{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T12:25:21Z","timestamp":1784031921460,"version":"3.55.0"},"update-to":[{"DOI":"10.1371\/journal.pntd.0013591","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000}}],"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T00:00:00Z","timestamp":1759449600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Bolivia has one of the highest burdens of Chagas disease. Transmission is most common through the triatomine bug vector carrying <jats:italic><jats:italic>Trypanosoma cruzi<\/jats:italic><\/jats:italic> infection, but a rising proportion of cases occurs through congenital transmission from mother to infant. Women living in endemic regions with high vector circulation are known to have an elevated risk of Chagas disease, but the relative risk of congenital transmission is unclear.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We performed a prospective observational study of pregnant women with Chagas disease and their infants at 11 hospitals in Bolivia from September 2020 to March 2023. High vector circulation zones were defined as having triatomine infestation in &gt;3% of local homes. Congenital Chagas disease was diagnosed in infants using polymerase chain reaction (PCR) at birth, micromethod at birth and 1 month, or serology at 9 months.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>We enrolled 238 pregnant women, with a mean age of 28.7 years; 139 (58.4%) lived in high vector circulation areas. Of these, 19 women delivered infants who tested positive for <jats:italic><jats:italic>T. cruzi<\/jats:italic><\/jats:italic> infection (transmission rate 8.0%). Infants with congenital Chagas disease were significantly more likely to require hospitalization after birth (21.1% vs. 5.8%, p\u2009=\u20090.013). Women living in high vector circulation areas were more likely to have homes with mud walls (p\u2009&lt;\u20090.001) and thatched roofs (p\u2009&lt;\u20090.001) and to report having seen triatomine bugs in their home (p\u2009=\u20090.001). Congenital transmission rates did not significantly differ between women from low or high vector circulation zones (10.1% [9 of 139] vs. 6.5% [10 of 99], p\u2009=\u20090.31).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Congenital transmission of Chagas disease remains common through multiple regions of Bolivia, regardless of local vector circulation control, and is associated with markedly higher rates of infant hospitalization after birth.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0013591","type":"journal-article","created":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T17:35:06Z","timestamp":1759512906000},"page":"e0013591","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Congenital transmission of Chagas disease by vector circulation zone in Bolivia"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6588-2492","authenticated-orcid":true,"given":"Beatriz Amparo","family":"Rodr\u00edguez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Freddy","family":"Tinajeros","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beth J.","family":"Condori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9423-8399","authenticated-orcid":true,"given":"Melissa Klein","family":"Cutshaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,10,3]]},"reference":[{"key":"pntd.0013591.ref001","unstructured":"Organization WH. Chagas disease (also known as American trypanosomiasis); 2024. Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/chagas-disease-(american-trypanosomiasis)"},{"issue":"1","key":"pntd.0013591.ref002","doi-asserted-by":"crossref","first-page":"59","DOI":"10.5334\/gh.1150","article-title":"Global, regional, and national trends of Chagas disease from 1990 to 2019: comprehensive analysis of the global burden of disease study","volume":"17","author":"SA G\u00f3mez-Ochoa","year":"2022","journal-title":"Glob Heart"},{"issue":"5","key":"pntd.0013591.ref003","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1056\/NEJMra1410150","article-title":"Chagas\u2019 disease","volume":"373","author":"C Bern","year":"2015","journal-title":"N Engl J Med"},{"issue":"6","key":"pntd.0013591.ref004","first-page":"33","article-title":"Chagas disease in Latin America: an epidemiological update based on 2010 estimates","volume":"90","author":"WH Organization","year":"2015","journal-title":"WER"},{"issue":"1","key":"pntd.0013591.ref005","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1111\/1471-0528.12396","article-title":"Frequency of the congenital