Via Médecins Sans Frontières: Colombia: Fighting a silent disease. Excerpt:

Chagas is widespread in Latin America, killing 14,000 people a year. In 2009, MSF started a treatment program in the region of Arauca, Colombia, near the border with Venezuela – however applying a 60 day treatment program in a conflict zone presents some unique challenges.

Angela lives in Genareros, an indigenous community in Arauca region, Colombia. In April 2010, two of her seven children completed their treatment for Chagas, a disease transmitted by an insect common in rural areas where people live in houses made of clay and straw. As Angela’s young children Yosney and Maryeli celebrated the end of their treatment, she found out that another two of her children also had the disease.

Chagas disease is endemic in most Latin American countries. In Colombia, Arauca is one of the most affected regions. The disease is caused by the trypanosoma cruzi parasite and transmitted mainly by the ‘kissing bug’, a blood-sucking insect known in Colombia as ‘pito’.

People with the disease may live for years without showing any symptoms. If untreated, however, Chagas can lead to serious health problems − mainly heart and intestinal complications − and even death.

Integrating the fight against Chagas into primary healthcare services

At the end of 2009, Médecins Sans Frontières (MSF) integrated Chagas screening and treatment into its primary healthcare services already carried out though mobile clinics in Arauca, a conflict-affected region bordering Venezuela.  This is the first time that MSF has carried out Chagas treatment in a conflict context.

“It is a real challenge, because the treatment requires constant follow up for a period of two months, and there is always the concern that we will be unable to reach a community due to security constraints or because an armed group has  stopped road movements in the region,” said Patrick Swartenbroekx, MSF field coordinator in Arauca.

The first community to undergo screening was Genareros, where Angela lives with her seven children. Out of the 97 blood samples taken from children between nine months and 18 years old, 11 were confirmed positive.

“We were surprised to find such a high rate in Genareros. Fortunately, we didn’t find the same rate when we extended the screening to other communities,” said Dr. Rafael Herazo, medical focal point for MSF’s project in Arauca.

Photo courtesty of Médecins Sans Frontières (http://www.msf.ca/news-media/news/2010/05/colombia-fighting-a-silent-disease/)

Sixty days of treatment

So far, the MSF team in Arauca has collected 1,617 blood samples in 10 different communities and completed laboratory tests for 514 samples. The lab results found that one in 28 people tested positive for Chagas.

Confirmed patients are given a medical check-up before they start a two-month long treatment. This is important to check whether the patients have already developed the disease. “If the person has developed a serious cardiac complication, for example, there is little we can do to treat the disease,” said Dr. Herazo.