What is the global prevalence of Chagas disease (American trypanosomiasis) internationally?

Updated: Apr 26, 2019
  • Author: Louis V Kirchhoff, MD, MPH; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Answer

T cruzi is endemic in Mexico and all the countries of Central America and South America. The Caribbean Islands are not endemic. In 2016, the World Health Organization estimated that a total of 6-8 million people are infected with T cruzi and that about 12,000 deaths each year can be attributed to Chagas disease. [93] Moreover, emigration of millions of people from endemic countries to nonendemic regions has resulted in several hundred thousand T cruzi–infected persons living in the latter areas, particularly in the United States and Europe. [77, 94, 95, 96] The total number of new T cruzi infections per year is estimated to be 28,000, fully 15,000 of which result from congenital transmission. [43] To give a country‑specific perspective on the relative prevalence rates, in 2007, PAHO published the following data regarding the countries most affected by Chagas disease: Bolivia (6.8% prevalence); Argentina (4.1%); El Salvador (3.4%); Honduras (3.1%); Paraguay (2.5%); Guatemala (2%); Ecuador (1.7%); French Guyana, Guyana, and Surinam (1.2%); Venezuela (1.2%); Nicaragua (1.1%); Brazil (1%); and Mexico (1%). [97]

As noted above, in recent years, the epidemiology of T cruzi infection has improved markedly in many endemic countries, as blood bank and vector-control programs have been implemented. Because of the success of programs directed at domiciliary vector programs, prevalence rates in younger age groups have been decreasing substantially in many areas. [17, 18, 98, 99, 100] All endemic countries have adopted statutory or regulatory mandates for screening donated blood for T cruzi, the most recent of which was Mexico. [30, 29, 101] .

In the author’s view, the enormous progress made in controlling Chagas disease in recent decades clearly indicates that the obstacles hindering the complete elimination of T cruzi transmission to humans are primarily economic and political. In this context, no additional major advances, such as a more detailed understanding of the pathogenesis of Chagas disease, [102, 103] further genetic analyses, [6, 104] novel diagnostic approaches, or breakthroughs in vaccine development, [105] are necessary for its completion. Other investigators take an opposing view regarding the application of such high-technology approaches to the problem of Chagas disease. [106]


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