Chagas Disease Epidemiology Forecast 2026-2035

Parameter

Insight

Largest Patient Pool

United States

Fastest Growing Country

Spain

High-Risk Population

In non-endemic countries, women of reproductive age with epidemiological links to endemic regions and their newborns are particularly important for screening because congenital transmission can occur without obvious maternal symptoms.

Key Diagnostic Method

Serological testing is the principal diagnostic method for chronic Chagas disease, using antibody assays to detect infection with Trypanosoma cruzi. Confirmation generally requires two serological tests based on different methods or antigen preparations, with additional testing when results are discordant.

Major Risk Factor

The major epidemiological risk factor is residence in, or maternal and family links to, a region where Trypanosoma cruzi transmission occurs. In endemic settings, exposure to infected triatomine insects is a key route.

Major gap in the market

The principal gap is the underdiagnosis of chronic infection and inconsistent access to risk-based screening and longitudinal care.

Epidemiology Segment

Key Insights

Diagnosed Prevalent Cases of the Disease

A harmonized count of diagnosed prevalent Chagas disease cases across the eight countries was not established from the reviewed 2023–2026 evidence. The United States has an estimated infected population of approximately 300,000, but this should not be interpreted as the number formally diagnosed. In the United Kingdom, a 2026 report of screening conducted in London during 2023–2025 identified 14 confirmed cases among 523 people screened; this is a selected screening cohort, not a national diagnosed-case count. Comparable recent national counts were not verified for Germany, France, Italy, Spain, Japan, and India.

Gender-Specific Cases of the Disease

Recent evidence does not support a reliable, harmonized male-to-female distribution of diagnosed Chagas disease across the eight countries. Women of reproductive age are a key screening population because identifying infection before pregnancy can help prevent congenital transmission, while testing during pregnancy can support timely assessment of newborns. However, the importance of this screening group should not be interpreted as evidence that women have a higher overall prevalence than men. Country-level sex-specific case counts remain dependent on testing access and the populations targeted by screening programmes.

Age-Specific Cases of the Disease

Chagas disease affects people of different ages, but its chronic complications often emerge years or decades after the initial infection. Children born to infected mothers are an important group for early testing because congenital infection can be asymptomatic and treatment is most effective when provided promptly. Adults with longstanding infection require assessment for cardiac and digestive involvement, even when symptoms are absent. A comparable 2023–2026 age-stratified distribution of diagnosed cases was not established across all eight countries; age-specific screening cohorts should not be treated as representative of the national infected population.

Ethnicity-Wise Cases of the Disease

In non-endemic settings, epidemiological risk assessment generally relies on country of birth, residence in endemic areas, maternal origin, and relevant exposure history rather than ethnicity as a proxy for infection. Nationality or ethnic identity alone cannot establish infection. Screening strategies should use clinically relevant exposure criteria and ensure access to testing without stigmatizing migrant communities.

Mortality and Survival Analysis of the Disease

Chagas-related mortality is principally associated with chronic cardiac complications, including arrhythmias, cardiomyopathy, and heart failure. Digestive complications can also contribute to long-term morbidity. The WHO’s 2026 fact sheet estimates that Chagas disease causes more than 10,000 deaths annually worldwide, but this global figure cannot be assigned to any of the eight countries individually.

Country

Key Insights

United States

A 2024 FDA fact sheet cites an estimated 300,000 people living with Chagas disease in the United States. This represents an estimate of the infected population rather than a measured national seroprevalence or a count of confirmed diagnoses. A 2025 review in the CDC’s Emerging Infectious Diseases journal noted that locally acquired infections have been identified in several states, but the true prevalence and incidence of locally acquired disease remain unknown because Chagas disease is not nationally notifiable.

Germany

A reliable nationwide prevalence estimate for Chagas disease in Germany based on 2023–2026 population data was not identified. As a non-endemic setting, the German burden is expected to be associated mainly with people who have lived in endemic regions and with potential congenital transmission. European reviews published in 2023 describe limited and uneven epidemiological data, while the 2024 ECDC review highlights the need for improved identification of at-risk individuals.

France

The available recent European evidence emphasizes underdiagnosis and inconsistent screening practices across non-endemic countries, limiting comparisons between national populations. French estimates should distinguish confirmed infections among screened individuals from the total number of people living with the disease. In the absence of a recent, representative French estimate with a defined denominator, a national prevalence percentage cannot be responsibly assigned.

Italy

Recent European literature identifies Italy, alongside Spain, as one of the countries contributing a substantial share of published evidence on Chagas disease outside endemic regions; however, the evidence remains uneven and does not establish a current national prevalence percentage. Screening of people with epidemiological links to endemic areas, particularly women of reproductive age and newborns at risk of congenital infection, remains important for improving case detection.

Spain

A 2024 multicentre primary-care study from Catalonia reported five Chagas diagnoses among 122 tested migrants, a positivity proportion of 4.1%; however, the data were collected in 2018 and therefore fall outside the requested data window. That figure should not be used as a 2023-2026 prevalence estimate. A recent national figure requires current population-based or surveillance data with a clearly defined denominator.

United Kingdom

A 2026 study of primary-care and community screening in London identified 14 confirmed Chagas disease cases among 523 people screened during 2023–2025, corresponding to a positivity proportion of 2.7% (95% CI: 1.5-4.5). Positivity was 1.1% among people screened in primary care and 4.5% at community screening events. These findings provide recent evidence of infection among selected people offered testing, but the cohort is not nationally representative and should not be interpreted as UK population prevalence.

Japan

A reliable nationwide prevalence estimate for Chagas disease in Japan based on population data collected during 2023-2026 was not identified. Japan is a non-endemic setting where infection risk is primarily associated with people who have lived in endemic areas and with possible congenital or transfusion-related transmission. A published Japanese screening study reported results from a selected migrant cohort, but its underlying observations predate the requested data window and are therefore excluded from this assessment.

India

India is not considered a principal endemic setting for Trypanosoma cruzi, and the reviewed evidence did not establish a representative national burden estimate or a comparable recent series of confirmed cases. Imported or individually diagnosed cases should not be used to infer population prevalence.