The Goal of the World Chagas Disease Day 2023 is to Integrate Primary Care-Level Universal Care and Surveillance

World Chagas Disease Day is celebrated on April 14; this year, the emphasis is on raising public knowledge of the condition, facilitating access to vital care, and instituting disease surveillance at the basic healthcare level. The parasite Trypanosoma cruzi, which causes Chagas disease and kills 12,000 people annually, is thought to infect 6-7 million individuals worldwide, according to the World Health Organization (WHO). This puts 75 million additional people at risk of infection. Annual incidence is between 30 and 40 000 cases, however in many nations, detection rates are poor (less than 10% and frequently less than 1%), and those who are ill frequently face considerable obstacles to a proper diagnosis and healthcare.

Chagas disease is frequently referred to as a “silent disease” since the majority of patients show no symptoms during either the acute or chronic phases of infection, up until a point at which the damage is too great to be repaired. It continues to be a problem for public health, particularly in a number of endemic regions of continental Latin America where the strain on health systems is great. When therapy is given promptly after infection, and the disease can be detected and monitored at the earliest level of medical care, the condition is curable.

In order to ensure efficient case detection, notification, and management, diagnostic and care services should be decentralized and integrated into mainstream national health systems.
Speaking ahead of World Chagas Day, Dr. Ibrahima Socé Fall, Director of the WHO’s Global NTD Programme, said, “Chagas disease continues to have a negative impact on the lives of far too many people, both in Latin America and around the world. In order to improve case detection and diagnosis and to make sure that more and more people can take use of the therapies available to combat this crippling disease, I join my colleagues on the ground in pushing for strengthened primary health care.

About Chagas disease

The protozoan parasite Trypanosoma cruzi is what causes Chagas disease, commonly referred to as American trypanosomiasis. The term “vectorial transmission” refers to the process by which these parasites are mostly spread by contact with the feces or urine of infected blood-sucking triatomine bugs. These insects frequently inhabit homes and peridomiciliary buildings like chicken coops, pens, and warehouses in both rural and suburban locations.
Typically, they remain hidden throughout the day and only come out to hunt at night to ingest human and animal blood. The triatomine bug is sometimes known as the “kissing bug” because it typically attacks exposed skin, such as the face. The bug subsequently urinates or defecates not far from the bite.

When a person unconsciously spreads the bug’s excrement or urine into a bite, other skin breaks, the eyes, or the mouth, parasites enter the body. Along with vectorial transmission, another possible method of transmission involves oral transfer through tainted food.

The illness plagued Latin American rural populations for generations. The importance of other transmission routes, like blood transfusion, congenital transmission, and even organ transplantation, has increased in light of the successes in controlling vectorial transmission as well as massive population shifts from rural to urban areas and eventually across continents.

There isn’t a vaccination available now to prevent Chagas disease. The most efficient methods of disease prevention in Latin America continue to include domiciliary vector management, transfusion and transplantation screening, and identifying infection in girls and women of reproductive age to prevent congenital transmission.

Progress despite difficulties

Despite difficult circumstances, significant advancements have been made in the fight against Chagas disease. Domiciliary vector transmission has been stopped as of today in numerous regions of Argentina, Bolivia, Brazil, Colombia, El Salvador, French Guiana, Guatemala, Guyana, Mexico, Peru, Chile, Costa Rica, Honduras, Nicaragua, Paraguay, and Uruguay.
The Chagas disease has been identified over the past few decades in numerous nations outside of Latin America, including the United States of America and Canada. A few African, Eastern Mediterranean, and Western Pacific nations as well as certain European nations have also reported cases.

Although there has been an increase in population travel, T. cruzi can spread everywhere, including through food, blood transfusions, organ transplants, and congenital transmission from mother to child. All of the nations of Latin America have instituted universal screening of blood donors and blood products, and this practice is spreading throughout the world to nations with Chagas disease cases. In order to completely remove the possibility of congenital Chagas disease, many nations are scaling up this intervention.

Benznidazole and nifurtimox, two drugs used to treat Chagas disease, are currently donated to WHO by Bayer AG and Insud Pharma Group, respectively, and are made largely free of charge to the national health services of countries requesting these medications. This represents a significant advancement in strengthening timely access to quality-assured medicines for all those in need and closing treatment gaps.
Of the 44 nations where Chagas disease cases have been found, six (Brazil, Chile, Ecuador, Mexico, Paraguay, and Uruguay) have already created rules for disclosing both acute and chronic cases as well as for carrying out epidemiological surveillance of disease transmission.

Improving epidemiological reporting systems in all 44 countries is a special focus for WHO and its partners. Disease reporting and monitoring are key components in the battle against Chagas disease.
Dr. Pedro Albajar Vias, who oversees WHO’s global Chagas disease program, said in a statement prior to World Chagas Disease Day 2023 that “the establishment of robust surveillance systems from the first level of care upwards is crucial to ending the prevalence of Chagas disease and ultimately to stopping disease transmission. “We need to see increases in the capacity and resources for the prevention of transmission, early diagnosis, control, and strengthened surveillance.

The dedication of WHO to eradicate Chagas

WHO is dedicated to collaborating with all afflicted nations to eradicate the illness. In order to increase public awareness of the condition, the 72nd World Health Assembly voted to create World Chagas condition Day, which would be observed on April 14. By 2030, Chagas disease should no longer be a concern for public health in a number of nations, according to the road map for neglected tropical diseases from 2021 to 2030.

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