Background:

Chagas disease (CD) is a major endemic infection in Latin America, affecting an estimated 6 to 8 million people. Its transmission exhibits considerable variability influenced by environmental factors (rainfall, temperature, deforestation) and social conditions (poverty, rurality, inadequate housing).

Objective:

To analyze the regional and temporal variability of CD in Colombia from 2015 to 2022 and its association with social, demographic, and environmental factors.

Methods:

An analytical ecological study was conducted using data from SIVIGILA. Crude and age-standardized incidence rates were estimated by sex, municipality, and year. Associations with socio-environmental determinants were assessed using generalized linear models and panel regression. Temporal dynamics were examined with stationarity tests and ARIMA models, while multilevel negative binomial models were fitted (menbreg), and spatial dependence was evaluated using Moran's I index.

Results:

Between 2015 and 2022, a total of 47,847 CD cases were reported in Colombia, 56.6% of them in women. Standardized incidence rates ranged from 0.29 to 0.99 per 100,000 inhabitants, showing a declining trend since 2016. The Llanos and Eastern regions exhibited higher incidence than the Amazon region. Multidimensional poverty (IRR = 1.15; 95% CI: 1.08-1.21) and female sex (IRR = 1.40; 95% CI: 1.10-1.77) were associated with increased risk. The regions of Santander, Boyacá, and Arauca exhibited persistent high-incidence clusters across the analyzed timeframe.

Conclusions:

CD in Colombia displays marked spatiotemporal heterogeneity and is positively associated with multidimensional poverty and gender disparities, these findings underscore the need for targeted, territory-sensitive, and sustainable interventions.