UF researcher races to diagnose Chagas disease

When Norman Beatty first witnessed people sleeping under mosquito nets in rural Arizona, he was stunned.

And yet, some residents of remote areas in the U.S., including parts of Florida, use the nets in their homes each night – not to protect against mosquitoes, but kissing bugs, blood-sucking insects that can spread a potentially lethal disease known as Chagas.

Research on Chagas Disease and the Sustainable Development Goals (SDGs)

Those nets were a catalyst for Dr. Beatty an assistant professor of medicine in the University of Florida’s Division of Infectious Diseases and Global Medicine and a member of the Emerging Pathogens Institute.

Since 2015, Beatty has dedicated his research program to the study of Chagas, a little-known illness caused by a microscopic parasite called Trypanosoma cruzi, passed primarily via the feces of infected kissing bugs.

Goal 3: Good Health and Well-being

Chagas disease can be a silent killer: Symptoms may take decades to appear and are often irreversible once they are recognized. Most people infected with T. cruzi do not know they carry the parasite, Beatty said. Without treatment, they can remain infected for life. About one-third will develop chronic Chagas, which can attack the heart, brain and gastrointestinal and peripheral systems with fatal results.

An estimated 300,000 people are living with Chagas disease in the U.S., but fewer than 1% have been diagnosed. Florida, home to both the kissing bug and T. cruzi, is thought to have the third-highest number of people living with chronic Chagas, behind California and Texas. But the disease remains poorly studied in the state and globally.

“Chagas truly is a neglected tropical disease,” said Beatty. “A tremendous amount of work needs to be done to understand this parasite and how it’s affecting human beings.”

Goal 10: Reduced Inequalities

Chagas is also a disease of inequity, he said. In the U.S., it disproportionately affects people who have immigrated from Latin America, where the parasite is more common, and those exposed to kissing bugs in rural areas. These groups also tend to have limited access to healthcare.

Investigating Chagas Disease in Florida

As part of a three-year investigation, Beatty and UF/IFAS collaborators Samantha Wisely, Nathan Burkett-Cadena and John Diaz, as well as Colin Forsyth from the Drugs for Neglected Diseases initiative and Eva Novakova from the University of South Bohemia, have been working with urgency to track and diagnose the disease in Florida and investigate the ways in which T. cruzi spreads.

Goal 3: Good Health and Well-being

“It’s important that we try to reach all the populations at risk for Chagas,” Beatty said. “Without access to resources, patients will continue to manifest the chronic disease state and may die from this infection without ever knowing they had this disease.”

Screening Program and Early Detection

To help close the gap, Beatty and his colleagues have established a screening program in clinics and hospitals, including UF Health, targeting people with the highest risk of infection. His research suggests that using two rapid blood tests simultaneously could be a swift, simple way of diagnosing the disease, a boon in rural areas that lack laboratories.

Time is of the essence: When detected early enough, T. cruzi infections can be treated with antiparasitic medications. The sooner a patient receives therapy, the less chance the disease will progress to a chronic stage.

Goal 3: Good Health and Well-being

“What we want to do is unearth undiagnosed cases of Chagas disease,” Beatty said. “People with a chronic infection should be under the care of a physician to help manage this disease before it becomes potentially fatal.”

Research on Chagas Disease Transmission

Little is known about the prevalence of Chagas in Florida. It is not a reportable disease to Florida’s Department of Health, meaning that the state is not monitoring its occurrence, and researchers are unable to track infections via routine blood and organ donor screening. Many healthcare providers aren’t even aware Chagas is in Florida, and testing can be limited, Beatty said.

Beatty suspects that some people living with Chagas in Florida became infected with T. cruzi locally, rather than abroad.

Goal 3: Good Health and Well-being

“There are vulnerable populations in the state of Florida who are exposed to these bugs,” he said. “There’s a lack of awareness that this is truly a problem.”

Understanding the Disease and Its Spread

Kissing bugs aren’t the only organisms capable of spreading the T. cruzi parasite. Infected humans and other mammals can transmit the parasite to their offspring, and the parasite can be passed through blood and organ donations.

Beatty, Wisely and Burkett-Cadena have also pinpointed Florida’s opossums as possible spreaders of T. cruzi. The opossum, Didelphis virginiana, is one of 27 mammal species in the U.S. known to serve as a reservoir host for the parasite, suggesting that Chagas may be a zoonotic disease as well as a vector-borne one.

Goal 15: Life on Land

A 2022 study led by UF/IFAS graduate student Carson Torhost showed that more than half of Florida opossums trapped and tested by researchers carried the parasite in their blood, feces and/or anal gland secretions. Opossums spray these secretions into the environment where they could contaminate crops and garden vegetables or other surfaces with which people could come into contact.

Goal 3: Good Health and Well-being

“Basically, we found that Florida opossums are wildly infected with Trypanosoma cruzi,” Beatty said. “There are other sources of infection that haven’t been described well yet, and my impression is that the opossum is a part of that story.”

Continued Research and Efforts

The complexity of Chagas – and the dearth of research on the disease – provides continual fuel for Beatty

SDGs, Targets, and Indicators

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being
• SDG 10: Reduced Inequalities
• SDG 17: Partnerships for the Goals

The article discusses the issue of Chagas disease, a neglected tropical disease that affects people in rural areas and disproportionately impacts immigrants from Latin America and those with limited access to healthcare. This highlights the connection to SDG 3, which aims to ensure healthy lives and promote well-being for all at all ages. The article also mentions the inequities in the prevalence and diagnosis of Chagas disease, highlighting the relevance to SDG 10, which focuses on reducing inequalities within and among countries. Additionally, the article mentions collaborations and partnerships between researchers and institutions, indicating a connection to SDG 17, which emphasizes the importance of partnerships for achieving sustainable development.

2. What specific targets under those SDGs can be identified based on the article’s content?

• SDG 3.3: By 2030, end the epidemics of AIDS, tuberculosis, malaria, and neglected tropical diseases and combat hepatitis, water-borne diseases, and other communicable diseases.
• SDG 10.3: Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory laws, policies, and practices and promoting appropriate legislation, policies, and action in this regard.
• SDG 17.16: Enhance the global partnership for sustainable development, complemented by multi-stakeholder partnerships that mobilize and share knowledge, expertise, technology, and financial resources.

Based on the article’s content, the specific targets that can be identified are SDG 3.3, which aims to end the epidemics of neglected tropical diseases, and SDG 10.3, which aims to reduce inequalities of outcome. Additionally, the article highlights the importance of partnerships and collaborations in addressing Chagas disease, aligning with SDG 17.16.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

• Indicator for SDG 3.3: Number of cases and deaths from neglected tropical diseases.
• Indicator for SDG 10.3: Proportion of population with access to healthcare services.
• Indicator for SDG 17.16: Number of partnerships and collaborations established to address neglected tropical diseases.

The article mentions the number of people living with Chagas disease in the U.S. and the low diagnosis rate, which can be used as an indicator for measuring progress towards SDG 3.3. The article also highlights the limited access to healthcare for certain populations, which can be used as an indicator for measuring progress towards SDG 10.3. Additionally, the article mentions the collaborations between researchers and institutions, indicating the establishment of partnerships to address neglected tropical diseases, which can be used as an indicator for measuring progress towards SDG 17.16.

Table: SDGs, Targets, and Indicators

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