Target population | Screening methods | Primary goal | Secondary goal | Intervention details and effectiveness | Published estimates of Chagas disease prevalence |
Blood donors | Serology | Prevent transmission | Refer infected persons for management | Discard screen-positive donations; highly effective | Approximately 1/15,000 first-time donors, up to 1/2700 in high-risk areas[1] |
Organ donors | Risk-based*, serology | Prevent transmission | Heart from infected donor not used; use of other organs with appropriate monitoring; highly effective | 0.9% in combined risk-based and serologic donor screening[2] | |
Pregnant females from Latin America; infants born to infected mothers | Maternal serology, serial testing of infants¶; serology in siblings | Detect and treat infected infants early in life | Refer infected mothers and their other children for treatment | Early treatment of infants; treatment of mothers after lactation ends; treat infected siblings; highly effective in infants and children, moderate in young mothers | Approximately 10 mothers and <1 infected child per 4000 high-risk females (majority born in Latin America)[3] |
Immigrants from Latin AmericaΔ and individuals with other risk factors* | Risk-based*, serology | Detect asymptomatic infected individuals | Refer family members at risk◊ | Treatment of infected individuals; effectiveness high in children, uncertain in adults | 0.5 to 4% in high-risk populations; many of those detected were >50 in whom treatment not generally recommended[4-6] |
Patients from Latin America with immunosuppressive conditions (HIV, transplant candidates, transplant recipients) | Serology; molecular testing if high index of suspicion | Detect infected individuals before reactivation occurs | Treatment of Trypanosoma cruzi reactivation can be life-saving; prospective monitoring for reactivation improves prognosis | No systematic data on prevalence of T. cruzi in these populations in the United States |
* Risk factors include being born or having lived ≥6 months in an endemic country of Latin America, persons born to a mother with confirmed T. cruzi infection, or persons with evidence of a bite or other exposure to a triatomine bug in Latin America or regions of United States with known enzootic cycles.
¶ Polymerase chain reaction (plus microscopy if available) twice in the first 3 months of life, followed by immunoglobulin G serology at 9 months or later.
Δ Highest priority for children, young adults, and females of childbearing age due to considerations of antitrypanosomal treatment effectiveness[7].
◊ Family members of infected individuals should also be tested if they share the same risk factors, such as residence in an endemic country[8].Do you want to add Medilib to your home screen?