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<p>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.</p>

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

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月30日

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  • Pietro Marraffa,
  • Matteo Dentato,
  • Mario Cesare Nurchis,
  • Andrea Angheben,
  • Lia Olivo,
  • Giulia Barbera,
  • Gianfranco Damiani,
  • Maria Michela Gianino

摘要

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.