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American Trypanosomiasis (Chagas Disease).

Luis E Echeverria1, Carlos A Morillo2

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Infectious Disease Clinics of North America
|February 5, 2019
PubMed
Summary

Chagas disease, caused by a parasite endemic to the Americas, is now global. While acute infections often resolve, a significant percentage develop severe cardiomyopathy and heart failure years later.

Keywords:
CardiomyopathyChagas diseaseHeart failureParasitologyTrypanosomiasis

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Area of Science:

  • Infectious Diseases
  • Cardiology
  • Parasitology

Background:

  • American trypanosomiasis, or Chagas disease, is caused by the parasite Trypanosoma cruzi.
  • Global migration has led to the worldwide spread of Chagas disease.
  • While acute infections may resolve spontaneously, a substantial portion of individuals develop chronic complications.

Purpose of the Study:

  • To review the current understanding of Chagas disease epidemiology and clinical progression.
  • To discuss the controversies and ongoing investigations regarding etiologic treatment in asymptomatic carriers and early cardiomyopathy patients.
  • To highlight the rapid progression of heart failure and its impact on morbidity and mortality.

Main Methods:

  • Literature review of Chagas disease epidemiology, clinical manifestations, and treatment strategies.
  • Analysis of data on the progression of cardiomyopathy and heart failure in chronic Chagas disease.
  • Evaluation of current guidelines and research on etiologic treatment efficacy.

Main Results:

  • Chagas disease, endemic to the Americas, is now a global health concern due to migration.
  • A significant percentage (20-40%) of infected individuals develop cardiomyopathy 20-30 years post-infection.
  • Heart failure progression in Chagas disease is rapid, leading to high morbidity and mortality.

Conclusions:

  • Etiologic treatment is recommended for acute, congenital, and reactivation cases, and in women of childbearing age.
  • Treatment efficacy in asymptomatic carriers and those with early cardiomyopathy requires further investigation.
  • Effective management strategies are crucial to mitigate the rapid progression of heart failure and reduce mortality in Chagas disease.