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

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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.

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          Author and article information

          Journal
          Acta Trop.
          Acta tropica
          1873-6254
          0001-706X
          Feb 2014
          : 130
          Affiliations
          [1 ] Department of Community Health, School of Medicine, Federal University of Ceará, 60430-140 Fortaleza, Brazil. Electronic address: rogerlandio@bol.com.br.
          [2 ] Department of Community Health, School of Medicine, Federal University of Ceará, 60430-140 Fortaleza, Brazil.
          [3 ] Department of Community Health, School of Medicine, Federal University of Ceará, 60430-140 Fortaleza, Brazil; Anton Breinl Centre for Public Health and Tropical Medicine, School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, QLD 4811, Australia. Electronic address: heukelbach@web.de.
          Article
          S0001-706X(13)00276-3
          10.1016/j.actatropica.2013.10.002
          24139912
          09888fbe-b771-4314-98f9-2bf668670b07
          Copyright © 2013 Elsevier B.V. All rights reserved.
          History

          Brazil,Chagas disease,Epidemiology,Prevalence,Systematic review,Trypanosoma cruzi

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