Review

Authors: Natasha S Hochberg, Susan P Montgomery

Chagas disease, which is caused by infection with the parasite , is a leading neglected tropical disease in the United States. An estimated 240 000 to 350 000 persons in the United States are infected, primarily immigrants from Mexico, Central America, and South America, where the disease is endemic. The parasite is transmitted by the triatomine bug but can also be passed through blood transfusion, via organ transplant, or congenitally. Approximately 30% of infected persons later develop cardiac and/or gastrointestinal complications. Health care providers should consider screening at-risk patients with serologic testing. Early diagnosis and treatment with benznidazole or nifurtimox can help prevent complications.

Topics: Humans; United States; Chagas Disease; Trypanosoma cruzi; Nifurtimox; Emigrants and Immigrants; Organ Transplantation

PubMed: 36780647
DOI: 10.7326/AITC202302210

Review

Authors: Maria Carmo Pereira Nunes, Wistremundo Dones, Carlos A Morillo...

Chagas disease, caused by the parasite Trypanosoma cruzi, is a serious health problem in Latin America and is an emerging disease in non-endemic countries. In recent decades, the epidemiological profile of the disease has changed due to new patterns of immigration and successful control in its transmission, leading to the urbanization and globalization of the disease. Dilated cardiomyopathy is the most important and severe manifestation of human chronic Chagas disease and is characterized by heart failure, ventricular arrhythmias, heart blocks, thromboembolic phenomena, and sudden death. This article will present an overview of the clinical and epidemiological aspects of Chagas disease. It will focus on several clinical aspects of the disease, such as chronic Chagas disease without detectable cardiac pathology, as well as dysautonomia, some specific features, and the principles of treatment of chronic cardiomyopathy.

Topics: Chagas Disease; Death, Sudden, Cardiac; Humans; Prognosis

PubMed: 23770163
DOI: 10.1016/j.jacc.2013.05.046

Review

Authors: Eva H Clark, Louisa A Messenger, Jeffrey D Whitman...

SUMMARYAs Chagas disease remains prevalent in the Americas, it is important that healthcare professionals and researchers are aware of the screening, diagnosis, monitoring, and treatment recommendations for the populations of patients they care for and study. Management of infection in immunocompromised hosts is challenging, particularly because, regardless of antitrypanosomal treatment status, immunocompromised patients with Chagas disease are at risk for reactivation, which can be lethal. Evidence-based practices to prevent and manage reactivation vary depending on the type of immunocompromise. Here, we review available data describing Chagas disease epidemiology, testing, and management practices for various populations of immunocompromised individuals, including people with HIV and patients undergoing solid organ and hematopoietic stem cell transplantation.

Topics: Humans; Immunocompromised Host; Chagas Disease; Trypanosoma cruzi

PubMed: 38546225
DOI: 10.1128/cmr.00099-23

Review

Authors: Caryn Bern, Louisa A Messenger, Jeffrey D Whitman...

is the etiological agent of Chagas disease, usually transmitted by triatomine vectors. An estimated 20 to 30% of infected individuals develop potentially lethal cardiac or gastrointestinal disease. Sylvatic transmission cycles exist in the southern United States, involving 11 triatomine vector species and infected mammals such as rodents, opossums, and dogs. Nevertheless, imported chronic infections in migrants from Latin America vastly outnumber locally acquired human cases. Benznidazole is now FDA approved, and clinical and public health efforts are under way by researchers and health departments in a number of states. Making progress will require efforts to improve awareness among providers and patients, data on diagnostic test performance and expanded availability of confirmatory testing, and evidence-based strategies to improve access to appropriate management of Chagas disease in the United States.

Topics: Chagas Disease; Disease Management; Disease Susceptibility; Humans; Molecular Diagnostic Techniques; Molecular Epidemiology; Phenotype; Public Health Surveillance; Trypanosoma cruzi; United States

PubMed: 31776135
DOI: 10.1128/CMR.00023-19

Authors: Claudio Leinig Pereira da Cunha

Topics: Chagas Cardiomyopathy; Chagas Disease; Heart; Heart Diseases; Humans

PubMed: 35830097
DOI: 10.36660/abc.20220418

Authors: Rebecca J Chancey, Morven S Edwards, Susan P Montgomery...

