RISK-FACTORS FOR TRYPANOSOMA-CRUZI INFECTION AMONG CHILDREN IN CENTRAL BRAZIL - A CASE-CONTROL STUDY IN VECTOR CONTROL SETTINGS

This population-based case-control study was conducted in northern Col as State, central Brazil, in rural settings under vector control surve illance. One hundred forty-nine children seropositive for Trypanosoma cruzi antibodies, selected in a cross-sectional survey carried out in village schools, were compared with 298 seronegative classmate control s matched for age, sex, and place of residence. Information on potenti al environmental, familiar, and social economic risk factors for T. cr uzi infection was collected during household visits, and interviews wi th parents and entomologic inspections of domestic and peridomestic en vironments were conducted. The presence of triatomines in dwellings or evidence of triatomine colonization was found to be statistically ass ociated with seropositivity in children. The presence of exuviae and a report of triatomines indoors or outdoors by householders in the past were strong predictors of an infected child. Children from seropositi ve mothers had a 3.9-fold increase in the risk of having anti-T. cruzi antibodies after adjusting for the confounding variables, including t riatomine capture, mother's age, and family size in multivariate analy sis. Parent's report of vector presence showed a 97.7% sensitivity in identifying a dwelling with at least one seropositive child. The possi bility of transplacental T. cruzi transmission and its implication for Chagas' disease control were considered.