Materiały źródłowe

• #1

  https://www.who.int/news-room/fact-sheets/detail/chagas-disease-(american-trypanosomiasis)

  Chagas disease is curable if antiparasitic treatment is initiated early, in the acute phase. In chronic infection, the treatment and follow up can potentially prevent or curb disease progression and prevent transmission, for instance, during pregnancy and birth. […] Key strategies to prevent Chagas disease include vector control (in Latin America); blood screening prior transfusion and transplantation; testing and treating girls, women of reproductive age, newborns and siblings of mothers with the infection; earliest possible diagnosis and comprehensive follow-up and health care; and information, education and communication for communities and health professionals. […] There is no vaccine to prevent Chagas disease. Vector control, reducing interaction between humans and vector insects, has been the most effective method of prevention in Latin America. Blood screening is necessary to prevent infection through transfusion, organ transplantation, and congenital transmission, and to increase detection and care of the affected population all over the world.

• #1 Chagas Disease | What We Do | World Heart Federation

  https://world-heart-federation.org/what-we-do/chagas-disease/

  In areas of Mexico, Central America, and South America, where the Trypanosoma cruzi parasite is present in triatomine bugs, improved housing and spraying insecticide inside housing to eliminate the bugs has significantly decreased the spread of Chagas disease. […] Screening of blood donations for Chagas is another important public health tool to help prevent spreading the disease through blood transfusions. Early detection and treatment of new cases, including mother-to-baby (congenital) cases, will also help reduce the burden of disease. […] In other regions where Chagas disease is now found but is not widespread, control strategies should focus on preventing transmission from blood transfusion, organ transplantation, and mother to child.

• #1 Chagas disease – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chagas-disease/symptoms-causes/syc-20356212

  If you live in a high-risk area for Chagas disease, these steps can help prevent infection: […] Don’t sleep in a mud, thatch or adobe house. These types of homes are more likely to harbor triatomine bugs than are other types of buildings. […] Use netting soaked with bug killer, called insecticide, over the bed with sides tucked in. […] Use bug killers to remove insects from a home. […] Use insect repellent on exposed skin.

• #1 Chagas Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459272/

  Preventing Chagas disease primarily relies on public health initiatives and reducing exposure to the reduviid bug in endemic regions. Public health campaigns should focus on educating communities about the bugs habitats, its nocturnal feeding behavior, and ways to minimize contact. Encouraging the use of insecticide-treated bed nets, sealing cracks in walls and roofs, and improving housing conditions such as using plastered walls and screened windows can significantly reduce the risk of infestation. […] Additionally, community-based vector control programs, including insecticide spraying and environmental management, play a crucial role in reducing transmission. Proper food hygiene is also essential, as oral transmission through contaminated food or beverages has been reported in some outbreaks.

• #1 Center of Excellence for Chagas Disease | Slymar, CA | Prevention

  https://chagasus.org/prevention/

  The best way to prevent Chagas disease is to eliminate kissing bugs. In Latin America, widespread pesticide spraying has halted transmission of Chagas disease in Uruguay, Chile, Brazil, Paraguay, and elsewhere. […] A more sustainable solution to prevent Chagas disease is to provide adequate housing conditions for affected populations. […] Studies demonstrate that programs which combine housing improvements with pesticide spraying are the most effective at preventing transmission of Chagas disease.

• #1 SciELO Brazil – Chagas disease prevention through improved housing using an ecosystem approach to health Chagas disease prevention through improved housing using an ecosystem approach to health

  https://www.scielo.br/j/csp/a/xpWJYkBWxg5XMhbgGPGvT6f/?lang=en

  Family participation in housing improvement was assumed when at least one member of the family participated with the assigned instructor in performing the improvements planned jointly with the family members. […] The main focus of this study was the modification of artificial domiciliary and peridomiciliary ecotopes, attacking Chagas disease vectors via housing improvements. […] Integrated and sustainable vector control requires not only spraying, but the incorporation of environmental organization, community mobilization, and participation centered on peridomiciliary entomological surveillance.

• #1 Preventing the transmission of American trypanosomiasis and its spread into non-endemic countries | Infectious Diseases of Poverty | Full Text

  https://idpjournal.biomedcentral.com/articles/10.1186/s40249-015-0092-7

  American trypanosomiasis, commonly known as Chagas disease, is caused by the hemoflagellate protozoan parasite Trypanosoma cruzi. With no vaccine yet available, only two proven drugs, namely benznidazole and nifurtimox, can be used for efficient treatment of acute cases. […] To control Chagas disease, interruption of transfusion transmission is a very important target in control programmes of endemic countries. Therefore, extensive blood-donor screening for T. cruzi infection is the main measure implemented in all of the endemic Latin American countries, though the coverage has not yet reached 100 %. […] The focus should be placed on the risk of transmission through blood transfusions; organ, tissue, or cell transplants; and congenital transmission, as well as potentially acquiring infection during travel to endemic areas. Therefore, the following strategies for prevention of the disease spreading to non-endemic countries are needed.

• #1 Prevention of Chagas disease (American trypanosomiasis) – Canada.ca

  https://www.canada.ca/en/public-health/services/diseases/chagas-disease-american-trypanosomiasis/prevention-chagas-disease-american-trypanosomiasis.html

  There is no vaccine or medication that protects against Chagas disease. […] If you travel to an area where Chagas disease occurs, you should take the proper precautions. […] You can protect yourself from bug bites by following the precautions below. […] Avoid sleeping: outdoors, in poorly-built houses made from mud or thatch. […] Sleep under a bed net treated with insecticide if you must sleep outdoors. […] Practise safe food and water precautions. […] Avoid getting blood transfusions and organ transplants in areas where Chagas disease is found. […] If this is the case, confirm that the donated blood or organ has been tested for Chagas disease. If you cannot confirm this testing, and it is not an emergency, return home for treatment.

• #1 What Are the Public Health Measures for the Prevention of Chagas Disease?

  https://www.icliniq.com/articles/infectious-diseases/chagas-disease-and-public-health-measures-for-its-prevention

  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. […] 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: Enzyme-linked immunosorbent assay (ELISA). The indirect immunofluorescence (IIF). Hemagglutination inhibition test (HAI). Complement enzyme-linked immunosorbent assay (c-ELISA) 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.

• #1 Chagas disease Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/chagas-disease

  Insect control with insecticides and houses that are less likely to have high insect populations will help control the spread of the disease. […] Blood banks in Central and South America screen donors for exposure to the parasite. The blood is discarded if the donor has the parasite. Most blood banks in the United States began screening for Chagas disease in 2007.

