Chagas disease and mortality in a community-based cohort in Colombia: evidence for age-dependent effect modification

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ID: 320446
2026
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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 <60 y of age (HR 4.96 [95% CI 1.80 to 13.71]) but not among those ≥60 y of age (HR 0.73 [95% CI 0.43 to 1.22]). RMST analysis confirmed an absolute survival loss of 121 d at approximately 10 y of follow-up in the younger subgroup (p=0.02). 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.
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Authors Martha Lucía Díaz, Lyda Z. Rojas, Clara Isabel González-Rugeles, Luis Eduardo Echeverría, Sergio Alejandro Gómez‐Ochoa
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Journal transactions of the royal society of tropical medicine and hygiene
Year 2026
DOI
10.1093/trstmh/trag074
URL
https://doi.org/10.1093/trstmh/trag074
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