000097:blood; D014355:Chagas Disease / Q000151:congenital* / Q000453:epidemiology / Q000635:transmission*; D002675:Child, Preschool; D015331:Cohort Studies; D016054:DNA, Protozoan / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005312:Fetal Blood / Q000469:parasitology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000706:statistics & numerical data*; D008800:Mexico / Q000453:epidemiology; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000453:epidemiology*; D016036:Seroepidemiologic Studies; D011795:Surveys and Questionnaires; D014349:Trypanosoma cruzi / Q000235:genetics / Q000276:immunology* / Q000302:isolation & purification; D055815:Young Adult
D000913:Antibodies, Protozoan; D016054:DNA, Protozoan