American trypanosomiasis, or Chagas disease, is a zoonotic disease and as such cannot be eradicated. It is estimated that over 150 species from 24 families of domestic and wild animals across vast regions of the Americas carry the parasite responsible for Chagas disease, Trypanosoma cruzi. This parasite is spread in the feces of triatomine bugs, which are also widely distributed, particularly in Latin America. Over 60 triatomine species have been found to be infected with T. cruzi.
According to recent data from the World Health Organisation, almost 10 million people are infected by T. cruzi, and considering the geographic distribution of the insect vectors, a further 20 million are considered at risk. Almost 30% of infected individuals develop heart problems and 10% develop digestive or neurological disorders that require treatment.
While control measures to eliminate domestic vectors and prevent infections due to the transfusion of infected blood products have been successful in several Latin American countries, large regions across the continent require new vector control tools and strategies, as the biological behaviour of the vectors and their interactions with their surroundings vary greatly from one area to the next.
Even though Chagas disease was discovered over 100 years ago (by the Brazilian doctor, Carlos Chagas) and important advances have been made in our understanding of the mechanisms involved in the development of the disease and the biology and transmission cycles of T. cruzi, fundamental questions remain to be addressed by researchers.
Currently available treatments for Chagas disease are not 100% effective, and we therefore need to find new anti-parasitic drugs that are more effective yet easy to administer. Information is also lacking on biomarkers that could help to predict who will develop the disease and when in order to guide the design of appropriate clinical monitoring programmes for infected individuals.
Furthermore, researchers have identified a wide variety of T. cruzi genotypes, associated with different transmission cycles and geographic regions, responsible for different manifestations of Chagas disease. There are still gaps in our knowledge, however, and further validation is needed in order to be able to offer more reliable diagnostic methods. There are also unanswered questions regarding other modes of disease transmission. Oral infection through the consumption of food contaminated with the parasite, for instance, is becoming increasingly common and requires further study.
Finally, researchers are increasingly turning their attention to a relatively new phenomenon: the migration of infected individuals to non-endemic areas. The increase in cases in new settings requires new clinical care protocols, improved control measures in blood banks, and appropriate monitoring of infected patients.
X Workshop on Chagas Disease
On March 6th 2014 the city of Barcelona is hosting the 10th edition of the Workshop on Chagas Disease.