Facing Chagas disease

Prognosis of chronic Chagas heart disease and other pending clinical challenges

“…Considering the percentage of people who progress to the cardiac form of Chagas disease, it is estimated that there are currently between 600 and 900 thousand people with chronic Chagas heart disease in the country, the majority of which are in older age groups, a population with a higher frequency of comorbidities. (7) Considering the actuarial charts available, we can expect the existence of people with chronic heart disease for thirty or forty more years in Brazil or even longer if we consider the population of the Amazon region that is being infected orally at present and may develop chronic heart disease in the future. It is possible that we are now perceiving only the tip of the iceberg with regard to the future consequences of changing the current epidemiological profile of the disease in the Amazon region.…”

“…Early detection of Chagas disease and its clinical-evolutionary characterisation are feasible by means of the diagnostic arsenal currently available, but its universalisation is still far from being possible, both in endemic rural regions and in urban centres, due to the lack of knowledge of the disease by health professionals and also due to problems of patient access to different levels of public health care. (7) As the management of heart disease requires continuity of care, it is necessary to seek the best solutions for its diagnosis, staging, treatment and, above all, to ensure patient compliance with treatment. To achieve these goals, it is essential to invest in the education of health teams, and in a country of continental dimensions such as Brazil, the training and updating of professionals can be achieved through the use of distance education, which has gained significant momentum in recent years, fostered by more universal access to mobile technology and the internet.…”

“…It was found that the severity of chronic heart disease is directly related to the occurrence and intensity of heart disease in the acute phase, (6) and in the anatomical-physiological field, myocytolysis, fibrosis and neurovegetative dysautonomy have been considered the main basis of severe disease, factors that still challenge doctors and researchers today. (7,8)…”

Induction of Autophagy by Ursolic Acid Promotes the Elimination of Trypanosoma cruzi Amastigotes From Macrophages and Cardiac Cells

“…T. cruzi has a biphasic biological cycle that develops in both the insect vector and the mammalian hosts. In the latter, T. cruzi behaves as an obligate intracellular parasite, interacting with compartments from the vesicular transport pathways to invade the host cell and establish its replicative niche ( Nunes et al., 2013 ; Dias, 2017 ; Guarner, 2019 ). T. cruzi is capable of infecting several classes of host cells.…”

Combination With Tomatidine Improves the Potency of Posaconazole Against Trypanosoma cruzi

“…Due to increasing global migration, CD has spread to other continents through a diversity of other transmission routes such as blood transfusion, organ transplantation, and mother-to-child (Gascon et al, 2010;Peŕez-Molina and Molina, 2018). Also, oral transmission due to beverages contaminated with the feces or with infected triatomines currently represents a serious challenge in many endemic areas such as Brazil (Coura et al, 2014;Dias, 2017). This neglected disease presents a short acute phase with patent parasitemia, which is usually asymptomatic or oligosymptomatic with "flu-like" symptoms (Prata, 2001;Rassi et al, 2010).…”