The Economic Burden of Chagas Disease: A Systematic Review

Background: Chagas disease (CD) is a neglected disease affecting millions worldwide, yet little is known about its economic burden. This systematic review is part of RAISE project, a broader study that aims to estimate the global prevalence, mortality, and health and economic burden attributable to chronic CD and Chronic Chagas cardiomyopathy. The objective of this study was to assess the main costs associated with the treatment of CD in both endemic and non-endemic countries.

Methods: An electronic search of the Medline, Lilacs, and Embase databases was conducted until 31st, 2022, to identify and select economic studies that evaluated treatment costs of CD. No restrictions on place or language were made. Complete or partial economic analyses were included.

Results: Fifteen studies were included, with two-thirds referring to endemic countries. The most commonly investigated cost components were inpatient care, exams, surgeries, consultation, drugs, and pacemakers. However, significant heterogeneity in the estimation methods and presentation of data was observed, highlighting the absence of standardization in the measurement methods and cost components. The most common component analyzed using the same metric was hospitalization. The mean annual hospital cost per patient ranges from $25.47 purchasing power parity US dollars (PPP-USD) to $18,823.74 PPP-USD, and the median value was $324.44 PPP-USD. The lifetime hospital cost per patient varies from $209,44 PPP-USD for general care to $14,351.68 PPP-USD for patients with heart failure.

Discussion: Despite the limitations of the included studies, this study is the first systematic review of the costs of CD treatment. The findings underscore the importance of standardizing the measurement methods and cost components for estimating the economic burden of CD and improving the comparability of cost components magnitude and cost composition analysis. Finally, assessing the economic burden is essential for public policies designed to eliminate CD, given the continued neglect of this disease.

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References

Perez-Molina J, Molina I . Chagas disease. Lancet. 2017; 391(10115):82-94. DOI: 10.1016/S0140-6736(17)31612-4. View

Gomez-Ochoa S, Rojas L, Echeverria L, Muka T, Franco O . Global, Regional, and National Trends of Chagas Disease from 1990 to 2019: Comprehensive Analysis of the Global Burden of Disease Study. Glob Heart. 2022; 17(1):59. PMC: 9414802. DOI: 10.5334/gh.1150. View

Herrador Z, Rivas E, Gherasim A, Gomez-Barroso D, Garcia J, Benito A . Using hospital discharge database to characterize Chagas disease evolution in Spain: there is a need for a systematic approach towards disease detection and control. PLoS Negl Trop Dis. 2015; 9(4):e0003710. PMC: 4401715. DOI: 10.1371/journal.pntd.0003710. View

Wilson L, Strosberg A, Barrio K . Cost-effectiveness of Chagas disease interventions in latin america and the Caribbean: Markov models. Am J Trop Med Hyg. 2005; 73(5):901-10. View

Cook C, Cole G, Asaria P, Jabbour R, Francis D . The annual global economic burden of heart failure. Int J Cardiol. 2014; 171(3):368-76. DOI: 10.1016/j.ijcard.2013.12.028. View

Castillo-Riquelme M, Guhl F, Turriago B, Pinto N, Rosas F, Martinez M . The costs of preventing and treating chagas disease in Colombia. PLoS Negl Trop Dis. 2008; 2(11):e336. PMC: 2581604. DOI: 10.1371/journal.pntd.0000336. View

Lidani K, Andrade F, Bavia L, Damasceno F, Beltrame M, Messias-Reason I . Chagas Disease: From Discovery to a Worldwide Health Problem. Front Public Health. 2019; 7:166. PMC: 6614205. DOI: 10.3389/fpubh.2019.00166. View

. Chagas disease in Latin America: an epidemiological update based on 2010 estimates. Wkly Epidemiol Rec. 2015; 90(6):33-43. View

Olivera M, Buitrago G . Economic costs of Chagas disease in Colombia in 2017: A social perspective. Int J Infect Dis. 2019; 91:196-201. DOI: 10.1016/j.ijid.2019.11.022. View

10.

Evers S, Goossens M, de Vet H, van Tulder M, Ament A . Criteria list for assessment of methodological quality of economic evaluations: Consensus on Health Economic Criteria. Int J Technol Assess Health Care. 2005; 21(2):240-5. View

11.

Ribeiro-Rotta R, Rosa E, Milani V, Dias N, Masterson D, Silva E . The cost of oral cancer: A systematic review. PLoS One. 2022; 17(4):e0266346. PMC: 9022815. DOI: 10.1371/journal.pone.0266346. View

12.

Abuhab A, Trindade E, Aulicino G, Fujii S, Bocchi E, Bacal F . Chagas' cardiomyopathy: the economic burden of an expensive and neglected disease. Int J Cardiol. 2013; 168(3):2375-80. DOI: 10.1016/j.ijcard.2013.01.262. View

13.

Schofield C, Dias J . A cost-benefit analysis of Chagas disease control. Mem Inst Oswaldo Cruz. 1991; 86(3):285-95. DOI: 10.1590/s0074-02761991000300002. View

14.

Guedes P, Silva G, Gutierrez F, Silva J . Current status of Chagas disease chemotherapy. Expert Rev Anti Infect Ther. 2011; 9(5):609-20. DOI: 10.1586/eri.11.31. View

15.

Ramsey J, Elizondo-Cano M, Sanchez-Gonzalez G, Pena-Nieves A, Figueroa-Lara A . Opportunity cost for early treatment of Chagas disease in Mexico. PLoS Negl Trop Dis. 2014; 8(4):e2776. PMC: 3990484. DOI: 10.1371/journal.pntd.0002776. View

16.

Ademar Sales Junior P, Molina I, Murta S, Sanchez-Montalva A, Salvador F, Correa-Oliveira R . Experimental and Clinical Treatment of Chagas Disease: A Review. Am J Trop Med Hyg. 2017; 97(5):1289-1303. PMC: 5817734. DOI: 10.4269/ajtmh.16-0761. View

17.

Vazquez-Prokopec G, Spillmann C, Zaidenberg M, Kitron U, Gurtler R . Cost-effectiveness of chagas disease vector control strategies in Northwestern Argentina. PLoS Negl Trop Dis. 2009; 3(1):e363. PMC: 2613538. DOI: 10.1371/journal.pntd.0000363. View

18.

Vallejo M, Montenegro P, Reyes P . [How much does the medical treatment of chronic Chagas cardiopathy cost? Direct costs in a cardiology hospital]. Arch Cardiol Mex. 2002; 72(2):129-37. View

19.

Barbosa Franca S, Xavier de Abreu D . [Hospital morbidity for Chagas disease in Brazil]. Rev Soc Bras Med Trop. 1996; 29(2):109-15. View

20.

SCHENONE H . [Human infection by Trypanosoma cruzi in Chile: epidemiology estimates and costs of care and treatment of the chagasic patient]. Bol Chil Parasitol. 1998; 53(1-2):23-6. View