A new targeted screening strategy could make the diagnosis and treatment of Chagas disease more feasible in low-resource settings, concludes a new study, publishing on December 26, 2007, in the open-access journal PLoS Neglected Tropical Diseases.
Trypanosoma cruzi, the single-cell parasite that causes Chagas disease, is transmitted by triatomine bugs that infest houses in poor communities. The disease, which infects an estimated 11 million people in Latin America, kills more people than any other parasitic disease in the Americas.
Chagas disease control programs have traditionally focused on interrupting the transmission of T. cruzi through vector control measures (such as insecticide spraying), rather than on active case detection and specific treatment of infected people. While control actions have reduced the geographic range and prevalence of major triatomine vectors, without attention to timely diagnosis of those already infected, the window of opportunity for effective treatment (such as giving anti-parasitic drugs) is missed. An important reason for the low rates of treatment is that health services and control programs in Latin America lack sufficient resources for comprehensive blood screening and supervised treatment in the most affected areas.
The study, by Michael Levy (Emory University and the Centers for Disease Control and Prevention, Atlanta, USA, currently at the Fogarty International Center of the NIH) and colleagues, demonstrates an alternative screening strategy that could potentially be much more efficient and cost-effective, and therefore much more viable in the resource-poor regions plagued by the disease.
The researchers performed a serological survey in children 218 years old living in a peri-urban community of Arequipa, Peru, where a vector control campaign is currently disrupting transmission of T. cruzi. They found that 5.3% of children had already been infected by the time their households
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