**3. Epidemiological aspects**

*T. cruzi* gets its entry into the body through its vector, the triatomines, members of the reduvius family when the insect ingests blood from an infected animal. The protozoan replicates in the intestine of the triatomine and is excreted from its feces. The main route of transmission in humans is the inoculation of feces directly on the mucous membranes, or in skin lesions that are generated by scratching or damage caused by the insect bites. It can also occur by blood transfusion or tissue transplantation (organ or bone marrow) from an infected person and by transmission from the mother to her fetus during pregnancy. There is another way of transmission, the oral route, which occurs when the ingestion of feces from triatomine infected with *T. cruzi*, when the consumption of meat or blood of wild animals, or contamination from utensils for prepare food. The estimated incidence has dropped from 500,000 in 1991 to 30,000 new cases of infection per year in 2010. The annual cost to an individual's society for chronic disease care was \$ 4059 (range \$ 3569–4434) in Latin America, 13,580 (\$ 11,340–15,003) in Europe, and \$ 15,762 (\$ 13,249–17,442) in the US, Canada and Australia, globally the weighted measure of the annual cost of health care and the productivity of a person with chronic disease was \$ 4660, the estimated annual global burden of the disease is \$ 627.46 million in health spending and 806,170 disability-adjusted life years, 10% of this burden affects non-endemic countries [7].

In the case of Latin America, 20% of its population is at risk of acquiring the infection, especially in endemic areas. In Mexico, it is considered a public health problem, since it is estimated that 1.1 million people are infected. The incidence from 2000 to 2007 remained in the range of 0.07–0.37 per 100,000 people, increasing to 0.70 in 2012. During 2018, 150 cases were registered throughout the republic. According to a 2013–2018 report, Chagas disease is the most serious parasitic disease in Latin

America, since there are 110 million people at risk of infection in 21 different countries, likewise, the World Health Organization has classified it as one of the 14 lagging diseases [8].
