**1. Introduction**

Chagas disease (CD), the parasitic infection caused by the kinetoplastid protozoan *Trypanosoma cruzi*, is also known as American trypanosomiasis, for the huge endemic areas in South and Central Americas [1], but autochthonous human [2–4] and domestic/wild animal [5–8] cases were reported in the United States, and due to migration, it is already considered a public health problem on a global scale reaching different continents [9–11]. It is noteworthy that climate changes may promote the northward insect vector propagation [12], possibly generating new foci or endemic areas, and suitable climatic conditions may be available in African and Asian nations [13]. Besides the vector bloodmeal, congenital, blood transfusion and organ transplantation [14], CD may be transmitted orally via food and beverages contaminated by triatomine feces such as sugarcane and açai juices [15, 16] and even water, stored in/near domiciles in arid regions [15, 16], as the parasite is able to survive in such media [17].

It is alarming that 6–7 million people are estimated to have CD worldwide, with *circa* 173,000 new cases/year and over 75 million people are at risk. CD is the parasitic disease of highest mortality in Latin America as 9490 deaths were reported in 2019. Furthermore, the real prevalence is largely unknown as most chronic patients are asymptomatic and even symptomatic patients have poor access to health public system. CD is endemic in 21 countries in Central and Latin America where about 5.7 million people have CD and 25% of the population is at risk [18]. In 2020, it was estimated that there were 3.2 million infected people, which can reach 1.5% of the general population. In addition, about 70 million are at risk of infection [19]. The prevalence of CD is presumably vastly underestimated. In January 2020, a study carried out by the ArtScience Initiative for Health Promotion, carried out by Oswaldo Cruz Foundation (Fiocruz) and collaborating organizations, showed a CD seropositivity of 20% in a tested population of an endemic area [20]. It must be mentioned this study was not designed to access CD prevalence and was biased by the population intention to get diagnosis procedures.

CD represents economic losses in excess of \$1.2 billion/year to endemic countries in South America, in addition to more than \$7 billion a year at global levels [21], including treatment and loss of productivity. Since no proven effective and approved vaccines are available for this disease, chemotherapy represents the only therapeutic intervention, as well as an important way to control them.

CD etiological treatment is directed according to the phase and clinical presentation of the disease, which is mandatory in the acute phase, congenital cases, or reactivation due to immunosuppression. In the chronic phase, the trypanocidal treatment is indicated in children and adolescents, recent infection, and women of childbearing age [22].
