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Chagas disease control-surveillance in the Americas: the multinational initiatives and the practical impossibility of interrupting vector-borne Trypanosoma cruzi transmission

Chagas disease (CD) still imposes a heavy burden on most Latin American countries. Vector-borne and mother-to-child transmission cause several thousand new infections per year, and at least 5 million people carry Trypanosoma cruzi. Access to diagnosis and medical care, however, is far from universal...

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Autores principales: de Arias, Antonieta Rojas, Monroy, Carlota, Guhl, Felipe, Sosa-Estani, Sergio, Santos, Walter Souza, Abad-Franch, Fernando
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Instituto Oswaldo Cruz, Ministério da Saúde 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9261920/
https://www.ncbi.nlm.nih.gov/pubmed/35830010
http://dx.doi.org/10.1590/0074-02760210130
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author de Arias, Antonieta Rojas
Monroy, Carlota
Guhl, Felipe
Sosa-Estani, Sergio
Santos, Walter Souza
Abad-Franch, Fernando
author_facet de Arias, Antonieta Rojas
Monroy, Carlota
Guhl, Felipe
Sosa-Estani, Sergio
Santos, Walter Souza
Abad-Franch, Fernando
author_sort de Arias, Antonieta Rojas
collection PubMed
description Chagas disease (CD) still imposes a heavy burden on most Latin American countries. Vector-borne and mother-to-child transmission cause several thousand new infections per year, and at least 5 million people carry Trypanosoma cruzi. Access to diagnosis and medical care, however, is far from universal. Starting in the 1990s, CD-endemic countries and the Pan American Health Organization-World Health Organization (PAHO-WHO) launched a series of multinational initiatives for CD control-surveillance. An overview of the initiatives’ aims, achievements, and challenges reveals some key common themes that we discuss here in the context of the WHO 2030 goals for CD. Transmission of T. cruzi via blood transfusion and organ transplantation is effectively under control. T. cruzi, however, is a zoonotic pathogen with 100+ vector species widely spread across the Americas; interrupting vector-borne transmission seems therefore unfeasible. Stronger surveillance systems are, and will continue to be, needed to monitor and control CD. Prevention of vertical transmission demands boosting current efforts to screen pregnant and childbearing-aged women. Finally, integral patient care is a critical unmet need in most countries. The decades-long experience of the initiatives, in sum, hints at the practical impossibility of interrupting vector-borne T. cruzi transmission in the Americas. The concept of disease control seems to provide a more realistic description of what can in effect be achieved by 2030.
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spelling pubmed-92619202022-07-13 Chagas disease control-surveillance in the Americas: the multinational initiatives and the practical impossibility of interrupting vector-borne Trypanosoma cruzi transmission de Arias, Antonieta Rojas Monroy, Carlota Guhl, Felipe Sosa-Estani, Sergio Santos, Walter Souza Abad-Franch, Fernando Mem Inst Oswaldo Cruz Review Chagas disease (CD) still imposes a heavy burden on most Latin American countries. Vector-borne and mother-to-child transmission cause several thousand new infections per year, and at least 5 million people carry Trypanosoma cruzi. Access to diagnosis and medical care, however, is far from universal. Starting in the 1990s, CD-endemic countries and the Pan American Health Organization-World Health Organization (PAHO-WHO) launched a series of multinational initiatives for CD control-surveillance. An overview of the initiatives’ aims, achievements, and challenges reveals some key common themes that we discuss here in the context of the WHO 2030 goals for CD. Transmission of T. cruzi via blood transfusion and organ transplantation is effectively under control. T. cruzi, however, is a zoonotic pathogen with 100+ vector species widely spread across the Americas; interrupting vector-borne transmission seems therefore unfeasible. Stronger surveillance systems are, and will continue to be, needed to monitor and control CD. Prevention of vertical transmission demands boosting current efforts to screen pregnant and childbearing-aged women. Finally, integral patient care is a critical unmet need in most countries. The decades-long experience of the initiatives, in sum, hints at the practical impossibility of interrupting vector-borne T. cruzi transmission in the Americas. The concept of disease control seems to provide a more realistic description of what can in effect be achieved by 2030. Instituto Oswaldo Cruz, Ministério da Saúde 2022-07-06 /pmc/articles/PMC9261920/ /pubmed/35830010 http://dx.doi.org/10.1590/0074-02760210130 Text en https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License
spellingShingle Review
de Arias, Antonieta Rojas
Monroy, Carlota
Guhl, Felipe
Sosa-Estani, Sergio
Santos, Walter Souza
Abad-Franch, Fernando
Chagas disease control-surveillance in the Americas: the multinational initiatives and the practical impossibility of interrupting vector-borne Trypanosoma cruzi transmission
title Chagas disease control-surveillance in the Americas: the multinational initiatives and the practical impossibility of interrupting vector-borne Trypanosoma cruzi transmission
title_full Chagas disease control-surveillance in the Americas: the multinational initiatives and the practical impossibility of interrupting vector-borne Trypanosoma cruzi transmission
title_fullStr Chagas disease control-surveillance in the Americas: the multinational initiatives and the practical impossibility of interrupting vector-borne Trypanosoma cruzi transmission
title_full_unstemmed Chagas disease control-surveillance in the Americas: the multinational initiatives and the practical impossibility of interrupting vector-borne Trypanosoma cruzi transmission
title_short Chagas disease control-surveillance in the Americas: the multinational initiatives and the practical impossibility of interrupting vector-borne Trypanosoma cruzi transmission
title_sort chagas disease control-surveillance in the americas: the multinational initiatives and the practical impossibility of interrupting vector-borne trypanosoma cruzi transmission
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9261920/
https://www.ncbi.nlm.nih.gov/pubmed/35830010
http://dx.doi.org/10.1590/0074-02760210130
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