This document focuses on making recommendations for the diagnosis and treatment of Chagas disease, an infection caused by Trypanosoma cruzi, the protozoan agent of a systemic parasitic disease. Methodology: These clinical practice guidelines were prepared following the WHO handbook for guideline dev...elopment (5). A multidisciplinary development group was formed, comprised of thematic experts, epidemiologists, methodologists, and users. Since there were no existing guidelines that could be adapted, the guidelines were developed from scratch.
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Due to the particular Amazonian situation of vectorial transmission based mostly on the wild cycle of Trypanosoma cruzi with diversity of triatomine vectors involved in effective transmission, and the variety of eco-epidemiological situations that facilitate such transmission, the countries of the A...mazon agreed that the development and strengthening of preventive actions based on comprehensive surveillance and detection of effective vectorial transmission, based on mandatory notification of acute or chronic cases, was required. In addition, it was recommended that surveillance and prevention and/or vector control actioDue to the particular Amazonian situation of vectorial transmission based mostly on the wild cycle of Trypanosoma cruzi with diversity of triatomine vectors involved in effective transmission, and the variety of eco-epidemiological situations that facilitate such transmission, the countries of the Amazon agreed that the development and strengthening of preventive actions based on comprehensive surveillance and detection of effective vectorial transmission, based on mandatory notification of acute or chronic cases, was required.
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La enfermedad de Chagas (ECha), resultado de la infección por el Trypanosoma cruzi, afecta varias poblaciones de las
zonas rurales de Suramérica y América Central. En los últimos años la enfermedad ha cobrado importancia epidemiológica no sólo porque se ha incrementado la detección de caso...s, sino por la presencia, en la infección crónica, de cardiopatía, patología de considerable gravedad clínica y cuya aparición aumenta el riesgo de incapacidad y reducción de la expectativa de vida.
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La enfermedad de Chagas, también conocida como tripanosomiasis americana, es causada por el parásito Trypanosoma cruzi. La forma más común de contraer la infección es a través del contacto con las heces de un insecto triatominio (conocido con los nombres de chinche besucona, benchuca, vinchuca..., chipo o barbeiro), el cual se alimenta de la sangre de seres humanos y animales.
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A systematic review of clinical and observational antiparasitic treatment studies to assess the potential for establishing an individual participant-level data platform.
Chagas disease (CD), caused by the parasite Trypanosoma cruzi, affects ~6–7 million people worldwide. Significant limitations s...till exist in our understanding of CD. Harnessing individual participant data (IPD) from studies could support more in-depth analyses to address the many outstanding research 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, which is caused by infection with the parasite Trypanosoma cruzi, is known as the silent disease. An estimated 8 million people have the disease and most of them do not know that they are infected.
Carlos Chagas discovered American trypanosomiasis, also named Chagas disease (CD) in his honor, just over a century ago. He described the clinical aspects of the disease, characterized by its etiological agent (Trypanosoma cruzi) and identified its insect vector. Initially, CD occurred only in Latin... America and was considered a silent and poorly visible disease. More recently, CD became a neglected worldwide disease with a high morbimortality rate and substantial social impact, emerging as a significant public health threat. In this context, it is crucial to better understand better the epidemiological scenarios of CD and its transmission dynamics, involving people infected and at risk of infection, diversity of the parasite, vector species, and T. cruzi reservoirs. Although efforts have been made by endemic and non-endemic countries to control, treat, and interrupt disease transmission, the cure or complete eradication of CD are still topics of great concern and require global attention. Considering the current scenario of CD, also affecting non-endemic places such as Canada, USA, Europe, Australia, and Japan, in this review we aim to describe the spread of CD cases worldwide since its discovery until it has become a global public health concern.
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Pathogens . 2021 Nov 16;10(11):1493.doi: 10.3390/pathogens10111493
.Chronic manifestations of Chagas disease present as disabling and life-threatening condi-tions affecting mainly the cardiovascular and gastrointestinal systems. Although meaningful research has outlined the different molecular mech...anisms underlying Trypanosoma cruzi’s infection and the host-parasite interactions that follow, prompt diagnosis and treatment remain a challenge, particu-larly in developing countries and also in those where the disease is considered non-endemic. This review intends to present an up-to-date review of the parasite’s life cycle, genetic diversity, virulence factors, and infective mechanisms, as well as the epidemiology, clinical presentation, diagnosis, and treatment options of the main chronic complications of Chagas disease.
