Challenges in Chagas Disease Control Through Transmission Routes

Abstract

Of the communicable diseases, Chagas has the greatest prevalence in Latin America. In early prevention of Chagas disease, it is important to distinguish between the wild and domestic cycles for the transmission of the Trypanosoma cruzi parasite. The risk of people becoming infected is very different from one cycle to another, as is the possibility of carrying out effective vector control interventions. Advances made in the control of Chagas in recent decades shows that existing technical knowledge, where it has been applied properly, has been sufficient to significantly reduce the burden of the disease in Latin America. The consolidation of established processes is limited by the high operational cost and decentralization of the vector control programs. Given these circumstances, it became clear that there was a need for a “paradigm shift” from the old vertical model of action, to a horizontal model of prevention and control of transmitting disease vectors, with a strong empowerment of government at regional and municipal levels. Given the different transmission routes of the disease, other control mechanisms are key to stopping transmission: concise clinical guidelines for blood banks, congenital transmission and organ transplants; compliance with the rules of food preparation to avoid cases of oral transmission; and antiparasitic treatment of patients with Chagas has a role in the control of the disease at the public health level. Therefore, the control of Chagas disease requires effective coordination between different levels of health systems.