Evaluation and Management of Congenital Chagas Disease in the United States

J Pediatric Infect Dis Soc. 2019 Nov 6;8(5):461-469. doi: 10.1093/jpids/piz018.


Chagas disease is underappreciated as a health concern in the United States. Approximately 40 000 women of childbearing age living in the United States have chronic Chagas disease. Most of them are unaware that they have an infection that is transmissible to their offspring. The estimated US maternal-to-infant transmission rate of Trypanosoma cruzi is 1% to 5%. Ten percent to 40% of neonates with congenital T cruzi infection have clinical signs consistent with a congenital infection but no findings are unique to Chagas disease. If left untreated, 20% to 40% of infants with Chagas disease will later develop potentially fatal cardiac manifestations. Molecular testing can confirm the diagnosis in neonates. Treatment is well tolerated in infancy and usually results in cure. Screening of at-risk women during pregnancy can identify maternal infection and allow early assessment and treatment for congenital T cruzi infection.

Keywords: Trypanosoma cruzi; Chagas disease; congenital infection.

Publication types

  • Review

MeSH terms

  • Chagas Disease / diagnosis*
  • Chagas Disease / therapy
  • Chagas Disease / transmission
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical*
  • Molecular Diagnostic Techniques
  • Polymerase Chain Reaction
  • Pregnancy
  • Pregnancy Complications, Parasitic / diagnosis*
  • Pregnancy Complications, Parasitic / therapy
  • Risk Factors
  • Trypanosoma cruzi
  • United States