World Chagas Disease Day 2024: urging early diagnosis and care for life
World Chagas Disease Day 2024: urging early diagnosis and care for life World Health Organization (WHO)
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World Chagas Disease Day 2024: Early Diagnosis and Lifelong Care
14 April marks the fifth World Chagas Disease Day. The theme for 2024 focuses on early diagnosis and lifelong care, to increase public awareness of Chagas disease and secure greater support and funding for early diagnosis and comprehensive follow-up care initiatives.
The Sustainable Development Goals (SDGs)
- Goal 3: Good Health and Well-being
- Goal 10: Reduced Inequalities
- Goal 17: Partnerships for the Goals
The Burden of Chagas Disease
According to the World Health Organization (WHO), an estimated 6–7 million people worldwide are infected with Trypanosoma cruzi, the parasite that causes Chagas disease, leading to some 12 000 deaths every year. At least 75 million people are at risk of infection, with annual incidence estimated to be about 30–40 000 cases. However, in many countries, detection rates are low (less than 10% and often less than 1%) and people suffering from the disease often encounter significant barriers to diagnosis and adequate healthcare.
Importance of Strengthening Global Surveillance
“Strengthening global surveillance for Chagas disease over the next few years is an essential step towards understanding its real burden and in taking appropriate measures to tackle its neglect”, said Dr Jérôme Salomon, Assistant Director-General, Universal Health Coverage/Communicable and Noncommunicable Diseases at WHO.
The Silent Disease
Chagas disease is often called a “silent disease” because most patients have no symptoms either during the acute or the chronic phases of infection, until damage is too advanced to be reversed. It remains a public health problem, especially in several endemic areas of continental Latin America, where the burden on health systems is the highest one. In recent years, however, climate change and global migration have expanded the reach of the disease to several countries beyond the Americas.
Transmission Routes
Transmission of Chagas disease can occur through six routes:
- Vectorial
- Oral
- Congenital
- Transfusional
- Organ transplantation
- Laboratory accident
Despite cases being documented in 44 countries across the world, only six countries have information systems in place to monitor existing cases and active transmission routes.
The Importance of Early Detection and Lifelong Care
Early detection is key as Chagas disease is curable when treatment is provided soon after infection. If this does not happen because diagnosis is delayed, the infection can transform into a life-threatening condition. In this case, adequate care throughout life is essential. Detection, treatment, and monitoring of the disease can be carried out at the primary health-care level in most cases.
Comprehensive Approaches for Chagas Disease
World Chagas Disease Day 2024 emphasizes the importance of early diagnosis and lifelong care, advocating comprehensive approaches spanning diagnosis and treatment for any confirmed case. Also essential are transmission prevention measures including:
- Vector control
- Blood screening prior to transfusion and transplantation
- Testing and treating girls, women of reproductive age, newborns, and siblings of mothers with infection
- Information, education, and communication for communities and health professionals
Decentralizing diagnostic and care services within national health systems can significantly enhance case detection, notification, and management.
Call to Action
Speaking ahead of World Chagas Disease Day 2024, the Director of WHO’s Global Neglected Tropical Diseases Programme, Dr Ibrahima Socé Fall, said: “I invite everyone to join WHO in observing World Chagas Disease Day. This is an occasion to reflect on how climate change and migration have changed the epidemiological landscape of Chagas disease and turned it into a global condition in just a few years, underscoring the urgent need for heightened awareness and support for initiatives focused on early diagnosis and comprehensive care”.
About Chagas Disease
Chagas disease, also known as American trypanosomiasis, is caused by the protozoan parasite, Trypanosoma cruzi, which is mainly transmitted to humans by contact with the faeces/urine of infected blood-sucking triatomine bugs – this is called vectorial transmission. These bugs typically live in the wall or roof cracks of homes and peridomiciliary structures, such as chicken coops, pens, and warehouses, in rural and suburban areas alike.
