title: Risk factors for Chagas disease among pregnant women in El Salvador.
abstract: OBJECTIVE
  To determine the seroprevalence of Chagas disease among pregnant women and estimate the risk factors for Chagas disease during pregnancies.
  
  
  METHODS
  Community-based serological tests on Trypanosoma cruzi and structured interviews on socio-demographic and socio-economic status were conducted with pregnant women registered at three health centres in Sonsonate province, El Salvador.
  
  
  RESULTS
  Of 797 pregnant women participating in the study, 29 (3.6%) were infected with Chagas disease. None had clinical symptoms. The results of bivariate analyses showed the significant association between seropositivity and maternal age ≥35 years, anaemia, illiteracy, having no formal school education and having knowledge on Chagas disease (P < 0.05). The results of multivariate analysis indicate that age ≥35 years and anaemia were significantly associated with being infected with Chagas disease among pregnant women (OR = 3.541 and 5.197, respectively).
  
  
  CONCLUSIONS
  We recommend that the national Chagas disease control programme be better coordinated with the national maternal and child health programme to introduce blood screening for T. cruzi during antenatal visits. If financial constraint allows systematic blood screening to be only partially implemented, resources should be focused on pregnant women ≥35 years and women who have anaemia.
authors.affiliation: Department of Biomedical Chemistry, School of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Emi
authors.initials: E
authors.lastname: Sasagawa
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Aiga
authors.forename: Edith Y
authors.initials: EY
authors.lastname: Corado
authors.forename: Blanca L
authors.initials: BL
authors.lastname: Cuyuch
authors.forename: Marta A
authors.initials: MA
authors.lastname: Hernández
authors.forename: Ana V
authors.initials: AV
authors.lastname: Guevara
authors.forename: José E
authors.initials: JE
authors.lastname: Romero
authors.forename: Hector M
authors.initials: HM
authors.lastname: Ramos
authors.forename: Rafael A
authors.initials: RA
authors.lastname: Cedillos
authors.forename: Chizuru
authors.initials: C
authors.lastname: Misago
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Kita
mesh_terms: D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000150:complications; D014355:Chagas Disease / Q000453:epidemiology* / Q000635:transmission; D003430:Cross-Sectional Studies; D004544:El Salvador / Q000453:epidemiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D011247:Pregnancy; D015995:Prevalence; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: El Salvador; Seroprevalencia; Trypanosoma cruzi; chagas disease; enfermedad de Chagas; femmes enceintes; maladie de Chagas; mujeres embarazadas; pregnant women; seroprevalence; séroprévalence