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Trypanosoma cruzi-infected pregnant women without vector exposure have higher parasitemia levels: implications for congenital transmission risk

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dc.contributor.author Rendell, Victoria R.
dc.contributor.author Gilman, Robert Hugh
dc.contributor.author Valencia, Edward
dc.contributor.author Galdos-Cardenas, Gerson
dc.contributor.author Verastegui Pimentel, Manuela Renee
dc.contributor.author Sanchez, Leny
dc.contributor.author Acosta, Janet
dc.contributor.author Sanchez, Gerardo
dc.contributor.author Ferrufino, Lisbeth
dc.contributor.author LaFuente, Carlos
dc.contributor.author Abastoflor, Maria del Carmen
dc.contributor.author Colanzi, Rony
dc.contributor.author Bern, Caryn
dc.date.accessioned 2019-02-06T14:53:12Z
dc.date.available 2019-02-06T14:53:12Z
dc.date.issued 2015
dc.identifier.uri https://hdl.handle.net/20.500.12866/5400
dc.description.abstract BACKGROUND: Congenital transmission is a major source of new Trypanosoma cruzi infections, and as vector and blood bank control continue to improve, the proportion due to congenital infection will grow. A major unanswered question is why reported transmission rates from T. cruzi-infected mothers vary so widely among study populations. Women with high parasite loads during pregnancy are more likely to transmit to their infants, but the factors that govern maternal parasite load are largely unknown. Better understanding of these factors could enable prioritization of screening programs to target women most at risk of transmission to their infants. METHODOLOGY/PRINCIPAL FINDINGS: We screened pregnant women presenting for delivery in a large urban hospital in Bolivia and followed infants of infected women for congenital Chagas disease. Of 596 women screened, 128 (21.5%) had confirmed T. cruzi infection; transmission occurred from 15 (11.7%) infected women to their infants. Parasite loads were significantly higher among women who transmitted compared to those who did not. Congenital transmission occurred from 31.3% (9/29), 15.4% (4/26) and 0% (0/62) of women with high, moderate and low parasite load, respectively (chix2 for trend 18.2; p<0.0001). Twin births were associated with higher transmission risk and higher maternal parasite loads. Infected women without reported vector exposure had significantly higher parasite loads than those who had lived in an infested house (median 26.4 vs 0 parasites/mL; p<0.001) with an inverse relationship between years of living in an infested house and parasite load. CONCLUSIONS/SIGNIFICANCE: We hypothesize that sustained vector-borne parasite exposure and repeated superinfection by T. cruzi may act as an immune booster, allowing women to maintain effective control of the parasite despite the down-regulation of late pregnancy. en_US
dc.language.iso eng
dc.publisher Public Library of Science
dc.relation.ispartofseries PLoS ONE
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Adult en_US
dc.subject Female en_US
dc.subject Humans en_US
dc.subject Young Adult en_US
dc.subject Pregnancy en_US
dc.subject Infant, Newborn en_US
dc.subject Infectious Disease Transmission, Vertical en_US
dc.subject Trypanosoma cruzi en_US
dc.subject Chagas Disease/blood/parasitology/transmission en_US
dc.subject Parasite Load en_US
dc.subject Parasitemia/blood/transmission en_US
dc.subject Pregnancy Complications, Parasitic/blood en_US
dc.title Trypanosoma cruzi-infected pregnant women without vector exposure have higher parasitemia levels: implications for congenital transmission risk en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1371/journal.pone.0119527
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#1.06.01
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.02
dc.relation.issn 1932-6203


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