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Front. Public Health, 02 July 2019 Sec. Infectious Diseases: Epidemiology and Prevention
Volume 7 - 2019 | https://doi.org/10.3389/fpubh.2019.00166
Chagas disease (CD) is an anthropozoonosis caused by the protozoan parasite Trypanosoma cruzi, that affects about 6–8 million people worldwide (1) a...nd causes approximately 50,000 deaths per year. Another 65–100 million people are living in areas at risk for infection worldwide (2–4). Even though over a century has passed since its discovery, CD remains one of the leading public health problems for most Latin American countries
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Revista Médica del Hospital General de México, Vol. 81. Issue 3.Pages 154-164 (July - September 2018)
Chagas disease is a parasitic zoonosis caused by Trypanosoma cruzi, a protozoan whose transmission to humans is primarily vector-borne. It is estimated that 6–8 million people worldwide are inf...ected and that 65–100 million people are at risk of becoming infected. Its clinical spectrum is very broad. During the acute phase, non-specific manifestations develop that may go unnoticed. During the chronic phase, specific manifestations develop that are diagnosed late and increase the morbidity and mortality of those suffering from it.
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In areas of Mexico, Central America, and South America, where the Trypanosoma cruzi parasite is present in triatomine bugs, improved housing and spraying insecticide inside housing to eliminate the bugs has significantly decreased the spread of Chagas disease. Screening of blood donations for Chagas... is another important public health tool to help prevent spreading the disease through blood transfusions. Early detection and treatment of new cases, including mother-to-baby (congenital) cases, will also help reduce the burden of disease.
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In 2005, the World Health Organization (WHO) recognized Chagas disease (CD; Trypanosoma cruzi infection) as a neglected tropical disease (NTD) [1] and included it into the global plan to combat NTDs [2]. The Target 3.3 of the United Nations Sustainable Development Goals (UN/SDG) aims at ending the e...pidemics of NTDs by 2030 [3]. Mother-to-child (congenital/connatal) transmission is currently the main mode of transmission of T. cruzi over blood transfusions and organ transplantations in vector-free areas within and outside Latin America (LA). Based on recent demonstrations that congenital transmission can be prevented [4–7], WHO has shifted its objective, in 2018, from control to elimination of congenital CD (cCD).
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WHO's 2020 milestones for Chagas disease include having all endemic Latin American countries certified with no intradomiciliary Trypanosoma cruzi transmission, and infected patients under care. Evaluating the variation in historical exposure to infection is crucial for assessing progress and for und...erstanding the priorities to achieve these milestones.
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Chagas disease, which is caused by infection with the parasite Trypanosoma cruzi, is known as the silent disease. An estimated 8 million people have the disease and most of them do not know that they are infected.
About six to seven million people worldwide, mostly in Latin America, are estimated to be infected with
Trypanosoma cruzi, the parasite that causes Chagas disease (WHO data from 2021). Chagas disease is
found mainly in endemic areas of 21 Latin American countries. Chagas disease was once entirely
...
confined to rural areas but in the last decades, due to population movements, most infected people live
in urban settings and the disease has spread to other continents. The burden of disease is due to its
chronic progression with people still suffering years later after initial infection.
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Advice and guidance on the health needs of migrant patients for healthcare practitioners.
Chagas disease is increasingly reported in Latin American migrants who have settled in Europe. It has rarely been reported in the UK due to lack of testing and awareness.
Chagas disease (American trypanosomia...sis) is a zoonosis caused by the flagellate protozoan parasite Trypanosoma cruzi.
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Principaux faits
D’après les estimations, 6 à 7 millions de personnes dans le monde sont infectées par Trypanosoma cruzi (T. Cruzi), le parasite responsable de la maladie de Chagas. La plupart de ces personnes vivent en Amérique latine.
La transmission à l’être humain se fait principalem...ent, en Amérique latine, par l’intermédiaire d’un insecte appelé triatome, qui peut être porteur de T. cruzi.
