Document Type

Capstone Experience

Graduation Date

8-2024

Degree Name

Master of Public Health

Department

Epidemiology

First Committee Member

David Brett-Major, MD, MPH (Chair), Professor, Department of Epidemiology

Second Committee Member

Kendra Ratnapradipa, PhD, MSW, Assistant Professor, Department of Epidemiology

Third Committee Member

Jana Broadhurst, MD, PhD, DTM&H, Associate Professor, Department of Pathology and Microbiology

Abstract

Background: Chagas disease, caused by the parasite Trypanosoma cruzi, is endemic in many Latin American countries and now the southern United States. An increasing number of Chagas cases in the U.S. have occurred because of autochthonous transmission and enzootic cycles involving infected wildlife and domestic animals, like canines.

Objective: This study aimed to explore canine seroprevalence as a trigger for enhanced human Chagas surveillance by describing detected U.S. T. cruzi from human and canine testing data, creating maps to explore geographic areas with potential high yield for T. cruzi surveillance via animal testing, and developing a SWOT analysis for designing a pilot surveillance program.

Methods: To calculate canine and human Chagas cumulative burden, this study examined the number of canine indirect fluorescent antibody (IFA) tests performed by the Texas Veterinary Medical Diagnostic Lab (TVMDL) and the number positive at the state level from March 1, 2019, through April 5, 2024 and looked at the number of confirmed positive human first-time donor specimens reported at the state level from 2014-2019 by The Association for the Advancement of Blood and Biotherapies (AABB) and corresponding state population from the U.S. census. A Chi-Square analysis was performed to identify overlap between human and canine Chagas blood testing data. Human and canine blood data and other risk factor data were then mapped to perform a visual comparison for geographic overlap.

Results: An inverse association was present between canine and human cumulative burden intensity. A geographic overlap existed between most states that had a positive canine IFA and positive first-time human blood donation. A similar overlap between these states and other risk factors examined was also present.

Conclusions: Although not without limitations, analysis of available human and canine blood data and other risk factors can contribute to knowledge of endemic and hyperendemic areas and influence recommendations for future surveillance program designs.

Available for download on Monday, August 04, 2025

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