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TropicalMed
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Burden of Chagas Disease in the Americas
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Burden of Chagas Disease in the Americas

A special issue of Tropical Medicine and Infectious Disease (ISSN 2414-6366). This special issue belongs to the section "Neglected and Emerging Tropical Diseases".

Deadline for manuscript submissions: closed (31 March 2023) | Viewed by 18270

Special Issue Editors

Dr. Norman Beatty

E-Mail Website
Guest Editor
Department of Medicine, Division of Infectious Diseases and Global Medicine, University of Florida College of Medicine, Gainesville, FL 32610, USA
Interests: Chagas disease; triatomine biology; vector-borne diseases; clinical tropical medicine; neglected tropical diseases
Dr. Colin Forsyth

E-Mail Website
Guest Editor
Drugs for Neglected Diseases initiative, New York, NY 10006, USA
Interests: Chagas disease; epidemiology; anthropology; health disparities; neglected tropical diseases
Dr. Omar Cantillo-Barraza

E-Mail Website
Guest Editor
Grupo Biología y Control de Enfermedades Infecciosas, Universidad de Antioquia, Medellin 050010, Colombia
Interests: Chagas disease; Trypanosoma cruzi molecular diagnostics; triatomine biology; tropical diseases; parasitology

Special Issue Information

Dear Colleagues,

Chagas disease is a neglected tropical disease cause by the protozoan parasite Trypanosoma cruzi. This kinetoplastid parasite has a complex life cycle involving susceptible hosts and the triatomine insect vector, as well as certain mammals (e.g., opossum). Infection is found throughout the Americas and occurs via several routes of exposure, including the vector-borne, congenital, and even oral consumption of contaminated food and drink products. Despite progress in recent years, some areas of Mexico, Central and South America have persistent vector transmission, while congenital transmission remains an important route in both endemic and non-endemic countries. In North America, very little is known concerning the burden of disease from autochthonous transmission or among people from endemic regions of Latin America. However, Chagas disease is a leading cause of heart disease in the Americas. Improving our understanding of the incidence, prevalence, and risk factors for Chagas disease is key to informing public health programs addressing this highly neglected disease.

The scope of this Special Issue shall encompass the following:

  • New research focused on the epidemiology of Chagas disease in endemic and non-endemic regions of the Americas;
  • Triatomine biology and distribution in the Americas;
  • Trypanosoma cruzi infection among susceptible sylvatic, peridomestic, and domestic animal hosts;
  • Programs to improve awareness and access to care among those at risk for Chagas disease in the Americas.

Dr. Norman L. Beatty
Dr. Colin J. Forsyth
Dr. Omar Cantillo-Barraza
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Tropical Medicine and Infectious Disease is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Chagas disease
  • Trypanosoma cruzi
  • Triatomine
  • Kissing bug
  • Neglected tropical disease
  • Congenital Chagas disease
  • Oral Chagas disease
  • Chagas heart disease
  • Gastrointestinal Chagas disease
  • Canine Chagas disease

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Published Papers (7 papers)

