En los medios

Chagas, an unresolved issue in Argentina

 

About 1,600,000 people are estimated to be infected in our country, and there is vector transmission in 9 provinces. Specialists explained the national scenario, stressed the importance of interrupting the mother-to-child transmission route, and indicated that the budget assigned to the related programs is the highest in the last decade.

In 2019, the World Health Organization designated April 14 as the World Chagas Disease Day, with the aim of making visible a disease that affects more than 7 million people in the world, of which 20% correspond to Argentina. This disease, which was discovered in 1909, has been an unresolved issue of the national health system for more than one century.

The parasite Trypanosoma cruzi is transmitted through vinchucas, flying bugs that usually bite humans, leaving the infected faeces near the bite site; faeces enter the body when the person scratches the area. It can also be transmitted through blood transfusion, organ donation or from mother to child during pregnancy. The disease can go unnoticed for years due to the lack of symptoms; however, it can affect the heart and the nervous system over time.

It is estimated that 1,600,000 people are infected in our country. “Thirty percent of the people infected with Chagas disease develop severe problems. Among the main signs are cardiac alterations, which become more severe, leading to failure, very often ending up in sudden death”, explained Marcelo Abril, chief executive officer of Mundo Sano, a foundation devoted to neglected diseases. Every year, 10,000 people die of this disease in the world.

Thirty percent of the people infected with Chagas disease develop severe problems. Among the main signs are cardiac alterations.

Since the 1960s, our country has struggled for controlling transmission. At present, there is no vector transmission in 10 provinces, which are certified. “However, sixty years later, there is still vector transmission in 9 provinces”, explained Ricardo Hernández, head of the Chagas Area of National Vector Coordination of the Argentine Ministry of Health. Hernandez also referred to the regional situation, and explained that Brazil, Paraguay and Uruguay are certified as countries free of domiciliary vector transmission.

“Over these years, there have been significant advances in the reduction of transmission, in the control of safe blood transfusions and in organ transplants; however, we have not achieved the same results in the treatment of infected people, and this is still an unresolved issue. Substantial work has to be done to ensure the inclusion of the disease in the primary health care system. Ending with mother-to-child transmission is the other great unresolved issue”, explained Abril from Mundo Sano, an organization that created the campaign Not a single baby with Chagas in 2009.

Children with Chagas disease

As estimated by the Foundation, every year 1,300 babies are born with Chagas disease, which represents an average of four new-borns a day in Argentina. “At the global level, 9 thousand children are born with this disease every year; it means one every hour. Ending with this transmission route is an ambitious but attainable objective: it is necessary to diagnose and perform controls during pregnancy. If the result is positive, it is necessary to monitor and be alert at the moment of birth. Treating the baby during the first year of life is more efficient; thus, they are relieved from the burden of a jeopardized health in the future”, stressed Abril.

On the other hand, Hernández stated that they work with the aim of ending with congenital transmission, but that the pandemic has been an obstacle. “Every year, more than 300 thousand pregnant women are screened, but this number dropped due to the COVID-19 pandemic, since fewer people have presented for controls and the human resources devoted to these studies have been focused on the health emergency”, Hernandez stated.

“It is in mother-to-child transmission where the coverage gap is most tremendous and unfair. We want to enhance these efforts. The child must be tested at birth and, if negative, the test must be repeated 10 months later, and so on, up to the age of one year and a half. Between 40% and 50% of children born to positive mothers are tested; however, ensuring the follow-up of negative patients and of those that are not tested is very difficult. As a result, now 4 to 5% of the children born to mothers that tested positive are covered, when 100% should be”, said Hernández.

It has been demonstrated that a child born to a positive mother can overcome the disease if properly treated. “Cure is possible up to the age of 19”, stated Hernández. Likewise, if a positive woman receives treatment, the possibility of having a baby with Chagas disease in the future is reduced.

In line with Hernández, “the aim is that there is no more vertical transmission within three years and to certify elimination in the entire country. Our second great goal is to end with congenital transmission. For this purpose, we are monitoring the provinces and working in cooperation. The idea is that the provinces start to solve the problem or to change their strategies. From now to 2024, we want that no more babies are born with Chagas disease”.

Law 26.281

More than thirteen years after the approval of the norm intended to prevent, control and eradicate Chagas disease from the entire national territory, it has still not been regulated. Last year, the la Asociación Civil por la Igualdad y la Justicia (ACIJ, Civil Association for Equality and Justice), along with other organizations and people infected with the disease sent a note asking for its regulation. “They answered that they had started the process and that it consisted of four stages, one of them included a stage for the participation of the civil society and the organizations”, reported Francisco Rodríguez, lawyer of ACIJ.

In this sense, Hernández agreed on the need of such progress and indicated that they succeeded in starting the process with the current administration. “We know that there will be a space for consultation with the participation of experts and organizations. We believe in participation of communities because we work for people and they are the ones who have to be represented”.

Another advance in the topic is the increase of the budget. Rodríguez, the ACIJ lawyer, indicated that this year, the budget resources allocated to the programs associated with the disease were the highest in the last 10 years. “We also celebrated the creation of the National Chagas Disease Plan, but we are waiting for it to be made available. Anyway, we noticed a substantial change in terms of public policies and we believe that those measures are heading in the right direction”.

According to the ACIJ, in Argentina there are approximately 7 million people at risk of becoming infected and more people living with Chagas disease than in Brazil and Mexico, two countries with a larger population.

According to ACIJ, in Argentina there are approximately 7 million people at risk of becoming infected: “There are more people living with Chagas disease than in Brazil and Mexico, two countries with a larger population. It is the main endemic disease in the country and requires coordinated efforts. It is a commitment that we took in line with the Sustainable Development Goals”.

According to ACIJ, in Argentina there are approximately 7 million people at risk of becoming infected: “There are more people living with Chagas disease than in Brazil and Mexico, two countries with a larger population. It is the main endemic disease in the country and requires coordinated efforts. It is a commitment that we took in line with the Sustainable Development Goals”.

In the area led by Hernández, people work in a plan for the training and awareness raising of health teams; and with the incorporation of more technicians and professionals in the near future, they expect to be able to control and eradicate the vector from 140 thousand houses this year. Moreover, Rodríguez mentioned that they will work in the campaign “Comprehensive and equitable health care and services for all” of the Pan American Health Organization, with the aim of empowering, making the problem visible and ending with prejudices.

Finally, Hernández stressed: “The population has to know that Chagas disease is present all throughout the country, but that it can be cured in most of the cases. Diagnosis and treatment are free. It is not a disease to feel ashamed about, it can be in every house. It needs to be de-stigmatised”

In first person

Brigitte found out that she had Chagas disease some time after her arrival in Spain. “Thanks to my mother, who knew about the possibility of transmission during pregnancy, I had the test done. I went to the Tropical Medicine Unit of the Ramón y Cajal Hospital, I had the test done and tested positive”, she remembered.

“I underwent treatment, because I was told that if I thought of having a baby in the future, treatment would prevent transmission. It was very comforting to have done everything that I could. Now I have two girls and a boy that were born healthy”.

It is a disease that receives little attention but that affects a lot of people. “To those people affected by the disease I would like to say that if they were treated, they should continue with follow-up; if they did not, that they should do it as soon as possible and they should seek for information because there are hospitals prepared for the treatment, which can provide treatment so that they can manage the disease better. Those who are in doubt, I encourage them to look for resources to get informed: they shouldn’t live with fear or be indifferent because there are many centres where they can find support”, recommended Brigitte.

https://elauditor.info/actualidad/chagas–una-deuda-pendiente-en-argentina_a60770d05ab11550422ff5560

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