Chagas - libdoc.who.int - World Health Organization

Chagas
2
The impact of recent disease control initiatives on disease epidemiology since 1990 is
highlighted in Table 1.
Epidemiological
parameters
1990 2000 2006
Annual deaths >45,000 21,000 12,500
Cases of human infection 30 million 18 million 15 million
New cases per year 700,000 200,000 41,200
Population at risk 100 million 40 million 28 million
Number of countries 21 21 21
Challenges in Chagas disease control
Table 1. Changes in the
epidemiological parameters
and decrease in the incidence
of Chagas disease due to the
interruption of transmission:
1990, 2000, 2006.
Source TDR/PAHO/WHO
Despite the gains that have been achieved, there is a long way to go. Several estimates
indicate that there are still some 20,000 deaths per year in endemic regions due to Chagas
disease. In terms of morbidity, a 1993 World Bank report estimated that Chagas disease
represented more than 2 million DALYs annually. Even if this burden of disease is
adjusted in the context of currently available epidemiological information, Chagas disease
still represents the second highest burden of disease (BOD) among Tropical Diseases in
the Americas. This is still unacceptably high. Under ideal epidemiological surveillance
conditions, and in line with current diagnostic capacity at the health services, at least
55,585 persons per year would require etiological treatment against Trypanosoma cruzi
– among the 108,595,000 inhabitants living in Chagas disease endemic regions in the
Americas. It also must be underlined that Chagas disease is a health problem associated
with poverty. Poor housing conditions, especially within the rural settings and the urban
poverty belts of the large cities where access to adequate medical attention is limited or
not available, are a major factor in transmission by domestic and peri-domestic vectors.
Chagas disease also coexists with other poverty-related diseases, further complicating
control and treatment. The triatomine insects and the disease that they transmit, will
exist as long as poor housing conditions, frequent population migrations and irrational
urbanization persist in Latin America.
Reporte del grupo de trabajo científico sobre la enfermedad de Chagas, 2005 • TDR/GTC/06