Chagas disease (CD), caused by the parasite Trypanosoma cruzi, affects ~6–7 million people worldwide. Significant limitations still exist in our understanding of CD. Harnessing individual participant data (IPD) from studies could support more in-depth analyses to address the many outstanding resea...rch questions. This systematic review aims to describe the characteristics and treatment practices of clinical studies in CD and assess the breadth and availability of research data for the potential establishment of a data-sharing platform.
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Chagas disease (CD) is caused by the parasite Trypanosoma cruzi, and it is endemic in Central, South America, Mexico and the
South of the United States. It is an important cause of early mortality and morbidity, and it is associated with poverty and stigma. A third of
the cases evolve into chronic... cardiomyopathy and gastrointestinal disease. The infection is transmitted vertically and by blood/organ
donation and can reactivate with immunosuppression. Case identification requires awareness and screening programmes targeting the
population at risk (women in reproductive age, donors, immunocompromised patients). Treatment with benznidazole or nifurtimox is most
effective in the acute phase and prevents progression to chronic phase when given to children. Treating women antenatally reduces but does
not eliminate vertical transmission. Treatment is poorly tolerated, contraindicated during pregnancy, and has little effect modifying the
disease in the chronic phase. Screening is easily performed with serology. Migration has brought the disease outside of the endemic
countries, where the transmission continues vertically and via blood and tissue/organ donations. There are more than 32 million migrants
from Latin America living in non-endemic countries. However, the infection is massively underdiagnosed in this setting due to the lack of
awareness by patients, health authorities and professionals. Blood and tissue donation screening policies have significantly reduced
transmission in endemic countries but are not universally established in the non-endemic setting. Antenatal screening is not commonly
done. Other challenges include difficulties accessing and retaining patients in the healthcare system and lack of specific funding for the
interventions. Any strategy must be accompanied by education and awareness campaigns directed to patients, professionals and policy
makers. The involvement of patients and their communities is central and key for success and must be sought early and actively. This review
proposes strategies to address challenges faced by non-endemic countries
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Chagas disease (CD) is a neglected tropical disease, endemic in Latin America, but due to migration and environmental changes it has become a global public health issue.
Chagas disease constitutes a public health problem, and Spain is the non-endemic country with the highest burden of disease outside the Americas. It represents a model for non-endemic countries regarding health policies to control the disease. This study is aimed to generate estimates of the T.cruzi... prevalence and the number of undetected and untreated individuals with the infection in Spain and to compare them with the actual number of cases reported by official sources.
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A 7.7 magnitude earthquake struck at 04:17 local time on 6 February 2023, with its epicentre located in Pazarcık district
in Kahramanmaraş province, Türkiye. Over 1200 aftershocks have since been reported. These are Türkiye’ s most powerful
earthquakes since 1939
In response to the devastating earthquakes impacting Türkiye and the Syrian Arab Republic, the World Health Organization delivered 72 metric tons of trauma and emergency surgery supplies, including treatments, to both countries to support ongoing response efforts.
A first charter flight depar...ted to Türkiye on 9 February carrying 37 metric tons of life-saving supplies, and a second flight is scheduled to deliver 35 metric tons of supplies to the Syrian Arab Republic today.
In total, these life-saving supplies from both flights will be used to treat and care for 100 000 people as well as for 120 000 urgent surgical interventions in both countries.
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À la suite des tremblements de terre dévastateurs qui ont frappé la Türkiye et la République arabe syrienne, l’Organisation mondiale de la Santé a livré 72 tonnes de fournitures pour des soins de traumatologie et de chirurgie d’urgence, y compris des traitements, afin de soutenir les opé...rations en cours dans ces deux pays.
Un premier vol affrété a décollé pour la Türkiye le 9 février avec 37 tonnes de fournitures vitales à son bord et un deuxième vol doit livrer aujourd’hui 35 tonnes de fournitures à la République arabe syrienne.
Les fournitures vitales livrées grâce à ces deux vols serviront, au total, à traiter et à soigner 100 000 personnes et à réaliser 120 000 interventions chirurgicales urgentes dans les deux pays.
