title: Mother-to-Child Transmission of Chagas Disease in El Salvador.
abstract: 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.
authors.affiliation: 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 e-sasagawa@umin.ac.jp.
authors.forename: Emi
authors.initials: E
authors.lastname: Sasagawa
authors.affiliation: 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.
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Aiga
authors.affiliation: 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.
authors.forename: Edith Yanira
authors.initials: EY
authors.lastname: Corado Soriano
authors.affiliation: 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.
authors.forename: Blanca Leticia
authors.initials: BL
authors.lastname: Cuyuch Marroquín
authors.affiliation: 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.
authors.forename: Marta Alicia
authors.initials: MA
authors.lastname: Hernández Ramírez
authors.affiliation: 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.
authors.forename: Ana Vilma
authors.initials: AV
authors.lastname: Guevara de Aguilar
authors.affiliation: 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.
authors.forename: José Eduardo
authors.initials: JE
authors.lastname: Romero Chévez
authors.affiliation: 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.
authors.forename: Hector Manuel
authors.initials: HM
authors.lastname: Ramos Hernández
authors.affiliation: 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.
authors.forename: Rafael Antonio
authors.initials: RA
authors.lastname: Cedillos
authors.affiliation: 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.
authors.forename: Chizuru
authors.initials: C
authors.lastname: Misago
authors.affiliation: 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.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Kita
mesh_terms: D014355:Chagas Disease / Q000453:epidemiology* / Q000635:transmission*; D004544:El Salvador / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology* / Q000469:parasitology; D014349:Trypanosoma cruzi / Q000302:isolation & purification