• #1 Prevention of Transfusion-Induced Chagas’ Disease by Amphotericin B in: The American Journal of Tropical Medicine and Hygiene Volume 29 Issue 5 (1980)

  https://www.ajtmh.org/abstract/journals/tpmd/29/5/article-p761.xml

  Amphotericin B, a polyene antibiotic effective against eukaryotic cells, can eliminate the trypomastigote form of Trypanosoma cruzi from blood stored at 4C. This antitrypanosomal effect can be achieved with a concentration of 3 g/ml within 48 hours. This concentration of amphotericin B does not produce hemolysis over a period of 3 weeks. Amphotericin B may be considered as a replacement for crystal violet in blood bank blood to prevent transfusion-induced Chagas’ disease.

• #1

  https://www.who.int/news/item/16-11-2018-preventing-mother-to-child-transmission-of-chagas-disease-from-control-to-elimination

  The World Health Organization (WHO) is shifting its focus towards active screening of girls and women of childbearing age to detect the presence of Trypanosoma cruzi, the causative parasite of Chagas disease. […] Recent evidence demonstrates that diagnosing and treating women of this age group before pregnancy can effectively prevent congenital transmission. […] Up to now, control and prevention strategies for Chagas disease largely relied on the early detection and treatment of infected newborns and siblings of pregnant women. But a recent shift in approaches to prevent transmission globally including in non-endemic countries is through active, systematic screening of girls and women at risk of infection and provides excellent opportunities for prevention of posterior transmission throughout pregnancy and birth.

• #1 WHF IASC Roadmap on Chagas Disease | Global Heart

  https://globalheartjournal.com/articles/10.5334/gh.484

  Successful control strategies will address both domestic and peridomestic structures and raise awareness in the affected communities about the reasons for these efforts. […] Congenital transmission is most effectively interrupted by screening all women of childbearing age and treating seropositive women with anti-parasitic agents prior to pregnancy. […] Several observational studies indicate that anti-trypanosomal treatment of women is dramatically effective in preventing congenital transmission in future pregnancies. […] While contraindicated during pregnancy, treatment of females of childbearing age is now recommended in major guidelines. […] Orally acquired CD, an important syndrome in the Amazon region, is associated with a potentially virulent acute phase. […] Implementation of safe food-handling practices combined with health promotion activities on the prevention of oral transmission are needed to prevent continued oral CD outbreaks.

• #1 Caring for Kids New to Canada – Chagas Disease (American trypanosomiasis)

  https://kidsnewtocanada.ca/conditions/chagas

  Screening of blood donors and blood is done to prevent transmission via blood and blood products. […] All children of women with T. cruzi infection should be tested for Chagas disease. […] Canadian Blood Services has added additional questions to the blood donor screening questionnaire to assess a donors potential risk of exposure to Chagas disease: Have you spent at least 6 continuous months in Mexico, Central or South America? and Were you or your mother or grandmother born in these regions? If donors answer yes to either question, platelets and frozen plasma for transfusion are not produced from their blood and they are tested for the presence of T. cruzi antibodies. […] Treatment for Chagas disease is recommended for all cases of congenital acute and chronic disease in children and adolescents younger than 18 years of age.

• #1 Congenital Chagas disease: Updated recommendations for prevention, diagnosis, treatment, and follow-up of newborns and siblings, girls, women of childbearing age, and pregnant women | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0007694

  Pregnant women, by antenatal screening for infection performed before or even when entering in maternity. Among those who are infected, there is no way to identify in advance those who will transmit the infection to their offspring, and there are no means of preventing such congenital infection at that moment (antiparasitic treatment is not recommended during pregnancy, see Treatment of infected girls or adults). Infected mothers should be treated after delivery and lactation period (see Treatment of infected girls or adults) (aiming to prevent recurrent congenital transmission in successive gestations and reduce the pool of infected population). […] Cases of congenital T. cruzi infection should be treated as soon as the diagnosis has been confirmed. The current experience of expert clinical groups in treating congenital T. cruzi infection confirms that (i) both benznidazole (BZ) and nifurtimox (NF) can be used to treat congenital cases; (ii) the recommended dose of BZ in infants is 5 to 7 mg/kg per day, divided in 2 doses, and that of NF is 10 to 15 mg/kg per day, divided in 3 doses;

• #1 Integrating Chagas Disease Screening Into Primary Health Care < Yale School of Medicine

  https://medicine.yale.edu/news-article/integrating-chagas-disease-screening-into-primary-health-care/

  April 10, 2023 by Elisabeth Reitman […] The importance of screening a birthing parent or a patient contemplating pregnancy is highlighted both by the reduced risk of congenital transmission in patients treated prior to pregnancy, as well as the greater than 90% cure rate in infants treated within the first year of life. This high cure rate presents health care providers with a critical opportunity to prevent spread of Chagas disease from one generation to the next. […] In 2022 Recommendations for Screening and Diagnosis of Chagas Disease in the United States was published in The Journal of Infectious Diseases. The authors are experts on Chagas disease in the U.S., including public health professionals, clinicians, and researchers. They published four major recommendations which they ranked by importance: Born in or lived 6 months in an endemic country (Mexico, Central or South America). Having a family member with Chagas disease. Lived in housing made of natural materials (mud, adobe, thatch, palm leaves) in Mexico, Central or South America. Being bitten by kissing bugs or finding kissing bugs in the home.

• #1 Chagas disease – PAHO/WHO | Pan American Health Organization

  https://www.paho.org/en/topics/chagas-disease

  There is no vaccine for the disease Chagas. Integrated vector control is the most effective method of preventing Chagas disease in Latin America, including chemical control by insecticides in infested homes, improvements in houses to prevent vector infestation, personal preventive measures such as bed nets, and informative education and communication to the community about vector-borne diseases. […] Serological screening in blood donors is necessary to prevent infection through blood transfusion and organ transplant. […] Chagas screening in pregnant women during prenatal care is needed to provide early diagnosis and treatment to newborns and other children of infected mothers. […] Good hygiene practices in food preparation, transportation, storage and consumption; screening of blood donors; testing of organ, tissue or cell donors and receivers; and screening.

