Analysis of the epidemiological, clinical, sociodemographic, and geospatial conditions of the female population of Isarzama, based on information obtained from Chagas disease screening

Authors

DOI:

https://doi.org/10.63688/5c5yt586

Keywords:

Chagas disease, Trypanosoma cruzi, machine learning, georeferencing, epidemiological surveillance

Abstract

Chagas disease continues to be a public health problem in Bolivia, especially in women of reproductive age due to the risk of congenital transmission. The objective of the study was to develop and evaluate a predictive model for the early detection and stratification of the risk of seroreactivity for Trypanosoma cruzi in women from Isarzama, Cochabamba. A quantitative, observational, and cross-sectional analytical study was conducted with 326 participants, integrating epidemiological, clinical, sociodemographic, environmental, serological, and geospatial variables. Seroreactivity reached approximately 11%. The main associated factors were maternal history of Chagas disease, presence of kissing bugs, family history, and adobe housing. The model reported sensitivity of 94.4%, specificity of 91.8%, accuracy of 92.6%, and AUC-ROC of 0.95. The geospatial analysis allowed the identification of sectors with greater environmental risk, while the digital monitoring showed high attendance at controls and continuity of the process. It is concluded that the integration of epidemiological factors, georeferencing and digital monitoring has the potential to strengthen the prioritization of screening and epidemiological surveillance at the first level of care.

Downloads

Download data is not yet available.

References

Breiman, L. (2001). Random forests. Machine Learning, 45, 5–32. https://doi.org/10.1023/A:1010933404324

Chen, T., & Guestrin, C. (2016). XGBoost: A scalable tree boosting system. Proceedings of the 22nd ACM SIGKDD International Conference on Knowledge Discovery and Data Mining, 785–794. https://doi.org/10.1145/2939672.2939785

Christodoulou, E., Ma, J., Collins, G. S., Steyerberg, E. W., Verbakel, J. Y., & Van Calster, B. (2019). A systematic review shows no performance benefit of machine learning over logistic regression for clinical prediction models. Journal of Clinical Epidemiology, 110, 12–22. https://doi.org/10.1016/j.jclinepi.2019.02.004

Collins, G. S., Moons, K. G. M., Dhiman, P., Riley, R. D., Beam, A. L., Van Calster, B., Ghassemi, M., Liu, X., Reitsma, J. B., van Smeden, M., Boulesteix, A.-L., Camaradou, J. C., Celi, L. A., Denaxas, S., Denniston, A. K., Glocker, B., Golub, R. M., Harvey, H., Heinze, G., … Logullo, P. (2024). TRIPOD+AI statement: Updated guidance for reporting clinical prediction models that use regression or machine learning methods. BMJ, 385, e078378. https://doi.org/10.1136/bmj-2023-078378

Cucunubá, Z. M., Gutiérrez-Romero, S. A., Ramírez, J.-D., Velásquez-Ortiz, N., Ceccarelli, S., Parra-Henao, G., Henao-Martínez, A. F., Rabinovich, J., Basáñez, M.-G., Nouvellet, P., & Abad-Franch, F. (2024). The epidemiology of Chagas disease in the Americas. The Lancet Regional Health – Americas, 37, 100881. https://doi.org/10.1016/j.lana.2024.100881

Delgado-Noguera, L. A., Hernández-Pereira, C. E., Ramírez, J. D., Hernández, C., Velásquez-Ortiz, N., Clavijo, J., Ayala, J. M., Forero-Peña, D., Márquez, M., Suarez, M. J., Traviezo-Valles, L., Escalona, M. A., Perez-Garcia, L., Mejias Carpio, I., Sordillo, E. M., Grillet, M. E., Llewellyn, M. S., Gabaldón, J. C., & Paniz-Mondolfi, A. E. (2022). Tele-entomology and tele-parasitology: A citizen science-based approach for surveillance and control of Chagas disease in Venezuela. Parasite Epidemiology and Control, 19, e00273. https://doi.org/10.1016/j.parepi.2022.e00273

Ghilardi, F. D. R., Silva, G., Vieira, T. M., Mota, A., Bierrenbach, A. L., Damasceno, R. F., Oliveira, L. C., Chiavegatto Filho, A. D. P., & Sabino, E. (2024). Machine learning for predicting Chagas disease infection in rural areas of Brazil. PLOS Neglected Tropical Diseases, 18(4), e0012026. https://doi.org/10.1371/journal.pntd.0012026

Gurgel-Gonçalves, R., Julião, G. R., Ferreira, R. A., Souza, R. C. M., Rojas-Cortez, M., Vieira, T. M., Miranda, V. L., Brant, J. L., Obara, M. T., Albuquerque e Silva, R., Ibarrola-Vannucci, A. K., Marti, G., & Ceccarelli, S. (2026). New technologies for identification and surveillance of Chagas disease vectors. Revista da Sociedade Brasileira de Medicina Tropical, 59, e0597-2025. https://doi.org/10.1590/0037-8682-0597-2025

Hochberg, N. S., & Montgomery, S. P. (2023). Chagas disease. Annals of Internal Medicine, 176(2), ITC17–ITC32. https://doi.org/10.7326/AITC202302210

Lundberg, S. M., & Lee, S.-I. (2017). A unified approach to interpreting model predictions. Advances in Neural Information Processing Systems, 30, 4765–4774.

