{
  "abstract": "Background: Chagas disease is a burdensome condition in non-endemic countries, yet underdiagnosed and underestimated. We aimed to assess cost-effectiveness of alternative screening models in Latin American residents in Italy.\n\nMethods: A decision-analytic model combining a decision tree and a Markov model (annual cycles) was developed to simulate the lifetime progression of chronic disease. Four strategies were compared: usual care (no systematic screening), community-based active screening and two primary care–based approaches (standard and enhanced). Outcomes included costs, quality-adjusted life years (QALYs), incremental cost-effectiveness ratios (ICERs) and net monetary benefit (NMB), from a healthcare system perspective, using a €30,000/QALY threshold. Deterministic and probabilistic sensitivity analyses assessed robustness.\n\nResults: Preliminary results estimated that all screening strategies were cost-effective compared with usual care, with ICERs below the threshold. In the base-case analysis, ICERs were €8,397/QALY for active screening, €14,249/QALY for standard primary care and €7,360/QALY for enhanced primary care. Per 10,000 individuals, active screening generated the largest health gains (+101 QALYs) even if with higher incremental costs (€850,478). Deterministic sensitivity analysis was primarily driven by disease prevalence and treatment effectiveness, probabilistic analysis confirmed robustness, with mean ICERs of €24,140/QALY (active screening) and €21,551/QALY (enhanced primary care) and probabilities of cost-effectiveness of 89.1% and 90.1%, respectively.\n\nConclusions: The lack of systematic screening for Chagas disease in migrants is a missed opportunity to improve health outcomes and resource use. Community-based approaches maximise health gains, while strengthened primary care offers a resource-efficient and scalable option. These findings support the integration of Chagas screening into routine public health and primary care services in Europe.\n\nKey messages: • Systematic screening for Chagas disease in Latin American populations in non-endemic countries is cost-effective and cost-useful compared with usual care.\n\n• Primary care–based strategies provide an efficient and scalable alternative to community-based screening.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": "abstract",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "name": "P Marraffa"
    },
    {
      "name": "L Marega"
    },
    {
      "name": "MM Gianino"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/42ckya1ngnjnr.bib",
  "cited_by": 0,
  "doi": "10.1093/eurpub/ckag169.394",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13697506/",
  "id": "42ckya1ngnjnr",
  "issns": [
    "1101-1262",
    "1464-360X"
  ],
  "landing_url": "https://doi.org/10.1093/eurpub/ckag169.394",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "3. PARALLEL PROGRAMME"
    ],
    [
      "heading",
      "AcademicSubjects/MED00860"
    ],
    [
      "heading",
      "AcademicSubjects/SOC01210"
    ],
    [
      "heading",
      "AcademicSubjects/SOC02610"
    ],
    [
      "openalex",
      "2713|Trypanosoma species research and implications"
    ]
  ],
  "openalex": "W7223648959",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13697506/pdf/?tool=EBI",
  "pmcid": "PMC13697506",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "Oxford University Press",
  "ris": "https://research.draconitic.com/paper/42ckya1ngnjnr.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:33Z",
      "native_id": "PMC13697506",
      "source": "pmc",
      "url": "https://doi.org/10.1093/eurpub/ckag169.394"
    },
    {
      "first_seen": "2026-10-30T12:21:45Z",
      "native_id": "PMC:PMC13697506",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13697506"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Trypanosoma species research and implications",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Cost-effective but underused: evaluating screening strategies for indeterminate Chagas disease",
  "title_text": "Cost-effective but underused: evaluating screening strategies for indeterminate Chagas disease",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:34:32Z",
  "url": "https://research.draconitic.com/paper/42ckya1ngnjnr",
  "venue": "The European Journal of Public Health",
  "versions": []
}