• #1 Chagas Disease: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21876-chagas-disease

  If you live in or travel to areas where Chagas disease is common, you can reduce your risk by: […] Using insecticide spray around houses and other structures. […] Making sure buildings and sleeping areas are well-sealed. […] Using netting to protect yourself from triatomine bugs. […] Not drinking unpasteurized juices or eating food that could be contaminated with T. cruzi or triatomine poop. […] Consider being screened for Chagas if you’re pregnant or plan to become pregnant and you’ve been in an area where Chagas spreads. […] Public health efforts like screening donated blood, sealing living spaces against bugs and using insecticide have reduced cases of Chagas disease in areas where it’s transmitted.

• #1 Chagas Disease / American Trypanosomiasis

  https://oklahoma.gov/health/health-education/acute-disease-service/tickborne-and-mosquitoborne-diseases/chagas-disease-american-trypanosomiasis.html

  Avoid sleeping in thatch, mud, or adobe houses. […] If traveling to a country with high levels of disease, sleep inside screened areas, under a permethrin-impregnated bed net, or an air-conditioned room. […] Avoid insect bites. […] Use insecticides to kill bugs and reduce the risk of transmission. […] Wash and cook any food that could be contaminated with insect feces. […] Remain aware that, in some countries, the blood supply may not always be screened for American trypanosomiasis and blood transfusions may carry a risk of infection.

• #1 Fighting Strategies Against Chagas’ Disease: A Review

  https://www.mdpi.com/2076-0817/14/2/183

  Maintaining strict food and beverage hygiene, coupled with public awareness campaigns, has proven effective in reducing cases. […] Finally, in laboratory settings, the implementation of strict biosafety standards and specialized training for handling potentially infectious samples significantly reduces the risk of accidents that can result in occupational transmission. […] These strategies not only decrease the incidence of new infections, but also contribute to a broader control of Chagas disease in diverse epidemiological contexts.

• #1 IAMAT | Chagas Disease

  https://www.iamat.org/risks/chagas-disease

  One of the most effective ways to prevent Chagas Disease is to sleep under a permethrin-treated bed net. […] Also, avoid drinking unpasteurized juices and only eat well cooked foods or fruits that can be peeled. […] When travelling in endemic areas, do not sleep in huts since the Triatoma insects shelter in the palm-front roofs and in the wall cracks. […] When choosing a campsite, stay away from palm trees; do not set your tent close to stone or wood piles where the insects may be hiding. […] When checking into modest or older hotels (alojamientos), search for hidden insects under the mattress, behind picture frames, in drawers, or dark corners of the room. Carry insect and insecticides repellents with you. […] Before sleeping, apply insect repellent to exposed parts of your body (available in sprays, lotions, and towelettes), which may help to keep the insects away. Any commercially available preparation containing DEET (N, N-diethyl-meta-toluamide) is suitable. […] Use bed nets to prevent contact with insects. Put a cloth over the bed net to prevent the feces of infected insect from falling on you. […] Protect your hands with a cloth, paper, or gloves, if it is necessary to handle the insects.

• #1 Chagas Disease | Washington State Department of Health

  https://doh.wa.gov/you-and-your-family/illness-and-disease-z/chagas-disease

  If you are traveling to or visiting rural areas that might have Chagas disease, be sure to: […] Stay in well-built places, such as air-conditioned or screened rooms. This lowers the risk of contact with infected kissing bugs, which often live in poorly built dwellings and are active at night. […] Sleep under bed nets treated with long-lasting insecticide. […] Wear clothing that covers your skin and use EPA-registered insect repellant on skin that’s exposed. […] Do not eat salads, raw vegetables, unpeeled fruits, and unpasteurized fruit juices. […] There are no vaccines or medicines that can prevent Chagas disease at this time. […] If you have previously lived or spent time in areas where infected kissing bugs are present, discuss with your healthcare provider whether screening for Chagas disease is recommended.

• #1 Chagas Disease: Adult and Adolescent OIs | NIH

  https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-opportunistic-infections/chagas-disease

  All people with HIV with epidemiologic risk factors for Chagas disease should be tested for antibody to T. cruzi to detect latent infection. […] A single course of treatment with benznidazole or nifurtimox should be offered to individuals with T. cruzi infection who have not been previously treated and who do not have advanced Chagas cardiomyopathy, with a discussion of potential risks and benefits and shared decision making. […] Although direct data are lacking, optimization of antiretroviral therapy (ART) may help prevent Chagas reactivation in coinfected patients. […] Therapy for Chagas disease with benznidazole or nifurtimox is effective in reducing parasitemia and preventing clinical manifestations or slowing progression in patients with acute and reactivated disease. […] Benznidazole and nifurtimox are only partially effective in the chronic phase of T. cruzi infection and may be suppressive rather than curative.

• #1

  https://www.gov.uk/guidance/chagas-disease-migrant-health-guide

  Offer serological testing for Chagas disease to Latin American migrants: […] Offer pre-conception screening to Latin American migrant women of child-bearing age. Pre-conception screening with treatment can also reduce the risk of congenital infection. […] Offer serological testing to pregnant women who are migrants from Latin America. While treatment of Chagas during pregnancy is contraindicated, identification is important to detect and treat congenital infection. Treatment of infants is highly effective and well tolerated. Failure to identify and treat infected infants poses risk of morbidity and premature mortality from chronic Chagas later in life. […] Offer screening to immunosuppressed individuals (particularly those with HIV infection, undergoing transplantation or cancer chemotherapy) as they may be at risk of reactivation of infection and associated complications.

• #1

  https://www.who.int/news-room/fact-sheets/detail/chagas-disease-(american-trypanosomiasis)

  Depending on the geographical area, WHO recommends the following approaches to prevention and control: development of information, education and communication materials and activities, contextualized for the different scenarios and actors, and based on a One Health approach; early access to diagnosis, treatment and follow up; screening of newborns and other children of infected mothers; screening of blood donors; testing of organ, tissue or cell donors and receivers; spraying of dwellings and surrounding areas with residual insecticides; house improvements and house cleanliness to prevent vector infestation; and personal preventive measures such as bednets, good hygiene practices in food preparation, transportation, storage and consumption. […] All health professionals, beginning at the first level of care (primary health care), and appropriately trained and updated, have a crucial role in enhancing the detection, treatment, follow-up, and notification of cases.