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ستجابةً للهزات الأرضية المدمرة التي ضربت تركيا والجمهورية العربية السورية، أرسلت منظمة الصحة العالمية إلى البلدين المنكوبين 72 طناً مترياً من الإمدادات اللازمة لم...الجة الرضوح وإجراء العمليات الجراحية الطارئة، بما يشمل الأدوية، لدعم جهود الاستجابة الجارية.
وقد غادرت طائرة الإمدادات الأولى إلى تركيا في 9 شباط/فبراير حاملةً 37 طناً مترياً من الإمدادات المنقذة للأرواح، ومن المقرر أن تغادر الرحلة الثانية اليوم إلى الجمهورية العربية السورية وعلى متنها 35 طناً مترياً من الإمدادات
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En respuesta a los devastadores terremotos que afectaron a Türkiye y a la República Árabe Siria, la Organización Mundial de la Salud entregó 72 toneladas de suministros de cirugía de traumatología y de emergencia, incluidos tratamientos, a ambos países para apoyar las iniciativas de respuest...a en curso.
El 9 de febrero, un primer vuelo chárter con 37 toneladas métricas de suministros vitales partió con destino a Türkiye, y está previsto que un segundo vuelo entregue hoy 35 toneladas de suministros a la República Árabe Siria.
En total, los suministros vitales transportados en ambos vuelos se utilizarán para tratar y atender a 100 000 personas, así como para llevar a cabo 120 000 intervenciones quirúrgicas urgentes en ambos países.
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In the early morning of 6 February 2023, a magnitude 7.8 earthquake struck southern Türkiye near the northern
border of Syria. The earthquake was followed 11 minutes later by a magnitude 6.7 aftershock. Many aftershocks
continue to be felt across the region. Whilst the impact is still being ass...essed, initial reports evidence significant
damage in the areas of southern Türkiye and northern Syria.
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In the early morning of 6 February 2023, a magnitude 7.8 earthquake occurred in southern Türkiye near the
northern border of Syria. The earthquake was followed 11 minutes later by a magnitude 6.7 aftershock. Many
aftershocks are still being felt across the region. Whilst the impact is still bei...ng assessed, initial reports evidence
significant damage in the areas of southern Türkiye and northern Syria.
In response, the Syria Ministry of Health (MoH) activated its emergency operations centre (EOC) on 6 Feb 2023
under the chairmanship of the Deputy Minister. In all affected governorates, public and private health facilities
and medical convoys have been repurposed to support the response and are being managed by the National
Ministry of Health (MoH) and Directorate of Health (DoH) at governorate level. Support has been directed to
affected areas, with medical convoys including 28 ambulances and 7 mobile clinics, deployed from the health
directorates of Damascus, Rural Damascus, Quneitra, Homs, Tartous, Aleppo and Latakia
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TUATION UPDATE
In the early morning of 6 February 2023, a magnitude 7.8 earthquake occurred in southern Türkiye near the
northern border of Syria. The earthquake was followed 11 minutes later by a magnitude 6.7 aftershock. Many
aftershocks are still being felt across the region. Whilst the imp...act is still being assessed, initial reports evidence
significant damage in the areas of southern Türkiye and northern Syria.
In response, the Syria Ministry of Health (MoH) activated its emergency operations centre (EOC) on 6 Feb 2023
under the chairmanship of the Deputy Minister. In all affected governorates, public and private health facilities
and medical convoys have been repurposed to support the response and are being managed by the National
Ministry of Health (MoH) and Directorate of Health (DoH) at governorate level. Support has been directed to
affected areas, with medical convoys including 28 ambulances and 7 mobile clinics, deployed from the health
directorates of Damascus, Rural Damascus, Quneitra, Homs, Tartous, Aleppo and Latakia. At the same time, 4
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At 4:17 in the morning on 6 February, a magnitude 7.8
earthquake struck northwestern Turkey. According to
latest reports, this enormous tremor has already caused
over 16,000 deaths in both Turkey, and Syria while over
20,000 are reportedly injured. At least 20 strong
aftershocks have also been ...reported in southern and
central Turkey and will likely continue for the next several
days. The damage has been incredible, with dozens of
cities and town experiencing severe damage to
infrastructure.
