Chagas disease, caused by the protozoan Trypanosoma cruzi, transmitted mainly by vector insects known as "kissing bugs", is a neglected disease that affects millions of people in Latin America. Despite advances in prevention and treatment, Chagas disease still represents a significant public health challenge, with the potential to cause serious long-term heart and digestive problems, leading to death.
Transmission and Vectors: The Cycle of Infection
The main form of transmission of Chagas disease is vector-borne, through the bite of an infected kissing bug. When feeding on blood, the kissing bug deposits feces containing the protozoan Trypanosoma cruzi on the person's skin. The itching caused by the bite leads the person to scratch the area, facilitating the entry of the protozoan into the bloodstream.
Other forms of transmission include:
- Congenital transmission: from mother to child during pregnancy.
- Contaminated blood transfusion.
- Organ transplantation from infected donors.
- Ingestion of food contaminated with barber bug feces.
- Laboratory accidents.
Disease Phases and Symptoms: A Variable Clinical Picture
Chagas Disease has two main phases:
- Acute phase: generally asymptomatic or with mild symptoms, such as fever, malaise, swelling at the site of the bite and enlarged lymph nodes.
- Chronic phase: may take years or decades to manifest, with serious symptoms such as Chagas cardiomyopathy (heart disease), megaesophagus and megacolon (dilation of the esophagus and colon).
Diagnosis and Treatment: Challenges and Limited Options
Chagas Disease is diagnosed by means of serological tests that detect antibodies against Trypanosoma cruzi in the patient's blood. Differential diagnosis with other diseases is essential, especially in the acute phase.
Chagas disease is treated with the drugs benznidazole and nifurtimox, which are more effective in the acute phase of the disease. Treatment in the chronic phase is controversial and aims mainly to control symptoms and prevent complications.
Prevention and Control: Essential Measures
Prevention of Chagas disease involves vector control measures, such as:
- Improving housing conditions, by building brick houses and eliminating cracks and holes that serve as shelter for barbers.
- Using insecticides to eliminate barbers in homes.
- Screening doors and windows to prevent insects from entering.
- Quality control of blood used in transfusions and organs used in transplants.
- Strict hygiene when handling food.
Raising awareness among the population about the risks of Chagas disease and the importance of seeking medical care in the event of symptoms are also essential.
Chagas Disease Worldwide: A Continuous Risk
Chagas disease is endemic in Latin American countries, but can also be found in other parts of the world due to the migration of infected people. The World Health Organization (WHO) monitors cases of Chagas disease worldwide and develops strategies for prevention and control of the disease.
Chagas disease, despite being a neglected disease, continues to be a threat to global public health. Continuous research and development of new drugs and vaccines are essential to combat this disease and protect the population.
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