Chagas disease is present in 18 countries (see figure to below) on the American continent in two different ecological zones: the Southern Cone region, where the main vector lives inside human homes and in peri-domiciliary areas; and Central America and Mexico where the main vector species lives both inside dwellings and in uninhabited areas. Country-wide cross-sectional surveys in the 1980s found an overall prevalence of 17 million cases, with 4.8–5.4 million people exhibiting clinical symptoms, an annual incidence of 700,000-800,000 new cases and 45,000 deaths due to the cardiac form of the disease. Other studies indicate an infection prevalence of 13 million, with 3.0–3.3 million symptomatic cases and an annual incidence of 200,000 cases in 15 countries, with estimates of death around 50,000 people.

The disease remains a priority health problem due to:

• the need for surveillance and control in areas where sylvatic vectors can invade dwellings
• the medical and social costs of care for infected people in the absence of efficient and well-tolerated therapy, especially against the chronic form of the disease
• the difficulty in obtaining priority for control activities and vector elimination in areas where vectorial transmission has been interrupted
• the need to continue strengthening mandatory blood-donor screening in endemic areas, as well as in non-endemic areas where increased travel and/or immigration of potentially infected donors might compromise donated blood supplies.

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