Trypanocidal drugs for late-stage, symptomatic Chagas disease (<i>Trypanosoma cruzi</i>
 infection)

Vallejo, Maité; Reyes, Pedro Pa; Garcia, Mireya Martinez; Garay, Alejandro G Gonzalez

doi:10.1002/14651858.cd004102.pub3

Cited by 6 publications

(8 citation statements)

References 77 publications

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“…The implantation of a cardiac pacemaker may indicate having a weak heart or irregular beats 28 . Drug treatment was also pointed out as a reason for fear among this population, which is probably due to the possibility of severe adverse side effects caused by use of trypanocidal drugs (benznidazole and nifurtimox), such as cutaneous rash, gastrointestinal symptoms, and peripheral polyneuropathy [55][56][57] . In this scenario, communication is required between healthcare professionals and patients, especially regarding health education strategies.…”

Section: Discussionmentioning

confidence: 99%

Health-Related Quality of Life Reported by Patients With Chagas Disease: A Systematic Review of Qualitative Evidence With GRADE Recommendations

Silva

Oliveira

Xavier

et al. 2022

Rev. Soc. Bras. Med. Trop.

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Patients with Chagas disease have reduced health-related quality of life (HRQoL). Hence, we aimed to identify the factors that mostly affected their HRQoL. This was a systematic review of qualitative studies. The Latin American and Caribbean Health Sciences Literature, Medical Literature Analysis and Retrieval System Online, Excerpta Medica Database, Web of Science, and SciVerse Scopus databases were searched for relevant studies without language or date restrictions. The search and data analysis were performed by independent reviewers; all qualitative studies that reported the factors that had an impact on the HRQoL of patients with Chagas disease were included. The risk of bias was assessed using the Critical Appraisal Skills Program Qualitative Study Checklist; confidence in the evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative approach. Five studies were included in this review: four in Brazil and one in California, United States, with immigrants from Central and South America. The sample consisted of 207 patients with chronic Chagas disease. Stigma, physical limitations, work absenteeism, emotional or mental aspects, fear of treatment, and fear of the future had the strongest impact on the HRQoL. All items showed moderate confidence except for fear of treatment (low confidence). The physical, emotional, mental, and cultural aspects affected the HRQoL of patients with chronic Chagas disease. Identification of these factors is important in the development of strategies aimed at improving the HRQoL of this population.

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Section: Discussionmentioning

confidence: 99%

Health-Related Quality of Life Reported by Patients With Chagas Disease: A Systematic Review of Qualitative Evidence With GRADE Recommendations

Silva

Oliveira

Xavier

et al. 2022

Rev. Soc. Bras. Med. Trop.

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“…Specific trypanocide treatment was offered to all Chagas disease patients aged 55 years or less, in the absence of contraindication and based on the current evidence [2,7,9,24]. Response to treatment was defined as PCR results becoming negative in those patients this test was ordered.…”

Section: Management Of Data After the Screening Campaign And Follow-up Of People With Chagas Diseasementioning

confidence: 99%

“…Approved drugs for treating Chagas disease are benznidazole and nifurtimox, whose efficacy is high during the acute phase (including in congenitally infected newborns) but less so in the chronic phase, when the drugs' effectiveness in preventing disease progression is unclear [6,7]. However, recent studies have shown that benznidazole can reduce complications associated with Chagas cardiomyopathy by decreasing the markers of severe cardiomyopathy [8], blood antibodies [9], and mortality [10] and it also is associated with a lower risk of clinical events. Nevertheless, in patients aged older than 55 years, treatment should be individualized to manage the risk of side effects [6,11].…”

Section: Introductionmentioning

confidence: 99%

Community-based screening of Chagas disease among Latin American migrants in a non-endemic country: an observational study

