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Cost-effectiveness analysis of screening for congenital Chagas disease in a non-endemic area

Author

Listed:
  • Pietro Marraffa

    (Università di Torino)

  • Matteo Dentato

    (Università di Torino)

  • Mario Cesare Nurchis

    (Università degli Studi Link
    Università Cattolica del Sacro Cuore)

  • Andrea Angheben

    (IRCCS Sacro Cuore – Don Calabria HospitalNegrar)

  • Lia Olivo

    (Università degli Studi Link)

  • Giulia Barbera

    (Università di Torino)

  • Gianfranco Damiani

    (Università Cattolica del Sacro Cuore
    Fondazione Policlinico Universitario A. Gemelli IRCCS)

  • Maria Michela Gianino

    (Università di Torino)

Abstract

Chagas disease (CD) is an emerging public health concern in Europe. In non-endemic countries, congenital transmission is the main route of new infections. Italy is the second-largest host country in Europe for Latin American migrants and the prevalence of the disease is estimated around 3.5%. The aim is to evaluate the cost-effectiveness of a congenital CD screening program in pregnant women at risk of infection living in Italy and their newborns. We conducted a cost-effectiveness analysis from the perspective of the Italian National Health Service, comparing a screening scenario with a no-screening scenario. A Bayesian decision tree model with a lifetime horizon was developed. In the base-case analysis, the screening strategy yielded an incremental cost-effectiveness ratio of €15,193 per quality-adjusted life year gained (95% CI: €14,885–€15,552), falling well within the accepted cost-effectiveness threshold (€30,000–€50,000) in Italy. Probabilistic sensitivity analysis confirmed the robustness of these findings. Here we show that screening for congenital CD is a cost-effective strategy that improves health outcomes and aligns with international public health priorities. Our findings support the implementation of a national screening program integrated within existing maternal care pathways, contributing to the prevention of neglected tropical diseases and the promotion of migrant health.

Suggested Citation

  • Pietro Marraffa & Matteo Dentato & Mario Cesare Nurchis & Andrea Angheben & Lia Olivo & Giulia Barbera & Gianfranco Damiani & Maria Michela Gianino, 2025. "Cost-effectiveness analysis of screening for congenital Chagas disease in a non-endemic area," Nature Communications, Nature, vol. 16(1), pages 1-11, December.
    • Handle: RePEc:nat:natcom:v:16:y:2025:i:1:d:10.1038_s41467-025-63760-0
    DOI: 10.1038/s41467-025-63760-0
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    References listed on IDEAS

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    3. Sarah Matthews & Ayzsa Tannis & Karl Philipp Puchner & Maria Elena Bottazzi & Maria Luisa Cafferata & Daniel Comandé & Pierre Buekens, 2022. "Estimation of the morbidity and mortality of congenital Chagas disease: A systematic review and meta-analysis," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 16(11), pages 1-21, November.
    4. Edeltraud J Lenk & William K Redekop & Marianne Luyendijk & Adriana J Rijnsburger & Johan L Severens, 2016. "Productivity Loss Related to Neglected Tropical Diseases Eligible for Preventive Chemotherapy: A Systematic Literature Review," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 10(2), pages 1-19, February.
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