Chagas Disease in the New York City Metropolitan Area

Area of Science:

• Infectious Diseases
• Parasitology
• Public Health

Background:

• Chagas disease (caused by Trypanosoma cruzi) is a growing global concern, with an estimated 300,000 infected individuals in the US.
• Awareness of Chagas disease among US healthcare providers is notably low.

Purpose of the Study:

• To review the clinical experience of managing Chagas disease patients in the New York City metropolitan area.
• To describe screening methods, clinical presentations, diagnostic findings, and treatment outcomes for Chagas disease.

Main Methods:

• Retrospective review of 60 Chagas disease patients managed in New York City hospitals.
• Analysis of patient demographics, country of origin, detection methods, clinical manifestations, EKG and imaging findings, and treatment regimens.

Main Results:

• The majority of patients originated from El Salvador (40%), with blood donor screening being a common detection method (35%).
• Nearly half of the patients (48%) were asymptomatic at diagnosis.
• Treatment with benznidazole or nifurtimox was initiated in 27 patients, but 7 did not complete therapy due to side effects or loss to follow-up. Ten patients developed advanced heart failure.

Conclusions:

• Recommend targeted screening for asymptomatic, at-risk populations to enable early detection before clinical disease progression.
• Advocate for comprehensive evaluation including electrocardiogram, echocardiogram, chest x-ray, and relevant gastrointestinal imaging.
• Emphasize appropriate patient treatment while cautioning providers about potential adverse effects that may hinder treatment completion.