Risk factors for Chagas disease among pregnant women in El Salvador.

OBJECTIVES: To determine the seroprevalence of Chagas disease among pregnant women and estimate the risk factors for Chagas disease during pregnancies. METHODS: Community-based serological tests on Trypanosoma cruzi and structured interviews on socio-demographic and socio-economic status were conducted with pregnant women registered at three health centres in Sonsonate province, El Salvador. RESULTS: Of 797 pregnant women participating in the study, 29 (3.6%) were infected with Chagas disease. None had clinical symptoms. The results of bivariate analyses showed the significant association between seropositivity and maternal age ≥35 years, anaemia, illiteracy, having no formal school education and having knowledge on Chagas disease (P < 0.05). The results of multivariate analysis indicate that age ≥35 years and anaemia were significantly associated with being infected with Chagas disease among pregnant women (OR = 3.541 and 5.197, respectively). CONCLUSION: We recommend that the national Chagas disease control programme be better coordinated with the national maternal and child health programme to introduce blood screening for T. cruzi during antenatal visits. If financial constraint allows systematic blood screening to be only partially implemented, resources should be focused on pregnant women ≥35 years and women who have anaemia.

The onchocerciasis elimination program for the Americas: a history of partnership

The decision in 1987 by the pharmaceutical firm Merck & Co. to provide Mectizan (ivermectin) free of charge to river blindness control programs has challenged the international public health community to find effective ways to distribute the drug to rural populations most affected by onchocerciasis. In the Americas, PAHO responded to that challenge by calling for the elimination of all morbidity from onchocerciasis from the Region by the year 2007 through mass distribution of ivermectin. Since 1991, a multinational, multiagency partnership (consisting of PAHO, the endemic countries, nongovernmental development organizations, the Centers for Disease Control and Prevention in Atlanta, Georgia, as well as academic institutions and funding agencies) has developed the political, financial, and technical support needed to move toward the realization of that goal. This partnership is embodied in the Onchocerciasis Elimination Program for the Americas (OEPA), which is supported by the River Blindness Foundation (RBF) and now by the Carter Center. OEPA was conceived as a means of maintaining a regional initiative to eliminate what is otherwise a low priority disease. Since its inception in 1993, the OEPA has provided more than US$2 million in financial, managerial, and technical assistance to stimulate and/or support programs in Brazil, Colombia, Ecuador, Guatemala, Mexico and Venezuela, so as to take full advantage of the Merck donation. Now halfway into a five-year, US$ 4 million grant provided through the Inter-American Development Bank, the OEPA's capacity to support the regional initiative is assured through 1999

Comparación de dos métodos de laboratorio para examinar xenodiagnósticos / Comparison of two laboratories methods in xenodiagnosis

El presente trabajo ha tenido por objetivo comparar la efectividad de dos métodos, el examen individual del contenido intestinal de los triatomíneos y el examen por homogeneización de todas las ninfas usadas, que resultaron igualmente sensibles para descubrir Trypanosoma cruzi y T. rangeli en xenodiagnósticos tomados al azar y por duplicado (AU)

Comparación de dos métodos de laboratorio para examinar xenodiagnósticos / Comparison of two laboratories methods in xenodiagnosis

El presente trabajo ha tenido por objetivo comparar la efectividad de dos métodos, el examen individual del contenido intestinal de los triatomíneos y el examen por homogeneización de todas las ninfas usadas, que resultaron igualmente sensibles para descubrir Trypanosoma cruzi y T. rangeli en xenodiagnósticos tomados al azar y por duplicado (AU)

Comparacion de dos metodos de laboratorio para examinar xenodiagnosticos. / Comparison of two laboratories methods in xenodiagnosis

El presente trabajo ha tenido por objetivo comparar la efectividad de dos metodos, el examen individual del contenido intestinal de los triatomineos y el examen por homogeneizacion de todas las ninfas usadas que resultaron igualmente sensibles para descubrir Trypanosoma cruzi y T. rangeli en xenodiagnosticos tomados al azar y por duplicado

Chagas' disease in El Salvador

Several studies on Chagas' disease in El Salvador have supplied important epidemiologic information, including the following: (1) Rates of house infestation by triatomid vectors have ranged from 26.3 per cent to 100 per cent in various localities studied, higher rates being found in rural than in urban areas. (2) Triatoma dimidiata and Rhodnius prolixus are the two vectors of T. cruzi in El Salvador, with T. dimidiata predominating in localities at elevations above 600 meters and R. prolixus in those below 300 meters. (3) T. cruzi infection rates in these triatomids have ranged from 15.3 to 48.8 per cent, the average being 25.3 per cent. The average rate found for T. rangeli infection of these triatomids was 5.6 per cent. (4) T. cruzi infection in humans has been nore prevalent among rural dwellers than among urban inhibitants. Xenodiagnosis positivity rates have ranged between 3.8 and 18.4 per cent of the individuals examined. Positive reactions to the complement fixation test have ranged from 17.3 to 46.7 per cent. (5) The acute phase of the disease has been observed in both children and young adults. Nevertheless, ECG and radiologic changes appear to be less common and milder than those reported in South American countries. (6) Further studies are required in order to better define the status of Chagas' disease in El Salvador (Au)