# Seroepidemiological survey and seropositivity rate for Trypanosoma cruzi infection in a community-based cardiac screening initiative in Feira de Santana, Bahia, Brazil

## TL;DR

This study finds that 8.5% of people in a Brazilian city had a parasite infection linked to poor housing and migration, showing the need for better screening and vector control.

## Contribution

The study integrates AI-based ECG analysis with serological testing to estimate T. cruzi seropositivity in a high-risk community.

## Key findings

- 8.5% of tested individuals were seropositive for T. cruzi.
- Household exposure to triatomines was the strongest risk factor for infection.
- Most infected individuals were migrants from other endemic regions.

## Abstract

Chagas disease (CD), caused by Trypanosoma cruzi, is a significant public health issue in Latin America, particularly in endemic regions. This study integrates a seroepidemiological survey with large-scale echocardiographic screening conducted in Feira de Santana, a highly endemic city in Bahia, Brazil, to estimate the seropositivity rate of T. cruzi infection and identify associated risk factors. Peripheral blood samples were analyzed using in-house ELISA based on IBMP chimeric antigens and an indirect hemagglutination assay. Among 1,115 participants enrolled in the cardiac screening initiative, 140 underwent serological testing comprising individuals who screened positive based on clinical data, conventional ECG, and ECG-AI, and controls matched in a 2:1 ratio. Of these, 8.5% tested seropositive, with household exposure to triatomines identified as the strongest risk factor (prevalence ratio = 4.38, p = 0.004). Most seropositive individuals were migrants from other endemic areas, underscoring the influence of population mobility on CD epidemiology. This study highlights the importance of integrating diagnostic tools and vector control strategies into community-based health initiatives to improve early detection, reduce disease burden, and inform public health interventions in underserved regions.

Chagas disease, caused by the parasite Trypanosoma cruzi, remains a major health concern in Latin America, especially in areas with limited access to healthcare. In this study, we combined artificial intelligence-based electrocardiogram analysis and cardiac screening with serological testing to detect undiagnosed T. cruzi infections in Feira de Santana, a city in the state of Bahia, Brazil. By analyzing electrocardiogram data, epidemiological information, and laboratory assays, we identified individuals at increased risk and confirmed infection using validated serological methods. Our results showed that people who reported the presence of triatomine bugs inside their homes were significantly more likely to be infected, emphasizing the role of vector exposure in T. cruzi transmission. In addition, most seropositive individuals were unaware of their condition and had migrated from other endemic regions. These findings highlight the importance of combining innovative technologies with community-based screening initiatives can improve early detection of T. cruzi infection and guide public health strategies in vulnerable populations.