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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
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Latin America where poverty is widespread). Chagas disease (T. cruzi infection) is also referred to as American trypanosomiasis
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The protozoan parasite Trypanosoma cruzi causes Chagas disease, an important public health problem throughout Latin America. Current therapeutic options are characterised by limited efficacy, long t
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reatment regimens and frequent toxic side-effects. Advances in this area have been compromised by gaps in our knowledge of disease pathogenesis, parasite biology and drug activity. Nevertheless, several factors have come together to create a more optimistic scenario. Drug-based research has become more systematic, with increased collaborations between the academic and commercial sectors, often within the framework of not-for-profit consortia. High-throughput screening of compound libraries is being widely applied, and new technical advances are helping to streamline the drug development pipeline. In addition, drug repurposing and optimisation of current treatment regimens, informed by laboratory research, are providing a basis for new clinical trials. Here, we will provide an overview of the current status of Chagas disease drug development, highlight those areas where progress can be expected, and describe how fundamental research is helping to underpin the process.
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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, incr
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easingly, 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 disea
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se 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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Taeniasis and cysticercosis caused by the parasite T. solium affect vulnerable populations,
mainly in Latin America, sub-Saharan Africa and Asia, where pigs (the intermediate host) roam
free and p
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oor sanitation allows pigs access to human faeces.
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Over the past decade, the reduction of maternal mortality in Latin America and the Caribbean has shown signs of a marked slowdown and in some cases a reversal, jeopardizing commitments made at the g
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lobal and regional levels and by the Member States themselves, including those established in the Sustainable Development Goals.
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A century after its discovery, Chagas' disease still represents a major public health challenge in Latin America. Moreover, because of growing population movements, an increasing number of cases of
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imported Chagas' disease have now been detected in non-endemic areas, such as North America and some European countries. This parasitic zoonosis, caused by Trypanosoma cruzi, is transmitted to humans by infected Triatominae insects, or occasionally by non-vectorial mechanisms, such as blood transfusion, mother to fetus, or oral ingestion of materials contaminated with parasites. Following the acute phase of the infection, untreated individuals enter a chronic phase that is initially asymptomatic or clinically unapparent. Usually, a few decades later, 40-50% of patients develop progressive cardiomyopathy and/or motility disturbances of the oesophagus and colon. In the last decades several interventions targeting primary, secondary and tertiary prevention of Chagas' disease have been attempted. While control of both vectorial and blood transfusion transmission of T cruzi (primary prevention) has been successful in many regions of Latin America, early detection and aetiological treatment of asymptomatic subjects with Chagas' disease (secondary prevention) have been largely underutilised. At the same time, in patients with established chronic disease, several pharmacological and non-pharmacological interventions are currently available and have been increasingly used with the intention of preventing or delaying complications of the disease (tertiary prevention). In this review we discuss in detail each of these issues.
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This report includes analysis from informal regional consultations in the African Region, the Caribbean and North America, Latin America, South-Eas
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t Asia Region, European Region, Eastern Mediterranean Region, alongside three forums in the Western Pacific Region. It analyses the overarching similarities, regional nuances and priorities raised across the six WHO regions for the meaningful engagement of individuals with lived experience.
It is the second publication in the WHO Intention to action series, which aims to enhance the limited evidence base on the impact of meaningful engagement and address the lack of standardized approaches on how to operationalise meaningful engagement. The Intention to action series aims to do this by providing a platform from which individuals with lived experience, and organizational and institutional champions, can share solutions, challenges and promising practices related to this cross-cutting agenda. The Intention to action series also aims to provide powerful narratives, inspiration and evidence towards the Fourth United Nations High Level Meeting on NCDs in 2025 and achieving the 2030 United Nations Sustainable Development Goals (SDGs).
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This report includes analysis from informal regional consultations in the African Region, the Caribbean and North America, Latin America, South-Eas
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t Asia Region, European Region, Eastern Mediterranean Region, alongside three forums in the Western Pacific Region. It analyses the overarching similarities, regional nuances and priorities raised across the six WHO regions for the meaningful engagement of individuals with lived experience.
It is the second publication in the WHO Intention to action series, which aims to enhance the limited evidence base on the impact of meaningful engagement and address the lack of standardized approaches on how to operationalise meaningful engagement. The Intention to action series aims to do this by providing a platform from which individuals with lived experience, and organizational and institutional champions, can share solutions, challenges and promising practices related to this cross-cutting agenda. The Intention to action series also aims to provide powerful narratives, inspiration and evidence towards the Fourth United Nations High Level Meeting on NCDs in 2025 and achieving the 2030 United Nations Sustainable Development Goals (SDGs).
more
This report includes analysis from informal regional consultations in the African Region, the Caribbean and North America, Latin America, South-Eas
...
t Asia Region, European Region, Eastern Mediterranean Region, alongside three forums in the Western Pacific Region. It analyses the overarching similarities, regional nuances and priorities raised across the six WHO regions for the meaningful engagement of individuals with lived experience.
It is the second publication in the WHO Intention to action series, which aims to enhance the limited evidence base on the impact of meaningful engagement and address the lack of standardized approaches on how to operationalise meaningful engagement. The Intention to action series aims to do this by providing a platform from which individuals with lived experience, and organizational and institutional champions, can share solutions, challenges and promising practices related to this cross-cutting agenda. The Intention to action series also aims to provide powerful narratives, inspiration and evidence towards the Fourth United Nations High Level Meeting on NCDs in 2025 and achieving the 2030 United Nations Sustainable Development Goals (SDGs).
more
This report includes analysis from informal regional consultations in the African Region, the Caribbean and North America, Latin America, South-Eas
...
t Asia Region, European Region, Eastern Mediterranean Region, alongside three forums in the Western Pacific Region. It analyses the overarching similarities, regional nuances and priorities raised across the six WHO regions for the meaningful engagement of individuals with lived experience.