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10 pages, 465 KiB  
Article
Assessment of Community Awareness and Screening of Chagas Disease in the Latin American Community of Greater New Orleans
by Claudia Herrera, Kerlly J. Bernabé, Eric Dumonteil, James DeCuir, Julie M. Thompson, Mariana Avendano, Weihong Tu, Maxwell M. Leonhardt, Bianka A. Northland, Jynx Frederick, Bryn Prieto, Angel Paternina-Caicedo, Emma Ortega, Maria Fonseca, Marcela Hincapie and Margarita Echeverri
Trop. Med. Infect. Dis. 2023, 8(12), 515; https://doi.org/10.3390/tropicalmed8120515 - 5 Dec 2023
Cited by 1 | Viewed by 1932
Abstract
Chagas disease is a public health problem in the Americas, from the southern United States (USA) to Argentina. In the USA, less than 1% of domestic cases have been identified and less than 0.3% of total cases have received treatment. Little is known [...] Read more.
Chagas disease is a public health problem in the Americas, from the southern United States (USA) to Argentina. In the USA, less than 1% of domestic cases have been identified and less than 0.3% of total cases have received treatment. Little is known about affected immigrant Latin American communities. A prospective study was conducted to assess knowledge about Chagas disease among the Latin American community living in the Greater New Orleans area. Participants answered a baseline questionnaire, viewed a short educational video presentation, completed a post-presentation questionnaire, and were screened with an FDA-approved blood rapid diagnostic test (RDT). A total of 154 participants from 18 Latin American countries (n = 138) and the USA (n = 16) were enrolled and screened for Trypanosoma cruzi infection. At baseline, 57% of the participants knew that Chagas disease is transmitted through an insect vector, and 26% recognized images of the vector. Following the administration of an educational intervention, the participants’ knowledge regarding vector transmission increased to 91% and 35% of participants were able to successfully identify images of the vector. Five participants screened positive for T. cruzi infection, indicating a 3.24% [95%CI: 1.1–7.5%] prevalence of Trypanosoma cruzi infection within the Latin American community of the New Orleans area. Results highlight the urgent need for improving access to education and diagnostics of Chagas disease. Full article
(This article belongs to the Special Issue Burden of Chagas Disease in the Americas)
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16 pages, 2020 KiB  
Article
Geographic Distribution of the Genus Panstrongylus Berg, 1879 in the Neotropic with Emphasis on Trypanosoma cruzi Vectors
by Evelyn Tineo-González, Rossy Fermín, Ana Bonilla-Rivero and Leidi Herrera
Trop. Med. Infect. Dis. 2023, 8(5), 272; https://doi.org/10.3390/tropicalmed8050272 - 11 May 2023
Cited by 1 | Viewed by 1823
Abstract
Panstrongylus is a Neotropical taxa of 16 species, some more widespread than others, that act as vectors of Trypanosoma cruzi, the etiologic agent of Chagas disease (CD). This group is associated with mammalian reservoir niches. There are few studies of the biogeography [...] Read more.
Panstrongylus is a Neotropical taxa of 16 species, some more widespread than others, that act as vectors of Trypanosoma cruzi, the etiologic agent of Chagas disease (CD). This group is associated with mammalian reservoir niches. There are few studies of the biogeography and niche suitability of these triatomines. Using zoo-epidemiological occurrence databases, the distribution of Panstrongylus was determined based on bioclimatic modelling (DIVA GIS), parsimonious niche distribution (MAXENT), and parsimony analysis of endemic species (PAE). Through 517 records, a wide presence of P. geniculatus, P. rufotuberculatus, P. lignarius, and P. megistus was determined and recorded as frequent vectors of T. cruzi in rainforest habitats of 24–30 °C. These distributions were modeled with AUC >0.80 and <0.90, as well as with the seasonality of temperature, isothermality, and precipitation as relevant bioclimatic variables. Individual traces for each taxon in Panstrongylus—1036 records—showed widely dispersed lines for frequent vectors P. geniculatus, P. lignarius, P. rufotuberculatus, and P. megistus. Other occasional vectors showed more restricted dispersal, such as P. howardi, P. humeralis, P. lenti, P. lutzi, P. tupynambai, P. noireaiui, and P. chinai. Areas of defined environmental variation, geological change, and trans domain fluid fauna, such as the American Transition Zone and the Pacific Domain of Morrone, had the highest Panstrongylus diversity. Pan-biogeographic nodes appear to be areas of the greatest species diversity that act as corridors connecting biotopes and allowing fauna migration. Vicariance events in the geologic history of the continent need to be investigated. The geographical distribution of Panstrongylus overlapped with CD cases and Didelphis marsupialis/Dasypus novemcinctus presence, two important reservoirs in Central and South America. The information derived from the distribution of Panstrongylus provides knowledge for surveillance and vector control programs. It would increase information on the most and less relevant vector species of this zoonotic agent, for monitoring their population behavior. Full article
(This article belongs to the Special Issue Burden of Chagas Disease in the Americas)
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15 pages, 6492 KiB  
Article
ECG Marker Evaluation for the Machine-Learning-Based Classification of Acute and Chronic Phases of Trypanosoma cruzi Infection in a Murine Model
by Paulina Haro, Nidiyare Hevia-Montiel and Jorge Perez-Gonzalez
Trop. Med. Infect. Dis. 2023, 8(3), 157; https://doi.org/10.3390/tropicalmed8030157 - 4 Mar 2023
Cited by 2 | Viewed by 2348
Abstract
Chagas disease (CD) is a neglected parasitic disease caused by the protozoan Trypanosoma cruzi (T. cruzi). The disease has two clinical phases: acute and chronic. In the acute phase, the parasite circulates in the blood. The infection can be asymptomatic or [...] Read more.
Chagas disease (CD) is a neglected parasitic disease caused by the protozoan Trypanosoma cruzi (T. cruzi). The disease has two clinical phases: acute and chronic. In the acute phase, the parasite circulates in the blood. The infection can be asymptomatic or can cause unspecific clinical symptoms. During the chronic phase, the infection can cause electrical conduction abnormalities and progress to cardiac failure. The use of an electrocardiogram (ECG) has been a methodology for diagnosing and monitoring CD, but it is necessary to study the ECG signals to better understand the behavior of the disease. The aim of this study is to analyze different ECG markers using machine-learning-based algorithms for the classification of the acute and chronic phases of T. cruzi infection in a murine experimental model. The presented methodology includes a statistical analysis of control vs. infected models in both phases, followed by an automatic selection of ECG descriptors and the implementation of several machine learning algorithms for the automatic classification of control vs. infected mice in acute and/or chronic phases (binomial classification), as well as a multiclass classification strategy (control vs. the acute group vs. the chronic group). Feature selection analysis showed that P wave duration, R and P wave voltages, and the QRS complex are some of the most important descriptors. The classifiers showed good results in detecting the acute phase of infection (with an accuracy of 87.5%), as well as in multiclass classification (control vs. the acute group vs. the chronic group), with an accuracy of 91.3%. These results suggest that it is possible to detect infection at different phases, which can help in experimental and clinical studies of CD. Full article
(This article belongs to the Special Issue Burden of Chagas Disease in the Americas)
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Review