transmission of Trypanosoma cruzi: a systematic review and meta-analysis","volume":"121","author":"EJ Howard","year":"2014","journal-title":"BJOG"},{"issue":"4","key":"pntd.0013591.ref006","doi-asserted-by":"crossref","first-page":"663","DOI":"10.4269\/ajtmh.23-0579","article-title":"Prevalence of maternal chagas disease and vertical transmission rates in Bolivia: a systematic review and meta-analysis","volume":"110","author":"F Tinajeros","year":"2024","journal-title":"Am J Trop Med Hyg"},{"issue":"10","key":"pntd.0013591.ref007","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0001250","article-title":"Congenital Chagas disease: recommendations for diagnosis, treatment and control of newborns, siblings and pregnant women","volume":"5","author":"Y Carlier","year":"2011","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0013591.ref008","volume-title":"Plan Nacional de Acci\u00f3n de Entomolog\u00eda y Manejo Integrado de Vectores Bolivia 2023-2025","author":"MdSyD Bolivia","year":"2023"},{"issue":"4","key":"pntd.0013591.ref009","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0002782","article-title":"Chagas disease vector control in a hyperendemic setting: the first 11 years of intervention in Cochabamba, Bolivia","volume":"8","author":"N Espinoza","year":"2014","journal-title":"PLoS Negl Trop Dis"},{"issue":"9","key":"pntd.0013591.ref010","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1111\/tmi.13640","article-title":"Improving houses in the Bolivian Chaco increases effectiveness of residual insecticide spraying against infestation with Triatoma infestans, vector of Chagas disease","volume":"26","author":"R Gon\u00e7alves","year":"2021","journal-title":"Trop Med Int Health"},{"key":"pntd.0013591.ref011","volume-title":"Manual de Normas T\u00e9cnicas y Operativas para el Tamizaje, Diagn\u00f3stico y Tratamiento de la Enfermedad de Chagas Cr\u00f3nica Reciente Infantil","author":"Epidemiology Unit CNP","year":"2007"},{"issue":"11","key":"pntd.0013591.ref012","doi-asserted-by":"crossref","first-page":"1667","DOI":"10.1086\/648070","article-title":"Congenital Trypanosoma cruzi transmission in Santa Cruz, Bolivia","volume":"49","author":"C Bern","year":"2009","journal-title":"Clin Infect Dis"},{"issue":"5","key":"pntd.0013591.ref013","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1097\/QCO.0000000000000478","article-title":"Congenital Chagas disease: current diagnostics, limitations and future perspectives","volume":"31","author":"LA Messenger","year":"2018","journal-title":"Curr Opin Infect Dis"},{"issue":"4","key":"pntd.0013591.ref014","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0000419","article-title":"Accurate real-time PCR strategy for monitoring bloodstream parasitic loads in chagas disease patients","volume":"3","author":"T Duffy","year":"2009","journal-title":"PLoS Negl Trop Dis"},{"issue":"1","key":"pntd.0013591.ref015","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0007024","article-title":"Improved DNA extraction technique from clot for the diagnosis of Chagas disease","volume":"13","author":"H Mayta","year":"2019","journal-title":"PLoS Negl Trop Dis"},{"issue":"1","key":"pntd.0013591.ref016","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0002000","article-title":"Analytical performance of a multiplex Real-Time PCR assay using TaqMan probes for quantification of Trypanosoma cruzi satellite DNA in blood samples","volume":"7","author":"T Duffy","year":"2013","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0013591.ref017","doi-asserted-by":"crossref","first-page":"1031455","DOI":"10.3389\/fmed.2023.1031455","article-title":"A multicenter comparative study of the performance of four rapid immunochromatographic tests for the detection of anti-Trypanosoma cruzi antibodies in Brazil","volume":"10","author":"JAD Iturra","year":"2023","journal-title":"Front Med (Lausanne)"},{"key":"pntd.0013591.ref018","unstructured":"Informaci\u00f3n Pol\u00edtico Administrativa: Centro Digital de Recursos Naturales de Bolivia. Available from: https:\/\/cdrnbolivia.com\/informacion-politico-administrativa.htm"},{"issue":"7","key":"pntd.0013591.ref019","doi-asserted-by":"crossref","DOI":"10.1093\/cid\/ciaa1885","article-title":"Risk factors for maternal chagas disease and vertical transmission in a Bolivian hospital","volume":"73","author":"MD Klein","year":"2021","journal-title":"Clin Infect Dis"},{"issue":"10","key":"pntd.0013591.ref020","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0007694","article-title":"Congenital Chagas disease: