Chagas disease screening of maternal donors in publicly banked umbilical cord blood in North Carolina, United States 2007–2023

Introduction Over 300,000 people living in the United States are estimated to have Chagas disease, a condition for which mother to child transmission may occur and early diagnosis is essential to reduce Chagas‐related morbidity and mortality. This study evaluated positive Trypanosoma cruzi (T. cruzi) screening serology among maternal donors of umbilical cord blood and assessed the process for linkage to care and treatment for those with Chagas disease. Methods A retrospective review was conducted of cord blood samples donated to the Carolina Cord Blood Bank in North Carolina from July 2007 to December 2023 with evaluation of positive T. cruzi antibody screening results and outcomes of reflex supplemental testing for Chagas disease. Donors with positive or unknown reflex testing were contacted by phone, and infant testing data were extracted from medical records. Results Among 27,444 cord blood donations, 52 samples (0.19%; 1.9 per 1000) had positive T. cruzi antibody screening results, with 12 confirmed positive by supplemental testing. All confirmed donors identified as Hispanic/Latinx. Seven donors were started on treatment for Chagas disease, but only four completed it. Cardiac symptoms were later documented in the medical record of three subjects who did not complete treatment. All evaluated infants tested negative for Chagas disease. Conclusions Screening at‐risk pregnant individuals for Chagas disease who have lived in high incidence areas has the benefits of early identification of infection and treatment in people of reproductive age, their children, and extended family members. A protocolized approach to perinatal screening and linkage to care is essential in overcoming barriers to Chagas diagnosis, evaluation, and treatment.