• #1 Chagas Disease Prevention // Projects // Pulte Institute for Global Development // University of Notre Dame

  https://pulte.nd.edu/projects/chagas-disease-prevention/

  Since the early 1990s, MAP International, a faith-based nonprofit that provides medicines and health supplies to communities in developing countries, has worked to fight this preventable disease in Morochata and Tiquipaya; two municipalities nestled in the western highlands of Bolivia. […] In recent years, the Bolivian government has expelled other external non-governmental, bilateral, and multilateral organizations, including USAID in 2013. This has made MAP International’s work in Morochata and Tiquipaya all the more essential. […] These solutions have included community health worker training; educational public health campaigns; working with the government to provide improved hygiene and residential infrastructure; and offering diagnosis and treatment support. […] A final report built upon the findings and subsequent discussions with MAP International and the AbbVie Foundation to articulate evidence-based next steps for the project, including expanding the Chagas Program into additional affected communities; producing audiovisual and print materials about disease control and prevention in Quechua; and supporting test kit and medication procurement.

• #1 Chagas Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459272/

  Clinician awareness is equally vital, particularly in endemic areas and among healthcare practitioners treating at-risk populations, including travelers, immigrants, and those receiving blood transfusions or organ transplants. […] By improving public awareness and clinician competence, preventive efforts can significantly decrease the burden of Chagas disease and reduce its long-term health consequences. […] Currently, Chagas disease has no vaccine. The main methods for preventing transmission include education, improved housing, vector control using bed netting, and screening donated blood and children in endemic areas.

• #1 Integrating Chagas Disease Screening Into Primary Health Care < Yale School of Medicine

  https://medicine.yale.edu/news-article/integrating-chagas-disease-screening-into-primary-health-care/

  Research on Chagas disease at Yale should be paired with more robust asymptomatic screening, whether that be for all higher risk patients, or targeted toward at-risk pregnant patients. The Yale New Haven Health System, Yale School of Public Health, Yale School of Medicine, Yale School of Nursing, and physician associate program provide fertile ground for developing a robust program, both for research and patient care. Ideally there would be community outreach, patient support programs, and interdisciplinary networks of healthcare professionals. As with any screening program, one of the most important things is to have an appropriate plan for screened patients who test positive, and for that we need collaboration between all relevant specialties.

• #1

  https://www.who.int/news-room/fact-sheets/detail/chagas-disease-(american-trypanosomiasis)

  Innovation, research and development, and evaluation of new diagnostics and medicines can accelerate the path towards the elimination of the disease as a public health problem. […] Promotion of biomedical, psychosocial and environmental studies focused on the determinants and risk factors of Chagas disease is essential to identify novel approaches for prevention and control.

• #1 The Low Variability of Tc24 in Trypanosoma cruzi TcI as an Advantage for Chagas Disease Prophylaxis and Diagnosis in Mexico

  https://www.mdpi.com/2076-0817/12/3/368

  Chagas disease is considered the principal neglected tropical disease on the American continent. […] For this reason, the findings of the present study strengthen the possibility of using Tc24 as a molecule that can be implemented as a candidate for prophylaxis and therapy against this disease. […] A previous study demonstrated that this protein is under negative selection pressure, probably due to the relevant role of this molecule in flagellar production, and adhesion to the vector and potentially to the vertebrate host. […] For this reason, and in accordance with most of the demonstrated evidence, TcI is the most frequently reported DTU in humans in the country up to now. […] The identification of the genetic variants that circulate in a region is essential in order to establish the potential efficiency of prophylactic vaccines.

• #1 WHF IASC Roadmap on Chagas Disease | Global Heart

  https://globalheartjournal.com/articles/10.5334/gh.484

  Treatment during the acute phase is highly effective, producing serological cure, reducing potentially severe clinical manifestations of the acute phase, and preventing progression to chronic CD. […] Anti-parasitic treatment during the chronic phase has an acceptable safety profile and is better tolerated in children than adults. […] Improved regimens of benznidazole and nifurtimox along with more research into their efficacy in adults, as well as development of new drugs with improved safety profiles and tolerability, are an important future step.

• #1 Target product profile for Chagas disease | DNDi

  https://dndi.org/diseases/chagas/target-product-profile/

  DNDi aims to develop an oral, age-adapted shorter-course treatment for Chagas disease that is safer and more effective than current options, for use in all regions and in both chronic and acute patients, including during pregnancy. […] The goal of test or intended use is to be used as an endpoint in clinical trials evaluating new anti-T. cruzi treatments or regimens. […] The objective is to develop a test to determine if a patient treated for Chagas disease has successfully responded to treatment, which is simple to perform and can be used as early as possible. […] The ideal conditions for the test would better suit the acceptable scenario (daily clinical management rather than clinical trial). […] The fewer the infrastructure requirements (i.e., power, water, skills), the more likely it is that this test can be adopted at lower levels, such as in the community or in primary healthcare facilities.

• #1 A decade of vector control activities: Progress and limitations of Chagas disease prevention in a region of Guatemala with persistent Triatoma dimidiata infestation | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0006896

  We propose that community-wide sprayings should be performed in communities with 15% infestation. […] Improving access to diagnostics at the local level should be a priority to reach women living in communities at highest risk. […] Integrated vector management strategies are needed for more sustainable effects. Control efforts should be maintained and optimized, since persistent infestation levels pose a constant threat for increased densities and renewed transmission.

• #1 Chagas disease – PAHO/WHO | Pan American Health Organization

  https://www.paho.org/en/topics/chagas-disease

  The World Health Assembly 2010 resolution WHA 63.20 and PAHO/WHO 2010 resolution CD50.R17, establish and implement the current Strategy and Plan of Action for Chagas disease prevention, control, and care. […] PAHO/WHO 2009 resolution CD49.R19 and 2016 resolution CD55.R9 of Neglected Infectious Diseases, provide a frame of reference on controlling and eliminating Chagas disease as a public health problem.

• #1 Preventing the transmission of American trypanosomiasis and its spread into non-endemic countries | Infectious Diseases of Poverty | Full Text

  https://idpjournal.biomedcentral.com/articles/10.1186/s40249-015-0092-7

  In general, all of non-endemic countries need to work together to increase networking at the global level, which focuses on strengthening global epidemiological surveillance and the sharing of information; prevent transmission by blood transfusions, organ transplantation, and congenital transmission; and promote diagnostic tools for the management of diagnosed cases.