updated recommendations for prevention, diagnosis, treatment, and follow-up of newborns and siblings, girls, women of childbearing age, and pregnant women","volume":"13","author":"Y Carlier","year":"2019","journal-title":"PLoS Negl Trop Dis"},{"issue":"2","key":"pntd.0013591.ref021","doi-asserted-by":"crossref","first-page":"201","DOI":"10.4269\/ajtmh.2004.70.201","article-title":"Maternal Trypanosoma cruzi infection, pregnancy outcome, morbidity, and mortality of congenitally infected and non-infected newborns in Bolivia","volume":"70","author":"F Torrico","year":"2004","journal-title":"Am J Trop Med Hyg"},{"issue":"10115","key":"pntd.0013591.ref022","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/S0140-6736(17)31612-4","article-title":"Chagas disease","volume":"391","author":"JA P\u00e9rez-Molina","year":"2018","journal-title":"Lancet"},{"key":"pntd.0013591.ref023","article-title":"Social stigma towards neglected tropical diseases: a systematic review","author":"K Hofstraat","year":"2016","journal-title":"Int Health"},{"issue":"1","key":"pntd.0013591.ref024","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0005251","article-title":"\u201cI cannot be worried\u201d: living with Chagas disease in tropical Bolivia","volume":"11","author":"CJ Forsyth","year":"2017","journal-title":"PLoS Negl Trop Dis"},{"issue":"8","key":"pntd.0013591.ref025","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0255226","article-title":"Social determinants in the access to health care for Chagas disease: a qualitative research on family life in the \u201cValle Alto\u201d of Cochabamba, Bolivia","volume":"16","author":"I Jimeno","year":"2021","journal-title":"PLoS One"},{"issue":"6","key":"pntd.0013591.ref026","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1093\/cid\/civ446","article-title":"Sustained domestic vector exposure is associated with increased Chagas cardiomyopathy risk but decreased parasitemia and congenital transmission risk among young women in Bolivia","volume":"61","author":"M Kaplinski","year":"2015","journal-title":"Clin Infect Dis"},{"issue":"4","key":"pntd.0013591.ref027","first-page":"279","article-title":"Maternal factors associated to congenital transmission of Chagas disease in children born and siblings in Chaco province, Argentina","volume":"75","author":"RM Chaparro","year":"2018","journal-title":"Rev Fac Cien Med Univ Nac Cordoba"},{"issue":"12","key":"pntd.0013591.ref028","doi-asserted-by":"crossref","first-page":"1498","DOI":"10.1111\/j.1365-3156.2007.01958.x","article-title":"Risk factors and consequences of congenital Chagas disease in Yacuiba, south Bolivia","volume":"12","author":"NA Salas","year":"2007","journal-title":"Trop Med Int Health"},{"issue":"5","key":"pntd.0013591.ref029","doi-asserted-by":"crossref","first-page":"1044","DOI":"10.4269\/ajtmh.2010.10-0326","article-title":"Detectable Trypanosoma cruzi parasitemia during pregnancy and delivery as a risk factor for congenital Chagas disease","volume":"83","author":"L Brutus","year":"2010","journal-title":"Am J Trop Med Hyg"},{"issue":"10","key":"pntd.0013591.ref030","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1016\/j.trstmh.2012.03.015","article-title":"Vertical transmission of Trypanosoma cruzi infection: quantification of parasite burden in mothers and their children by parasite DNA amplification","volume":"106","author":"J Bua","year":"2012","journal-title":"Trans R Soc Trop Med Hyg"},{"issue":"3","key":"pntd.0013591.ref031","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0119527","article-title":"Trypanosoma cruzi-infected pregnant women without vector exposure have higher parasitemia levels: implications for congenital transmission risk","volume":"10","author":"VR Rendell","year":"2015","journal-title":"PLoS One"}],"updated-by":[{"DOI":"10.1371\/journal.pntd.0013591","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000}}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0013591","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:14:29Z","timestamp":1760033669000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0013591"}},"subtitle":[],"editor":[{"given":"Abhay R","family":"Satoskar,","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,10,3]]},"references-count":31,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10,3]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0013591","relation":{"new_version":[{"id-type":"doi","id":"10.1371\/journal.pntd.0013591","asserted-by":"object"}]},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,3]]}}}