The Global Burden of Disease of Chagas Disease (American Trypanosomiasis)

Dear Colleagues,

Chagas disease (American trypanosomiasis), caused by the protozoan Trypanosoma cruzi, remains a significant cause of illness, disability, and death in Latin America. Due to the global migration of individuals from highly endemic areas and the latency of infection, Chagas disease has been identified in many countries. The disease remains predominantly a major neglected tropical disease of disenfranchised populations, reflecting the historical social and geopolitical realities that have prevailed in Mexico and Central and South America. An estimated 6–8 million infected individuals live in South America, Central America, and Mexico. In most endemic areas, vector-borne transmission is the most relevant form of human infection. As a result, large-scale vector-control programs, particularly in the Southern cone countries of South America, have reduced the incidence of Chagas disease [3–10]. Similarly, blood bank screening practices in endemic settings have decreased the number of infections acquired through this route [5,10]. Despite many achievements in reducing the overall burden of T. cruzi transmission in Latin America, there have been a series of recently documented reinfestations of previously insecticide-treated communities in parts of Venezuela, Colombia, and Bolivia [10]. Over the last few decades, the ingestion of foods or beverages contaminated with complete triatomines or their feces containing metacyclic trypomastigotes has been responsible for many cases of orally acquired Chagas disease. Chagas disease manifests most frequently as a cardiomyopathy; it is diverse and difficult to predict, with some patients remaining asymptomatic throughout their lifespan despite electrocardiographic or echocardiographic evidence of the disease, some presenting with signs, symptoms, and complications of progressive heart failure or life-threatening cardiac arrhythmias, and others dying unexpectedly without prior symptoms. Some other infected individuals may manifest gastrointestinal manifestations including esophageal or colonic dysfunction. The burden of disease of Chagas disease is substantial in terms of premature death, disability, and years lost in productivity.

This Special Issue will highlight various aspects of Chagas disease in endemic regions as well as other countries due to international migration from endemic countries. This Special Issue will explore new concepts in our understanding of Chagas disease, including:

• The increasing identification of the oral transmission of Chagas disease;
• Duration of antiparasitic therapy;
• Shorter latency of Chagas disease;
• Acute manifestations of Chagas disease.

Prof. Dr. Carlos Franco-Paredes
Dr. Andrés F. Henao-Martínez
Guest Editors

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• Chagas disease
• American trypanosomiasis
• Cardiomyopathy
• Gastrointestinal
• Esophageal dysfunction