Calling Attention to a Silent NTD – Chagas Disease

 

Mother and Child in Guatemala_1

By Raquel Corona-Parra

Chagas disease, or American Trypanosomiasis, is one of the 17 neglected tropical diseases (NTDs) recognized by the World Health Organization (WHO). It is primarily found in the Americas and it affects millions of people – however, like all NTDs, Chagas disease is a disease of poverty and its toll on the most vulnerable populations goes largely unnoticed.

It is estimated that around 10 million people are infected with Chagas disease worldwide, with more than 99% of the cases occurring in Latin America. The Pan American Health Organization (PAHO) estimates that around 100 million people are at risk for infection. Most of the endemic countries in the region are in Central and South America; however, according to the WHO, the disease is now also affecting communities in the United States, Canada, and some areas of Europe and the Western Pacific.

Increased political attention is needed, particularly in Mexico and the United States, to put an end to this NTD. in its declaration, The Global Chagas Disease Coalition calls for access to existing health tools, innovation and a global R&D agenda, transmission control to prevent Chagas in endemic and non-endemic countries, and advocacy to ensure public and policy awareness of this NTD.

In addition, Sabin Vaccine Institute and other partners are working tirelessly to combat and draw attention to Chagas disease. As part of this effort, a group of partners including the Global Chagas Disease Coalition, Sabin Vaccine Institute, the National School of Tropical Medicine at Baylor College of Medicine, Drugs for Neglected Diseases initiative (DNDi), Doctors Without Borders/Médecins Sans Frontières (MSF), Research!America, the American Society of Tropical Medicine and Hygiene (ASTMH), and PAHO, will host an event tomorrow titled “Advancing Life-Saving R&D Innovations for People Living with Chagas Disease – The Silent Killer.” To catch the live stream of the event, click here.

It starts with a kissing bug

Chagas disease is caused by the protozoan parasite Trypanosoma cruzi (T. cruzi) and it is transmitted most commonly by triatomine bugs, better known as “kissing bugs.” These bugs, which live in the cracks of mud, adobe, and palm thatch houses, bite humans at night as they sleep, usually in the face. The bug defecates close to the bite, and the parasite T. cruzi enters the body when the person scratches at the bite. Chagas disease can also be transmitted through blood transfusion, congenital transmission, organ transplantation and consumption of contaminated foods.

Symptoms and treatment

Chagas disease presents itself in two stages. During the first stage, the acute phase, the parasites cause mild symptoms such as fever, headache, and enlarged lymph glands. The second stage is a chronic phase when the parasites are in the heart and digestive muscle, causing symptoms such as cardiac disorders, digestive and neurological disorders, and can lead to sudden death or heart failure. Treatment for the disease includes benznidazole and nifurtimox, which are most effective in curing Chagas soon after infection occurs. The Sabin Vaccine Institute’s Product Development Partnership is currently developing a vaccine for Chagas in collaboration with Baylor College of Medicine and Texas Children’s Hospital, with support from the Slim Initiative for the Development of Neglected Tropical Disease Vaccines.

Recent Chagas efforts

In July, a group of experts gathered in El Salvador for the country’s first National Conference for the Prevention and Control of Chagas Disease. The event – organized by government ministries in El Salvador, Japan International Cooperation Agency (JICA), and PAHO – was convened to promote the scientific exchange of the advances in Chagas disease monitoring, control, diagnosis and treatment. JICA has been present in Central America since 2000, supporting the governments in their Chagas disease prevention efforts, particularly the IPCA initiative for Chagas disease control (Iniciativa de los Países de Centro América para la Interrupción de la Transmisión Vectorial, Transfusional y Atención Médica de la Enfermedad de Chagas). Minister of Health María Isabel Rodríguez stressed that although disease incidence has reduced, there are still a considerable amount of people who die from the effects of this NTD. To address this, a new technical surveillance group was formed during the conference to expand upon the efforts to control Chagas disease in El Salvador. In Guatemala, the recently launched National Plan to control and eliminate NTDs includes Chagas control activities.

PAHO and WHO have also supported Chagas control efforts in affected subregions of Latin America, through the following cooperation initiatives: the Southern Cone Initiative (Argentina, Bolivia, Brazil, Chile, Paraguay, and Uruguay), the Central America Initiative/IPCA (Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, and Panama), the Andean Initiative (Colombia, Ecuador, Peru, and Venezuela), and the Amazon Initiative (Bolivia, Brazil, Colombia, Ecuador, Guyana, French Guiana, Peru, Suriname, and Venezuela). The Mundo Sano Foundation, a Global Network partner, works on entomological surveillance and home improvement activities to combat Chagas in rural areas of Argentina.

Efforts to draw increased attention to Chagas disease continue to push forward. Remember to tune into the live stream of “Advancing Life-Saving R&D Innovations for People Living with Chagas Disease – The Silent Killer” here, and stay-tuned for an update from the event.

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