Personne ne va dans un établissement de soins de santé pour tomber malade. On s’y rend pour se faire soigner, pour accoucher
ou pour se faire vacciner. Cependant, des centaines de millions de personnes s’exposent à un risque accru d’infection en cherchant à obtenir des soins dans des éta...blissements de santé dépourvus de produits de première nécessité, notamment de services d’approvisionnement en eau, d’assainissement et d’hygiène, de gestion des déchets biomédicaux et de nettoyage (services WASH). L’absence de services WASH dans les établissements de santé compromet la sécurité et la dignité des patients, tout en menaçant d’exacerber la propagation d’infections résistantes aux agents antimicrobiens et en fragilisant les efforts déployés pour améliorer la santé des enfants et des mères.
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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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Rev. Panam Salud Publica. 2017;41:e153. doi: 10.26633/RPSP.2017.153
Worldwide, over 6 million people are infected with Trypanosoma cruzi, the pathogen that causes Chagas disease (CD). In the Americas, CD creates the greatest burden in disability-adjusted life years of any parasitic infection. In Co...lombia, 437 000 people are infected with T. cruzi, of whom 131 000 suffer from cardiomyopathy. Colombia’s annual costs for treating patients with advanced CD reach US$ 175 016 000. Although timely etiological treatment can significantly delay or prevent development of cardiomyopathy—and costs just US$ 30 per patient—fewer than 1% of people with CD in Colombia and elsewhere receive it.
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Microorganisms . 2022 Jul 14;10(7):1427.
Chagas disease (CD) is endemic in about 21 countries of the Americas. The disease has spread to recently Chagas-free regions, mainly due to migration, and can now also be diagnosed in countries such as the USA, Canada, many European and some African, eastern... Mediterranean and western Pacific countries. About 6 million people are infected and 70 million live with a daily risk of infection. Although many efforts have been made to control the disease, and some improvements were achieved, still, less than about 1% of the infected have access to diagnosis and treatment. This causes high morbidity and mortality rates with more than 12,000 deaths per year
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Research and Reports in Tropical Medicine 2022:13 25–40
Chagas disease (CD) or American trypanosomiasis is a neglected parasitic disease associated with significant mortality and morbidity that includes long-term disability, social stigma and a mental health toll. Perceived as a disease of the ve...ry poor, this infection, once limited to rural areas of Latin America (LA), has now spread via migration to non-endemic areas and countries, where transmission is maintained via non-vectorial routes.
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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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Chagas disease is named after the Brazilian physician Carlos Chagas, who discovered the disease in 1909. It is caused by the parasite Trypanosoma cruzi, which is transmitted to animals and people by insect vectors and is found only in the Americas (mainly, in rural areas of Latin America where pover...ty is widespread). Chagas disease (T. cruzi infection) is also referred to as American trypanosomiasis
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First discovered more than 100 years ago, Chagas disease continues to affect more than six million people worldwide and is one of the most prevalent public health problems in Latin America and, increasingly, on a global scale. In the last decades, migratory patterns have spread the disease to areas ...where it was previously unknown, including the United States of America (USA), Europe and the Western Pacific region. With an estimated 75 million individuals at risk of infection, Chagas disease is becoming a global health challenge with significant social and economic burdens for the people affected by it.
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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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After 100 years of chemotherapy with impractical and toxic drugs, an oral cure for human African trypanosomiasis (HAT) is available: Fexinidazole. In this case, we review the history of drug discovery for HAT with special emphasis on the discovery, pre-clinical development, and operational challenge...s of the clinical trials of fexinidazole. The screening of the Drugs for Neglected Diseases initiative (DNDi) HAT-library by the Swiss TPH had singled out fexinidazole, originally developed by Hoechst (now Sanofi), as the most promising of a series of over 800 nitroimidazoles and related molecules. In cell culture, fexinidazole has an IC50 of around 1 µM against Trypanosoma brucei and is more than 100-fold less toxic to mammalian cells. In the mouse model, fexinidazole cures both the first, haemolymphatic, and the second, meningoencephalitic stage of the infection, the latter at 100 mg/kg twice daily for 5 days. In patients, the clinical trials managed by DNDi and supported by Swiss TPH mainly conducted in the Democratic Republic of the Congo demonstrated that oral fexinidazole is safe and effective for use against first- and early second-stage sleeping sickness. Based on the positive opinion issued by the European Medicines Agency in 2018, the WHO has released new interim guidelines for the treatment of HAT including fexinidazole as the new therapy for first-stage and non-severe second-stage sleeping sickness caused by Trypanosoma brucei gambiense (gHAT). This greatly facilitates the diagnosis and treatment algorithm for gHAT, increasing the attainable coverage and paving the way towards the envisaged goal of zero transmission by 2030.
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Species of the genus Schistosoma are digenetic trematodes and the causative agents of the Neglected Tropical Disease (NTD) schistosomiasis; a parasitic disease that ranks second only to malaria in terms of socioeconomic impacts. Over 220 million people worldwide are currently infected, 90% of whom l...ive in sub-Saharan Africa (SSA), with an estimated annual mortality of at least 200,000. Infection in humans, as well as alternative mammalian definitive hosts, occurs in contaminated freshwater environments via cercariae shed from specific snail intermediate hosts. Early acute morbidity can occur following cutaneous penetration, sometimes leading to an urticarial rash known as swimmers itch or cercarial dermatitis.