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17 pages, 3598 KiB  
Review
Oral Chagas Disease in Colombia—Confirmed and Suspected Routes of Transmission
by Norman L. Beatty, Catalina Arango-Ferreira, Lídia Gual-Gonzalez, Sara Zuluaga, Melissa S. Nolan and Omar Cantillo-Barraza
Trop. Med. Infect. Dis. 2024, 9(1), 14; https://doi.org/10.3390/tropicalmed9010014 - 4 Jan 2024
Cited by 6 | Viewed by 4795
Abstract
Chagas disease (CD) remains endemic throughout many regions of Colombia despite implementing decades of vector control strategies in several departments. Some regions have had a significant decrease in vectorial transmission, but the oral ingestion of Trypanosoma cruzi through consumption of contaminated food and [...] Read more.
Chagas disease (CD) remains endemic throughout many regions of Colombia despite implementing decades of vector control strategies in several departments. Some regions have had a significant decrease in vectorial transmission, but the oral ingestion of Trypanosoma cruzi through consumption of contaminated food and drink products is increasingly described. This form of transmission has important public health relevance in Colombia due to an increase in reported acute CD cases and clinical manifestations that often lead to significant morbidity and mortality. Oral CD in Colombia has been associated with the consumption of contaminated fruit juices, such as palm wine, sugar cane, or tangerine juice and water for consumption, or contaminated surfaces where food has been prepared. Another interesting route of oral transmission includes ingestion of unbeknownst infected armadillos’ blood, which is related to a traditional medicine practice in Colombia. Some earlier reports have also implemented consumption of infected bush meat as a source, but this is still being debated. Within the Amazon Basin, oral transmission is now considered the principal cause of acute CD in these regions. Furthermore, new cases of acute CD are now being seen in departments where CD has not been documented, and triatomine vectors are not naturally found, thus raising suspicion for oral transmission. The oral CD could also be considered a food-borne zoonosis, and odoriferous didelphid secretions have been implemented in contaminating the human dwelling environment, increasing the risk of consumption of infectious metacyclic trypomastigotes. In this article, we will discuss the complex transmission dynamics of oral CD in Colombia and further examine the unique clinical manifestations of this route of infection. New insights into the oral transmission of Trypanosoma cruzi are being discovered in Colombia, which can help bring increased awareness and a better understanding of this neglected tropical disease to reduce the burden of CD throughout Latin America. Full article
(This article belongs to the Special Issue Burden of Chagas Disease in the Americas)
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22 pages, 3509 KiB  
Review
Knowledge Production on Congenital Chagas Disease across Time, Borders and Disciplines: A Comprehensive Scoping Review
by Elise Rapp and Marina Gold
Trop. Med. Infect. Dis. 2023, 8(9), 422; https://doi.org/10.3390/tropicalmed8090422 - 22 Aug 2023
Cited by 1 | Viewed by 1784
Abstract
Congenital transmission is a key route of Trypanosoma cruzi infection in Latin America and globally, contributing significantly to the burden of Chagas disease. The interruption of transmission from mother to child has recently become a focus issue. However, the research landscape on congenital [...] Read more.
Congenital transmission is a key route of Trypanosoma cruzi infection in Latin America and globally, contributing significantly to the burden of Chagas disease. The interruption of transmission from mother to child has recently become a focus issue. However, the research landscape on congenital Chagas disease remains largely unexplored. The purpose of this scoping review is to assess the production of knowledge on congenital Chagas disease (CCD), aiming to identify research trends and potential gaps. Our initial hypothesis was that the CCD literature overly represents the medical sciences and that there is a need for socio-cultural research on the subject. We conducted a systematic search of publications focusing on congenital Chagas disease in six languages (English, Spanish, Portuguese, French, German and Italian). This comprehensive literature search identified 876 studies that met the inclusion criteria, out of a total of 8893 sources. The relevant literature was analyzed by language, year of publication, discipline, source type and research location. The main outcome of this study has been to prove our hypothesis that there is a scarcity of knowledge produced within the non-biomedical sciences on CCD. This underscores the need for further exploration into the social and structural issues surrounding this disease. Visually clear data concerning congenital Chagas disease produced by this study can contribute to hone in future research efforts and support funding applications. Additionally, this article provides a reference list that other researchers can consult for their own studies. Full article
(This article belongs to the Special Issue Burden of Chagas Disease in the Americas)
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Other