Parmi les autres modes de transmission de la maladie de Chagas, figurent : la transmission orale (par voie alimentaire), la transfusion de sang ou de produits sanguins, la transmission mère-enfant (congénitale), la transplantation d’organes et les accidents de laboratoire.
La maladie de Chagas ne touchait auparavant que des zones rurales de la Région des Amériques, et surtout de l’Amérique latine. Ces dernières décennies, toutefois, les mouvements de population ont fait que la plupart des personnes infectées sont des habitants de zones urbaines (urbanisation) et que la maladie s’est propagée à d’autres continents (où T. cruzi se transmet par des voies non vectorielles).
L’infection à T. cruzi est curable si un traitement est instauré rapidement après l’infection.
Chez les personnes infectées de façon chronique, un traitement antiparasitaire peut éventuellement prévenir ou enrayer la progression de la maladie, et éviter sa transmission, notamment de la mère à l’enfant.
Jusqu’à 30 % des personnes infectées de façon chronique présentent des troubles cardiaques, et jusqu’à 10 % d’entre elles souffrent de troubles digestifs et/ou neurologiques, ce qui peut imposer un traitement particulier.
Les principales méthodes de prévention de la maladie de Chagas en Amérique latine sont la lutte antivectorielle ainsi que d’autres stratégies visant à réduire la transmission vectorielle.
Dans le monde entier, le dépistage sanguin joue un rôle crucial dans la prévention de l’infection par transfusion ou transplantation d’organes.
Il est essentiel de détecter et de traiter l’infection chez les femmes et les filles en âge de procréer, ainsi que de soumettre tout nouveau-né et ses frères et sœurs à un dépistage dans le cas où la mère est infectée et n’a jamais reçu de traitement antiparasitaire.
Certains facteurs socio-économiques et environnementaux influent fortement sur la maladie de Chagas, dont la propagation et les différentes dimensions interdépendantes justifient la nécessité de mettre en œuvre des stratégies de lutte multisectorielles.
Quelques pays ont mis en place la notification et la surveillance des cas aigus et chroniques et des voies de transmission actives, qui sont essentielles à la lutte contre la maladie de Chagas.
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Болезнь Шагаса, известная также как американский трипаносомоз, — потенциально опасное для жизни заболевание, вызываемое простейшим паразитом Trypanosoma cruzi.
A century after its discovery, Chagas' disease still represents a major public health challenge in Latin America. Moreover, because of growing population movements, an increasing number of cases of imported Chagas' disease have now been detected in non-endemic areas, such as North America and some E...uropean countries. This parasitic zoonosis, caused by Trypanosoma cruzi, is transmitted to humans by infected Triatominae insects, or occasionally by non-vectorial mechanisms, such as blood transfusion, mother to fetus, or oral ingestion of materials contaminated with parasites. Following the acute phase of the infection, untreated individuals enter a chronic phase that is initially asymptomatic or clinically unapparent. Usually, a few decades later, 40-50% of patients develop progressive cardiomyopathy and/or motility disturbances of the oesophagus and colon. In the last decades several interventions targeting primary, secondary and tertiary prevention of Chagas' disease have been attempted. While control of both vectorial and blood transfusion transmission of T cruzi (primary prevention) has been successful in many regions of Latin America, early detection and aetiological treatment of asymptomatic subjects with Chagas' disease (secondary prevention) have been largely underutilised. At the same time, in patients with established chronic disease, several pharmacological and non-pharmacological interventions are currently available and have been increasingly used with the intention of preventing or delaying complications of the disease (tertiary prevention). In this review we discuss in detail each of these issues.
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Chronic manifestations of Chagas disease present as disabling and life-threatening conditions affecting mainly the cardiovascular and gastrointestinal systems. Although meaningful research has outlined the different molecular mechanisms underlying Trypanosoma cruzi’s infection and the host-parasit...e interactions that follow, prompt diagnosis and treatment remain a challenge, particularly in developing countries and also in those where the disease is considered non-endemic. This review intends to present an up-to-date review of the parasite’s life cycle, genetic diversity, virulence
factors, and infective mechanisms, as well as the epidemiology, clinical presentation, diagnosis, and treatment options of the main chronic complications of Chagas disease.
more