Mother-to-child transmission of Chagas' disease in North America: why don't we do more?

OBJECTIVES

Mothers with Chagas' disease can transmit Trypanosoma cruzi to their fetuses, who often become carriers of the infection and are then at risk of developing severe cardiac disease later in the course of their lives. If identified early enough after birth, the infected newborns can be treated and cured. Our objective was to review the data available in Canada, Mexico, and the United States and to discuss the need for prevention programs.

METHODS

We reviewed the literature and estimated the number of seropositive mothers and newborns infected by T. cruzi.

RESULTS

We estimate that about 40,000 pregnant women and 2,000 newborns are likely to be infected by T. cruzi in North America. We have not identified any ongoing prevention programs.

CONCLUSIONS

Mother-to-child transmission of T. cruzi has all the characteristics required to be a public health priority, as it is relatively frequent, severe, identifiable, and treatable. In reality, it is a neglected disease and a missed opportunity. It is urgent to better understand the epidemiology of mother-to-child transmission of T. cruzi in North America and to develop effective prevention programs.