Chagas disease in the Bolivian Chaco: Persistent transmission indicated by childhood seroscreening study

Int J Infect Dis. 2019 Sep:86:175-177. doi: 10.1016/j.ijid.2019.07.020. Epub 2019 Jul 26.

Abstract

Background: Screening for Trypanosoma cruzi infection was performed amongst children in a rural community in the Bolivian Chaco, an area known for high prevalence. The force of infection (FOI) was estimated.

Methods: A total of 423 children attending the local school were screened using the Chagas Detect Plus (CDP) rapid test (InBios International, Inc.). CDP-positive specimens were further tested by indirect haemagglutination assay (IHA) and Wiener Recombinante v3.0 ELISA. A catalytic model was used to estimate FOI.

Results: Confirmed seroprevalence was 0.22, rising steeply with age. The mean age of seropositive individuals was 13 years. The calculated specificity of the rapid test was 91.9%. The annual incidence estimated from the FOI was 0.021.

Conclusions: This study demonstrates persistent transmission and continuing high levels of T. cruzi infection in the Bolivian Chaco, and highlights the practicality of school-based screening.

Keywords: Bolivian Chaco; Chagas disease; Screening study; T. cruzi; Trypanosoma cruzi.

MeSH terms

  • Adolescent
  • Bolivia / epidemiology
  • Chagas Disease / diagnosis
  • Chagas Disease / epidemiology
  • Chagas Disease / transmission*
  • Child
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Hemagglutination Tests
  • Humans
  • Male
  • Mass Screening
  • Prevalence
  • Rural Population
  • Schools
  • Sensitivity and Specificity
  • Seroepidemiologic Studies
  • Serologic Tests
  • Trypanosoma cruzi
  • Young Adult