Prevalence of Chagas disease in Brazil: A systematic review and meta-analysis

Abstract

Chagas disease is a major public health problem in Brazil and Latin America. During the last years, it has become an emerging problem in North America and Europe due to increasing international migration. Here we describe the prevalence of Chagas disease in Brazil through a systematic review. We searched national and international electronic databases, grey literature and reference lists of selected articles for population-based studies on Chagas disease prevalence in Brazil, performed from 1980 until September 2012. Forty-two articles with relevant prevalence data were identified from a total of 4985 references. Prevalence ranged from 0% to 25.1%. Most surveys were performed in the Northeast region, especially in the state of Piauí. We observed a high degree of heterogeneity in most pooled estimates (I(2)>75%; p<0.001). The pooled estimate of Chagas disease prevalence across studies for the entire period was 4.2% (95% CI: 3.1-5.7), ranging from 4.4% (95% CI: 2.3-8.3) in the 1980s to 2.4% (95% CI: 1.5-3.8) after 2000. Females (4.2%; 95% CI: 2.6-6.8), >60 year-olds (17.7%; 95% CI: 11.4-26.5), Northeast (5.0%; 95% CI: 3.1-8.1) and Southeast (5.0%; CI: 2.4-9.9) regions and mixed (urban/rural) areas (6.4%; 95% CI: 4.2-9.4) had the highest pooled prevalence. About 4.6 million (95% CI: 2.9-7.2 million) of people are estimated to be infected with Trypanosoma cruzi. The small number of studies and small-scale samples of the general population in some areas limit interpretation, and findings of this review do not necessarily reflect the situation of the entire country. Systematic population-based studies at regional and national level are recommended to provide more accurate estimates and better define the epidemiology and risk areas of Chagas disease in Brazil.

2 nd Brazilian Consensus on Chagas Disease, 2015

“…From this and other studies, the most recent estimates in Brazil regarding the number of people infected by T. cruzi vary from 1.9 million to 4.6 million people (35) (36) (37) , probably closer now to 1.0-2.4% of the population.…”

“…It was estimated that 4.6 million people (95% CI: 2.9-7.2 million) would be infected by T. cruzi in Brazil. Emphasizing the limitation of the findings in the literature, the authors highlight the need for new studies, with a view to obtaining truer estimates (35) .…”

“…It included publications from the period between 1980 and 2012, and estimated the pooled prevalence of Chagas disease at 4.2% [95% confidence interval (95% CI): 3.1-5.7], ranging from 4.4% (95% CI: 2.3-8.3) in the 1980s to 2.4% (95% CI: 1.5-3.8) after 2000 (35) . In that study, the highest prevalence was found in women (4.2%; 95% CI: 2.6-6.8), individuals over 60 years old (17.7%; 95% CI: 11.4-26.5), residents in the Northeastern (5.0%; 95% CI: 3.1-8.1) and Southeastern regions (5.0%; 95% CI: 2.4-9.9), and in mixed urban/rural areas (6.4%; 95% CI: 4.2-9.4).…”

“…Studies Management and Analysis of Demographic Dynamics (40) . a Parameters for estimates (minimum and maximum) of the prevalence of T. cruzi infection -PAHO, 2006 (17) ; Martins-Melo et al, 2014 (35) . b Parameters for maximum estimates of the prevalence of Chagas disease in the chronic phase with cardiac form (× 30%) and digestive form (× 10%).…”

New carbohydrazide derivatives of 1H-pyrazolo[3,4-b]pyridine and trypanocidal activity

“…This disease is considered as a neglected tropical disease, which means that it is associated with poverty and neglected by socio-economic system and by policy makers (Schmunis and Yadon 2010, Nunes et al 2013, Martins-Melo et al 2014, Chatelain 2015. It is estimated an annual incidence of 28,000 cases in the region of the Americas and causes about 12 thousand deaths annually.…”