• #1 Preventing the transmission of American trypanosomiasis and its spread into non-endemic countries | Infectious Diseases of Poverty | Full Text

  https://idpjournal.biomedcentral.com/articles/10.1186/s40249-015-0092-7

  Since 2007, the WHO has conducted a series of meetings, including Control and prevention of Chagas disease in Europe (2009) and Informal Consultation on Chagas Disease in the Western Pacific (2011), and issued the World Health Assembling resolution of WHA63.20 Chagas disease: control and elimination (2010)”. The general aim is to control Chagas disease in non-endemic countries and contribute to global efforts to interrupting disease transmission by (i) preventing T. cruzi transmission by systematically screening blood used for transfusions and organs intended for transplantation; (ii) clinic diagnosis, case management, and treating patients, including infected newborns through congenital transmission; and (iii) sharing information about Chagas disease, and training health personnel to facilitate diagnosis and medical care.

• #1 SciELO Brazil – Critical analysis of Chagas disease treatment in different countries Critical analysis of Chagas disease treatment in different countries

  https://www.scielo.br/j/mioc/a/JzcbFsm6ck9KKzgmFmCvc8k/

  Once treatment is initiated, scheduled visits are important to monitor possible adverse events and antiparasitic treatment compliance. […] In endemic areas, treatment coverage is extremely low, reaching only about 1% of estimated cases. […] Even though BNZ was recently approved by the FDA, patients with Chagas disease still have difficulty getting medication. […] Several initiatives are looking for feasible strategies to reduce the barriers to access to diagnosis and treatment. […] In endemic countries, the trend is for countries to gradually adopt the recommendation of universal screening in pregnant women. […] In non-endemic regions, screening for Chagas disease in asymptomatic Latin American adults is highly relevant, since it has been demonstrated that early diagnosis at primary care level and ulterior treatment is a cost-effective strategy. […] Therefore, considering the risk of reactivation and its bad prognosis, screening for T. cruzi should be performed in all HIV-infected individuals, individuals potentially exposed to T. cruzi infection, and in the children of HIV infected mothers.

• #1 SciELO Brazil – Critical analysis of Chagas disease treatment in different countries Critical analysis of Chagas disease treatment in different countries

  https://www.scielo.br/j/mioc/a/JzcbFsm6ck9KKzgmFmCvc8k/

  A comprehensive and multisectoral approach is needed to control Chagas disease efficiently and effectively. […] Programs such as the control of domestic vector populations and the implementation of screening programs in blood banks and among women of childbearing age, amongst others, have undoubtedly had an impact on progressively reducing transmission of Chagas disease. […] Timely identification and antiparasitic treatment of Chagas disease has important benefits, including prevention of future congenital transmission in treated mothers, serological cure in infants and children, and reduction of progression to advanced forms of the disease in adults. […] Therefore, early screening, diagnosis, and antiparasitic treatment of Chagas disease, in addition to representing a benefit for the patient, can also be considered as a public health strategy.

• #1

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4489466/

  The activities to prevent transmission of T. cruzi by transfusion are based on the implementation of blood bank control. […] The implementation of actions with sufficient evidence of efficacy carried out in an integrated manner throughout the country is a challenge of political and technical decision-making. […] Measures available of prevention of Chagas disease can reach high level of control due to total interruption of transmission by transfusion, total interruption of vector transmission in large areas and partial interruption or control in areas like Amazon Region and adequate level of coverage of timely diagnoses and treatment of people infected. […] Incorporating etiological treatment as a public health strategy useful at the primary, secondary and tertiary prevention levels is essential to reduce the burden of the disease and to eliminate Chagas disease as a public health issue.

• #1

  https://www.who.int/news/item/16-11-2018-preventing-mother-to-child-transmission-of-chagas-disease-from-control-to-elimination

  Accelerating the elimination of congenital transmission will mean implementing strategies and methods to detect, screen and diagnose all infected pregnant women as well as infected newborns and their siblings and to treat them as soon as possible. […] It will also imply implementing similar strategies for all women of childbearing age, ideally at paediatric age (under 19 years old) when the effectiveness of antiparasitic treatment is confirmed much more frequently and rapidly than in adults and with fewer adverse reactions. […] Implementing universal screening programmes requires appropriate laboratory protocols that, according to availability, should include old and new diagnostic tests, such as standardized and validated chemiluminescence. […] Experts attending the Second WHO Technical Consultation on the Control of Congenital Chagas disease in non-endemic countries also analysed the need to improve information and surveillance systems on congenital Chagas disease by notifying all cases, which can definitely help in measuring coverage and verifying the interruption of transmission. […] Domiciliary vectorial control and transfusional control, together with congenital transmission, remain the most effective methods of preventing transmission in Latin America.

• #2 Preventing Chagas Disease | Parasites – American Trypanosomiasis (also known as Chagas Disease) | CDC

  https://www.cdc.gov/chagas/prevention/index.html

  Chagas disease is caused by the parasite Trypanosoma cruzi. It usually spreads through contact with infected triatomine („kissing”) bugs. […] There are no drugs or vaccines to prevent Chagas disease. […] The best way to prevent Chagas disease is to prevent or limit contact with the kissing bug. […] Currently, no vaccines or medicines prevent Chagas disease. […] In the United States, consult a pest control expert before using insecticides against triatomine bugs, as there are none specifically approved for them here. […] Improving housing quality and using insecticides indoors have significantly cut down the spread of Chagas disease. […] Testing blood donations for Chagas has been an important way to help stop the disease from spreading via blood transfusions. […] In the United States the focus is on preventing the spread through blood transfusions, organ transplants, and from pregnant women to their babies.

• #2 Chagas disease – PAHO/WHO | Pan American Health Organization

  https://www.paho.org/en/topics/chagas-disease

  There is no vaccine for the disease Chagas. Integrated vector control is the most effective method of preventing Chagas disease in Latin America, including chemical control by insecticides in infested homes, improvements in houses to prevent vector infestation, personal preventive measures such as bed nets, and informative education and communication to the community about vector-borne diseases. […] Serological screening in blood donors is necessary to prevent infection through blood transfusion and organ transplant. […] Chagas screening in pregnant women during prenatal care is needed to provide early diagnosis and treatment to newborns and other children of infected mothers. […] Good hygiene practices in food preparation, transportation, storage and consumption; screening of blood donors; testing of organ, tissue or cell donors and receivers; and screening.

• #2 Chagas disease Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/chagas-disease

  Insect control with insecticides and houses that are less likely to have high insect populations will help control the spread of the disease. […] Blood banks in Central and South America screen donors for exposure to the parasite. The blood is discarded if the donor has the parasite. Most blood banks in the United States began screening for Chagas disease in 2007.

