Are maternal re‐infections with Trypanosoma cruzi associated with higher morbidity and mortality of congenital Chagas disease?
Open Access
- 25 April 2006
- journal article
- Published by Wiley in Tropical Medicine & International Health
- Vol. 11 (5), 628-635
- https://doi.org/10.1111/j.1365-3156.2006.01623.x
Abstract
Background Comparing two surveys performed in Bolivia in 1992–1994 and 1999–2001, we reported a significant decrease in the proportions of severe and mortal forms of congenital Chagas disease. This might be due to a reduction of vectorial density (VD) in maternal residence area, raising the question of a possible causal relationship between such VD, maternal parasitaemia and prognosis of congenital infection with Trypanosoma cruzi. Method Comparisons of haematological and parasitological data obtained from Bolivian mothers infected with T. cruzi, and of clinical and biological data obtained from their infected and uninfected newborns, stratified according to VD in the area of maternal residence. Results i) Blood hematocrit rates or hemoglobin amounts were within the normal ranges and similar in all the maternal groups, whatever the VD in their areas of residence; ii) mothers living in high VD areas displayed a higher frequency of hemocultures positive for T. cruzi; iii) newborns congenitally infected with T. cruzi, but not uninfected babies born from infected mothers, displayed higher frequencies of very low Apgar scores, low birth weights, prematurity, respiratory distress syndrome or anasarca, as well as higher mortality rates when their mothers lived in areas of high VD. Conclusion Frequent bites of blood sucking Reduvidae during pregnancy do not induce maternal anaemia, but, likely through multiple maternal re-infections with T. cruzi, increase maternal parasitemia and worsen congenital Chagas disease. Maternal dwelling in areas of high VD is associated with a serious increased risk of severe and mortal congenital Chagas disease.Keywords
This publication has 16 references indexed in Scilit:
- Congenital Transmission ofTrypanosoma cruziIs Associated with Maternal Enhanced Parasitemia and Decreased Production of Interferon‐γ in Response to Parasite AntigensThe Journal of Infectious Diseases, 2004
- MATERNAL TRYPANOSOMA CRUZI INFECTION, PREGNANCY OUTCOME, MORBIDITY, AND MORTALITY OF CONGENITALLY INFECTED AND NON-INFECTED NEWBORNS IN BOLIVIAThe American Journal of Tropical Medicine and Hygiene, 2004
- Congenital infection with Trypanosoma cruzi: from mechanisms of transmission to strategies for diagnosis and controlRevista da Sociedade Brasileira de Medicina Tropical, 2003
- COMPARISON OF POLYMERASE CHAIN REACTION METHODS FOR RELIABLE AND EASY DETECTION OF CONGENITAL TRYPANOSOMA CRUZI INFECTIONThe American Journal of Tropical Medicine and Hygiene, 2003
- Trypanosoma cruzi: Characterization of Reinfection and Search for Tissue Tropism in Hamsters (Mesocricetus auratus)Experimental Parasitology, 2001
- New Ballard Score, expanded to include extremely premature infantsThe Journal of Pediatrics, 1991
- Efecto de la reinfección sobre la evolución de ratas infectadas con Trypanosoma cruziRevista do Instituto de Medicina Tropical de São Paulo, 1990
- Feeding Patterns of Triatoma Infestans (Hemiptera: Reduviidae) in Relation to Transmission of American Trypanosomiasis in Argentina1Journal of Medical Entomology, 1982
- CHAGAS DISEASE, TRIATOMINE BUGS, AND BLOODLOSSThe Lancet, 1981
- Domestic risk factor—an attempt to assess risk of infection with Trypanosoma cruzi in houses in BrazilTransactions of the Royal Society of Tropical Medicine and Hygiene, 1973