Tag Archives: Chagas Diseases

Calling Attention to a Silent NTD – Chagas Disease

Chagas, Latin America and the Caribbean,

 

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.

Artfully Bringing Stories of Neglected Tropical Diseases to Life

Chagas, hookworm, Latin America and the Caribbean, NTDs, PAHO, ,

 

Update: We’re happy to share the news that Shelly Xie was recently awarded the 2013 ASTMH Communications Award

There are several ways to describe the impact of neglected tropical diseases (NTDs) on millions of families worldwide. But this may be one of the most artful and poetic we’ve seen.

Last week, medical student and artist Shelly Xie showcased two sand animations that thoughtfully illustrated stories of families infected with hookworm and Chagas disease at the Pan American Health Organization’s (PAHO) 52nd Directing Council. Shelly’s poetic narration, mixed with moving music and sand drawings, gave these complex stories life.

Shelly’s first animation tells the story of a Brazilian family. Maria, Antonio and their daughter Francisca contract hookworm – a parasitic disease which leaves them sick, tired and unable to work, go to school or take care of their crops.  This story is illustrative of the broader burden NTDs have on millions of Latin American and Caribbean families. Over 13.8 million preschool and 31 million school age children are at risk of hookworm and other parasitic intestinal worms.

Shelly’s second animation tells the story of a young couple in Argentina who contracts Chagas disease. After being bit by the Triatomine bug, both the husband and wife become too sick to work and take care of their livestock. Even worse, the mother is expecting a child who now has a chance of contracting Chagas disease as well. After a week, the couple begins to feel better – but what they don’t know is the side-effects of Chagas disease could lead to an enlarged colon and esophagus, or even heart failure in the years to come. It is estimated that 10 to 11 million people in Latin America and the Caribbean are living with Chagas, Shelly explains.

Shelly’s animations are part of PAHO’s Art Research Project – a program that works with different sectors of society to show how we can all have an impact on global health efforts. Her unique and artistic messaging has the power to include an even wider audience in NTD advocacy and awareness efforts worldwide.

2010 NTD Highlights: an eclectic list

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By: Alanna Shaikh

This is not a scientifically sound list. It is not based on any kind of criteria that make sense. It’s just my list, of what I remember as the most interesting developments in 2010 that related to neglected tropical diseases.

1.       The WHO issued its first annual report on neglected tropical diseases (NTDs). I was honestly surprised to discover it was the first, but better 2010 than never, right?  This kind of formal recognition of the seriousness of NTDs is a big part of what will make them less neglected. The report itself was thorough and detailed, and called for all the right things – more research, better drug access, and support to build health systems to eliminate the NTDs.

2.       Increased private participation in global health in general, and NTDs in particular. It seemed like the private sector was everywhere this year. We saw large drug donations to treat NTDs, including a five-year commitment from Glaxo Smith Kline to provide albendazole to protect children at risk for intestinal worms and a Sanofi Adventis cash commitment of $25 million dollars. We also saw broader corporate commitment to global health in companies that ranged from Coca-Cola to venture capital efforts.

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Where’s my Jetpack?

Global Development, Global Health, NTDs, poverty, Public Health, , , , , , , , , , ,

by: Alanna Shaikh

It’s 2010, and I still don’t have a jetpack. My car sticks stubbornly to the ground instead of flying. Food is still food, not high-tech pellets. And we still haven’t eliminated Chagas disease.

 On July 4th, 2007, the World Health organization launched an effort to eliminate Chagas disease by 2010. The effort included a new network devoted to fighting Chagas, which would expand successful efforts by the Pan American Health organization (PAHO) to control the disease.

 Three years later, Chagas is far from eliminated. It is endemic in 21 countries, and over seven million people are currently infected with the disease. True, we have seven more months left in 2010, but it seems unlikely we’ll treat a million people every month this year and get this thing done.

 What I find frustrating is that we failed at something with such a clearly defined scope. This isn’t the Millennium Development Goals here. We’re not trying to dramatically change life on this planet. We were just trying to get rid of one treatable disease that’s endemic only in Mexico and South America.

 So what happened?

 Chagas doesn’t have great drugs to treat it. The two drugs that work on Chagas – Nifurtimox and Benznidazole – aren’t 100% effective. They work best in early stages of the disease – they can cure up to 80% of people of you catch the disease early. If you wait until the Chagas is chronic, the cure rate goes down to 10-20%. That means you spend a lot of time, effort, and money on treatments that don’t work. In addition to wasting health system capacity, it’s not exactly an incentive to come in and get treated. The drugs also work better on kids than on adults.

 To make matters worse, Nifurtimox and Benznidazole have unpleasant side effects. They include some digestive stuff from Nifurtimox: stomach pain, anorexia, nausea, and vomiting and some terrifying blood and skin side effects from the Benznidazole: swelling, hypersensitive skin, and anemia. Again, really not an incentive to keep taking your drugs.

 Aside from drugs, you can take a surgical approach to Chagas. Needless to say, surgery for the disease is difficult, painful, risky, and expensive. It’s not a feasible approach to seven million people, many of which are children.

 If we’re going to eliminate Chagas, we need to develop better drugs. That didn’t happen in time for 2010 eradication, but the situation is not hopeless. The Drugs for Neglected Diseases initiative is working on Chagas. They plan to develop an easier to manage children’s version of benznidazole, investigate combination therapies for Chagas treatment, and develop at least one new drug for Chagas by 2014.

 Also we’ll be able to deliver the drug house-to-house via visiting nurses wearing jetpacks.

 Seriously, though – how do we make sure that the 2014 goals actually come true? We pay attention. We hold policymakers to their promises, track the progress of the Drugs for Neglected Diseases initiative, and notice if years pass by and the number of people with Chagas is still almost eight million.  

Alanna Shaikh is an expert in health consulting, writing about global health for UN Dispatch and about international relief and development at Blood & Milk. She also serves as a frequently contributing blogger to ‘End the Neglect.”

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