The Treatment of Chagas Disease (South American Trypanosomiasis)

In every way, Chagas disease remains as a sad shadow that defines poverty, as it reflects the political and social difficulties of Latin America. Its control represents a moral and ethical imperative, since the disease means a great social debt that Latin American people have incurred and must pay (1).

Within a few years of his great discovery, Carlos Chagas clearly perceived the magnitude of the problem of the disease that bears his name. Contributing to his vision were the wide dispersion of infected vectors throughout Latin America, equally pervasive adverse socioeconomic conditions, and the severe morbidity and high mortality of the disease (2). Chagas was indeed prescient. At the end of the 20th century, South American trypanosomiasis had been detected in 18 Latin American countries, affecting between 12 and 14 million individuals from Mexico to Patagonia (3). The control of vector and transfusion transmission is adequate in many large regions and poor in others, while still others, such as the Amazon and Central American forests, are new potential areas for endemic disease. Currently, the main challenges of Chagas disease are to accomplish 3 tasks: 1) Consolidate and maintain control of endemic disease by implementing sustainable epidemiologic surveillance programs; 2) provide effective medical care and social attention to already infected individuals; and 3) do research to support these 2 priorities, for example, by looking for better surveillance tools, developing new antiparasite drugs, and instituting better management of heart disturbances and other disease manifestations (3-5).

South American trypanosomiasis is a typical wild zoonosis of American tropical and subtropical regions. It results from the natural circulation of the parasite Trypanosoma (Schizotrypanum) cruzi among small mammals (Edentata, Carnivora, Lagomorpha, Rodentia, Primatae, Marsupialia) and invertebrate vectors of the subfamily Triatominae (Hemiptera, Reduviidae). As humans moved into wild spaces and infected …