Study 3 — The Chagas Translation Gap: 60-Year Evidence-to-Guideline Lag and CEA of Serology in Cardiomyopathy

Study 3 of the Hidden Infections research series. Trypanosoma cruzi evidence linking it to chronic cardiomyopathy has existed since the 1920s. Routine T. cruzi serology in patients presenting with nonischemic cardiomyopathy (NICM) is not recommended by major cardiology guidelines in North America or Europe — a 58-61-year translation lag. This study documents the lag, presents cost-effectiveness analysis showing CE of bundled serology at >=8% relative risk reduction for disease progression with antitrypanosomal treatment, and uses the BENEFIT trial as internal validation. Chagas disease is the leading cause of heart failure in Latin America and is increasingly prevalent in non-endemic countries through migration. Group A: Institutional lag and diagnostic failure. CC0 public domain. AI-assisted draft pre-print.