Chagas Disease Epidemiology: From Latin America to the World

Abstract

Chagas disease (CD) epidemiology is rapidly evolving in the context of human, socioeconomic, and environmental changes. Until the mid-twentieth century, CD was exclusively present in rural parts of the American continent, considered a disease of poverty associated with potentially lethal heart disease and was usually incurable. Since then, an increasing number of sporadic cases and evidence of congenital, post-transfusional and transplanted-related transmission have been identified first in urban regions of Latin America and more recently in other continents. This happens as a consequence of enhanced human mobility both within countries (rural to urban migration) and across borders in the context of socioeconomic and political development along with globalization. In parallel, hematophagous triatomines, the vectors of Trypanosoma cruzi, were increasingly identified in peri-urban regions of Latin America but also in other latitudes, such as in the United States, Australia, and in some Asian countries. Outbreaks of human cases following food-borne transmission have highlighted the risk of the development of emergent routes of transmission potentially affecting large numbers of people. Another example pertains to the global dissemination of Cimex lectularius (bedbugs) as a worldwide pest, difficult to control and with demonstrated susceptibility to T. cruzi infection.