02233nas a2200265   4500000000100000008004100001260001200042100001300054700001400067700001200081700001300093700002400106700001600130700001600146700002400162700001200186700001400198700002200212245012500234856004600359300000700405490000600412520153500418022001401953       2021                            d  bMDPI AG1 aNolan MS1 aMurray KO1 aMejia R1 aHotez PJ1 aVillar Mondragon MJ1 aRodriguez S1 aPalacios JR1 aMurcia Contreras WE1 aLynn MK1 aTorres ME1 aMonroy Escobar MC00aElevated Pediatric Chagas Disease Burden Complicated by Concomitant Intestinal Parasites and Malnutrition in El Salvador  uhttps://www.mdpi.com/2414-6366/6/2/72/pdf  a720 v63 a<jats:p>The eradication of the vector Rhodnius prolixus from Central America was heralded as a victory for controlling transmission of Trypanosoma cruzi, the parasite that causes Chagas disease. While public health officials believed this milestone achievement would effectively eliminate Chagas disease, case reports of acute vector transmission began amassing within a few years. This investigation employed a cross-sectional serosurvey of children either presenting with fever for clinical care or children living in homes with known triatomine presence in the state of Sonsonate, El Salvador. Over the 2018 calendar year, a 2.3% Chagas disease seroprevalence among children with hotspot clustering in Nahuizalco was identified. Positive serology was significantly associated with dogs in the home, older participant age, and a higher number of children in the home by multivariate regression. Concomitant intestinal parasitic infection was noted in a subset of studied children; 60% having at least one intestinal parasite and 15% having two or more concomitant infections. Concomitant parasitic infection was statistically associated with an overall higher parasitic load detected in stool by qPCR. Lastly, a four-fold higher burden of stunting was identified in the cohort compared to the national average, with four-fifths of mothers reporting severe food insecurity. This study highlights that polyparasitism is common, and a systems-based approach is warranted when treating Chagas disease seropositive children.</jats:p>  a2414-6366