Introduction
Chagas disease is a parasitic infection named after a Brazilian physician named Carlos Chagas, who discovered this disease in 1909. A parasite, Trypanosoma cruzi, causes the condition seen to be transmitted to humans and animals by insects as vectors. This disease is seen exclusively in the American regions, especially in underdeveloped rural areas of Latin America affected by poverty. In some places, Chagas disease is also addressed as American trypanosomiasis, deriving its name from the causative organism. Therefore, public health interventions in these areas are crucial to prevent contamination in the community and screen the blood for potential parasites.
How Does Chagas Disease Occur?
Chagas disease is spread through an infected bug called triatomine, or a kissing bug that feeds on by sucking blood from humans and animals. There are multiple ways the infection gets transmitted from mother to baby, contaminated or unscreened blood, organs from infected donors, and rarely through accidents in the laboratory or contaminated food. The clinical symptoms of Chagas disease include palpitations, dizziness (feeling weak, faint, spinning, or unsteady), syncope (passing out or fainting), difficulty breathing, water retention or edema, weight loss, difficulty swallowing, constipation (difficult bowel movements or slow movement of waste or stool), etc.
Where Is Chagas Disease Commonly Seen?
The incidence of Chagas disease is estimated to be around eight million people and is seen commonly in Mexico, Central, and South American regions. The triatomine bug is seen to grow in poorly maintained houses, including mud walls or thatched roofs, and has become a common problem and potentially infecting cause for the locals. Also, it is seen that almost three million people with this trypanosoma infection are seen only in the United States.
What Are the Public Health Measures for the Prevention of Chagas Disease?
Chagas disease is a locally spread disease in a particular part of the world limited to the American regions. Hence, isolating the infection and preventing community spread is very important to prevent an epidemic outbreak. Therefore, the public health sector has to form a team, discuss the outcome, and develop the preventive framework. Therefore, public health management is vital in handling, monitoring, and treating these infections. Here are some of the roles of the public health measures taken to prevent the spread.
Blood Screening Camps for the Presence of Parasitic Infection:
Chagas disease is a parasitic infection affecting the blood of the patient. It is very important in blood donation camps to screen the patient's blood before receiving it. As the disease is mainly confined to the American region, the pan-American society has provided specific guidelines for the screening of blood. The recommended blood tests that should be made for screening for Chagas disease are as follows:
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Enzyme-linked immunosorbent assay (ELISA).
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The indirect immunofluorescence (IIF).
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Hemagglutination inhibition test (HAI).
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Complement enzyme-linked immunosorbent assay (c-ELISA)
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Recombinant enzyme-linked immunosorbent assay (rec-ELISA).
The donor's blood samples are tested for the first time, and once the test is negative, they will not be further screened for it during other donations.
Congenital Screening For Chagas Disease in Children and Mothers:
Congenital Chagas disease is screened for all women of childbearing age. More than forty thousand women are affected by this condition, and the potential risk for mother-to-child transmission is around one to five percent. Identifying and testing the mothers for this disease helps in a potential decline in Chagas disease in children. The children are evaluated for Chagas disease if the mother shows the following symptoms:
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If the mother is positive for Chagas disease.
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If the infant shows any signs suggesting Chagas disease.
The screening is done by blood culture and PCR or polymerase chain reaction testing for the Trypanosoma DNA (deoxyribonucleic acid).
Newly Diagnosed Patients:
It is very important to keep track of newly diagnosed patients to know their current status. A complete medical history of the patient is taken, exposure of the patient to the possible source of infection is analyzed, and family history, history of mother's health, blood transfusion history, etc., are tested. If the patient tests positive, respective isolation measures are taken, and the patient will be put on anti-parasitic therapy for a definite period.
Updating Clinician Knowledge Thorough Conferences:
Constant updates regarding the research, advanced treatments, and new strains of the Trypanosoma parasite are updated with ongoing education programs, and further treatment modalities and screening methods are discussed.
Conducting Patient Education Programs:
Patient education programs are essential to get the treatment done. This awareness of the disease makes people understand the reason and seek medical help once the signs and symptoms arise. Seeking the help of healthcare is very important in limiting the progression of the disease and closely managing the patient's outcome toward well-being.
Screening of Donor Organs:
It is a must to screen the donors of organ donation for the treatment of this disease, as any signs of incubation of the worm can lead to transmission of a contaminated sample to the recipient, automatically spreading the disease.
Recording the Incidence of New Cases:
Keeping track of the incidence of new emerging cases of this disease is crucial as it gives us data on the occurrence and spread of the disease and helps in coming up with an approach to eliminating and eradicating the disease.
Anti-parasitic Treatment:
Anti-parasitic medications are treatments for worms or parasites inside the body. Anti-parasitic treatments can be given both orally and through vaccination shots. Here in the treatment of Chagas disease, vaccinations for parasitic infection are the treatment of choice to prevent or completely eradicate the disease.
Conclusion
Chagas disease, also known as American trypanosomiasis, is a potentially infectious disease, as discussed above. As the disease is highly contagious, proper preventive health care measures and significant monitoring tests are needed to limit and control its spread. Therefore, public health plays a huge role in maintaining the community's health and eradicating this disease. Although Chagas disease was a very threatening disease earlier, in recent times, the occurrence and spread of this disease have been limited and contained within the localized area preventing it from becoming a global pandemic.
