{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T03:18:54Z","timestamp":1783567134036,"version":"3.55.0"},"reference-count":44,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T00:00:00Z","timestamp":1681948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"UofSC Maternal\u2013child Health Catalyst Graduate Scholars program","award":["T1CMC35361"],"award-info":[{"award-number":["T1CMC35361"]}]},{"DOI":"10.13039\/100010001","name":"Health Resources and Services Administration","doi-asserted-by":"publisher","award":["T1CMC35361"],"award-info":[{"award-number":["T1CMC35361"]}],"id":[{"id":"10.13039\/100010001","id-type":"DOI","asserted-by":"publisher"}]},{"name":"UofSC Office of the Vice President of Research\u2019s SPARC","award":["T1CMC35361"],"award-info":[{"award-number":["T1CMC35361"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Congenital Chagas disease is a growing concern, prioritized by the World Health Organization for public health action. El Salvador is home to some of the highest Chagas disease (Trypanosoma cruzi infection) burdens in the Americas, yet pregnancy screening remains neglected. This pilot investigation performed a maternal T. cruzi surveillance study in Western El Salvador among women presenting for labor and delivery. From 198 consented and enrolled pregnant women, 6% were T. cruzi positive by serology or molecular diagnosis. Half of the infants born to T. cruzi-positive women were admitted to the NICU for neonatal complications. Geospatial statistical clustering of cases was noted in the municipality of Jujutla. Older women and those knowing an infected relative or close friend were significantly more likely to test positive for T. cruzi infection at the time of parturition. In closing, maternal T. cruzi infections were significantly higher than national HIV or syphilis maternal rates, creating an urgent need to add T. cruzi to mandatory pregnancy screening programs.<\/jats:p>","DOI":"10.3390\/tropicalmed8040233","type":"journal-article","created":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T01:42:39Z","timestamp":1681954959000},"page":"233","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Chagas Disease Maternal Seroprevalence and Maternal\u2013Fetal Health Outcomes in a Parturition Cohort in Western El Salvador"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5549-3947","authenticated-orcid":false,"given":"Mary K.","family":"Lynn","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9484-5431","authenticated-orcid":false,"given":"Marvin Stanley","family":"Rodriguez Aquino","sequence":"additional","affiliation":[{"name":"Health Research and Development Center (CENSALUD), University of El Salvador, San Salvador, El Salvador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0505-8880","authenticated-orcid":false,"given":"Pamela Michelle","family":"Cornejo Rivas","sequence":"additional","affiliation":[{"name":"Health Research and Development Center (CENSALUD), University of El Salvador, San Salvador, El Salvador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1367-1546","authenticated-orcid":false,"given":"Mufaro","family":"Kanyangarara","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5956-5220","authenticated-orcid":false,"given":"Stella C. 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J. Trop. Med. Hyg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e00023-19","DOI":"10.1128\/CMR.00023-19","article-title":"Chagas disease in the United States: A public health approach","volume":"33","author":"Bern","year":"2019","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Matthews, S., Tannis, A., Puchner, K.P., Bottazzi, M.E., Cafferata, M.L., Comand\u00e9, D., and Buekens, P. (2022). Estimation of the morbidity and mortality of congenital Chagas disease: A systematic review and meta-analysis. PLoS Negl. Trop. Dis., 16.","DOI":"10.1101\/2022.04.12.22273277"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e24","DOI":"10.1097\/INF.0000000000001733","article-title":"Survey of Pediatric Infectious Diseases Society Members about