Abstract Background Chagas disease (CD), caused by the parasite Trypanosoma cruzi, is one of the main overlooked urban diseases worldwide, with dilated cardiomyopathy being the most important and serious manifestation of the chronic phase. In addition to classic vector-borne transmission, vertical and oral transmission, blood transfusion and organ transplantation are some important forms of dissemination, mainly in non-endemic areas. According to data from the Brazilian health agency, the prevalence of CD varies across regions based on socioeconomic and environmental situation, with a concerning trend towards urbanization of the disease. Diagnosis is performed by means of serological tests that detect the presence of specific antibodies against T. cruzi in serum. These tests include indirect immunofluorescence, ELISA and direct agglutination assays. The aim of this study was to perform a retrospective profile analysis for the diagnosis of CD according to gender and age, using a database from a large Brazilian laboratory. Methods The study was based on a retrospective survey of laboratory tests between January 2023 and December 2024, involving patients assisted at several outpatient health centers and 34 hospital health centers, distributed in 12 Brazilian states. The data for the serological tests were obtained by indirect immunofluorescence methods using the Imuno-COM® Chagas kit (Wama, Diagnóstica) to detect Immunoglobulin G (IgG) and immunoassay for the identification of total antibodies using the Elecsys® Chagas Kit (Roche Diagnostics). Data analysis was performed according to the number of tests processed, and both tests could be analyzed for the same patient. Results A total of 30,012 tests were evaluated, of which 76.9% (23,069/30,012) were related to total antibody testing and 23.1% (6,943/30,012) to IgG testing. The overall positivity rate was 8.1% (2,428/30,012), with a positivity rate for total antibodies of 5.2% (1,190/23,069) and a positivity rate for IgG analysis of 17.8% (1,238/6,943). Among the positive cases, 58.6% (1,422/2,428) were related to the female gender. According to the age group, 65.1% (1581/2428) of the cases were detected in individuals over 60 years, followed by 22.6% (548/2428) between 51 to 60 years. Additionally, 89.1% (2,160/2,428) of the cases were detected in patients assisted by public health services, mostly located in the southeast region of Brazil. Regarding the type of care, 39.5% (960/2428) came from hospitals, of which 67.1% (645/960) were related to a cardiology hospital. We did not have access to patients’ symptoms, clinical history or further diagnostic procedures. Conclusion Our study corroborates data published by the Brazilian government and warns of the importance of continued attention, since the incidence in urbanized regions is significant and worrying. The rates of CD detected in a cardiology hospital demonstrate that the cardiac sequel of the chronic phase is a problem not only in countries where it is endemic, but also where infection occurs through non-traditional transmission (via vector). Understanding the local epidemiology of CD is essential to improve vector management and control, in addition to supporting the campaign against the disease and promoting significant improvements in global public health.
Nürmberger et al. (Wed,) studied this question.