• #2 PREVENTION OF THE TRANSMISSION OF CHAGAS’ DISEASE WITH PYRETHROID-IMPREGNATED MATERIALS in: The American Journal of Tropical Medicine and Hygiene Volume 68 Issue 3 (2003)

  https://www.ajtmh.org/abstract/journals/tpmd/68/3/article-p307.xml

  Interrupting the transmission of Chagas disease using insecticide-treated materials could be a cost-effective option, particularly for sylvatic vectors, which enter houses at night. […] This randomized trial showed that in both countries users of impregnated bed nets were well protected from vector bites (immediate benefit). […] Thus, users of impregnated bed nets are well protected from transmission of Chagas disease, and vector reduction or elimination can potentially be achieved in areas infested with Rhodnius prolixus and R. robustus.

• #2 Center of Excellence for Chagas Disease | Slymar, CA | Prevention

  https://chagasus.org/prevention/

  The best way to prevent Chagas disease is to eliminate kissing bugs. In Latin America, widespread pesticide spraying has halted transmission of Chagas disease in Uruguay, Chile, Brazil, Paraguay, and elsewhere. […] A more sustainable solution to prevent Chagas disease is to provide adequate housing conditions for affected populations. […] Studies demonstrate that programs which combine housing improvements with pesticide spraying are the most effective at preventing transmission of Chagas disease.

• #2 Prevention of Chagas disease (American trypanosomiasis) – Canada.ca

  https://www.canada.ca/en/public-health/services/diseases/chagas-disease-american-trypanosomiasis/prevention-chagas-disease-american-trypanosomiasis.html

  There is no vaccine or medication that protects against Chagas disease. […] If you travel to an area where Chagas disease occurs, you should take the proper precautions. […] You can protect yourself from bug bites by following the precautions below. […] Avoid sleeping: outdoors, in poorly-built houses made from mud or thatch. […] Sleep under a bed net treated with insecticide if you must sleep outdoors. […] Practise safe food and water precautions. […] Avoid getting blood transfusions and organ transplants in areas where Chagas disease is found. […] If this is the case, confirm that the donated blood or organ has been tested for Chagas disease. If you cannot confirm this testing, and it is not an emergency, return home for treatment.

• #2 Chagas Disease / American Trypanosomiasis

  https://oklahoma.gov/health/health-education/acute-disease-service/tickborne-and-mosquitoborne-diseases/chagas-disease-american-trypanosomiasis.html

  Avoid sleeping in thatch, mud, or adobe houses. […] If traveling to a country with high levels of disease, sleep inside screened areas, under a permethrin-impregnated bed net, or an air-conditioned room. […] Avoid insect bites. […] Use insecticides to kill bugs and reduce the risk of transmission. […] Wash and cook any food that could be contaminated with insect feces. […] Remain aware that, in some countries, the blood supply may not always be screened for American trypanosomiasis and blood transfusions may carry a risk of infection.

• #2 SciELO Brazil – Chagas disease prevention through improved housing using an ecosystem approach to health Chagas disease prevention through improved housing using an ecosystem approach to health

  https://www.scielo.br/j/csp/a/xpWJYkBWxg5XMhbgGPGvT6f/?lang=en

  Family participation in housing improvement was assumed when at least one member of the family participated with the assigned instructor in performing the improvements planned jointly with the family members. […] The main focus of this study was the modification of artificial domiciliary and peridomiciliary ecotopes, attacking Chagas disease vectors via housing improvements. […] Integrated and sustainable vector control requires not only spraying, but the incorporation of environmental organization, community mobilization, and participation centered on peridomiciliary entomological surveillance.

• #2 Preventing the transmission of American trypanosomiasis and its spread into non-endemic countries | Infectious Diseases of Poverty | Full Text

  https://idpjournal.biomedcentral.com/articles/10.1186/s40249-015-0092-7

  Since 2007, the WHO has conducted a series of meetings, including Control and prevention of Chagas disease in Europe (2009) and Informal Consultation on Chagas Disease in the Western Pacific (2011), and issued the World Health Assembling resolution of WHA63.20 Chagas disease: control and elimination (2010)”. The general aim is to control Chagas disease in non-endemic countries and contribute to global efforts to interrupting disease transmission by (i) preventing T. cruzi transmission by systematically screening blood used for transfusions and organs intended for transplantation; (ii) clinic diagnosis, case management, and treating patients, including infected newborns through congenital transmission; and (iii) sharing information about Chagas disease, and training health personnel to facilitate diagnosis and medical care.

• #2 Congenital Chagas disease: Updated recommendations for prevention, diagnosis, treatment, and follow-up of newborns and siblings, girls, women of childbearing age, and pregnant women | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0007694

  Congenital transmission of T. cruzi infection is considered as such when (i) a neonate is born to an infected mother (i.e., with positive serology and/or T. cruzi parasites circulating in the blood) and (ii) T. cruzi parasites are identified in neonate blood at or after birth or (iii) specific antibodies not of maternal origin are detected after birth and (iv) previous transmission to infant by vectors and/or blood transfusion has been ruled out. […] In order to eliminate congenital transmission of T. cruzi, efforts should be focused on 5 population groups living within or outside of LA (as defined previously), namely the following: […] Women of fertile age not yet pregnant (childbearing age), by detecting T. cruzi infection and treating those who are infected (aiming to prevent congenital transmission and reduce the pool of infected population)

• #2 SciELO Brazil – Critical analysis of Chagas disease treatment in different countries Critical analysis of Chagas disease treatment in different countries

  https://www.scielo.br/j/mioc/a/JzcbFsm6ck9KKzgmFmCvc8k/

  In this work, we aim to review antiparasitic treatment approaches to patients with Chagas disease, according to their geographic context. […] Treatment of Chagas disease still relies on old drugs licensed more than 50 years ago: nifurtimox (NFX, launched by Bayer in 1965) and benznidazole (BNZ, launched by Roche in 1971). […] Both compounds are considered to be very effective in acute and recent infections, and for the prevention of maternal-fetal transmission. […] Despite the limited rates of cure in the chronic phase, current recommendations advocate treatment for patients in the chronic phase if they do not have severe heart disease. […] This consensus is based mainly on the inferior long-term clinical progression observed in patients treated with benznidazole for the prevention of chagasic cardiomyopathy after an average follow-up of about 10 years, as well as in the prevention of congenital transmission of children born to infected and treated women of childbearing age.

