Key result
Chagas disease is not linked to overall mortality but carries ~400% higher risk under age 60.
Why the study?
Chagas disease is a leading cause of cardiomyopathy in Latin America, but community-based prospective data on its association with mortality remain scarce.
Does Chagas disease increase all-cause mortality in individuals from endemic communities?
Cohort (n=1,509)
Does Chagas disease increase all-cause mortality in individuals from endemic communities?
Chagas disease is associated with a nearly 5-fold increased risk of mortality in adults under 60 years of age in endemic communities, highlighting the need for intensified cardiovascular surveillance in this younger population.
May support age-specific monitoring in Chagas; leaves open randomized confirmation of benefit.
Background Chagas disease (CD), caused by Trypanosoma cruzi, is a leading cause of cardiomyopathy in Latin America. Community-based prospective data on the CD–mortality association remain scarce. Methods We analysed the ANTORCHA prospective cohort, enrolling individuals from T. cruzi-endemic communities in Santander, Colombia (2015–2025). The primary exposure was serologically confirmed CD; the primary outcome was all-cause mortality. Cox proportional hazards models with hierarchical adjustment and restricted mean survival time (RMST) were used. Results Among 1509 participants (314 Chagas positive), 81 deaths occurred over a median follow-up of 5.6 y. After full multivariate adjustment, CD was not associated with overall mortality (hazard ratio [HR] 1.02 [95% confidence interval {CI} 0.61 to 1.72]). A significant age-dependent interaction was identified (p=0.007): CD was independently associated with increased mortality among participants <60 y of age (HR 4.96 [95% CI 1.80 to 13.71]) but not among those ≥60 y of age (HR 0.73 [95% CI 0.43 to 1.22]). RMST analysis confirmed an absolute survival loss of 121 d at approximately 10 y of follow-up in the younger subgroup (p=0.02). Conclusions In this community-based cohort, CD was independently associated with markedly elevated mortality among adults <60 y of age. Younger T. cruzi-positive individuals warrant intensified cardiovascular surveillance.
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Díaz et al. (2026) conducted a cohort in Chagas disease (n=1,509). Serologically confirmed Chagas disease vs. Chagas negative individuals was evaluated on all-cause mortality (HR 1.02, 95% CI 0.61 to 1.72). Serologically confirmed Chagas disease was not associated with overall mortality (HR 1.02; 95% CI 0.61-1.72), but significantly increased mortality among adults <60 years of age (HR 4.96).
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