Chagas Disease Knowledge and Risk Behaviors of the Homeless Population in Houston, TX

  • Alexandra Ingber
  • Melissa N Garcia
  • Juan Leon
  • Kristy O MurrayEmail author


Chagas disease is a parasitic infection, caused by Trypanosoma cruzi, endemic in Latin America. Sylvatic T. cruzi-infected triatomine vectors are present in rural and urban areas in the southern USA and may transmit T. cruzi infection to at-risk populations, such as homeless individuals. Our study aimed to evaluate Chagas disease knowledge and behaviors potentially associated with transmission risk of Chagas disease among Houston, Texas’ homeless population by performing interviews with 212 homeless individuals. The majority of the 212 surveyed homeless individuals were male (79%), African-American (43%), American-born individuals (96%). About 30% of the individuals reported having seen triatomines in Houston, and 25% had evidence of blood-borne transmission risk (IV drug use and/or unregulated tattoos). The median total time homeless was significantly associated with recognition of the triatomine vector. Our survey responses indicate that the homeless populations may exhibit potential risks for Chagas disease, due to increased vector exposure, and participation in blood-borne pathogen risk behaviors. Our findings warrant additional research to quantify the prevalence of Chagas disease among homeless populations.


Chagas disease Trypanosoma cruzi Homeless Texas Vulnerable populations 92C60, 92D30 



The authors would like to thank Mandy Chapman Semple with the Homeless Initiatives in Houston, the team at Houston Police Department Homeless Outreach Team, and Charity Dominguez and Jess DiManno with SEARCH Homeless Services for their combined help in administering surveys. In addition, thank you to Dr. Solveig Cunningham for her guidance in the quantitative survey creation.

Compliance with Ethical Standards

Human subject approval and waiver of written consent were granted from Emory University’s Institutional Review Board (study number IRB00066083). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Conflicts of Interest

The authors declare that they have no conflicts of interest.


The authors received no funding for this research study.


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Copyright information

© W. Montague Cobb-NMA Health Institute 2017

Authors and Affiliations

  • Alexandra Ingber
    • 1
  • Melissa N Garcia
    • 2
  • Juan Leon
    • 1
  • Kristy O Murray
    • 2
    Email author
  1. 1.Rollins School of Public HealthEmory UniversityAtlantaUSA
  2. 2.National School of Tropical MedicineBaylor College of MedicineHoustonUSA

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