• #2

  https://www.gov.uk/guidance/chagas-disease-migrant-health-guide

  Offer serological testing for Chagas disease to Latin American migrants: […] Offer pre-conception screening to Latin American migrant women of child-bearing age. Pre-conception screening with treatment can also reduce the risk of congenital infection. […] Offer serological testing to pregnant women who are migrants from Latin America. While treatment of Chagas during pregnancy is contraindicated, identification is important to detect and treat congenital infection. Treatment of infants is highly effective and well tolerated. Failure to identify and treat infected infants poses risk of morbidity and premature mortality from chronic Chagas later in life. […] Offer screening to immunosuppressed individuals (particularly those with HIV infection, undergoing transplantation or cancer chemotherapy) as they may be at risk of reactivation of infection and associated complications.

• #2 Congenital Chagas disease: Updated recommendations for prevention, diagnosis, treatment, and follow-up of newborns and siblings, girls, women of childbearing age, and pregnant women | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0007694

  Treatment follow-up is recommended by parasitological and/or molecular tests in the weeks after the treatment onset for neonates displaying parasitemia. After treatment completion, patients need to be followed every 6 months with quantitative serological tests. The patient is considered cured when serology becomes negative. […] Clinical evaluation and follow-up are required for mothers displaying cardiac and/or digestive forms of CD. It is recommended that infected mothers do not donate blood and that cord blood from neonates born to infected mothers is not used for bone marrow transplantation, due to the risk of inducing an acute CD in an immunosuppressed recipient. […] The barriers to healthcare access should be reduced to facilitate the diagnosis of CD and avoid loss to follow-up in the target populations.

• #2 SciELO Brazil – Critical analysis of Chagas disease treatment in different countries Critical analysis of Chagas disease treatment in different countries

  https://www.scielo.br/j/mioc/a/JzcbFsm6ck9KKzgmFmCvc8k/

  Treatment during the acute phase is highly effective. […] A general consensus to treat patients in the acute phase of Chagas disease (regardless of the mechanism of infection), patients with congenital infection, and reactivations in immunosuppressed patients. […] Patients up to 18 years old and women of child-bearing age are considered the priority target populations. […] Treatment with either BNZ or NFX is not recommended during pregnancy because of their teratogenic potential and a pregnancy test is recommended in women of childbearing age. […] Although there are no randomized clinical trials that compare BNZ and NFX, BNZ is generally preferred due to its better tolerability. […] Several studies suggest that the use of a simpler fixed dose of BZN may be equivalent to an adjusted dose in terms of effectiveness, which would simplify administration and enhance compliance.

• #2

  https://www.who.int/news-room/fact-sheets/detail/chagas-disease-(american-trypanosomiasis)

  Depending on the geographical area, WHO recommends the following approaches to prevention and control: development of information, education and communication materials and activities, contextualized for the different scenarios and actors, and based on a One Health approach; early access to diagnosis, treatment and follow up; screening of newborns and other children of infected mothers; screening of blood donors; testing of organ, tissue or cell donors and receivers; spraying of dwellings and surrounding areas with residual insecticides; house improvements and house cleanliness to prevent vector infestation; and personal preventive measures such as bednets, good hygiene practices in food preparation, transportation, storage and consumption. […] All health professionals, beginning at the first level of care (primary health care), and appropriately trained and updated, have a crucial role in enhancing the detection, treatment, follow-up, and notification of cases.

• #2 Chagas Disease

  https://www.sandiegocounty.gov/content/sdc/hhsa/programs/phs/community_epidemiology/dc/chagasdisease.html

  Currently, there is no vaccine, or drugs, available to prevent Chagas disease spread. If you plan on traveling to Chagas endemic areas, it is important to take the following precautions: […] In areas where the T. cruzi parasite is present, improved housing and spraying insecticide inside housing to eliminate the bugs has decreased the spread of Chagas disease. […] Spray infested areas with long-lasting insecticides. […] Use bed nets treated with long-lasting insecticides. […] Apply insect repellent to exposed skin day and night. […] Follow food and beverage precautions. […] Avoid consuming salads, uncooked vegetables, unpeeled fruits, and unpasteurized fruit juices. […] Use weather stripping and caulking to close cracks and crevices. […] Seal openings where bugs can get in.

• #2 Chagas Disease | Washington State Department of Health

  https://doh.wa.gov/you-and-your-family/illness-and-disease-z/chagas-disease

  If you are traveling to or visiting rural areas that might have Chagas disease, be sure to: […] Stay in well-built places, such as air-conditioned or screened rooms. This lowers the risk of contact with infected kissing bugs, which often live in poorly built dwellings and are active at night. […] Sleep under bed nets treated with long-lasting insecticide. […] Wear clothing that covers your skin and use EPA-registered insect repellant on skin that’s exposed. […] Do not eat salads, raw vegetables, unpeeled fruits, and unpasteurized fruit juices. […] There are no vaccines or medicines that can prevent Chagas disease at this time. […] If you have previously lived or spent time in areas where infected kissing bugs are present, discuss with your healthcare provider whether screening for Chagas disease is recommended.

• #2 What Are the Public Health Measures for the Prevention of Chagas Disease?

  https://www.icliniq.com/articles/infectious-diseases/chagas-disease-and-public-health-measures-for-its-prevention

  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. […] 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. […] 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.

• #2 Recent advances in the prevention, diagnosis and treatment of Chagas Disease | Frontiers Research Topic

  https://www.frontiersin.org/research-topics/56637/recent-advances-in-the-prevention-diagnosis-and-treatment-of-chagas-disease/magazine

  Chagas disease, a neglected tropical disease caused by the parasite Trypanosoma cruzi, is a serious public health problem, affecting an estimated 6-7 million people worldwide, with approximately 30% of those infected developing chronic and potentially life-threatening cardiac or digestive complications. […] To face this neglected disease, groups around the world are developing vector control strategies, more effective diagnostic tools, new drugs and searching for parasite exclusive molecular targets for the development of new and more effective therapeutics. […] Recent advances in genomics, proteomics, and drug discovery have provided new opportunities for the prevention, diagnosis, and treatment of Chagas disease. […] In this Research Topic, we welcome Original Research articles, Technology Reports, Reviews, Brief Research Reports, and Mini Reviews that cover, but are not limited to, the following areas: – Epidemiology and surveillance of Chagas disease – Vector control strategies – Advances in diagnostics and screening tools – Drug discovery and development – Drug repurposing – Novel therapeutic approaches – New molecular targets.

