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Chagas disease: Epidemiology and control

Caryn Bern, MD, MPH
Section Editor
Peter F Weller, MD, FACP
Deputy Editor
Elinor L Baron, MD, DTMH


Chagas disease is caused by infection with the protozoan parasite Trypanosoma cruzi, most commonly transmitted by triatomine bugs. The major manifestations are Chagas cardiomyopathy and gastrointestinal disease. Issues related to the epidemiology and control of Chagas disease will be reviewed here. Other issues related to Chagas disease are discussed in detail separately. (See related topics.)


Overview — In the Western hemisphere, Chagas disease is responsible for a higher burden of morbidity and mortality than any other parasitic disease, including malaria [1]. T. cruzi infects humans and more than 100 species of nonhuman mammals. Vector-borne transmission occurs exclusively in the Americas, where an estimated 6 to 8 million people are infected (table 1) [2,3].

Historically, the disease occurred predominantly in rural areas of Latin America where poor housing conditions promoted frequent contact with infected vectors [4,5]. However, the epidemiology of the disease is changing due to migration of individuals within and outside of endemic countries, as well as successful programs to reduce transmission in endemic areas [5]. Since the establishment of control initiatives in the Southern Cone and other regions of Latin America, these and other trends have altered the epidemiology of Chagas disease, including:

Massive rural to urban migration

International migration of persons from Chagas disease-endemic areas to Europe and the United States


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