CHAGAS DISEASE | Symptoms, Diagnosis & Treatment

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Today is World Chagas Disease Day. It is organized by the World Health Organization (WHO), for the very first time the global community is celebrating World Chagas Disease Day. The proposal to designate 14 April as World Chagas Disease Day was initiated by the International Federation of Association of People Affected by Chagas Disease. The purpose is to globally raise the visibility and public awareness of the disease and to implement the strategies to prevent, control, eliminate, or eradicate the disease. World Health Assembly (WHOs decision-making body) endorsed the proposal on 24 May 2019 supported by several universities, research centers, national or international nongovernmental health platforms, foundations, and organizations.

The theme for Chagas disease Day is

Let’s make Chagas Disease visible now

Chagas disease is a major public health challenge. A silent and silenced disease for decades because of disease slow progression and it affect to poor people who has no access to health care and has no political voice. It was on this date (14 April) back in 1909 the very first patient a Brazilian girl is diagnosed with Chagas disease by Dr. Carlos Ribeiro Justiniano Chagas.

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Raising awareness  regarding this neglected tropical disease (NTD) which often diagnose in its later stage helps in improving the early detection and treatment of disease and also helps in controlling the spread of disease at an earlier stage.

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OVERVIEW

Chagas Diseases is also called American trypanosomiasis. It is an infectious disease caused by the parasite Trypanosoma cruzi which is found in the feces of Triatominae bugs. It is a potentially life-threatening illness that is transmitted through the faces or urine of a Triatomine bug. This bug is mainly found in Latin America. It is a forgotten disease that largely affects the rural and poor population. Millions of children and adults suffering worldwide from this disease and in the majority of cases they die.  6-7 million people worldwide are affected by Chagas disease.  10,000 people die each year and 75 million people are at risk of infection. During the past decades, the Chagas disease has been detected in most parts of America, Canada, and in many European and some western pacific countries.

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Chagas Disease Caused By

  • Chagas disease is caused by the parasite Trypanosoma cruzi which is transmitted through the insect known as Triatomine bug. These bugs live in the mud, thatch, or adobe huts in Mexico, South America, and Central America. They hide in the cervices of walls or roofs during the daytime and they come out at night often feeding on the sleeping humans.
  • Bugs defecate after feeding over humans and leave behind the parasite Trypanosoma cruzi over the skin of people. These parasites can enter the body by scratch or cut, through eyes or mouth, or through the wound of a bug bite, once the parasite enters the human body they multiply and spread.
  • Eating raw or undercooked food contaminated with feces of Trypanosoma cruzi
  • Getting a blood transfusion or organ transplant from an infected person
  • The child born to women infected with Trypanosoma cruzi
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These are some major causes of this disease so take care of yourself, eat well-cooked food. Before a blood transplant or any other organ check it at least once. Most important make a checkup of the woman’s child that was infected by the disease. By following these hacks you can be more secure.

Chagas Disease Symptoms

The symptoms of the disease appear after a Triatominae bite. Chagas disease has an acute and chronic phase. If left untreated infection remains lifelong. Symptoms may range from mild to severe. Most of the people experienced the symptoms in chronic or later stages.

Acute Phase

The acute phase of disease starts immediately after infection and may last up to a few weeks or months.  Symptoms of the acute phase if left untreated can sometimes lead to the chronic phase. Symptoms of the acute phase are mild often non-existent and unspecific. Acute symptoms are typical as follows

  • A skin lesion at the site of infection or swelling at the site of the bite
  • Purplish swelling of an eyelid
  •  Fever
  • Malaise
  • Rash
  • Nausea, diarrhea, or vomiting
  • Abdominal or chest pain
  • Difficulty in breathing
  • loss of appetite
  • headache
  • generalized lymphadenopathy  or swollen glands
  • enlargement of spleen and liver (hepatosplenomegaly)
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Chronic Symptoms

Following an acute phase, most infected persons entered through a prolonged asymptomatic phase of the disease called the chronic phase .mostly people remain in this phase and are unaware and asymptomatic for the rest of their lives. However, 20 to 30 % of patients suffering from Chagas disease developed 10 -20 years later severe and sometimes life-threatening medical problems over the course of their lives. The symptoms or complications of Chagas disease are as follows

  • Irregular heartbeat  or Arrhythmias
  •  An enlarged heart that can’t pump blood well or Chronic cardiomyopathies
  • Difficulty in swallowing due to enlarged esophagus
  • Abdominal pain or constipation due  to enlarged and dilated colon

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Chagas Disease Diagnosis

Your clinician will conduct a physical exam asking about your symptoms and factors that can put you at risk of Chagas disease. The diagnosis of the disease is made on the basis of the following tests

Blood Test

Chagas disease can be diagnosed by blood test

Either trypanosoma cruzi can be seen the blood smear in active phase

Or presence of  parasite specific antibodies in chronic phase

  • When the diagnosis of the disease is confirmed doctor may carry a series of tests to confirm other problems; these tests are as follows.
  • ECG
  • Echocardiogram
  • Chest X-ray
  • CT scan
  • Upper  endoscopy
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Chagas Disease Treatment

The mainstay of treatment of Chagas disease is as follows:

  • To kill the parasite by medications and managing the sign and symptoms of the disease.
  • Treatment of problems caused by chronic infection of the heart and digestive tract if present.

Medications

To kill the parasite two drugs (benznidazole and nifurtimox) are effective in curing the disease if given at an earlier stage of infection. The prognosis of the disease is good by these two medications if given soon after infection or at the onset of acute-phase including congenital infection. The efficacy of both drugs diminishes, however, the longer the person has been infected and the adverse reactions are more frequent at an older age.

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Prevention

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There is no vaccine for Chagas disease till now. As we all know that “prevention is better than cure” so by adopting certain measures we can prevent this deadly disease.

  • First, we need to improve housing in the areas affecting by Chagas disease. We can improve housing by plastering walls, replacing thatched roofs, fill the cracked roofs, and repeatedly insecticide spraying to houses that can result in a significant decrease of the bugs and help in reducing the spread of Chagas disease.
  • Personal preventive measures such as bed nets.
  • Blood and organ donors must be screen in affected countries including the U.S. to donors in order to prevent the disease from being spread through infected blood transfusions or organ transplantation.
  • Screening of women of childbearing age to prevent congenital disease
  • Good hygiene
  • Food safety  and hygiene needed  in food preparation, storage, and consumption
  • Vector control.

COVID-19 and Chagas Disease

If you suspect infection with COVID-19 and are undergoing treatment for Chagas disease, inform your health care professional to ensure you receive the best possible care. Source: World Health Organisation (WHO)

Disclaimer

This article is written for general public health and awareness only. If you are suffering from any health problem, contact to your local health care provider.  All copy rights are reserved. Any comments or queries are welcomed at info@livefitpk.com.

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