Back داء شاغاس Arabic داء شاجاس ARZ Хвароба Шагаса Byelorussian Болест на Шагас Bulgarian চাগাস রোগ Bengali/Bangla Chagasova bolest BS Malaltia de Chagas Catalan Chagasova choroba Czech Chagas sygdom Danish Chagas-Krankheit German

Chagas disease

Chagas disease
Other namesAmerican trypanosomiasis
Crescent-shaped Trypanosoma cruzi parasites surrounded by red blood cells
Photomicrograph of Giemsa-stained Trypanosoma cruzi trypomastigotes in human blood
Pronunciation
  • /ˈtʃɑːɡəs/, Portuguese pronunciation: [ˈʃaɡɐs]
SpecialtyInfectious disease
SymptomsFever, large lymph nodes, headache[1]
ComplicationsHeart failure, enlarged esophagus, enlarged colon[1]
CausesTrypanosoma cruzi spread by kissing bugs[1]
Diagnostic methodFinding the parasite, its DNA, or antibodies in the blood[2]
PreventionEliminating kissing bugs and avoiding their bites[1]
MedicationBenznidazole, nifurtimox[1]
Frequency6.5 million (2019)[3]
Deaths9,490 (2019)[3]

Chagas disease, also known as American trypanosomiasis, is a tropical parasitic disease caused by Trypanosoma cruzi. It is spread mostly by insects in the subfamily Triatominae, known as "kissing bugs". The symptoms change over the course of the infection. In the early stage, symptoms are typically either not present or mild, and may include fever, swollen lymph nodes, headaches, or swelling at the site of the bite.[1] After four to eight weeks, untreated individuals enter the chronic phase of disease, which in most cases does not result in further symptoms.[2][4] Up to 45% of people with chronic infections develop heart disease 10–30 years after the initial illness, which can lead to heart failure. Digestive complications, including an enlarged esophagus or an enlarged colon, may also occur in up to 21% of people, and up to 10% of people may experience nerve damage.[2]

T. cruzi is commonly spread to humans and other mammals by the kissing bug's bite wound and the bug's infected feces.[5] The disease may also be spread through blood transfusion, organ transplantation, consuming food or drink contaminated with the parasites, and vertical transmission (from a mother to her baby).[1] Diagnosis of early disease is by finding the parasite in the blood using a microscope or detecting its DNA by polymerase chain reaction.[4] Chronic disease is diagnosed by finding antibodies for T. cruzi in the blood.[6]

Prevention focuses on eliminating kissing bugs and avoiding their bites.[1] This may involve the use of insecticides or bed-nets.[7] Other preventive efforts include screening blood used for transfusions. Early infections are treatable with the medications benznidazole or nifurtimox, which usually cure the disease if given shortly after the person is infected, but become less effective the longer a person has had Chagas disease. When used in chronic disease, medication may delay or prevent the development of end-stage symptoms. Benznidazole and nifurtimox often cause side effects, including skin disorders, digestive system irritation, and neurological symptoms, which can result in treatment being discontinued.[2][8] New drugs for Chagas disease are under development,[9] and while experimental vaccines have been studied in animal models,[10][11] a human vaccine has not been developed.

It is estimated that 6.5 million people, mostly in Mexico, Central America and South America, have Chagas disease as of 2019,[1][3] resulting in approximately 9,490 annual deaths.[3] Most people with the disease are poor,[12] and most do not realize they are infected.[13] Large-scale population migrations have carried Chagas disease to new regions, which include the United States and many European countries.[1] The disease affects more than 150 types of animals.[14]

The disease was first described in 1909 by Brazilian physician Carlos Chagas, after whom it is named.[1] Chagas disease is classified as a neglected tropical disease.[15]

  1. ^ a b c d e f g h i j k "Chagas disease (American trypanosomiasis)". World Health Organization. 17 April 2019. Archived from the original on 20 January 2020. Retrieved 9 March 2020.
  2. ^ a b c d Cite error: The named reference Molina2018 was invoked but never defined (see the help page).
  3. ^ a b c d Cite error: The named reference GBD2019 was invoked but never defined (see the help page).
  4. ^ a b Cite error: The named reference Bern2015 was invoked but never defined (see the help page).
  5. ^ "DPDx – Trypanosomiasis, American. Fact Sheet". Centers for Disease Control (CDC). 30 April 2019. Archived from the original on 5 September 2019. Retrieved 10 March 2020.
  6. ^ Guarner J (May 2019). "Chagas disease as example of a reemerging parasite". Seminars in Diagnostic Pathology. 36 (3): 164–9. doi:10.1053/j.semdp.2019.04.008. PMID 31006555.
  7. ^ "Prevention of Chagas disease". World Health Organization. Archived from the original on 11 February 2018. Retrieved 24 February 2018.
  8. ^ Santi AM, Murta SM (2022). "Antioxidant defence system as a rational target for Chagas disease and Leishmaniasis chemotherapy". Memórias do Instituto Oswaldo Cruz. 117: e210401. doi:10.1590/0074-02760210401. PMC 8896756. PMID 35239945.
  9. ^ Porta EO, Kalesh K, Steel PG (2023). "Navigating drug repurposing for Chagas disease: advances, challenges, and opportunities". Front Pharmacol. 14: 1233253. doi:10.3389/fphar.2023.1233253. PMC 10416112. PMID 37576826.
  10. ^ Cite error: The named reference Rios2019 was invoked but never defined (see the help page).
  11. ^ Cite error: The named reference Vermelho2019 was invoked but never defined (see the help page).
  12. ^ Rassi Jr A, Rassi A, Marcondes de Rezende J (June 2012). "American trypanosomiasis (Chagas disease)". Infectious Disease Clinics of North America. 26 (2): 275–91. doi:10.1016/j.idc.2012.03.002. PMID 22632639. S2CID 34941921.
  13. ^ Capinera JL, ed. (2008). Encyclopedia of entomology (2nd ed.). Dordrecht: Springer. p. 824. ISBN 9781402062421.
  14. ^ Rassi A, Rassi A, Marin-Neto JA (April 2010). "Chagas disease". Lancet. 375 (9723): 1388–402. doi:10.1016/S0140-6736(10)60061-X. PMID 20399979. S2CID 5068417.
  15. ^ "Neglected Tropical Diseases". cdc.gov. 6 June 2011. Archived from the original on 4 December 2014. Retrieved 28 November 2014.

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