Achievements and challenges in controlling Chagas disease

ABSTRACT

American trypanosomiasis or Chagas disease continues to endanger the lives of many million people in Latin America, and through travel and population migration there is a risk of congenital cases in nonendemic settings. Substantial improvements in the transmission of the disease have been achieved through vector control and blood-bank screening. However, vector-borne transmission remains the main mode of acquisition of infection in many settings coupled with congenital transmission and food-borne and accidental exposure through transplantation or laboratory exposure. The main sites of affection include the heart and gastrointestinal tract. Antiparasitic treatment of indeterminate forms is successful in many cases by delaying the risk of progression of cardiomyopathy, but treatment of chronic chagasic cardiomyopathy remains mainly supportive. The BENEFIT trial that will be completed by late 2011 or early 2012 will provide evidence for or against treating chronic symptomatic forms. Control or eliminating Chagas disease transmission coupled with decreasing the associated burden of disease in Latin America will promote better health and social and economic development among the most impoverished populations in the region.