• #2 The Low Variability of Tc24 in Trypanosoma cruzi TcI as an Advantage for Chagas Disease Prophylaxis and Diagnosis in Mexico

  https://www.mdpi.com/2076-0817/12/3/368

  This was demonstrated in the currently used malaria vaccine against Plasmodium falciparum in Sudan and other African countries. […] Our study reveals the presence of a highly conserved fragment of the Tc24 protein across TcI isolates from Mexico and from other countries in Latin America, thus providing a potential target for the development of a regional vaccine that could protect most of the people in risk areas where TcI is the main circulating genotype. […] Tc24 was postulated as a vaccine candidate, and was tested on murine, canine, and nonhuman primate models, showing activity in decreasing the proliferation of parasites in the blood and decreasing cardiac damage in immunised animals. […] Given that historical studies, and the findings of the present work, confirmed that TcI is the only genotype detected in Mexico from human isolates from various states of the Mexican Republic, and that there is no genetic variability in any of them, it is possible to propose the development of in silico strategies for the production of antigens to optimise the diagnosis of Chagas disease such as quantitative ELISA methods that use this region of Tc24 without the need for parasitic cultures, and with the possibility of reducing biosafety requirements in diagnostic laboratories.

• #2 Target product profile for Chagas disease | DNDi

  https://dndi.org/diseases/chagas/target-product-profile/

  DNDi aims to develop an oral, age-adapted shorter-course treatment for Chagas disease that is safer and more effective than current options, for use in all regions and in both chronic and acute patients, including during pregnancy. […] The goal of test or intended use is to be used as an endpoint in clinical trials evaluating new anti-T. cruzi treatments or regimens. […] The objective is to develop a test to determine if a patient treated for Chagas disease has successfully responded to treatment, which is simple to perform and can be used as early as possible. […] The ideal conditions for the test would better suit the acceptable scenario (daily clinical management rather than clinical trial). […] The fewer the infrastructure requirements (i.e., power, water, skills), the more likely it is that this test can be adopted at lower levels, such as in the community or in primary healthcare facilities.

• #2 Chagas disease – PAHO/WHO | Pan American Health Organization

  https://www.paho.org/en/topics/chagas-disease

  The World Health Assembly 2010 resolution WHA 63.20 and PAHO/WHO 2010 resolution CD50.R17, establish and implement the current Strategy and Plan of Action for Chagas disease prevention, control, and care. […] PAHO/WHO 2009 resolution CD49.R19 and 2016 resolution CD55.R9 of Neglected Infectious Diseases, provide a frame of reference on controlling and eliminating Chagas disease as a public health problem.

• #2

  https://www.who.int/news/item/16-11-2018-preventing-mother-to-child-transmission-of-chagas-disease-from-control-to-elimination

  Accelerating the elimination of congenital transmission will mean implementing strategies and methods to detect, screen and diagnose all infected pregnant women as well as infected newborns and their siblings and to treat them as soon as possible. […] It will also imply implementing similar strategies for all women of childbearing age, ideally at paediatric age (under 19 years old) when the effectiveness of antiparasitic treatment is confirmed much more frequently and rapidly than in adults and with fewer adverse reactions. […] Implementing universal screening programmes requires appropriate laboratory protocols that, according to availability, should include old and new diagnostic tests, such as standardized and validated chemiluminescence. […] Experts attending the Second WHO Technical Consultation on the Control of Congenital Chagas disease in non-endemic countries also analysed the need to improve information and surveillance systems on congenital Chagas disease by notifying all cases, which can definitely help in measuring coverage and verifying the interruption of transmission. […] Domiciliary vectorial control and transfusional control, together with congenital transmission, remain the most effective methods of preventing transmission in Latin America.

• #2 Fighting Strategies Against Chagas’ Disease: A Review

  https://www.mdpi.com/2076-0817/14/2/183

  It has also been essential to develop sustainable vector control strategies based on improved risk assessment of infection and disease or to improve surveillance programs in all endemic regions. […] The future success of the fight against Chagas disease depends on efficient management of newly emerging infectious foci, maintenance of high levels of public awareness and governmental interest in controlling the disease, and continuous improvements in diagnostic, therapeutic and surveillance tools. […] The objective of this review is to describe the current status of strategies to control Chagas disease and highlight new research topics to reduce the burden of this public health problem. […] Specifically, we address selected aspects that include the biology of T. cruzi to better understand the dynamics of its transmission, the identification of methods focused on the prevention and control of the disease developed by local governments, international organizations, public health and civil society with both scientific and traditional or homemade approaches, as well as the recognition of the main social and ecological factors that have historically played a role in favoring or reducing the presence of the disease vector in the Latin American region.

• #3 Chagas Disease: MedlinePlus

  https://medlineplus.gov/chagasdisease.html

  Can Chagas disease be prevented? […] There are no vaccines or medicines to prevent Chagas disease. If you travel to areas where it occurs, you are at higher risk if you sleep outdoors or are staying in poor housing conditions. It is important to use insecticides to prevent bites and practice food safety.

• #3 Preventing Chagas Disease | Parasites – American Trypanosomiasis (also known as Chagas Disease) | CDC

  https://www.cdc.gov/chagas/prevention/index.html

  Chagas disease is caused by the parasite Trypanosoma cruzi. It usually spreads through contact with infected triatomine („kissing”) bugs. […] There are no drugs or vaccines to prevent Chagas disease. […] The best way to prevent Chagas disease is to prevent or limit contact with the kissing bug. […] Currently, no vaccines or medicines prevent Chagas disease. […] In the United States, consult a pest control expert before using insecticides against triatomine bugs, as there are none specifically approved for them here. […] Improving housing quality and using insecticides indoors have significantly cut down the spread of Chagas disease. […] Testing blood donations for Chagas has been an important way to help stop the disease from spreading via blood transfusions. […] In the United States the focus is on preventing the spread through blood transfusions, organ transplants, and from pregnant women to their babies.

• #3 Fighting Strategies Against Chagas’ Disease: A Review

  https://www.mdpi.com/2076-0817/14/2/183

  In the case of congenital transmission, early diagnosis in pregnant women, especially in high-prevalence areas, is essential. […] Timely treatment of infected neonates is highly effective and prevents long-term complications. […] Both benznidazole and nifurtimox are highly effective when administered during the first year of life for treating congenital Chagas disease. […] The effectiveness of these interventions is supported by evidence indicating that treatment prior to pregnancy reduces congenital transmission nearly to 100%, while neonatal screening and prompt treatment in infected infants achieve similar rates of cure. […] Preventive measures include ensuring proper food hygiene, the use of safe drinking water, along with vector control in food production areas, and the safe processing of products such as cane or fruit juices, particularly in rural areas of Latin America.

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