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

Martins-Melo, Francisco Rogerlândio, Ramos, Alberto Novaes Jr, Alencar, Carlos Henrique, and Heukelbach, Jorg (2014) Prevalence of Chagas disease in Brazil: a systematic review and meta-analysis. Acta Tropica, 130. pp. 167-174.

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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.

Item ID: 32926
Item Type: Article (Refereed Research - C1)
Keywords: Chagas disease, Trypanosoma cruzi, Brazil, prevalence, epidemiology, systematic review
ISSN: 1873-6254
Funders: Brazilian Swiss Joint Research Programme (BSJRP)
Projects and Grants: BSJRP grant no. 011008
Date Deposited: 30 Apr 2014 09:32
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111706 Epidemiology @ 50%
11 MEDICAL AND HEALTH SCIENCES > 1108 Medical Microbiology > 110803 Medical Parasitology @ 50%
SEO Codes: 92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920404 Disease Distribution and Transmission (incl. Surveillance and Response) @ 50%
92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920499 Public Health (excl. Specific Population Health) not elsewhere classified @ 50%
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