Chronic Chagas Disease: A Descriptive Analysis from the GeoSentinel Network, 2014-2023

Chagas disease, which is caused by the parasite Trypanosoma cruzi, poses a significant health challenge in Latin America, where it is endemic. Because of population movement, it has become increasingly relevant outside endemic areas, particularly in the United States and Europe. The objective for the present study is to describe demographic and clinical characteristics of individuals diagnosed with chronic Chagas disease in the GeoSentinel Network. A retrospective analysis of data submitted by GeoSentinel sites from October 2014 to August 2023 was performed. There were 1,795 confirmed cases, including 85.2% (n = 1,530) diagnosed in three Spanish sites. Most were women (n = 1,278; 71.2%), with a median age of 45 years (interquartile range [IQR]: 15). The majority were Bolivian (85.8%), whereas 5.5% were Salvadoran, and 2.5% were Paraguayan. The median time between a patient's departure from their home country to consultation was 14 years (IQR: 11-17). Most individuals were diagnosed using serological methods (98.8%), and almost all (98.9%) were managed as outpatients. The clinical form at diagnosis was recorded in only 1,438 (80.1%) subjects; the indeterminate phase was the most common (1,297; 90.2%), followed by cardiac (91; 6.3%) and gastrointestinal involvement (50; 3.5%). Patients with chronic Chagas disease registered at GeoSentinel sites are predominantly women of childbearing age with long stays in host countries after migration. Chagas disease can be transmitted from mother to child, but congenital transmission can be prevented with antiparasitic treatment; thus, early screening and access to care for those at risk may reduce new infections. Long-term prospective studies are needed to analyze the progression and prognosis of Chagas disease in nonendemic areas.