An Analysis of the Laboratory-Based Surveillance System for Chagas ─Belize, 2015-2020.
- Vector-borne
Background
Chagas, a neglected tropical disease caused by the parasite Trypanosoma cruzi, produces symptoms varying from asymptomatic in the acute phase to irreversible effects in the chronic phase. Brazil reported an average yearly age-adjusted mortality rate of 3.22 deaths per 100,000 population from 2000 to 2019. In Belize, screening is mostly done among blood donors whilst other cases may be detected through clinical suspicion. The objective of this analysis was to provide an epidemiological profile of Chagas in Belize.
Methods
A cross-sectional descriptive analysis was conducted for the period 2015-2020 of persons screened for Chagas reported in the Belize Health Information System. Prior to 2018, screening was done using ELISA method and thereafter ECLIA was used. Data extraction and analysis was done using Microsoft Excel. Descriptive statistical analysis and Prevalence Odds Ratio (POR) using stratification by Blood Donors and non-Blood Donors was calculated.
Results
A total of 18,914 persons were screened: 97% (18,347) blood donors and 3% (567) non-blood donors. There were 84 Chagas cases detected: 96% (81) blood donors, 4% (3 non-donors); 92% (77) were male; 20% (17) in the 35-39 age range; Belize and Cayo Districts each reported 25%; 70% (59) were from rural areas. The Stann Creek district had the highest prevalence rate at 37/100,000 population. The incidence rate was highest in 2016 at 4.8/100,000 population (range: 2.3-4.8/100,000) with a yearly average of 3.6/100,000 population. There were no reported deaths.
Conclusion
While Chagas screening is performed mostly among blood donors, it is strongly recommended to establish a surveillance system among the general population in order to have a complete epidemiological profile of the disease and to understand the associated risk factors. Additional research is necessary to identify populations at risk and to understand the behavior of the vector and disease.
Chagas, a neglected tropical disease caused by the parasite Trypanosoma cruzi, produces symptoms varying from asymptomatic in the acute phase to irreversible effects in the chronic phase. Brazil reported an average yearly age-adjusted mortality rate of 3.22 deaths per 100,000 population from 2000 to 2019. In Belize, screening is mostly done among blood donors whilst other cases may be detected through clinical suspicion. The objective of this analysis was to provide an epidemiological profile of Chagas in Belize.
Methods
A cross-sectional descriptive analysis was conducted for the period 2015-2020 of persons screened for Chagas reported in the Belize Health Information System. Prior to 2018, screening was done using ELISA method and thereafter ECLIA was used. Data extraction and analysis was done using Microsoft Excel. Descriptive statistical analysis and Prevalence Odds Ratio (POR) using stratification by Blood Donors and non-Blood Donors was calculated.
Results
A total of 18,914 persons were screened: 97% (18,347) blood donors and 3% (567) non-blood donors. There were 84 Chagas cases detected: 96% (81) blood donors, 4% (3 non-donors); 92% (77) were male; 20% (17) in the 35-39 age range; Belize and Cayo Districts each reported 25%; 70% (59) were from rural areas. The Stann Creek district had the highest prevalence rate at 37/100,000 population. The incidence rate was highest in 2016 at 4.8/100,000 population (range: 2.3-4.8/100,000) with a yearly average of 3.6/100,000 population. There were no reported deaths.
Conclusion
While Chagas screening is performed mostly among blood donors, it is strongly recommended to establish a surveillance system among the general population in order to have a complete epidemiological profile of the disease and to understand the associated risk factors. Additional research is necessary to identify populations at risk and to understand the behavior of the vector and disease.