Barriers to Treatment Access for Chagas Disease in Mexico

Manne, Jennifer; Snively, Callae S; Ramsey, Janine M.; Salgado, Marco Ocampo; Bärnighausen, Till; Reich, Michael R.

doi:10.1371/journal.pntd.0002488

Cited by 83 publications

(76 citation statements)

References 27 publications

(56 reference statements)

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“…Por otro lado, en México, como en otros países americanos, la disponibilidad de los medicamentos para la tripanosomiasis es limitada y su costo elevado, lo que limita el tratamiento temprano de la enfermedad y significa otro reto para las autoridades sanitarias 19 .…”

Section: Discussionunclassified

Cardiopatía Chagásica en un escolar: Reporte de caso

Méndez-Domínguez

Chi-Méndez

Canto-Losa

et al. 2017

Rev. chil. pediatr.

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ResumenIntroducción: La enfermedad de Chagas (ECh) o tripanosomiasis americana es una enfermedad transmitida principalmente por insectos hematófagos detectados en zonas rurales y urbanas desde México hasta Argentina. De acuerdo a la Organización Panamericana de la Salud, entre 7,7 y 10 millones de personas cursan con infección crónica. La ECh es causada por el protozoario flagelado Trypanosoma cruzi. Posterior al contacto inicial con el vector, la fase aguda es comúnmente seguida por una fase silente que dura 15-20 años antes de debutar con manifestaciones cardíacas, neurológi-cas o gastrointestinales. Objetivo: Analizar el curso clínico atípico de un caso de cardiopatía chagásica en un paciente pediátrico del sureste de México. Caso clínico: El paciente consultó al desarrollar un chagoma en la pierna izquierda. Cinco meses después, se observó en su electrocardiograma una taquicardia sinusal y un crecimiento auricular izquierdo con ondas P anchas e intervalo QT prolongado. En la radiografía de tórax se observó cardiomegalia (índice cardiotorácico = 0,52); en el ecocardiograma transtorácico mostró dilatación del atrio y ventrículo izquierdos. Conclusión: Es importante realizar evaluaciones cardíacas oportunas en pacientes pediátricos con ECh, pues no debe asumirse que cursarán con una fase silente o que debutarán tardíamente con cardiopatía. Keywords:Chagas Cardiomyopathy; Trypanosoma cruzi; Chagas Disease; Cardiomegaly Abstract Introduction: Chagas disease also known as American Trypanosomiasis is mainly caused by haematophagous insects widely distributed from Mexico to Argentina. According to the Panamerican Health Organization, 7.7 to 10 million people are living with chronic infection. Chagas disease is caused by Trypanosoma cruzi, a protozoan transmitted by triatomine vectors. After an initial acute phase, Chagas is followed by a silent phase that lasts 15-20 years before debuting with cardiac, neurological or gastrointestinal manifestations. Objective: To analyze the atypical clinical course

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Section: Discussionunclassified

Cardiopatía Chagásica en un escolar: Reporte de caso

Méndez-Domínguez

Chi-Méndez

Canto-Losa

et al. 2017

Rev. chil. pediatr.

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“…Many of the challenges involved in treating CD in Colombia are shared by other endemic and even nonendemic countries (30)(31)(32)(33)(34)(35). Although local contexts differ, several core components of the Colombian pilot project could provide a framework for increasing access to CD health care in diverse countries (Figure 2).…”

Section: Public Health Implicationsmentioning

confidence: 99%

Increasing access to comprehensive care for Chagas disease: development of a patient-centered model in Colombia

Marchiol¹,

Forsyth²,

Bernal³

et al. 2017

Rev Panam Salud Publica

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et al. Increasing access to comprehensive care for Chagas disease: development of a patient-centered model in Colombia. Rev Panam Salud Publica. 2017;41:e153. doi: 10.26633/RPSP.2017.153 Worldwide, over 6 million people are infected with Trypanosoma cruzi, the protozoan that causes Chagas disease (CD), yet fewer than 1% of them receive treatment. In Colombia, CD poses a major public health challenge. An estimated 437 000 Colombians are infected with T. cruzi, of whom 131 000 suffer from cardiomyopathy due to the advancement of the disease (1). CD also creates a heavy economic burden; the estimated annual cost of treating a patient in the chronic stage of the disease was US$ 1 028 in 2004 (equivalent to US$ 1 336 in 2017) (2). This entails a total annual cost of US$ 175 016 000 (2017 dollars) for Colombia's health system.CD is most often transmitted by insects of the triatomine subfamily, also known as kissing bugs or, in Colombia, pitos. However, CD can also spread via

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“…Mobile Health approaches are promising and should be explored further [24]. In some countries, availability of drugs is also an issue [25].…”

Section: Prevention and Treatmentmentioning

confidence: 99%

Mother-to-Child Transmission of Trypanosoma cruzi

Gebrekristos

Buekens

2014

Journal of the Pediatric Infectious Diseases Society

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Among the world's most neglected tropical diseases, Chagas disease is vector-borne and caused by Trypanosoma cruzi. T cruzi infection is endemic to South and Central America as well as Mexico. Due to population migration, T cruzi is increasingly becoming a public health problem in nonendemic settings. Success with vector control strategies has led to a relative increase in the burden attributable to congenital transmission of T cruzi. In endemic settings, approximately 5% of infected pregnant women transmit to their offspring. Congenital T cruzi infection is generally asymptomatic and parasitological and serological testing is required for diagnosis. This review highlights research gaps with a focus on (1) improving screening, diagnostic, and treatment options and (2) designing epidemiologic studies to understand risk factors for congenital T cruzi.

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Barriers to Treatment Access for Chagas Disease in Mexico

Cited by 83 publications

References 27 publications

Cardiopatía Chagásica en un escolar: Reporte de caso

Cardiopatía Chagásica en un escolar: Reporte de caso

Increasing access to comprehensive care for Chagas disease: development of a patient-centered model in Colombia

Mother-to-Child Transmission of Trypanosoma cruzi

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