In recent years, there has been growing awareness of the significant burden of Chagas disease in the United States (US). However, epidemiological data on both prevalence and access to care for this disease are limited. The objective of this study is to provide an updated national estimate of Chagas disease prevalence, the first state-level estimates of cases of T. cruzi infection in the US and to analyze these estimates in the context of data on confirmed cases of infection in the US blood supply and drug releases to affected patients over the period from 2007-2013.
In this study, we calculated estimates of the state and national prevalence of Chagas disease. The number of residents originally from Chagas disease endemic countries were computed using data on Foreign-Born Hispanic populations from the American Community Survey, along with recent prevalence estimates for Chagas disease in Latin America from the World Health Organization that were published in 2006 and updated in 2015. We then compare the distribution of estimated cases in each state to the number of infections identified in the donated blood supply per data from the AABB (formerly American Association of Blood Banks) and cases treated based on drug release data from the US Centers for Disease Control and Prevention.
The results of this analysis offer an updated national estimate of 238,091 cases of T. cruzi infection in the United States as of 2012, using the same method as was used by Bern and Montgomery to estimate cases in 2005. This represents 62,070 cases less than the most recent prior estimate. The state level results show four states with over 10,000 cases and an additional seven states with over 5,000 cases. Moreover, from 2007 to 2013, the AABB reported 1,908 confirmed cases of T. cruzi infection that were identified through screening of blood donations. Finally, during this same period, drug releases were provided to treat 432 cases.
This study demonstrates a substantial, geographically focal burden of Chagas disease in the US. It lends important new insight into the distribution of this disease and highlights the need for further research quantifying prevalence and incidence to guide interventions for both control and treatment of Chagas disease across the US.
S. Montgomery, None
V. Wirtz, None