Esta guía está enfocada en emitir recomendaciones para el diagnóstico y el tratamiento de la enfermedad de Chagas, como infección por Trypanosoma cruzi, agente protozoario de una parasitosis sistémica. Metodología: La presente guía de práctica clínica fue confeccionada siguiendo los método...s de elaboración de guías de la OMS (5). De forma general, se conformó un grupo desarrollador multidisciplinario compuesto por expertos temáticos, epidemiólogos, metodólogos y usuarios. Dado que no se identificaron guías susceptibles de ser adaptadas, la guía se desarrolló de novo.
Updated guideline, June 2019
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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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La transmisión de T. cruzi de un donante con la enfermedad de Chagas a un receptor de trasplante es poco frecuente y es resultado de la aplicación de un tratamiento quirúrgido. En este documento se proponen diez pautas para manejar y prevenir la transmisión de la enfermedad de Chagas por traspla...nte de órganos.
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Según las estimaciones, en las Américas hay entre 6 y 8 millones de personas con infección por T. cruzi, con aproximadamente 30 000 casos nuevos por año por transmisión vectorial, y 8000 casos nuevos anuales por transmisión congénita. Es decir, cerca de 65 millones de personas viven en la Reg...ión con el riesgo de contraer la infección. Además, durante cualquiera de las fases de esta parasitosis, las personas con la infección pueden sufrir algún grado de inmunosupresión, bien sea por una infección, una neoplasia o por un tratamiento farmacológico. En este decálogo se exponen los conceptos más importantes para tener en cuenta frente a la coexistencia de inmunosupresión y la infección por el T. cruzi.
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La enfermedad de Chagas es el resultado de la infección por elTrypanosoma cruzi. En Colombia, zona endémica para la enfermedad, existe al menos un millón de personas infectadas y tres millones en riesgo. Por lo anterior, el Ministerio de la Protección Social avaló la creación de una Guía de a...tención de la enfermedad de Chagas para el país.
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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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Según el INS (3) la enfermedad de Chagas continúa siendo un problema de salud pública en Colombia y es uno de los países de América Latina que más capta pacientes en fase aguda al año, sin embargo, la tasa de letalidad acumulada a periodo epidemiológico -PE- diez de 2018, es la más baja de ...los últimos siete años.
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Durante muchos años, la enfermedad de Chagas ha sido una entidad olvidada en nuestro medio, pese a que Colombia posee las condiciones apropiadas para que esta infección se desarrolle y se perpetúe en el tiempo.
Esto se refleja en el poco conocimiento de la enfermedad y en la existencia de muchos... individuos que sufren una pérdida significativa de su calidad y esperanza de vida, así como en costos importantes para el sistema de salud.
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La Tripanosomiasis Americana o Enfermedad de Chagas es una antropozoonosis,
es decir una enfermedad que afecta tanto al hombre como a numerosos animales
mamíferos y que es producida por un protozoario flagelado de la sangre y de los
tejidos el Trypanosoma cruzi.
The annual celebration of International Chagas Day on the 14th of April highlights the impact of this disease on the global health scenario.
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.
The Information, education and communication (IEC) activities, with the development of contextualized activities for various actors and scenarios about preventative measures and surveillance tools, are essential to increase awareness, reduce biomedical and psychosocial barriers to accessing diagnosi...s and care; keep the maximum number of actors involved; and reach the affected population, including family, friends and society in general.
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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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Chagas disease is a tropical parasitic infection transmitted by crawling, blood-sucking insects (kissing bugs). You may have flu-like symptoms or none at all. But the disease can lead to life-threatening complications. With prompt treatment, most people with Chagas disease, also known as American tr...ypanosomiasis, recover fully.
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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
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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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Chagas disease is caused by Trypanosoma cruzi, a protozoal organism primarily transmitted by triatomine insect vectors, also known as “kissing bugs.” It is a zoonotic disease originally described by Brazilian physician Dr. Carlos Chagas in 1909 and is widespread in Latin America. Although triato...mines and T. cruzi have long been endemic to the southern United States, awareness and identification of infected vectors and animals have recently increased throughout the United States. Canine Chagas disease can be acute or chronic and is predominantly characterized by inflammation and fibrosis of the heart, resulting in arrhythmias, myocardial dysfunction, heart failure, and sudden death, although many infected dogs are asymptomatic.
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Epidemiology
Chagas disease (American trypanosomiasis) is caused by the protozoan parasite Trypanosoma cruzi, and transmitted to humans by infected triatomine bugs, and less commonly by transfusion, organ transplant, from mother to infant, and in rare instances, by ingestion of contaminated food or... drink.1-4 The hematophagous triatomine vectors defecate during or immediately after feeding on a person. The parasite is present in large numbers in the feces of infected bugs, and enters the human body through the bite wound, or through the intact conjunctiva or other mucous membrane.
Vector-borne transmission occurs only in the Americas, where an estimated 8 to 10 million people have Chagas disease.5 Historically, transmission occurred largely in rural areas in Latin America, where houses built of mud brick are vulnerable to colonization by the triatomine vectors.4 In such areas, Chagas disease usually is acquired in childhood. In the last several decades, successful vector control programs have substantially decreased transmission rates in much of Latin America, and large-scale migration has brought infected individuals to cities both within and outside of Latin America.
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Chagas disease (CD) is endemic in the Americas, being present in 21 countries, where it affects about 6 million
people.(1) With such relevant numbers of people affected and disability adjusted life years lost, CD is a poverty-related
and poverty-promoting disease.
Although data describe a relevan...t ongoing public health problem for the American continent, significant results
in the interruption of transmission has been achieved by coordinated multi-country programs. In particular, the
Southern Cone Initiative (SCI), officially formalised in November 1991 by the Ministers of Health of Argentina, Brazil, Bolivia, Chile, Paraguay and Uruguay, has shown how a well-designed control program can significantly reduce
CD transmission.(2) Before this initiative, in these countries, there were 11 million infected persons and 50 million at
risk, 62% of the infected individuals of the whole continent.
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DOI: 10.5772/intechopen.102891Little progress has been made since the 1960s and 19. 70s to widen the therapeutic arsenal against Trypanosoma cruzi, the causative pathogen of Chagas disease, which remains a frustrating and perplexing infectious disease. This chapter focuses on the strategic and opera...tional challenges in the clinical drug development of a novel antitrypanosomal agent for Chagas disease. The various elements that contribute to a robust assessment of treatment effect including dose selection, choice of patient population, trial methodology, endpoint measures, and regulatory perspectives are discussed. The learnings herein should serve as resource to help researchers and other stakeholders optimize their clinical development plans and speed delivery of new medicines to patients with Chagas disease.
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