Autonomic Dysfunction and Risk Factors Associated with Trypanosoma cruzi Infection among Children in Arequipa, Peru

Chagas disease affects an estimated 8 million people in Latin America Infected individuals have 20-30% lifetime risk of developing cardiomyopathy, but more subtle changes in autonomic responses may be more frequent We conducted a matched case control study of children in Arequipa, Peru, where triatomine infestation and Trypanosoma cruzi infection are emerging problems We collected data on home environment, history physical examination, electrocardiogram, and autonomic testing Signs of triatomine infestation and/or animals sleeping in the child's room and household members with Chagas disease were associated with Increased infection risk Electrocardiogram findings did not differ between cases and controls However, compared with control children, infected children had blunted auto nomic responses by three different measures, the Valsalva maneuver, the cold pressor test, and the orthostatic test T cruzi-infected children show autonomic dysfunction, although the prognostic value of this finding is not clear Sustained vector control programs are essential to decreasing future 7 cruzi infections