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There is work to be done regarding awareness of cardiomyopathy resulting from Chagas disease in areas where it is not traditionally endemic, including the U.S., according to the American Heart Association (AHA).

This chronic tropical disease now affects more than 300,000 people in the U.S., especially immigrants. The protozoan infection can be asymptomatic or can progress to dilated cardiomyopathy with heart failure, ventricular arrhythmias and conduction disturbances, stroke, and other systemic or pulmonary embolisms, according to Maria Carmo Pereira Nunes, MD, PhD, and colleagues at the association.

One major need is an early biomarker for the diagnosis of Chagas disease, Nunes' group emphasized in a scientific statement endorsed by the Inter-American Society of Cardiology and published online in .

Current tests rely on microscopic examination of blood to determine if a person has the Trypanosoma cruzi parasite.

"A point-of-care diagnostic test could dramatically improve case detection and notification in transient populations. Of particular importance, a rapid test would need to demonstrate good performance characteristics across T. [Trypanosoma] cruzi genotypes and strains because data from South American populations may not be sufficient to predict test sensitivity in infections acquired in Central America and Mexico."

It is also important to have accurate disease prevalence estimates such that interventions can be evaluated for their cost-effectiveness, the statement noted. "Improved systematic surveillance among immigrant populations around the globe must be a high priority."

Most infected individuals in the United States, a typically low-prevalence area, are immigrants from endemic areas of Latin America, with blood banks reporting the most seropositive donations from California, Florida, and Texas, according to Nunes and colleagues.

Centers for Disease Control and Prevention named Chagas disease as one of five neglected parasitic infections in the country.

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