100 years of Chagas disease

Today, Médecins Sans Frontières (MSF) launched a new campaign, ‘Chagas: it’s time to break the silence’,  aiming to highlight what they describe as a silent killer.  With an  estimated 7.6 million people worldwide suffering from this disease, resulting in 14,000 deaths each year, and a further 75 million at risk of infection the global burden of Chagas disease (also known as American human trypanosomiasis) is significant.  Chagas disease is endemic in Latin America,  but the disease is becoming more widespread and international travel means that cases now crop up in the United States, Europe, Australia and Japan. The major approaches to control Chagas disease include improved case management and vector control programs, together with housing improvement through regional programs and blood bank screening.  One huge problem with this disease is that following infection patients can be asymptomatic for many years, but eventually develope conditions including cardiomyopathy, megaesophagus and megacolon which can result in disability and death. Identifying and treating those infected with T. cruzi early is a key goal that must be met if we are to reduce the burden of this disease.   

The campaign has been launched to coincide with the centenary of the discovery of Trypanosoma cruzi , its vector and the links of both to Chagas disease by Brazilian doctor Carlos Chagas. According to a fascinating editorial by  Carlos Franco-Paredes, Maria Elena Bottazzi and  Peter J. Hotez published this week in PLoS Neglected Tropical Diseases,  Chagas disease, together with the intestinal helminth infections, is responsible for the highest estimated burden due to infectious diseases in Latin America. The editorial also outlines some of the key challenges in combating this disease and the global efforts that are being made to tackle both prevention and cure.

In order to draw attention to some of the challenges that must be overcome in order to tackle this chronic infectious disease,  PLoS Neglected Tropical Diseases are publishing a series of articles coordinated by Médicins Sans Frontiéres (MSF) and Drugs for Neglected Disease Initiative (DNDi). Two articles will shortly be available online,  the first will outline the implementation of Chagas disease diagnosis and treatment by MSF in  Honduras, Guatemala, and Bolivia, whilst the  second article will highlight the latest developments in new drugs to treat this disease. Although the drugs used to treat Chagas disease are reknowned for side-effects, these are often manageable, according to Dr. Tom Ellman, MSF Head of Mission in Bolivia who stated that ‘ Doctors do not treat children, let alone adults, for fear of side-effects. we are showing that these are manageable in both cases. Leaving patients untreated is no longer ethical’ .

The latest developments in research into Chagas disease are also currently being discussed at an International symposium on Chagas disease that is currently ongoing in Rio de Janeiro, Brazil.  Clearly coordinated efforts from governments, NGOs and research agencies are urgently required to enable early treatment to reduce the burden of this parasitic disease.

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