Congenital Chagas Disease","volume":"37","author":"Edwards","year":"2018","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"478","DOI":"10.4269\/ajtmh.17-0516","article-title":"Congenital transmission of Trypanosoma cruzi in Argentina, Honduras, and Mexico: An observational prospective study","volume":"98","author":"Buekens","year":"2018","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1590\/0074-02760140405","article-title":"Congenital Chagas disease: An update","volume":"110","author":"Carlier","year":"2015","journal-title":"Mem. Do Inst. Oswaldo Cruz"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1111\/tmi.13398","article-title":"Epidemiology of Chagas disease in pregnant women and congenital transmission of Trypanosoma cruzi in the Americas: Systematic review and meta-analysis","volume":"25","author":"Santana","year":"2020","journal-title":"Trop. Med. Int. Health"},{"key":"ref_9","first-page":"286","article-title":"Case 4\/2019-26-Year-Old Man with Congenital Chagas Disease and Heart Transplantation","volume":"113","author":"Pinesi","year":"2019","journal-title":"Arq. Bras. Cardiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1620\/tjem.240.243","article-title":"Chagas Disease in Mexico: Report of 14 Cases of Chagasic Cardiomyopathy in Children","volume":"240","author":"Zenteno","year":"2016","journal-title":"Tohoku J. Exp. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1590\/0074-0276140416","article-title":"Acute Chagas disease in El Salvador 2000-2012-Need for surveillance and control","volume":"109","author":"Sasagawa","year":"2014","journal-title":"Mem\u00f3rias Do Inst. Oswaldo Cruz"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1161\/CIRCHEARTFAILURE.115.002229","article-title":"Prevalence and impact of Chagas disease among Latin American immigrants with nonischemic cardiomyopathy in Los Angeles, California","volume":"8","author":"Traina","year":"2015","journal-title":"Circ. Heart Fail."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e52","DOI":"10.1086\/605091","article-title":"An estimate of the burden of Chagas disease in the United States","volume":"49","author":"Bern","year":"2009","journal-title":"Clin. Infect. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.actatropica.2015.07.016","article-title":"Congenital Chagas disease as an ecological model of interactions between Trypanosoma cruzi parasites, pregnant women, placenta and fetuses","volume":"151","author":"Carlier","year":"2015","journal-title":"Acta Trop."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Dorn, P.L., McClure, A.G., Gallaspy, M.D., Waleckx, E., Woods, A.S., Monroy, M.C., and Stevens, L. (2017). The diversity of the Chagas parasite, Trypanosoma cruzi, infecting the main Central American vector, Triatoma dimidiata, from Mexico to Colombia. PLoS Negl. Trop. Dis., 11.","DOI":"10.1371\/journal.pntd.0005878"},{"key":"ref_16","unstructured":"PAHO (2016). Central America Conquers an Exotic Vector, Pan American Health Organization."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1007\/s40475-019-00176-z","article-title":"Chagas Disease Epidemiology in Central America: An Update","volume":"6","author":"Peterson","year":"2019","journal-title":"Curr. Trop. Med. Rep."},{"key":"ref_18","unstructured":"Murcia Contreras DERA, S. (2016, January 8). Ministerio de salud de El Salvador: Situacion Actual de Chagas en la Region Occidental de El Salvador. Proceedings of the Congreso Internacional de Vectores y del Trypanosoma Cruzi: Simposio Internacional Sobre la Enfermedad de Chagas, Cuernavaca, Mexico."