BACKGROUND: We conducted a study of congenital Trypanosoma cruzi infection in Santa Cruz, Bolivia. Our objective was to apply new tools to identify weak points in current screening algorithms, and find ways to improve them. METHODS: Women presenting for delivery were screened by rapid and conventional serological tests. For infants of infected mothers, blood specimens obtained on days 0, 7, 21, 30, 90, 180, and 270 were concentrated and examined microscopically; serological tests were performed for the day 90, 180, and 270 specimens. Maternal and infant specimens, including umbilical tissue, were tested by polymerase chain reaction (PCR) targeting the kinetoplast minicircle and by quantitative PCR. RESULTS: Of 530 women, 154 (29%) were seropositive. Ten infants had congenital T. cruzi infection. Only 4 infants had positive results of microscopy evaluation in the first month, and none had positive cord blood microscopy results. PCR results were positive for 6 (67%) of 9 cord blood and 7 (87.5%) of 8 umbilical tissue specimens. PCR-positive women were more likely to transmit T. cruzi than were seropositive women with negative PCR results (P < .05). Parasite loads determined by quantitative PCR were higher for mothers of infected infants than for seropositive mothers of uninfected infants P < .01). Despite intensive efforts, only 58% of at-risk infants had a month 9 specimen collected. CONCLUSIONS: On the basis of the low sensitivity of microscopy in cord blood and high rate of loss to follow-up, we estimate that current screening programs miss one-half of all infected infants. Molecular techniques may improve early detection.
BACKGROUND: We conducted a study of congenital Trypanosoma cruzi infection in Santa Cruz, Bolivia. Our objective was to apply new tools to identify weak points in current screening algorithms, and find ways to improve them. METHODS:Women presenting for delivery were screened by rapid and conventional serological tests. For infants of infected mothers, blood specimens obtained on days 0, 7, 21, 30, 90, 180, and 270 were concentrated and examined microscopically; serological tests were performed for the day 90, 180, and 270 specimens. Maternal and infant specimens, including umbilical tissue, were tested by polymerase chain reaction (PCR) targeting the kinetoplast minicircle and by quantitative PCR. RESULTS: Of 530 women, 154 (29%) were seropositive. Ten infants had congenital T. cruzi infection. Only 4 infants had positive results of microscopy evaluation in the first month, and none had positive cord blood microscopy results. PCR results were positive for 6 (67%) of 9 cord blood and 7 (87.5%) of 8 umbilical tissue specimens. PCR-positive women were more likely to transmit T. cruzi than were seropositive women with negative PCR results (P < .05). Parasite loads determined by quantitative PCR were higher for mothers of infected infants than for seropositive mothers of uninfected infants P < .01). Despite intensive efforts, only 58% of at-risk infants had a month 9 specimen collected. CONCLUSIONS: On the basis of the low sensitivity of microscopy in cord blood and high rate of loss to follow-up, we estimate that current screening programs miss one-half of all infected infants. Molecular techniques may improve early detection.
Authors: S B Blanco; E L Segura; E N Cura; R Chuit; L Tulián; I Flores; G Garbarino; J F Villalonga; R E Gürtler Journal: Trop Med Int Health Date: 2000-04 Impact factor: 2.622
Authors: Sergio Sosa-Estani; Miriam Rubi Gamboa-León; Jaime Del Cid-Lemus; Fernando Althabe; Jackeline Alger; Olivia Almendares; María L Cafferata; Jean-Philippe Chippaux; Eric Dumonteil; Luz Gibbons; Nicolás Padilla-Raygoza; Dominique Schneider; José M Belizán; Pierre Buekens Journal: Am J Trop Med Hyg Date: 2008-11 Impact factor: 2.345
Authors: Jennifer R Verani; Amy Seitz; Robert H Gilman; Carlos LaFuente; Gerson Galdos-Cardenas; Vivian Kawai; Elizabeth de LaFuente; Lisbeth Ferrufino; Natalie M Bowman; Viviana Pinedo-Cancino; Michael Z Levy; Francis Steurer; Charles W Todd; Louis V Kirchhoff; Lilia Cabrera; Manuela Verastegui; Caryn Bern Journal: Am J Trop Med Hyg Date: 2009-03 Impact factor: 2.345
Authors: Yagahira E Castro-Sesquen; Freddy Tinajeros; Caryn Bern; Gerson Galdos-Cardenas; Edith S Malaga; Edward Valencia Ayala; Kathryn Hjerrild; Steven J Clipman; Andrés G Lescano; Tabitha Bayangos; Walter Castillo; María Carmen Menduiña; Kawsar R Talaat; Robert H Gilman Journal: Clin Infect Dis Date: 2021-07-15 Impact factor: 9.079
Authors: Janhavi Sharma; Jennifer R Blase; Daniel F Hoft; John O Marentette; John Turk; Jane McHowat Journal: Infect Immun Date: 2016-03-24 Impact factor: 3.441
Authors: Pierre Buekens; María Luisa Cafferata; Jackeline Alger; Fernando Althabe; José M Belizán; Norma Bustamante; Yves Carlier; Alvaro Ciganda; Jaime H Del Cid; Eric Dumonteil; Rubí Gamboa-León; Jorge A García; Luz Gibbons; Olga Graiff; Jesús Gurubel Maldonado; Claudia Herrera; Elizabeth Howard; Laura Susana Lara; Benjamín López; María Luisa Matute; María Jesús Ramírez-Sierra; María Cecilia Robles; Sergio Sosa-Estani; Carine Truyens; Christian Valladares; Dawn M Wesson; Concepción Zúniga Journal: Am J Trop Med Hyg Date: 2017-11-30 Impact factor: 2.345
Authors: Alicia I Hidron; Robert H Gilman; Juan Justiniano; Anna J Blackstock; Carlos Lafuente; Walter Selum; Martiza Calderon; Manuela Verastegui; Lisbeth Ferrufino; Eduardo Valencia; Jeffrey A Tornheim; Seth O'Neal; Robert Comer; Gerson Galdos-Cardenas; Caryn Bern Journal: PLoS Negl Trop Dis Date: 2010-05-18
Authors: Susana Otero; Elena Sulleiro; Israel Molina; Maria Espiau; Anna Suy; Andrea Martín-Nalda; Concepción Figueras Journal: Am J Trop Med Hyg Date: 2012-09-17 Impact factor: 2.345