Chagas Disease: A Major Issue in the Americas

The "kissing bug" that transmits
Chagas disease 

Here is a brief NPR piece on Chagas disease. Chagas disease is one of the neglected tropical diseases, and is an insect-borne parasitic infection that affects people in the Americas, especially parts of rural Latin America.

The insect vectors for the disease are known as "kissing bugs." They live in the walls and roofs of houses made of adobe, mud, straw and thatch, and emerge at night to feed on people's faces (I am not making this up). The insects thereafter defecate and the parasite (Trypanosoma cruzi), which is in the stool, gets inoculated through the skin when a person scratches.

Town of La Hicaca; this is one of the sites where we see
patients in Honduras; Chagas disease is a major problem in the area

It is estimated that 11 million people are currently living with this infection, and untreated these diseases persist for life. Chagas disease is associated with major morbidity: over time the infection can lead to heart failure and death from arrhythmias, as well as dilatation of the esophagus and colon with attendant gastrointestinal issues.

Where we practice in rural Honduras Chagas is a major issue. One of our projects for our upcoming May-June trip is administering a survey to assess people's risk for developing the infection, and their knowledge and understanding about how to prevent these infections.

Another nice article on Chagas from the New York Times can be found here.

Neglected Tropical Diseases: An Update From the WHO

Distribution of soil-transmitted helminths (STHs) and proportion
of children requiring preventive chemotherapy; where we practice
in Honduras STHs are a major problem (www.who.int)

The World Health Organization (WHO) just released its second report on Neglected Tropical Diseases (NTDs); this is a 152 page document outlining the global response to combatting NTDs. The WHO also released a one page summary of this report's findings which can be found here.

As I have previously noted, NTDs include a group of seventeen tropical infections, mostly worms, that are associated with high morbidity (things such as poor growth and mental development in children, pregnancy complications) but low mortality. Despite their major negative effects on health they do not receive much "press" (as opposed to better known diseases such as malaria, HIV and tuberculosis). It is estimated that 1 in 6 people in the world currently suffer from an NTD. 

Global improvements in access to STH therapy have occurred over
the past few years (www.who.int)

In our work in Honduras we focus on decreasing the burden of NTDs, specifically, soil-transmitted helminths (intestinal worms). We estimate that somewhere between 30-70% of the patients we see are infected with one or more of these worms. We provide anti-helminthic therapy according to WHO guidelines, with the hopes of decreasing the overall burden of these infections in the population at large. According to the WHO, "deworming school-aged children is probably the most economically efficient public health activity that can be implemented in any low-income country."

Overall the WHO document is positive, noting recent improvements in combatting NTDs globally. Two diseases have been targeted for elimination, including guinea worm disease in 2015 and yaws in 2020. Global coverage for many other NTDs has improved in recent years, as well. Although there have been significant advances over the past few years, there is still a great deal of work to be done. 

The report also highlights the global dengue problem; the incidence of this disease has increased 30-fold in the past 50 years, and sustainable preventive measures need to be adopted globally to prevent continued spread of this mosquito-borne illness. 

Combating Neglected Tropical Diseases in Honduras

I had the great opportunity to 'guest blog' today over at the Global Network for Neglected Tropical Diseases' blog on our work to combat neglected tropical diseases in Honduras. The full blog post can be found here.

Neglected Tropical Diseases: Becoming Less Neglected?

Ascaris lumbricoides (the "large common roundworm"),
a soil-transmitted helminth; cdc.gov

Here is a nice article outlining the global problem of neglected tropical diseases, or "NTDs." These are a group of seventeen tropical infections, mostly worms, that are associated with high morbidity (things such as poor growth and mental development in children, pregnancy complications) but low mortality. Despite their major negative effects on health they do not receive much "press" (as opposed to better known diseases such as malaria, HIV and tuberculosis).

It is estimated that 1 in 6 people in the world currently suffer from an NTD. 

The article links to the "END7" campaign that has some great resources about NTDs, including a two minute long YouTube video that is worth checking out. Some nice general information about the seven most common NTDs can be found here.

In our work in Honduras we focus on decreasing the burden of NTDs, specifically, soil-transmitted helminths (intestinal worms). We estimate that somewhere between 30-70% of the patients we see are infected with one or more of these worms. We provide anti-helminthic therapy according to WHO guidelines, with the hopes of decreasing the overall burden of these infections in the population at large. According to the WHO, "deworming school-aged children is probably the most economically efficient public health activity that can be implemented in any low-income country."

The overall tone of the Guardian article is hopeful, noting that the movement to combat NTDs has gained momentum. However, as emphasized in the article, efforts to combat these diseases should be inter-disciplinary and address both environmental health issues in addition to eradicating disease at the individual level.