Chagas Disease Epidemiology in Central America: an Update

Purpose of Review Chagas disease is endemic to all seven Central American countries, where 12% of the population lives in areas where the disease is a risk. While neglect is a pervasive characteristic of Chagas disease in general, it tends to be especially overlooked in Central America, with more studies and resources devoted to the disease in South America. Here we report on the current epidemiological scenario of Chagas disease in Central America with the objective of presenting a panorama that includes national program details, recent morbidity data, new findings, and events relevant to the disease. Recent Findings Multinational initiatives and collaborations with external stakeholders that began around the beginning of this century led to the successful elimination of the vector species Rhodnius prolixus , which was last found in Guatemala in 2015. However, acute Chagas disease cases continue to be found in all countries with a surveillance system in place, mainly attributed to Trypanosoma cruzi transmission to humans by the native triatomine species Triatoma dimidiata and Rhodnius pallescens . Serological surveys targeting children have generally found varied T. cruzi infection prevalence, studies of transplacentally transmitted T. cruzi infection in the academic/public sectors have found a few cases in the region, and a new T. cruzi transmission focus was found in western Panama. Summary Chagas disease transmission and prevalence have been reduced in Central America over the past two decades, but there is still much progress to be made toward interruption of T. cruzi transmission to humans by native vector species. Other key areas for improvement are implementing screening for T. cruzi infection in pregnant women, improving reliability of diagnostic tests, expanding access to etiological treatment, and increasing availability and quality of data.