Prevalence and Risk Factors for Chagas Disease in Pregnant Women in Casanare, Colombia

Abstract

Abstract. Knowledge of the prevalence and risk factors associated with maternal infection is the first step to develop a surveillance system for congenital transmission of Chagas disease. We conducted a cross-sectional study in Casanare, a disease-endemic area in Colombia. A total of 982 patients were enrolled in the study. A global prevalence of Trypanosoma cruzi infection of 4.0% (95% confidence interval [CI] = 2.8-5.3%) was found. Multivariate analysis showed that the most important risk-associated factors were age 29 years (adjusted odds ratio [aOR] = 3.4, 95% CI = 0.9-12.4), rural residency (aOR = 2.2, 95% CI = 1.0-4.6), low education level (aOR = 10.2, 95% CI = 1.6-82.7), and previous knowledge of the vector (aOR = 2.2, 95% CI = 1.0-4.9). Relatives and siblings of infected mothers showed a prevalence of 9.3%. These findings may help physicians to investigate congenital cases, screen Chagas disease in siblings and relatives, and provide early treatment to prevent the chronic complications of Chagas disease.

Prevalence of Trypanosoma cruzi Infection among People Aged 15 to 89 Years Inhabiting the Department of Casanare (Colombia)

“…This may be related to the impact of previously implemented primary measures of control of transmission in this population, and is in agreement with the observation of an age >29 years as a risk factor for the infection in pregnant women in a recently published study in the same population [12].…”

“…Later, a study involving the analysis of infected vectors and their presence in housings that showed this region as the one with the highest risk of disease transmission in Colombia [26]. More recently, a study found a prevalence of 4% of infection among pregnant women and 9.3% among their relatives in the same population [12]. Hence, it is of great importance to implement well-organized surveillance strategies in this population, in order to the prompt detection of infected people, and most importantly, the implementation of a follow up program for these patients.…”

“…al. [12] was focused on measuring the prevalence of T. cruzi infection in pregnant women seeking health care at the health centers of Yopal. They included a total of 982 pregnant women, aged 13–46 years, and found a global prevalence of T. cruzi infection of 3.97%.…”

“…It is estimated that 1–12% of newborns of infected mothers could be infected [4]. A recent study found a prevalence of infection of 4% among pregnant women in Casanare [12]. Hence, the identification of infected people is of most importance for public health authorities, in order to know the real burden of the disease, as well as to establish measures towards secondary prevention for transfusion-borne and congenital Chagas disease.…”

Does my patient have chronic Chagas disease? Development and temporal validation of a diagnostic risk score

“…Past studies investigated the use of several potential determinants of Chagas disease, such as recognizing the kissing bug or reporting living in places with kissing bugs (22) (23) (24) (25) (26) (27) , previous knowledge of the vector (28) (29) , reporting being bitten by the kissing bug (24) , reporting living in mud houses or in rural areas (22) (23) (28) (29) (30) (31) , Latin America as a place of birth or destination of previous travel (22) (32) , reporting receiving blood transfusions in the past (27) (33) , reporting blood donations in the past (26) (30) , education (22) (28) (30) (33) , social condition or income (22) (30) , reporting siblings or relatives with Chagas disease (23) (26) (27) , sex (26) (31) , and age (26) (28) (30) (31) (33) . However, they were all investigated under different conditions (blood bank screening, vertical transmission screening, and in rural area inhabitants) for different purposes, resulting in substantially different results from this research.…”