2023-07-14 09:26:01
Seven million people suffer from Chagas disease in the world. In Spain, which is not an endemic area, a large percentage of people from Latin America are infected with the parasite and are not diagnosed. Experts recommend testing those from that area in order to treat them.
File photo of a specimen of the “beaked bug”, transmitter of Chagas disease. EFE/David de la Paz
makes it manifest a study carried out over 17 years (between 2002 and 2019) with 2,820 Latin American people, the majority of Bolivia, who attended the Hospital Clinic of Barcelonain Spain, and which reveals that 47% of them were infected with the Trypanosoma cruzi parasite, which causes Chagas disease, and 17% already had cardiac disorders.
The study, published in the revista PLOS Neglected Tropical Diseaseshas been led by the Barcelona Institute for Global Health (ISGlobal).
The majority of cases are women of working age, which reflects, according to the study, the migratory flows of recent years and allows screening and prevention programs to be directed.
According to the research, the electrocardiogram was sufficient to detect heart disease in most cases, but in 10% of them an echocardiogram was necessary.
The phases of a disease that can be fatal
Chagas disease has two phasesaccording to the World Health Organization (WHO).
The acute phase usually lasts two months after contracting the infection, but in most cases there are no symptoms or these are mild or not very specific. In fact, in less than half the cases, a characteristic initial sign may be a skin lesion or a bruised swelling of an eyelid.
It can also cause fever, headache, enlarged lymph nodes, paleness, muscle aches, shortness of breath, swelling, and abdominal or chest pain.
In the chronic phase, the parasites remain hidden mainly in the cardiac and digestive muscle. And between one and three decades later, a third of patients suffer from cardiac disorders and one in ten have digestive disorders (increase in the size of the esophagus or colon), neurological or mixed, says the WHO.
Chagas disease can be fatal over the years due to arrhythmias or progressive heart failure.
El vector: la vinchuca
This sickness is associated with poverty. The vector is the vinchuca or beaked bug. It lives in the cracks in the walls and ceilings of houses built with adobe bricks, branches or straw, that is, the most precarious houses, according to Doctors Without Borders.
The vector is endemic in 21 Latin American countries, says ISGlobal.
Detail of the infographic of the EFE Agency “Chagas or American trypanasomiasis” available at http://infografias.efe.com. EFE/
In non-endemic countries, points out the study led by ISGlobal, the parasite can be transmitted vertically, from mother to baby or, less frequently, by blood or organ donations.
In up to 40% of cases, the infection ends up affecting the heart and digestive system, causing Chagas disease.
Test to treat Chagas disease in Spain
The fact that 47% of the patients who attended the Barcelona Clinic during the time studied were undiagnosed, has made the first co-author of the work and coordinator of the Chagas Initiative, Irene Losadarecommend testing Latin American people who arrive in Spain.
In this way, they could be treated “if they are infected and, in the case of women of reproductive age, prevent vertical transmission of the parasite.”
And it is that the research team of the study confirms that many people who arrive from endemic regions of Latin America, such as Bolivia, have never been tested before.
The other co-author of the study es Pedro Laynez-Roldan, investigator of ISGlobal and doctor of the International Health Service of the Clínicwho also points out the importance of the echocardiogram in the initial evaluation of people with infection.
“There is a clear problem of underdiagnosis of the infection, even in Spain, one of the European countries with the highest diagnostic coverage,” he warns for his part Maria Jesus Pinazo, last author of the study, former ISGlobal researcher y actually in the Drugs for Neglected Diseases Initiative.
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