Abstract
Abstract
Background
Chagas disease (CD), caused by Trypanosoma cruzi, is a leading cause of cardiomyopathy in Latin America. Community-based prospective data on the CD–mortality association remain scarce.
Methods
We analysed the ANTORCHA prospective cohort, enrolling individuals from T. cruzi-endemic communities in Santander, Colombia (2015–2025). The primary exposure was serologically confirmed CD; the primary outcome was all-cause mortality. Cox proportional hazards models with hierarchical adjustment and restricted mean survival time (RMST) were used.
Results
Among 1509 participants (314 Chagas positive), 81 deaths occurred over a median follow-up of 5.6 y. After full multivariate adjustment, CD was not associated with overall mortality (hazard ratio [HR] 1.02 [95% confidence interval {CI} 0.61 to 1.72]). A significant age-dependent interaction was identified (p=0.007): CD was independently associated with increased mortality among participants
Conclusions
In this community-based cohort, CD was independently associated with markedly elevated mortality among adults <60 y of age. Younger T. cruzi-positive individuals warrant intensified cardiovascular surveillance.