# How do we classify organ involvement in Chagas disease? A systematic review of organ involvement since 1909, Highlighting the urgent need for a universal classification system in Chronic Chagas disease

## TL;DR

This paper reviews how Chagas disease has been classified by organ involvement since 1909 and highlights the urgent need for a universal classification system to improve diagnosis and treatment.

## Contribution

The paper emphasizes the lack of a standardized classification system for organ involvement in Chagas disease, especially for cardiac and digestive manifestations.

## Key findings

- There is no universally accepted classification system for organ involvement in Chagas disease.
- Current classifications hinder cross-population comparisons and accurate prognosis.
- A standardized classification system is needed for both endemic and non-endemic regions.

## Abstract

Chagas disease (CD) is recognized as one of the 20 neglected tropical diseases by the World Health Organization (WHO), posing a significant global health challenge. The objective of this work was to conduct a systematic methodology review to explore the different classifications used to describe the presence and degree of organ involvement in patients with CD since the disease’s description in 1909. We searched relevant electronic medical databases from their inception dates to July 2023. We also delved into historical variations and revisions of each classification, the necessary diagnostic methods, their prognostic value, and their uptake. Our study underscores the conspicuous absence of a universally accepted CD classification system for cardiac and digestive involvement, both in the context of clinical trials and within current clinical guidelines. This endeavour will facilitate cross-population comparisons if clinical manifestations and complementary test results are available for each patient, constituting a pivotal stride toward identifying precise prognoses and establishing a minimum data set requisite for a fitting CD classification, tailored to the test availability in both endemic and non-endemic regions.

Chagas disease (CD) is a serious global health issue, and in our research, we aimed to investigate how doctors classify the impact of this disease on different organs. CD is one of the neglected tropical diseases recognized by the World Health Organization. It is important for us to understand how this disease affects people because it can lead to severe health problems.

To conduct our study, we reviewed the various ways doctors have classified CD since it was first described in 1909. We looked at how these classifications have changed over time, the tests used to diagnose CD, and how these classifications are applied in clinical practice and research.

One crucial discovery we made during our research is that there isn’t a universally accepted classification system for CD, especially when it comes to assessing its impact on the heart and digestive system. This absence of a standard classification system makes it difficult to compare CD cases across different regions and to predict the disease’s progression in individual patients.

We believe that establishing a standardized classification system for CD is of utmost importance. Such a system would greatly assist doctors and researchers in gaining a better understanding of the disease, making more accurate predictions about how it will affect patients, and improving CD diagnosis and treatment, both in regions where the disease is prevalent and in areas where it’s not.

In summary, our study highlights the urgent need for a standardized method to classify Chagas disease, which is a significant global health concern. Establishing a common classification system would simplify the study and treatment of the disease, benefiting people worldwide.