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FIND and Standard Diagnostics (SD) have developed a lateral flow rapid diagnostic test (RDT) to screen for
T.b. gambiense HAT that is cheap and easy to use. The tests are packed individually and are stable at 40°C for
up to 25 months; they are performed on fresh blood obtained from a finger prick..., and no instrument or electricity is required. The RDT detects host antibodies to infection in populations that are at risk, or in suspect individuals. Positive cases are subjected to further confirmatory methods to identify HAT patients.
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Goal and objectives of the guideline
The goal of this guideline is to provide evidence-based recommendations to countries in their efforts to accomplish schistosomiasis morbidity control and elimination as a public health problem, and to move towards interruption of transmission.
The recommendatio...ns contained herein will help countries to implement national schistosomiasis control and elimination programmes and support efforts to verify the interruption of transmission.
The specific objectives are to provide guidance on:
prevalence thresholds, target age groups and frequency of preventive chemotherapy for schistosomiasis;
establishment of water, sanitation and hygiene (WASH) and snail control activities to support control and elimination of schistosomiasis;
use of diagnostic tests in humans in low transmission areas and for moving to, and evaluating the interruption of transmission of schistosomiasis;
tools for the assessment of Schistosoma spp. infection in snail hosts; and
diagnostic tests for the assessment of schistosomiasis infection in animal reservoirs of infection
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Over the past twenty years, huge efforts made by a broad coalition of stakeholders curbed the last epidemic and brought the disease to the brink of elimination. In this paper, the latest figures on disease occurrence, geographical distribution and control activities are presented. Strong evidence in...dicates that the elimination of sleeping sickness ‘as a public health problem’ by 2020 is well within reach. In particular, fewer than one thousand new cases were reported in 2018, and the area where the risk of infection is estimated as moderate, high or very high has shrunk to less than 200,000 km2. More than half of this area is in the Democratic Republic of the Congo. The interruption of transmission of the gambiense form, targeted by the World Health Organization (WHO) for 2030, will require renewed efforts to tackle a range of expected and unexpected challenges. The rhodesiense form of the disease represents a small part of the overall HAT burden. For this form, the problem of under detection is on the rise and, because of an important animal reservoir, the elimination of disease transmission is not envisioned at this stage.
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Today is World Chagas Disease Day. This year’s theme is Finding and reporting every case to defeat Chagas disease.
Despite progress, the global case detection rate for Chagas disease is low (estimated to be around 10%), posing a substantial barrier to accessing treatment and care and in prevent...ing transmission.
Often termed as a “silent and silenced disease”, many people with Trypanosoma cruzi infection (the parasite that causes the disease) develop no symptoms or unspecific mild symptoms. Moreover, many countries with cases lack systems to track the number of affected people and active transmission routes.
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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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Dracunculiasis (Guinea worm disease), caused by the parasite Dracunculus medinensis, is traditionally acquired by drinking water containing copepods (water fleas) infected with D. medinensis larvae, but in recent years also appears increasingly to be transmitted by eating fish or other aquatic anima...ls. The worm typically emerges through the skin on a lower limb of the host 1 year after infection, causing pain and disability.
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Neglected tropical diseases tend to cluster in the same poor populations, and to make progress with their control, they will have to be dealt with in an integrated manner. Peptide microarrays may be a solution to tese problems, where diagnosis for co-infection can be detected simultaneously using th...e one tool.
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During the 17 years since Surgical approaches to the urogenital manifestations of lymphatic filariasis was first published, there has been heightened awareness of the physical, economic and emotional burden of the genitourinary manifestations of filariasis. With the impetus to provide better guidanc...e for care of those suffering from LF, this update was both warranted and timely.
At the outset, the Committee noted that barriers continue to exist in care of patients affected by LF-associated morbidity. These barriers include lack of information for patients as well as for many healthcare providers, including general surgeons and others within health systems
This update offers a new consensus of the Committee regarding the staging of hydroceles caused by LF, also known as “filariceles”. It recommends integrating LF surgery with other efforts to strengthen surgical care by assessing health facilities for their surgical readiness using the WHO surgical assessment tool or “SAT”. It also recommends integratinghernia surgery with hydrocele surgery and integrating standards for prevention of surgical site infection (SSI).
The update revises recommendations for standard procedures and processes, offers an algorithm for diagnosis (including the use of ultrasound) and discusses postoperative care. It recommends collecting data using the staging and grading system described by Capuano and Capuano along with other metrics for public health management of LF.
A multifaceted approach has therefore been recommended to coordinate public health outreach with national surgical planning and local health systems to include supporting partners such as nongovernmental organizations. Surgical camps with mobile teams, as well as training of personnel at DCP3 “first level” or WHO Level II hospitals (depending on region and resources), have important roles for reducing LF morbidity.
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