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Nolan, M.S., Murray, K.O., Mejia, R., Hotez, P.J., Villar Mondragon, M.J., Rodriguez, S., Palacios, J.R., Murcia Contreras, W.E., Lynn, M.K., and Torres, M.E. (2021). Elevated Pediatric Chagas Disease Burden Complicated by Concomitant Intestinal Parasites and Malnutrition in El Salvador. Trop. Med. Infect. Dis., 6.","DOI":"10.3390\/tropicalmed6020072"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1111\/tmi.12440","article-title":"Risk factors for Chagas disease among pregnant women in El Salvador","volume":"20","author":"Sasagawa","year":"2015","journal-title":"Trop. Med. Int. Health"},{"key":"ref_21","unstructured":"P\u00e9rez Mata, B., Franco M\u00e1rquez, V., and Flores Moreno, I. (2013). Incidencia de la Enfermedad de Chagas en mujeres Embarazadas de 10 a 49 a\u00f1os de las Unidades Comunitarias de Salud Familiar: Ciudad Barrios (San Miguel), Chilanga (Moraz\u00e1n) y Cant\u00f3n el Piche (La Uni\u00f3n) en el Periodo de Septiembre a Noviembre de 2012. [Ph.D. Thesis, Universidad de El Salvador]."},{"key":"ref_22","unstructured":"Ventura Urbino, F., Caledonio Blanco, E., and Arya Bonilla, D. (2012). Enfermedad de Chagas en Mujeres en el Tercer Trimestre de Gestacion y su Transmision Transplacentaria, que Asisten al Control Prenatal de la Unidad Comunitaria de Salud Familiar de Conchagua del Departamento de La Union Periodo de Julio-Agosto 2012. [Bachelor\u2019s Thesis, Universidad de El Salvador]."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Carlier, Y., Altcheh, J., Angheben, A., Freilij, H., Luquetti, A.O., Schijman, A.G., Segovia, M., Wagner, N., and Albajar Vinas, P. (2019). Congenital Chagas disease: Updated recommendations for prevention, diagnosis, treatment, and follow-up of newborns and siblings, girls, women of childbearing age, and pregnant women. PLoS Negl. Trop. Dis., 13.","DOI":"10.1371\/journal.pntd.0007694"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Ram\u00edrez, J.D., Herrera, G., Hern\u00e1ndez, C., Cruz-Saavedra, L., Mu\u00f1oz, M., Fl\u00f3rez, C., and Butcher, R. (2018). Evaluation of the analytical and diagnostic performance of a digital droplet polymerase chain reaction (ddPCR) assay to detect Trypanosoma cruzi DNA in blood samples. PLoS Negl. Trop. Dis., 12.","DOI":"10.1371\/journal.pntd.0007063"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Duffy, T., Cura, C.I., Ramirez, J.C., Abate, T., Cayo, N.M., Parrado, R., Bello, Z.D., Velazquez, E., Mu\u00f1oz-Calderon, A., and Juiz, N.A. (2013). Analytical performance of a multiplex Real-Time PCR assay using TaqMan probes for quantification of Trypanosoma cruzi satellite DNA in blood samples. PLoS Negl. Trop. Dis., 7.","DOI":"10.1371\/journal.pntd.0002000"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1016\/j.jmoldx.2015.04.010","article-title":"Analytical validation of quantitative real-time PCR methods for quantification of Trypanosoma cruzi DNA in blood samples from Chagas disease patients","volume":"17","author":"Cura","year":"2015","journal-title":"J. Mol. Diagn."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1093\/cid\/cix064","article-title":"Prevalence of Chagas disease in the Latin American\u2013born population of Los Angeles","volume":"64","author":"Meymandi","year":"2017","journal-title":"Clin. Infect. Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.actatropica.2019.02.014","article-title":"First report of family clusters of Chagas disease seropositive blood donors in Mexico City and their epidemiological relevance","volume":"193","author":"Espinoza","year":"2019","journal-title":"Acta Trop."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1093\/cid\/cix277","article-title":"Toward improving early diagnosis of congenital Chagas disease in an endemic setting","volume":"65","author":"Messenger","year":"2017","journal-title":"Clin. Infect. Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1854","DOI":"10.3389\/fmicb.2019.01854","article-title":"Congenital Transmission of Trypanosoma cruzi: A review about the interactions between the parasite, the placenta, the maternal and the fetal\/neonatal immune responses","volume":"10","author":"Kemmerling","year":"2019","journal-title":"Front. Microbiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"165591","DOI":"10.1016\/j.bbadis.2019.165591","article-title":"Epidemiology and pathogenesis of maternal-fetal transmission of Trypanosoma cruzi and a case for vaccine development against congenital Chagas disease","volume":"1866","author":"Rios","year":"2020","journal-title":"Biochim. Biophys. Acta (BBA)-Mol. Basis Dis."