Women and congenital Chagas' disease in Santa Cruz, Bolivia: epidemiological and sociocultural aspects.

A total of 910 mothers attending the Percy Boland Maternity Institute in Santa Cruz were investigated. Of these mothers, 9.5% transmitted Chagas' disease to their children. It was observed that the frequency of congenital transmission in the city was influenced by certain socio-cultural factors relating to the mother, such as increased fertility, early age of motherhood and blood transfusions, and also by the movement of migrants from other endemic regions of Bolivia and from rural areas in the same department. It is postulated that the persistence of the disease in the urban setting is due to a second-generation transmission cycle. Comments are made on how regions where Chagas' disease is endemic become risk areas for women migrating from non-endemic regions, as well as on the need to develop an adequate strategy for the control of this non-vectorial form of transmission of Chagas' disease.