14th April 2020 will mark the 1st World Chagas Disease Day commemoration. The disease is a neglected tropical disease which mostly affects people living in poverty. World Chagas Disease Day aims at raising visibility and public awareness about people with the disease and the resources needed for its prevention, control or elimination.

Understanding Chagas

Chagas disease, also known as American trypanosomiasis, is a tropical disease caused by a parasite Trypanosoma cruzi and transmitted to people by insect vectors found especially, in rural areas of Latin America. The disease is termed a “silent and silenced disease” not just due to its slow progression and frequently asymptomatic clinical course but also because of the fact that it mainly affects people living in poverty who have no access to healthcare or political voice.

What Causes Chagas Disease

Once the parasite is left behind by infected bugs, it enters the human body through the mouth, eyes, a cut or scratch. A person can also be infected with this disease by:

  • Being born to a woman who has the parasite,
  • Eating uncooked food that has been contaminated with faeces of the T, cruzi infected bug,
  • Getting an organ from a donor who is infected,
  • Getting blood from a person who is infected,
  • Spending time in a forest that contains wild animals that may have the parasite,
  • Working in a lab where there is accidental exposure to the parasite that causes Chagas disease.

Signs and Symptoms of Chagas Disease

Chagas disease can either be acute or chronic causing the following signs and symptoms.

Acute phase

This phase lasts for weeks or months and a person with the disease may not have any symptoms. However, in some cases, these symptoms may occur:

  • Fatigue
  • Fever
  • Body aches
  • Loss of appetite
  • Nausea, diarrhea or vomiting
  • Swelling of the eyelid
  • Rash

These symptoms usually go away on their own but they can also advance into the chronic phase.

Chronic phase

The signs and symptoms of this disease may start to occur even 10 to 20 years after the initial infection. They may include:

  • Irregular heartbeat
  • Sudden cardiac arrest
  • Problem swallowing as a result of an enlarged esophagus
  • Congestive heart failure
  • Pain in the abdomen or constipation due to an enlarged colon

Diagnosing Chagas Disease

Like many illnesses, a physical exam is conducted to help in the diagnosing Chagas disease after the patient has made the doctor aware of the symptoms they are experiencing. The doctor will also want to know if you are exposed to any factors that can put you at risk of getting infected with the disease. A blood test is then carried out to confirm the presence of the T. cruzi parasite or the antibodies produced to fight the parasite.

To find out if the disease is in the chronic phase and if it has caused any damage to the heart, additional tests may be carried out. These include:

  • Chest x-ray is done to check if the heart is enlarged.
  • Electrocardiogram is performed to record the heart’s electrical activity.
  • Echocardiogram uses sound waves to capture moving images of the heart, thereby making it possible for the doctor to see any changes in the heart or its function.
  • Upper endoscopy is performed using a thin flexible tube called an endoscope which is used to transmit images of the esophagus onto a screen.
  • Abdominal x-ray is a procedure that is done using radiation to capture images of the stomach and intestines.

Treating Chagas Disease

Chagas disease treatment is aimed at killing the T. cruzi parasite and managing the signs and symptoms caused by the disease. Antiparasitic treatment is used to kill the parasite while symptomatic treatment is done to manage the symptoms of the infection.

In the chronic phase, treatment is done to treat heart and digestive-related complications and in severe cases, surgery may be performed.

Can Chagas Disease be prevented?

Prevention of this disease is done by avoiding the risk factors that increase the chance of being infected. This can be made possible by:

  • Using insecticide to remove insects from where you live
  • Using insect repellent on exposed body parts
  • Avoiding sleeping in a mud or thatched house
  • Using insect-soaked netting over your bed.

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