Health-related quality-of-life associated with Chagas disease in Argentina and Spain

Abstract

Objectives: Evidence on health-related quality of life (HRQoL) in Chagas disease is essential for under- standing its burden and informing interventions. However, studies on HRQoL variation during disease progression and treatment are limited. This study provides new estimates of perceived HRQoL levels among individuals with T.cruzi infection, patients with Chagas disease, and at-risk populations, using a preference-based measure relevant for economic evaluations. Methods: HRQoL data were collected from 1383 individuals in Argentina and 157 in Spain using the EQ- 5D-3L questionnaire. We estimated utility scores and examined clinical subgroups, adjusting for sociode- mographic factors. Overall HRQoL determinants were analyzed with truncated inflated beta regression models; domain-specific determinants with seemingly unrelated ordered probit models. Results: Chagas disease significantly reduces HRQoL, with lower scores among older individuals and women. Chronic cardiac disease and symptoms were key determinants. Higher HRQoL was linked to be- ing male, more educated, and asymptomatic. Urban residents, particularly in San Juan, Argentina, reported lower HRQoL. In Spain, HRQoL declined by 0.01 per month during treatment, likely due to side effects. Conclusion: This first large EQ-5D-3L study on Chagas disease in endemic and non-endemic settings enables QALY estimation and can inform economic evaluations to guide healthcare priorities.