Seroprevalence Patterns Suggestive of Postnatal Trypanosoma cruzi Acquisition in a Low-Infestation Area of Eastern Bolivia

Abstract

Chagas disease remains a major public health concern in Latin America, with Bolivia reporting one of the highest burdens of infection. While congenital transmission has become the predominant route of new infections in several countries, vector-borne transmission persists in rural and peri-urban regions. Postrervalle, in the department of Santa Cruz, is officially classified as a low-infestation area; however, updated community-level data remain limited. We conducted a cross-sectional study in July 2023 involving 58 mothers and 104 of their children in Postrervalle. Participants underwent serological screening with three diagnostic assays, and epidemiological data were collected via structured maternal questionnaires. Logistic regression models were used to assess associations between child Trypanosoma cruzi seropositivity and maternal or household exposures during pregnancy. Seroprevalence was 15.5% among mothers and 3.8% among children. Notably, all seropositive children were born to mothers who tested seronegative, suggesting non-congenital transmission. In multivariable analysis, living in houses with mud walls during pregnancy was strongly associated with child seropositivity (adjusted OR = 38.566), while older child age also increased the odds of infection. Other maternal exposure variables showed elevated but imprecise associations. Despite its classification as a low-infestation area, Postrervalle shows serological patterns consistent with postnatal acquisition linked to domestic structural conditions that facilitate triatomine colonization. These findings overall highlight the need for integrated serological and entomological surveillance to better characterize and prevent Chagas transmission in rural communities.