Triatomine bugs typically hide during the day, becoming active only at night when they feed on animal and human blood. They usually bite an exposed area of skin such as the face – hence one of its popular names, the “kissing bug”, and then defecate or urinate close to the bite. Parasites enter the body when the person instinctively smears the bug’s faeces or urine into the bite, other skin breaks, or into the eyes or mouth.
For centuries, the disease was a problem of rural populations in Latin America, where vectorial transmission is still prevalent. However, massive population movements from rural into urban areas – and eventually across continents – have increased the relevance of other transmission routes, such as oral transmission via contaminated food, blood transfusion, congenital transmission, organ transplantation, and laboratory accident. Climate change has also expanded the geographical distribution of triatomine bugs.
Early detection is key as Chagas disease is curable when treatment is provided soon after infection. If this does not happen because of delayed diagnosis, the infection can transform into a life-threatening condition. In this case, adequate care throughout life is essential. Detection, treatment, and monitoring of the disease can be carried out at the primary health-care level in most cases.
There is currently no vaccine against Chagas disease. Domiciliary vectorial control, food safety, transfusion and transplantation screening, along with detecting infection in girls and women of childbearing age to prevent congen
SDGs, Targets, and Indicators
| SDGs | Targets | Indicators |
|---|---|---|
| SDG 3: Good Health and Well-being | Target 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 | Indicator 3.3.5: Number of people with Chagas disease diagnosed and provided with treatment |
| SDG 3: Good Health and Well-being | Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services, and access to safe, effective, quality, and affordable essential medicines and vaccines for all | Indicator 3.8.1: Coverage of essential health services (defined as the average coverage of essential services based on tracer interventions that include reproductive, maternal, newborn and child health, infectious diseases, non-communicable diseases, and service capacity and access) |
| SDG 10: Reduced Inequalities | Target 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 | Indicator 10.3.1: Proportion of population reporting having personally felt discriminated against or harassed in the previous 12 months on the basis of a ground of discrimination prohibited under international human rights law |
| SDG 17: Partnerships for the Goals | Target 17.17: Encourage and promote effective public, public-private, and civil society partnerships, building on the experience and resourcing strategies of partnerships | Indicator 17.17.1: Amount of United States dollars committed to public-private partnerships |
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
2. What specific targets under those SDGs can be identified based on the article’s content?
- Target 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
- Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services, and access to safe, effective, quality, and affordable essential medicines and vaccines for all
- Target 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
- Target 17.17: Encourage and promote effective public, public-private, and civil society partnerships, building on the experience and resourcing strategies of partnerships
3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?
- Indicator 3.3.5: Number of people with Chagas disease diagnosed and provided with treatment
- Indicator 3.8.1: Coverage of essential health services (defined as the average coverage of essential services based on tracer interventions that include reproductive, maternal, newborn and child health, infectious diseases, non-communicable diseases, and service capacity and access)
- Indicator 10.3.1: Proportion of population reporting having personally felt discriminated against or harassed in the previous 12 months on the basis of a ground of discrimination prohibited under international human rights law
- Indicator 17.17.1: Amount of United States dollars committed to public-private partnerships
4. SDGs, Targets, and Indicators
| SDGs | Targets | Indicators |
|---|---|---|
| SDG 3: Good Health and Well-being | Target 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 | Indicator 3.3.5: Number of people with Chagas disease diagnosed and provided with treatment |
| SDG 3: Good Health and Well-being | Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services, and access to safe, effective, quality, and affordable essential medicines and vaccines for all | Indicator 3.8.1: Coverage of essential health services (defined as the average coverage of essential services based on tracer interventions that include reproductive, maternal, newborn and child health, infectious diseases, non-communicable diseases, and service capacity and access) |
| SDG 10: Reduced Inequalities | Target 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 | Indicator 10.3.1: Proportion of population reporting having personally felt discriminated against or harassed in the previous 12 months on the basis of a ground of discrimination prohibited under international human rights law |
| SDG 17: Partnerships for the Goals | Target 17.17: Encourage and promote effective public, public-private, and civil society partnerships, building on the experience and resourcing strategies of partnerships | Indicator 17.17.1: Amount of United States dollars committed to public-private partnerships |
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Source: who.int
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