Objective:

To assess the impact of COVID-19 on screening and diagnostic coverage for Chagas disease among pregnant women and newborns in three Bolivian departments.

Material and methods:

Quantitative, observational, retrospective time-series study (monthly unit, 2018-2022) comparing pre-pandemic, pandemic, and post-pandemic periods. Departmental program data; descriptive analyses and logistic regression of the neonatal "control gap”

Results:

Screening decreased for both pregnant women and newborns across all departments. Santa Cruz: pregnant women 78 966, 68 338, and 45 266; newborns 9 666, 8 720, and 4 182. Cochabamba: pregnant women 138 175, 106 785, and 58 946; newborns 5 482, 3 892, and 1 640. Chuquisaca: pregnant women 35 779, 30 597, and 14 414; newborns 4 303, 2 836, and 1 246. Maternal positivity declined: Santa Cruz 15,2%, 13,6%, and 10,8%; Cochabamba 9,9%, 8,31%, and 7,1%; Chuquisaca 21,1%, 16,9%, and 14,1%. Recorded vertical transmission remained below 3% across settings. The neonatal control gap was heterogeneous: Santa Cruz narrowed from pre-pandemic to pandemic and increased post-pandemic (OR 2,6; p<0,001); Cochabamba showed no significant changes; Chuquisaca showed a mixed pattern (pre-pandemic to pandemic OR 1,09; pandemic to post-pandemic OR 0,83; p<0,001).

Conclusions:

COVID-19 markedly contracted maternal- infant Chagas screening coverage with heterogeneous departmental effects and persistent post-pandemic gaps. Low apparent vertical transmission likely reflects under-diagnosis. Recovery of coverage, strengthened surveillance, and improvements to neonatal diagnostic algorithms are urgently needed.

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