Chagas Disease, A Review of the Literature

Abstract

Chagas disease is a vector-borne (triatomine) infection caused by the protozoan parasite Trypanosoma cruzi. Synonyms for this disease are: American trypanosomiasis, Chagas disease and T. cruzi infection.  ^{10, 5}

The most common form of transmission of Chagas disease is through hematophagous triatomine insects (triatominae), which develop in dwellings in precarious conditions, The disease can also be transmitted by blood transfusion, organ transplantation, oral and congenital routes, and even more rarely by exceptional routes such as sexual contact and non-Triatominae vectors. American Trypanosomiasis is endemic in much of Mexico, Central and South America ^1,11. it is estimated that ~6 million individuals are infected throughout Latin America, while ~300,000 are infected in the U.S.^{1, 10, 11,16}

Chagas disease has two clearly differentiated phases. Initially, the acute phase lasts about two months after infection, they may have a skin lesion or a purplish swelling of an eyelid, they may have fever, headache, enlarged lymph nodes, pallor, muscle aches, shortness of breath, swelling, and abdominal or chest pain. During the chronic phase, the infection can cause sudden death due to cardiac arrhythmias or progressive heart failure due to destruction of the cardiac muscle and its innervations. ¹⁵

Appropriate diagnostics for acute infection, nucleic acid amplification testing (NAAT) from blood is recommended; For chronic infection, serological testing is employed. Antitrypanosomal agents, benznidazole and nifurtimox, have shown efficacy in treating T. cruzi infection, The most serious complication is chronic chagasic heart disease, since it is the main cause of death in sick patients. ¹⁶