Open Access Research article

Association of Trypanosoma cruzi infection with risk factors and electrocardiographic abnormalities in northeast Mexico

Zinnia Judith Molina-Garza1, José Luis Rosales-Encina2, Roberto Mercado-Hernández1, Daniel P Molina-Garza3, Ricardo Gomez-Flores1 and Lucio Galaviz-Silva1*

Author Affiliations

1 Universidad Autónoma de Nuevo León, Facultad de Ciencias Biológicas, Ave. Universidad SN, Cd. Universitaria, San Nicolás de los Garza, Nuevo León 66451, México

2 Departamento de Infectómica y Patogénesis Molecular, CINVESTAV, Av. Instituto Politécnico Nacional 2508, Col. San Pedro Zacatenco, Del. Gustavo A. Madero, México City, CP 07360DF, México

3 Secretaría de Salud del Estado de Nuevo León, Hospital General de Cerralvo, Cerralvo, Nuevo León 66451, México

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BMC Infectious Diseases 2014, 14:117  doi:10.1186/1471-2334-14-117

Published: 1 March 2014

Abstract

Background

American trypanosomiasis is a major disease and public health issue, caused by the protozoan parasite Trypanosoma cruzi. The prevalence of T. cruzi has not been fully documented, and there are few reports of this issue in Nuevo Leon. The aim of this study was to update the seroprevalence rate of T. cruzi infection, including an epidemiological analysis of the risk factors associated with this infection and an electrocardiographic (ECG) evaluation of those infected.

Methods

Sera from 2,688 individuals from 10 municipalities in the state of Nuevo Leon, Mexico, were evaluated using an enzyme-linked immunosorbent assay and an indirect hemagglutination assay. An ECG case–control study was performed in subjects seropositive for T. cruzi and the results were matched by sex and age to seronegative residents of the same localities. A univariate analysis with χ2 and Fisher’s exact tests was used to determine the association between seropositivity and age (years), sex, and ECG changes. A multivariate analysis was then performed to calculate the odd ratios between T. cruzi seropositivity and the risk factors.

Results

The seropositive rate was 1.93% (52/2,688). In the ECG study, 22.85% (8/35) of the infected individuals exhibited ECG abnormalities. Triatoma gerstaeckeri was the only vector reported. The main risk factors were ceiling construction material (P ≤ 0.0024), domestic animals (P ≤ 0.0001), and living in rural municipalities (P ≤ 0.0025).

Conclusions

These findings demonstrate a 10-fold higher prevalence of Chagas disease than previously reported (0.2%), which implies a serious public health threat in northeastern Mexico. The epidemiological profile established in this study differs from that found in the rest of Mexico, where human populations live in close proximity to domiciliary triatomines.

Keywords:
Chagas disease; Trypanosoma cruzi; Serology; Electrocardiographic abnormalities; Epidemiology