It is the second publication in the WHO Intention to action series, which aims to enhance the limited evidence base on the impact of meaningful engagement and address the lack of standardized approaches on how to operationalise meaningful engagement. The Intention to action series aims to do this by providing a platform from which individuals with lived experience, and organizational and institutional champions, can share solutions, challenges and promising practices related to this cross-cutting agenda. The Intention to action series also aims to provide powerful narratives, inspiration and evidence towards the Fourth United Nations High Level Meeting on NCDs in 2025 and achieving the 2030 United Nations Sustainable Development Goals (SDGs).
more
This report includes analysis from informal regional consultations in the African Region, the Caribbean and North America, Latin America, South-Eas
...
t Asia Region, European Region, Eastern Mediterranean Region, alongside three forums in the Western Pacific Region. It analyses the overarching similarities, regional nuances and priorities raised across the six WHO regions for the meaningful engagement of individuals with lived experience.
It is the second publication in the WHO Intention to action series, which aims to enhance the limited evidence base on the impact of meaningful engagement and address the lack of standardized approaches on how to operationalise meaningful engagement. The Intention to action series aims to do this by providing a platform from which individuals with lived experience, and organizational and institutional champions, can share solutions, challenges and promising practices related to this cross-cutting agenda. The Intention to action series also aims to provide powerful narratives, inspiration and evidence towards the Fourth United Nations High Level Meeting on NCDs in 2025 and achieving the 2030 United Nations Sustainable Development Goals (SDGs).
more
Disability, CBR & Inclusive Development, Vol.25 (2014) pp.72-81
This article highlights some lessons about the strategy of community-based inclusive education, drawn from different programmes in Latin
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America.
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The ongoing political, socio-economic and human rights events in Venezuela have led to the outflow of almost 4 million refugees and migrants, the biggest population movement in the history of Latin America
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and the Caribbean. The Gender-Based Violence (GBV) working group of the Regional Coordination Platform supports national stakeholders to prevent and respond to GBV using a multisectoral, survivor-centered approach based on international humanitarian principles. In line with the 2019 Regional Response Plan for Refugees and Migrants from Venezuela (RMRP), the GBV working group prioritizes prevention, mitigation and response to GBV, with special emphasis on addressing sexual violence and trafficking in persons for the purpose of sexual exploitation.
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WFP's Hunger Map depicts the prevalence of undernourishment in the population of each country in 2016-18. From Africa and Asia to Latin America and the Near East, there are 821 million people - more
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than 1 in 9 of the world population - who do not get enough to eat. Our downloadable Hunger Map provides invaluable info that helps school teachers and children to learn more about the biggest single risk to global health.
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Version dated April 1st, 2020.
The flow of migrants and refugees from Venezuela constitutes the largest mobilization of people in the history of Latin America. By March 2020, more than 4.9 million
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Venezuelans have left their country and from these, more than 4.1 million have been mobilized to countries in Latin America and the Caribbean. The motives for this mobilization are diverse, but those related to health care issues stand out, among which is the condition of living with HIV/AIDS. In the situation of demand for medical care that COVID-19 has generated, it is much more difficult to receive attention for people who are not included in the health systems of countries that are recipient due to the limitations that their migratory status may impose.
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A new reportshows that people in some 25 countries are set to face devasting levels of hunger in coming months due to the fallout from the COVID-19 pandemic. While the greatest concentration of need is in Africa, countries in Latin
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America and the Caribbean, and in the Middle East and Asia – including middle-income countries - are also being ravaged by crippling levels of food insecurity
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The Bolivarian Republic of Venezuela has been facing a sociopolitical and economic situation that has negatively impacted social and health indicators. There have been intensified population movements both within the country and to other countries, particularly to Argentina, Brazil, Chile, Colombia,
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Costa Rica, Curaçao, Dominican Republic, Ecuador, Guyana, Mexico, Panama, Paraguay, Peru, Trinidad and Tobago, and Uruguay. Since 2017, an estimated 5.2 million Venezuelans have migrated to other countries, including an estimated 4.3 million who have gone to countries in Latin America and the Caribbean.
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In Danger: UNAIDS Global AIDS Update 2022
recommended
Progress in prevention and treatment is faltering around the world, putting millions of people in grave danger. Eastern Europe and central Asia, Latin America, and the Middle East and North Africa h
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ave all seen increases in annual HIV infections over several years. In Asia and the Pacific, UNAIDS data now show new HIV infections are rising where they had been falling. Action to tackle the inequalities driving AIDS is urgently required to prevent millions of new HIV infections this decade and to end the AIDS pandemic
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J Clin Med . 2020 May 18;9(5):1517. doi: 10.3390/jcm9051517.
Chagas disease (CD) is a major burden in Latin America, expanding also to non-endemic countries. A gold standard to detect the CD causi
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ng pathogen Trypanosoma cruzi is currently not available. Existing real time polymerase chain reactions (RT-PCRs) lack sensitivity and/or specificity. We present a new, highly specific RT-PCR for the diagnosis and monitoring of CD.
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