Mischler, P., Kearney, M., McCarroll, J. C., Scholte, R. G. C., Vounatsou, P., & Malone, J. B. (2012). Environmental and socio-economic risk modelling for Chagas disease in Bolivia. Geospatial Health, 6(3), S59–S66. https://doi.org/10.4081/gh.2012.123

Moons, K. G. M., Damen, J. A. A., Kaul, T., Hooft, L., Andaur Navarro, C., Dhiman, P., Beam, A. L., Van Calster, B., Celi, L. A., Denaxas, S., Denniston, A. K., Ghassemi, M., Heinze, G., Kengne, A. P., Maier-Hein, L., Liu, X., Logullo, P., McCradden, M. D., Liu, N., … van Smeden, M. (2025). PROBAST+AI: An updated quality, risk of bias, and applicability assessment tool for prediction models using regression or artificial intelligence methods. BMJ, 388, e082505. https://doi.org/10.1136/bmj-2024-082505

Organización Mundial de la Salud. (2026, 8 de abril). Enfermedad de Chagas (tripanosomiasis americana). Ficha informativa de la OMS

Organización Panamericana de la Salud. (2019). Guía para el diagnóstico y el tratamiento de la enfermedad de Chagas. Organización Panamericana de la Salud. Documento de la OPS

Pascual-Vázquez, G., Alonso-Sardón, M., Rodríguez-Alonso, B., Pardo-Lledías, J., Romero Alegría, A., Fernández-Soto, P., Muñoz Bellido, J. L., Muro, A., & Belhassen-García, M. (2023). Molecular diagnosis of Chagas disease: A systematic review and meta-analysis. Infectious Diseases of Poverty, 12, 95. https://doi.org/10.1186/s40249-023-01143-7

Riley, R. D., Ensor, J., Snell, K. I. E., Harrell, F. E., Jr., Martin, G. P., Reitsma, J. B., Moons, K. G. M., Collins, G. S., & van Smeden, M. (2020). Calculating the sample size required for developing a clinical prediction model. BMJ, 368, m441. https://doi.org/10.1136/bmj.m441

Rodríguez, B. A., Tinajeros, F., Condori, B. J., & Cutshaw, M. K. (2025). Congenital transmission of Chagas disease by vector circulation zone in Bolivia. PLOS Neglected Tropical Diseases, 19(10), e0013591. https://doi.org/10.1371/journal.pntd.0013591

Rojas de Arias, A., Monroy, C., Guhl, F., Sosa-Estani, S., Souza Santos, W., & Abad-Franch, F. (2022). Chagas disease control-surveillance in the Americas: The multinational initiatives and the practical impossibility of interrupting vector-borne Trypanosoma cruzi transmission. Memórias do Instituto Oswaldo Cruz, 117, e210130. https://doi.org/10.1590/0074-02760210130

Salvador, F. G. F., Oliveira, L. F. A., Pimentel, M. I. F., Lyra, M. R., Hasslocher-Moreno, A. M., Holanda, M. T., Varela, M. C., Silveira, H., & Valete, C. M. (2025). Telemedicine in the clinical care of Chagas disease and American cutaneous leishmaniasis: Pilot study in a public referral hospital in Brazil. Frontiers in Public Health, 13, 1616368. https://doi.org/10.3389/fpubh.2025.1616368

Santana, K. H., Oliveira, L. G. R., Castro, D. B., & Pereira, M. (2020). Epidemiology of Chagas disease in pregnant women and congenital transmission of Trypanosoma cruzi in the Americas: Systematic review and meta-analysis. Tropical Medicine & International Health, 25(7), 752–763. https://doi.org/10.1111/tmi.13398

Saunders, M., Small, A., Dedicoat, M., & Roberts, L. (2012). The development and validation of a risk score for household infestation by Triatoma infestans, a Bolivian vector of Chagas disease. Transactions of the Royal Society of Tropical Medicine and Hygiene, 106(11), 677–682. https://doi.org/10.1016/j.trstmh.2012.07.006

Schijman, A. G., Alonso-Padilla, J., Britto, C., & Herrera Bernal, C. P. (2024). Retrospect, advances and challenges in Chagas disease diagnosis: A comprehensive review. The Lancet Regional Health – Americas, 36, 100821. https://doi.org/10.1016/j.lana.2024.100821

Steyerberg, E. W., Harrell, F. E., Jr., Borsboom, G. J. J. M., Eijkemans, M. J. C., Vergouwe, Y., & Habbema, J. D. F. (2001). Internal validation of predictive models: Efficiency of some procedures for logistic regression analysis. Journal of Clinical Epidemiology, 54(8), 774–781. https://doi.org/10.1016/S0895-4356(01)00341-9

Tinajeros, F., Rodríguez-Olguin, B. A., & Cutshaw, M. K. (2024). Prevalence of maternal Chagas disease and vertical transmission rates in Bolivia: A systematic review and meta-analysis. The American Journal of Tropical Medicine and Hygiene, 110(4), 663–668. https://doi.org/10.4269/ajtmh.23-0579

Van Calster, B., McLernon, D. J., van Smeden, M., Wynants, L., & Steyerberg, E. W. (2019). Calibration: The Achilles heel of predictive analytics. BMC Medicine, 17, 230. https://doi.org/10.1186/s12916-019-1466-7

Published

2026-08-28

How to Cite

Porco Sola, B. (2026). Analysis of the epidemiological, clinical, sociodemographic, and geospatial conditions of the female population of Isarzama, based on information obtained from Chagas disease screening. Sage Sphere International Journal Esfera Sabia Revista Internacional, 3(1), 1-17. https://doi.org/10.63688/5c5yt586