et al. 2021

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Background Chagas disease is a parasitic disease endemic to Latin America, but it has become a disease of global concern due to migration flows. Asymptomatic carriers may host the parasite for years, without knowing they are infected. The aim of this study is to assess prevalence of Chagas disease and evaluate the participants’ level of knowledge between Latin American migrants attending a community-based screening campaign. Methods Three community-based campaigns were performed in Alicante (Spain) in 2016, 2017 and 2018, including educational chats and blood tests for Trypanosoma cruzi serology. Participants completed a questionnaire assessing knowledge about the mechanisms of transmission, disease presentation, diagnosis, and treatment. People seropositive for T. cruzi underwent diagnostic confirmation by two different tests. Results were analyzed by multivariable logistic regression and expressed as adjusted odds ratios (aORs), adjusting for age, sex, and time in Spain. Results A total of 596 participants were included in the study; 17% were aged under 18 years. Prevalence in adults was 11% [54/496; 95% confidence interval (CI): 8.3–14.5%] versus 0% among children. All but one case were in Bolivians. Diagnosis was independently associated with having been born in Bolivia (aOR: 102, 95% CI: 13–781) and a primary school-level education (aOR: 2.40, 95% CI: 1.14–5.06). Of 54 people diagnosed with Chagas disease (most of whom were asymptomatic), 42 (77.7%) returned to the clinic at least once, and 24 (44.4%) received treatment. Multivariable analysis showed that coming from Argentina (aOR: 13, 95% CI: 1.61–1188) or Bolivia (aOR: 1.90, 95% CI: 1.19–3.39) and having received information about Chagas disease in Spain (aOR: 4.63, 95% CI: 2.54–8.97) were associated with a good level of knowledge on the disease. Having primary level studies (aOR: 0.59, 95% CI: 0.34–0.98) and coming from Ecuador (aOR: 4.63, 95% CI: 2.52–847) were independently associated with a lower level of knowledge. Conclusions Community-based interventions are a good strategy for diagnosing neglected diseases such as Chagas disease in non-endemic countries and for identifying and treating infected, asymptomatic individuals. Graphic abstract

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“…In humans, chronic T. cruzi infection leads to heart failure and death in 20-30% of infected patients (WHO 2014;Krats 2019). Chagas disease is difficult to diagnosis, and only two drugs, Nifurtimox and Benznidazole, are currently available to treat it, both of which have severe side effects (Vallejo et al 2020).…”

Section: Introductionmentioning

confidence: 99%

Mini-exon gene reveals circulation of TcI Trypanosoma cruzi (Chagas, 1909) (Kinetoplastida, Trypanosomatidae) in bats and small mammals in an ecological reserve in southeastern Mexico

Gómez-Sánchez¹,

Ochoa-Díaz-López²,

Espinoza‐Medinilla³

et al. 2022

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A wide variety of mammals are involved in the sylvatic cycle of Trypanosoma cruzi, the causative agent of Chagas disease. In many areas in Latin America where T. cruzi is endemic, this cycle is poorly known, and its main reservoirs have not been identified. In this study we analyzed T. cruzi infection in bats and other small mammals from an Ecological Reserve in southeastern Mexico. From January through March 2021, we captured wild individuals to extract cardiac and peripheral blood, and infection was detected by PCR of the mini-exon gene. In bats, the prevalence of infection was 16.36%, while in small mammals the prevalence was 28.57%. All of the samples that were positive for T. cruzi were identified as the TCI genotype. Our findings suggest that this zone, situated at the periphery of urban zones might have epidemiological relevance in the sylvatic cycle of T. cruzi and needs to be monitored. The infection of bats in this area is particularly concerning since the flight pattern of this populations overlaps with human settlements. Despite being subject to conservation protections, there continue to be anthropogenic actions that disturb the study area, which could exacerbate risks to public health.

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Trypanocidal drugs for late-stage, symptomatic Chagas disease (Trypanosoma cruzi infection)

Cited by 6 publications

References 77 publications

Health-Related Quality of Life Reported by Patients With Chagas Disease: A Systematic Review of Qualitative Evidence With GRADE Recommendations

Health-Related Quality of Life Reported by Patients With Chagas Disease: A Systematic Review of Qualitative Evidence With GRADE Recommendations

Community-based screening of Chagas disease among Latin American migrants in a non-endemic country: an observational study

Mini-exon gene reveals circulation of TcI Trypanosoma cruzi (Chagas, 1909) (Kinetoplastida, Trypanosomatidae) in bats and small mammals in an ecological reserve in southeastern Mexico

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Trypanocidal drugs for late-stage, symptomatic Chagas disease (Trypanosoma cruzi infection)

Cited by 6 publications

References 77 publications

Health-Related Quality of Life Reported by Patients With Chagas Disease: A Systematic Review of Qualitative Evidence With GRADE Recommendations

Health-Related Quality of Life Reported by Patients With Chagas Disease: A Systematic Review of Qualitative Evidence With GRADE Recommendations

Community-based screening of Chagas disease among Latin American migrants in a non-endemic country: an observational study

﻿Mini-exon gene reveals circulation of TcI Trypanosoma cruzi (Chagas, 1909) (Kinetoplastida, Trypanosomatidae) in bats and small mammals in an ecological reserve in southeastern Mexico

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Mini-exon gene reveals circulation of TcI Trypanosoma cruzi (Chagas, 1909) (Kinetoplastida, Trypanosomatidae) in bats and small mammals in an ecological reserve in southeastern Mexico