Introduction
Foodborne transmission of Trypanosoma cruzi is an increasingly recognized cause of acute Chagas disease outbreaks in Latin America. Unlike classical vector-borne transmission, these events involve high parasite inocula, severe clinical presentations, and rapid clustering of cases. In Colombia, outbreaks associated with contaminated beverages and artisanal food production reveal vulnerabilities that extend beyond clinical detection into surveillance, food safety, and intersectoral coordination. This study aimed to evaluate public health preparedness for foodborne T. cruzi transmission in Colombia using a One Health and systems-thinking framework.
Methods
A qualitative institutional case study was conducted using a One Health and systems-thinking framework. Sixty-two official documents issued between 2000 and 2024—including surveillance guidelines, outbreak reports, regulatory instruments, and response protocols—were reviewed. Structured consultations were performed with stakeholders from health, food safety, agricultural, and territorial authorities. Data were analyzed using hybrid deductive–inductive thematic analysis focusing on surveillance integration, regulatory clarity, territorial response capacity, and intersectoral coordination.
Results
Preparedness for foodborne Chagas disease was limited by fragmented institutional responsibilities and delayed cross-sector activation. Surveillance systems operated in parallel, often linking food safety investigations only after clinical confirmation of acute cases. Upstream prevention was constrained by unclear mandates for identifying contamination pathways. Territorial capacity varied widely, and coordination mechanisms functioned mainly during outbreaks rather than prevention phases. These factors produced response delays and hindered early containment.
Conclusions
Foodborne Chagas disease represents a distinct epidemiological scenario requiring integrated surveillance beyond vector control frameworks. Strengthening preparedness requires interoperable surveillance systems, defined cross-sector responsibilities, and institutionalized One Health coordination. Addressing governance gaps is essential to prevent recurrent outbreaks and to adapt Chagas disease control strategies to emerging transmission pathways.
