Epidemiological Surveillance of Chagas Disease in Rural Communities of a Municipality in Piauí, Brazil

Chagas disease, caused by <i>Trypanosoma cruzi</i>, remains a neglected tropical disease of public health importance in Latin America, particularly in rural areas. In Floriano, Piauí, Brazil, data on infection prevalence are limited. This cross-sectional population-based study assessed the seroprevalence of <i>T. cruzi</i> infection and analyzed sociodemographic factors associated with seropositivity among residents of 41 rural communities in Floriano. A total of 1212 individuals aged over six years were examined, revealing a seroprevalence of 3.2% (39/1212), with positive cases detected in 17 communities. Infection was significantly associated with older age (≥60 years; <i>p</i> < 0.0001), low educational level (<i>p</i> = 0.0184), retirement status (<i>p</i> < 0.0001), and low income (<i>p</i> = 0.0505). Logistic regression confirmed age as the strongest determinant of infection (OR = 7.647; 95% CI: 3.741-18.61; <i>p</i> < 0.0001), while higher monthly income showed a negative association with infection (OR = 0.17; 95% CI: 0.01-0.82; <i>p</i> = 0.086), indicating a trend toward significance. These findings highlight the persistence of <i>T. cruzi</i> infection in rural Floriano, predominantly among elderly individuals living in poverty. The identification of previously undiagnosed chronic cases reinforces the urgent need for targeted epidemiological surveillance, early diagnosis, and community-based health education to strengthen local control and prevention strategies.