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"401864","DOI":"10.1155\/2014\/401864","article-title":"Chagas\u2019 disease: Pregnancy and congenital transmission","volume":"2014","author":"Cevallos","year":"2014","journal-title":"BioMed Res. Int."},{"key":"ref_33","unstructured":"Salvador, G.d.E. (2017). Medici\u00f3n Multidimensional de la Pobreza, Ministerio de Econom\u00eda, Secretar\u00eda T\u00e9cnica y de Planificaci\u00f3n."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e00158-21","DOI":"10.1128\/JCM.00158-21","article-title":"Comparative performance of latest-generation and FDA-cleared serology tests for the diagnosis of Chagas disease","volume":"59","author":"Kelly","year":"2021","journal-title":"J. Clin. Microbiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1510","DOI":"10.1016\/j.cmi.2019.06.009","article-title":"Digital PCR: A new technology for diagnosis of parasitic infections","volume":"25","author":"Pomari","year":"2019","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1186\/s40249-022-01008-5","article-title":"Re-emerging threat of Trypanosoma cruzi vector transmission in El Salvador, update from 2018 to 2020","volume":"11","author":"Nitahara","year":"2022","journal-title":"Infect. Dis. Poverty"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"972","DOI":"10.4269\/ajtmh.2012.11-0652","article-title":"Chagas disease: Assessing the existence of a threshold for bug infestation rate","volume":"86","author":"Aiga","year":"2012","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_38","unstructured":"MINSAL (2021). Informe Nacional Situaci\u00f3n del VIH en El Salvador A\u00f1o 2020, Ministerio de Salud."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.3855\/jidc.4035","article-title":"Prevalence of Trypanosoma cruzi infection in blood donors in El Salvador between 2001 and 2011","volume":"8","author":"Sasagawa","year":"2014","journal-title":"J. Infect. Dev. Ctries."},{"key":"ref_40","unstructured":"MINSAL (2021). Lineamientos T\u00e9cnicos Para la Atenci\u00f3n de la Mujer en el Per\u00edodo Preconcepcional, Prenatal, Parto, Puerperio y al Reci\u00e9n Nacido. Servicios en SSR Para Atenci\u00f3n de Emergencias o Desastres, Ministerio de Salud."},{"key":"ref_41","unstructured":"Amaya Manc\u00eda, C., Ling Romero, N., and Elizabeth Sanchez, T. (2013). Evaluacion de la Calidad de la Atencion de Los Controles Prenatales Basicos Brindados a Las Mujeres Embarazadas, Por el Equipo Comunitario de Salud Familiar Urbano de el Municipio de Chalchuapa Departamento de Santa Ana, en el Periodo de Enero a Diciembre de 2012. [Ph.D. Thesis, Universidad de El Salvador]."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Hotez, P.J. (2008). Neglected Infections of Poverty in the United States of America. PLoS Negl. Trop. Dis., 2.","DOI":"10.1371\/journal.pntd.0000256"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Mahoney West, H., Milliren, C.E., Manne-Goehler, J., Davis, J., Gallegos, J., Perez, J.H., and K\u00f6hler, J.R. (2022). Effect of clinician information sessions on diagnostic testing for Chagas disease. PLoS Negl. Trop. Dis., 16.","DOI":"10.1371\/journal.pntd.0010524"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Andrade, D.V., Gollob, K.J., and Dutra, W.O. (2014). Acute Chagas disease: New global challenges for an old neglected disease. PLoS Negl. Trop. Dis., 8.","DOI":"10.1371\/journal.pntd.0003010"}],"container-title":["Tropical Medicine and Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2414-6366\/8\/4\/233\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:19:28Z","timestamp":1760123968000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2414-6366\/8\/4\/233"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,20]]},"references-count":44,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["tropicalmed8040233"],"URL":"https:\/\/doi.org\/10.3390\/tropicalmed8040233","relation":{},"ISSN":["2414-6366"],"issn-type":[{"value":"2414-6366","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,20]]}}}