A new report published today in the scientific journal PLOS Neglected Tropical Diseases details the progress made in combatting the most socially and economically impacting parasitic disease in Latin America.
Chagas disease, a highly prevalent and potentially fatal tropical disease found primarily in Central and South America, currently affects approximately 15 million people and is responsible for some 15,000 deaths each year. Despite this fact Chagas has not achieved the noteriety of other neglected diseases such as malaria. For around a third of infected people the disease becomes chronic, sometimes resurfacing decades later with devastating effects, most commonly ending in heart failure. It is a parasitic infection (Trypanosoma cruzi) transmitted several ways including via the so-called ‘kissing bugs’ (Triatominae), which earn their name through a tendency to suck the blood on the face of their victims. It has been speculated that Darwin’s chronic medical complaints were manifestations of Chagas disease, ultimately caused by coming into contact with kissing bugs.
I think it would be interesting for Chile to have this program at a national level…
Dr Cristina Alonso-Vega
However as lead author of the Bolivian study Dr. Cristina Alonso-Vega makes clear, there is also, “a more hidden mechanism: congenital transmission.” Although there is an excellent chance of cure when infants are treated in the first year of life, the fact that symptoms are not always present makes diagnosis challenging.
The implementation of the congenital Chagas disease programme in Bolivia has shown that through several years of work there have been 1,093 children successfully diagnosed and 97% of children who underwent treatment tested negative for Chagas disease. “Based on such encouraging results, the challenge now is twofold: to expand the program coverage nationwide and to spread this successful treatment model to other countries with endemic Chagas disease,” said Dr. Alonso-Vega.
In terms of the Chagas situation in neighbouring Chile, Dr Alonso-Vega believes, “the prevalence in mothers is lower (about 3%) than in Bolivia (about 20%), but according to some sources the congenital transmission rate is a little higher in Chile (4.7% vs 2.6%). The differences in transmission rates could be explained by the use, in Chile, of molecular biology techniques, which are much more effective for parasitological diagnosis.”
Alonso-Vega suggested that, ” nevertheless, the protocol for diagnosis and treatment of congenital Chagas disease, could be adapted to Chile’s health system by using molecular biology techniques instead (or along with)the micromethod technique. I think it would be interesting for Chile to have this program at a national level in the Chagas endemic areas and in areas with a lot of migration (such as Santiago).”