Geographic distribution of risk and the impact of congenital Chagas disease in Chile

Abstract

Introduction: In Chile, Chagas disease (ChD) persists even after the interruption of vector-borne transmission, with 152 cases reported in children under 2 years of age between 2011 and 2022.

Objective: To determine the incidence and total risk in women in general and in women of reproductive age, their geographic distribution by community, and the reproductive contribution of congenital ChD.  

Method: Population-based study of mandatory notifiable disease cases for ChD from 2021 to 2023. The incidence and total relative risk were estimated by sex and women of reproductive age using the Besag-York-Mollie model by community.  

Results: The incidence of reported ChD cases was high (over 10 per 100,000 inhabitants), with presence in non-endemic areas for vectors and changes in geographic distribution.  The rate (per 100,000 inhabitants)  in 2023 was higher in women (7.35) than in men (3.81) and 5.27 in women of reproductive age.  The estimate of congenital ChD (33 for one generation) is not enough to explain the current prevalence of CD.  

Conclusion: The incidence of ChD in women and the geographic distribution of women of reproductive age are good predictors of the risk of congenital ChD in Chile (endemic and non-endemic areas).