Topics: Humans; Chagas Disease; Infectious Disease Transmission, Vertical

PubMed: 37002357
DOI: 10.1542/pir.2022-005857

Review

Authors: Clever Gomes, Adriana B Almeida, Ana C Rosa...

OBJECTIVE

To contribute to the discussion on the research findings indicating the sexual transmission of American trypanosomiasis and Chagas disease in humans.

METHODS

A review of the literature was performed to investigate the routes of transmission of Trypanosoma cruzi parasites and to evaluate the distribution of Chagas disease, which is now found across five continents.

RESULTS

The epidemiological profile of American trypanosomiasis, which is still considered a neglected disease of the poor people of Latin America, has changed over time. A family-based study demonstrated that the blood protozoan T. cruzi can be transmitted sexually from infected males and females to naïve mates.

CONCLUSIONS

Evidence that Chagas disease can be transmitted sexually, coupled with the migration of individuals with Chagas disease to previously non-endemic countries and increased travel to endemic countries, has implications for public health. Improved screening of blood supplies and prenatal care are required to prevent congenital spread.

Topics: Chagas Disease; Female; Humans; Latin America; Male; Neglected Diseases; Prenatal Care; Research; Sexually Transmitted Diseases; Travel

PubMed: 30664986
DOI: 10.1016/j.ijid.2019.01.021

Authors: Aaron W Tustin, Natalie M Bowman

Topics: Chagas Disease; Humans; Infant, Newborn; Infectious Disease Transmission, Vertical

PubMed: 27037106
DOI: 10.1542/pir.2015-0116

Review

Authors: Ana María Cevallos, Roberto Hernández

Chagas disease is a chronic infection that kills approximately 12,000 people a year. Mass migration of chronically infected and asymptomatic persons has caused globalization of Chagas disease and has made nonvectorial infection, including vertical and blood-borne transmission, more of a threat to human communities than vectorial infection. To control transmission, it is essential to test all pregnant women living in endemic countries and all pregnant women having migrated from, or having lived in, endemic countries. All children born to seropositive mothers should be tested not only within the first month of life but also at ~6 months and ~12 months of age. The diagnosis is made by identification of the parasite in blood before the age of 6 months and by identification of the parasite in blood and/or positive serology after 10 months of age. Follow up for a year is essential as a significant proportion of cases are initially negative and are only detected at a later stage. If the condition is diagnosed and treated early, the clinical response is excellent and the majority of cases are cured.

Topics: Chagas Disease; Emigration and Immigration; Endemic Diseases; Female; Humans; Pregnancy; Trypanosoma cruzi

PubMed: 24949443
DOI: 10.1155/2014/401864

Review

Authors: V Balouz, F Agüero, C A Buscaglia...

Chagas disease, caused by the protozoan Trypanosoma cruzi, is a lifelong and debilitating illness of major significance throughout Latin America and an emergent threat to global public health. Being a neglected disease, the vast majority of Chagasic patients have limited access to proper diagnosis and treatment, and there is only a marginal investment into R&D for drug and vaccine development. In this context, identification of novel biomarkers able to transcend the current limits of diagnostic methods surfaces as a main priority in Chagas disease applied research. The expectation is that these novel biomarkers will provide reliable, reproducible and accurate results irrespective of the genetic background, infecting parasite strain, stage of disease, and clinical-associated features of Chagasic populations. In addition, they should be able to address other still unmet diagnostic needs, including early detection of congenital T. cruzi transmission, rapid assessment of treatment efficiency or failure, indication/prediction of disease progression and direct parasite typification in clinical samples. The lack of access of poor and neglected populations to essential diagnostics also stresses the necessity of developing new methods operational in point-of-care settings. In summary, emergent diagnostic tests integrating these novel and tailored tools should provide a significant impact on the effectiveness of current intervention schemes and on the clinical management of Chagasic patients. In this chapter, we discuss the present knowledge and possible future steps in Chagas disease diagnostic applications, as well as the opportunity provided by recent advances in high-throughput methods for biomarker discovery.

Topics: Biomarkers; Chagas Disease; Humans; Latin America; Neglected Diseases; Public Health; Trypanosoma cruzi

PubMed: 28325368
DOI: 10.1016/bs.apar.2016.10.001