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

Pietro Marraffa, Matteo Dentato, Mario Cesare Nurchis (), Andrea Angheben, Lia Olivo, Giulia Barbera, Gianfranco Damiani and Maria Michela Gianino
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Pietro Marraffa: Università di Torino
Matteo Dentato: Università di Torino
Mario Cesare Nurchis: Università degli Studi Link
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
Maria Michela Gianino: Università di Torino

Nature Communications, 2025, vol. 16, issue 1, 1-11

Abstract: 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.

Date: 2025
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DOI: 10.1038/s41467-025-63760-0

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