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7 pages, 534 KiB  
Brief Report
Chagas Disease Diagnostic Testing in Two Academic Hospitals in New Orleans, Louisiana: A Call to Action
by Alvaro Proaño, Eric Dumonteil and Claudia Herrera
Trop. Med. Infect. Dis. 2023, 8(5), 277; https://doi.org/10.3390/tropicalmed8050277 - 15 May 2023
Cited by 3 | Viewed by 1795
Abstract
Chagas disease, caused by the protozoa parasite Trypanosoma cruzi, is an anthropozoonosis that represents a major public health problem in the Americas, affecting 7 million people with at least 65 million at risk. We sought to assess the intensity of disease surveillance [...] Read more.
Chagas disease, caused by the protozoa parasite Trypanosoma cruzi, is an anthropozoonosis that represents a major public health problem in the Americas, affecting 7 million people with at least 65 million at risk. We sought to assess the intensity of disease surveillance based on diagnostic test requests from hospitals in New Orleans, Louisiana. We extracted information from send-out labs at two major tertiary academic hospitals in New Orleans, Louisiana, USA, from 1 January 2018 to 1 December 2020. We found that in these three years there were 27 patients for whom Chagas disease testing was ordered. Most of these patients were male (70%), with a median age of 40 years old, and their most common ethnical background was Hispanic (74%). These findings demonstrate undertesting of this neglected disease in our region. Given the low Chagas disease surveillance, we need to increase awareness, health promotion, and education among healthcare workers. Full article
(This article belongs to the Special Issue Burden of Chagas Disease in the Americas)
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11 pages, 291 KiB  
Case Report
Aplastic Anemia and Chagas Disease: T. cruzi Parasitemia Monitoring by Quantitative PCR and Preemptive Antiparasitic Therapy
by Noêmia Barbosa Carvalho, Vera Teixeira de Freitas, Rita Cristina Bezerra, Erika Shimoda Nakanishi, Elvira Pereira Velloso, Hermes Ryoiti Higashino, Marjorie Vieira Batista, Guilherme Henrique Fonseca, Vanderson Rocha, Silvia Figueiredo Costa and Maria Aparecida Shikanai-Yasuda
Trop. Med. Infect. Dis. 2022, 7(10), 268; https://doi.org/10.3390/tropicalmed7100268 - 27 Sep 2022
Cited by 3 | Viewed by 2304
Abstract
Background: Aplastic anemia is a rare and life-threatening condition, seldomly witnessed concomitantly with Chagas disease. We aim to discuss the management of these patients under risk of chronic Chagas disease reactivation (CDR), a severe condition with a high morbimortality that occurs in chronic [...] Read more.
Background: Aplastic anemia is a rare and life-threatening condition, seldomly witnessed concomitantly with Chagas disease. We aim to discuss the management of these patients under risk of chronic Chagas disease reactivation (CDR), a severe condition with a high morbimortality that occurs in chronic Chagas disease patients under immunosuppression. Case reports: Trypanosoma cruzi (T. cruzi) parasitemia was monitored in three patients for 4–58 months by conventional PCR (cPCR), quantitative PCR (qPCR), microhematocrit/buffy coat, blood culture, and/or xenodiagnosis. One patient received antiparasitic treatment (benznidazole) and the other received allopurinol. Although parasitemia was controlled during and after benznidazole treatment at 300 mg/d for 51 days, in one patient, hematologic parameters worsened continuously before, during, and after treatment. Allopurinol led only to the temporary suppression of T. cruzi parasitemia in the second patient, but after danazol and hematological improvement, parasitemia became undetectable until the end of monitoring. Discussion and Conclusion: Unexpected undetectable or low parasitemia by cPCR/qPCR was reported. We show that the monitoring of parasitemia by qPCR and the use of preemptive therapy when the parasitemia was positive proved to be beneficial to our patients. As a result of the toxicity of more effective antiparasitics, shorter regimens of benznidazole or less toxic drugs in preemptive therapy are options that deserve future studies. Full article
(This article belongs to the Special Issue Burden of Chagas Disease in the Americas)
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