Estimation of the morbidity and mortality of congenital Chagas disease: a systematic review and meta-analysis

Abstract

Chagas disease is caused by the parasite Trypanosoma cruzi , which can be passed from mother to infant. It is estimated that one million women of reproductive age are infected with T. cruzi. Prior to our work, the proportion of infants infected with T. cruzi congenitally presenting with clinical symptoms was unknown. After systematically searching for and identifying studies that collected information on infants with congenital Chagas disease, we summarized and analyzed 47 studies. Our pooled analysis of these studies estimated that 28.3% of infants with congenital Chagas disease were symptomatic and 2.2% died. Prior work has shown that transmission of T. cruzi from mother to child occurs in 5% of cases. Other studies have shown that this transmission is preventable through treatment of women prior to conception, and infants can be cured if shown to be infected at birth. Our estimated proportion of 28.3% of infants diagnosed with cCD at birth presenting with clinical symptoms are comparable to infants diagnosed with congenital toxoplasmosis presenting with clinical symptoms (10.0%-30.0%) and congenital cytomegalovirus (10.0%-15.0%). More studies comparing infected mother-infant dyads to non-infected mother-infant dyads are needed to determine an association of this burden to cCD infection.