**5.** *Trypanosoma cruzi* **infection-induced cardiomyopathy**

Chagas disease is named after Carlos Ribeiro Justiniano Chagas, a Brazilian doctor and researcher who discovered the disease in 1909. In May 2019, according to the decision of the Seventy-second World Health Assembly, World Day against Chagas Disease was set on April 14 (the day in 1909, when Carlos Chagas diagnosed the first human case of the disease in a two-year-old girl named Berenice). Chagas disease, also known as American trypanosomiasis, is a life-threatening disease caused by the protozoan parasite *Trypanosoma cruzi*. (*T. cruzi*) [67]. An estimated 6–7 million people worldwide are infected with *T. cruzi*, mostly in Latin America, the parasite that causes Chagas disease [68]. Chagas disease is primarily found in endemic areas of 21 countries in the Latin American continent and is mostly transmitted to humans through contact with the feces or urine of triatomine bugs (vector-borne) [69]. Although the majority of these infected individuals reside in Mexico, Central America, and South America, migration patterns have resulted in large numbers

of infected individuals in formerly nonaffected areas, including Europe, Japan, Australia, Canada, and the United States [70], with an estimated 300,000 individuals in the United States alone [71]. These bed bugs are also known as "kissing bugs" and have many other names depending on the geographic area.

## **5.1 Global distribution**

Chagas disease was once completely confined to rural areas of the American continent—mostly Latin America (excluding the Caribbean islands). Most of the infected people live in urban environments (urbanization), mainly due to increased population mobility over the past few decades, with an increasing number of infections found in the United States, Canada, many European countries, and some African, Eastern Mediterranean, and Western Pacific countries [72].
