BOGOTA (AlertNet) - Better diagnosis and treatment are needed to combat Chagas, a little-known disease that affects up to 15 million people worldwide and kills an estimated 14,000 each year, medical charity Medecins Sans Frontieres (MSF) has said.
One hundred years after the Brazilian doctor Carlos Chagas discovered the parasitic disease, which is transmitted by a cockroach-like bug endemic to Latin America, little headway has been made in research.
There is still a lack of innovative treatments, new medicines, rapid diagnosis tests and cure tests for one of the worldÂ?s most neglected diseases.
Â?ItÂ?s a disease that predominately affects poor people, thatÂ?s one of the reasons why no-one pays Chagas any attention. ItÂ?s a silent killer,Â? Tom Ellman, head of mission for MSF in Bolivia, told AlertNet by phone.
The disease is primarily spread by a blood-sucking insect that bites at night and hides in animal hutches, thatched roofs and cracks in adobe houses where many of Latin AmericaÂ?s poor live.
Â?The strongest risk factor for getting Chagas is poor housing,Â? said Ellman.
Transmission is also possible from mother to child, blood transfusions, organ transplants and contaminated food.
HARD TO SPOT
Chagas is a difficult disease to spot. It is estimated that only one in three people living with Chagas will develop life-threatening health problems, such as heart disease, cardiac arrest, and intestinal complications.
It can also take up to 30 years or more for chronic health problems among Chagas sufferers to develop, compounding the difficulties for people to get diagnosed correctly and get timely treatment.
Â?You donÂ?t see the disease, and the majority of people will never know they have been infected,Â? said Ellman. Â?People with Chagas rarely have classic acute symptoms.Â?
Treatment, particularly in remote, poor rural communities across Latin America, is hard to come by. The only two existing drugs being used to treat Chagas were developed over 40 years ago and Brazil is the only producer of the drugs in the world. Side effects, such as skin rashes, are common.
Â?There have been no advances in the treatment of Chagas disease in the last 40 years. Even though the drugs are safe to use, we need better and new drugs,Â? said Ellman.
Even when treatment is given, it is difficult to determine whether a Chagas sufferer has been cured.
Â?ItÂ?s hard to spot the antibodies in blood tests and so itÂ?s difficult to say, particularly in adults, whether someone is cured,Â? said Ellman.
With one million people out of BoliviaÂ?s population of nine million infected with Chagas, the Andean nation has the highest rate of Chagas disease in the world. Bolivia, like most governments in Latin America, has traditionally focused on preventing the spread of Chagas, usually by spraying houses with insecticide, rather than treatment of patients.
But prevention is not enough.
Â?Communities living with Chagas need to start demanding their governments better diagnosis and access to the drug, which is what happened with HIV/AIDs in the U.S.,Â? said Ellman.
MSF is working with the Bolivian health ministry to promote blood screening of Chagas, and make treatment and diagnosis more widely available in public health centres, where people can receive treatment as they would for more well-known illnesses like diarrhea and malaria.
Despite recent efforts to raise awareness of Chagas, it remains a low priority among health ministries in Latin America. The tropical disease also receives scant attention from researchers and pharmaceutical companies in and outside the region.
It is estimated that only $10 million was spent on research about Chagas in 2007, accounting for just 0.4 per cent of all spending on research of the worldÂ?s neglected diseases.
In recent years, worldwide migration means that more cases of Chagas are being reported outside of Latin America. Around 300,000 people live with Chagas in the U.S. and more cases are being diagnosed in Europe, Australia and Japan.
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