Chagas Disease (CD) is a tropical disease caused by the parasite Trypanosoma cruzi. In 2022, The Bolivian Chagas Network reported that approximately 7 million people are infected with CD and 25 million are at risk of infection. More than one million of these cases stemmed from Bolivia, the country that retained the highest rate of CD in the world.

The Impact of Chagas Disease

There is no vaccine against CD, but if detected in the initial acute phase it can be treated.

The disease mostly spreads as a result of vector-borne transmission. These blood-sucking bugs, called triatomine, bite an infected animal or person and pass the parasites on to humans via feces. These bugs also tend to bite people’s faces, and are therefore referred to as “Kissing Bugs.”

CD can also be transmitted via blood and organ donation as also congenital transmission, from a pregnant woman to her baby. Contraction of CD in the initial phase presents as mild flu-like symptoms and in the later stages can lead to cardiac, digestive and neurological alterations. It has been detected in 21 countries in Latin America and is endemic to this region. In November 2023, The Global Health Innovative Technology Fund reported, that in comparison to all other parasitic diseases in the Americas, CD carried the largest burden of disability-adjusted life years.

The Bolivian Chagas Platform

In 2009, The Bolivian Chagas Platform was formed in a bid to control CD. It consisted of both local and international forces with a strong emphasis placed on promoting trans-nationality to allow research to be shared. Groups involved in The Bolivian Chagas Platform included ISGlobal, CEADES, AECID and the Bolivian National Chagas Program.

Originally piloted in three of Bolivia’s most affected regions, Cochabamba, Tarija and Chuquisaca, a specific strategy was implemented in seven centers to begin with. The four focus areas were: providing care, training health personnel, performing research and engaging with the community.

Due to the success of the pilot program, the operation was scaled up and extended to a further 52 centers.

The results of the Platform have been positive and have improved the care for CD at both national and international levels.

Detecting Chagas Disease

The existence of the Bolivian Chagas Platform centers has facilitated the screening of more patients, resulting in the detection of a greater number of CD cases. CD is often referred to as a “silent disease” as infected patients present either with no symptoms at all or with ambiguous symptoms resulting in misdiagnosis. If treatment is not given quickly, the damage becomes irreversible, and the patient cannot be cured. Therefore, timely detection of CD to ensure early treatment is crucial to save a person’s life. Furthermore, early detection of the CD helps in its control because transmission is prevented.

Increasing Research and Resources Available

ISGlobal reports that, at present, there are two drugs available for treating CD, nifurtimox and benznidazole. Research studies on this disease have been scarce due to limited resources and funding. As a result, the majority of people infected with CD do not have access to treatment.

The Bolivian Chagas Network reported that of the 57,871 people who tested positive for CD, 32.1% were able to be treated as a result of this platform. Furthermore, 67% of health care workers were given CD training, more resources were provided and detailed research was undertaken.

Whilst the two drugs used to treat CD are highly effective, they were developed over 50 years ago, therefore greater updated research is imperative.

Minimizing the Stigma and Promoting Awareness

Despite 10,000 people dying from Chagas Disease every year, it remains largely unheard of by the general public.

The UN has reported the negative consequences of the stigma associated with CD. Largely people view CD as confined to rural and poorer areas, but this is not the case. ISGlobal reported that in Spain, only an estimated 30% of people with CD are diagnosed and treated.

– Heidi Helen Horgan
Photo: Flickr