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On 6 February at 4:17 am, a 7.8 degrees magnitude earthquake struck southern Turkey near Syria’s
northern border. The US Geological Survey said the earthquake was centered about 33 km (20 miles)
from Gaziantep, a major city and provincial capital. Tremors were felt as far away as Lebanon, Greece...,
Palestine, and the island of Cyprus. Another big earthquake was felt on the same day at around 1:24
pm local time, largely in the same affected areas. Aftershocks will continue to shake the area as fault
lines adjust to such a huge initial tremor. There’s even a risk—albeit a small one—of an aftershock
bigger than the original quake.
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Little progress has been made since the 1960s and 1970s to widen the therapeutic arsenal against Trypanosoma cruzi, the causative pathogen of Chagas disease, which remains a frustrating and perplexing infectious disease. This chapter focuses on the strategic and operational challenges in the clinica...l drug development of a novel antitrypanosomal agent for Chagas disease. The various elements that contribute to a robust assessment of treatment effect including dose selection, choice of patient population, trial methodology, endpoint measures, and regulatory perspectives are discussed. The learnings herein should serve as resource to help researchers and other stakeholders optimize their clinical development plans and speed delivery of new medicines to patients with Chagas disease.
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Chagas disease (CD) is caused by Trypanosoma cruzi. When acquired, the
disease develops in stages. For diagnosis, laboratory confirmation is required, and an extensive assessment of the patient’s health should be performed. Treatment consists of the administration of trypanocidal drugs, which may... cause severe adverse effects. The objective of our systematic review was to analyze data contained in the CD published case reports to understand the challenges that patients and clinicians face worldwide.
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This review focusses on the interactions between the etiologic agent of Chagas disease, Trypanosoma cruzi, and its triatomine vector. The flagellate mainly colonizes the intestinal tract of the insect. The effect of triatomines on trypanosomes is indicated by susceptibility and refractoriness phenom...ena that vary according to the combination of the strains. Other effects are apparent in the different regions of the gut. In the stomach, the majority of ingested blood trypomastigotes are killed while the remaining transform to round stages. In the small intestine, these develop into epimastigotes, the main replicative stage. In the rectum, the population density is the highest and is where the infectious stage develops, the metacyclic trypomastigote. In all regions of the gut, starvation and feeding of the triatomine affect T. cruzi. In the small intestine and rectum, starvation reduces the population density and more spheromastigotes develop. In the rectum, feeding after short-term starvation induces metacyclogenesis and after long-term starvation the development of specific cells, containing several nuclei, kinetoplasts and flagella. When considering the effects of T. cruzi on triatomines, the flagellate seems to be of low pathogenicity. However, during stressful periods, which are normal in natural populations, effects occur often on the behaviour, eg, in readiness to approach the host, the period of time before defecation, dispersal and aggregation. In nymphs, the duration of the different instars and the mortality rates increase, but this seems to be induced by repeated infections or blood quality by the feeding on infected hosts. Starvation resistance is often reduced by infection. Longevity and reproduction of adults is reduced, but only after infection with some strains of T. cruzi. Only components of the surface coat of blood trypomastigotes induce an immune reaction. However, this seems to act against gut bacteria and favours the development of T. cruzi.
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This technical report presents the epidemiology of human and animal leishmaniases in the EU and its neighbouring countries and concludes that the disease remains widespread and underreported in many countries of southern Europe, northern Africa, and the Middle East and that there is a need to improv...e leishmaniasis prevention and control based on robust surveillance in humans, animals, and vectors, and to increase public awareness following a one health approach.
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Even before Russia invaded Ukraine, the global economy was suffering from the repercussions of several man-made conflicts, climate shocks, COVID-19 and rising costs — with devastating consequences for poor people in low-income and developing countries. The war in Ukraine — a major “breadbasket...” for the world — is deepening these challenges on an unprecedented scale. In the immediate, swift and bold action is required by both wealthy and low-income nations to avert further humanitarian and economic catastrophe.
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Russia's unprovoked invasion of Ukraine, a country known as the 'breadbasket of Europe', is raising fears of a
global food crisis, further exacerbating existing food security challenges worldwide. Much depends on the
response of the international community, including the EU, to a number of rapidly... evolving scenarios.
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