14 April 2020 | Geneva −− Today the global community celebrates the first World Chagas Disease Day. The event makes visible one of the most neglected tropical diseases prioritized by the World Health Organization (WHO) as it continues to affect millions, worldwide. Chagas disease was discovered more than a century ago but stayed largely ignored.
“Chagas disease has been associated for a long time with mainly poor, rural and marginalized populations and is characterized by poverty and exclusion” said Dr Mwelecele Ntuli Malecela, Director, WHO Department of Control of Neglected Tropical Diseases. “It is time we end this neglect and the social stigma associated with infection that stands as a major barrier to effective screening, diagnosis, treatment and control.”
The social consequences of stigma associated with Chagas disease lead to social rejection. People who suffer from the disease can face work restrictions because it is often associated with poor health and potential difficulties in performing work, and even sudden death, creating a fear of financial losses by employers. Among others, it is for these reasons that people are reluctant to seek medical help – leading to more serious clinical manifestations and final complications and further spread of the disease.
In Latin America, Chagas disease has been mostly transmitted to humans by contact with the faeces or urine of particular species of triatomine bugs infected with the parasite Trypansosoma cruzi.
These bugs typically live in the wall or roof cracks of homes in rural or suburban areas. Normally they hide during the day and are active at night when they feed on human blood by biting an exposed area of skin, such as the face (hence its local name ‘kissing bug’, among many others). Soon after its blood meal, the bug defecates or urinates close to the bite. The parasites enter the body when the person instinctively reacts to the bite while smearing the bug faeces or urine into the bite or any other skin break, the eyes and the mouth or by contamination of food during its preparation, storage and consumption, frequently causing outbreaks of oral transmission with higher morbidity and mortality rates.

Urbanization and spread

But with rapid urbanization and movement of populations between Latin America and other countries outside the region, the disease spread to urban areas and to other countries and continents, including Europe and some African, Eastern Mediterranean and Western Pacific countries.
In recognition of this growing public health problem and the need to create awareness on ways to increase detection and prevent its spread, the Seventy-second World Health Assembly – WHO’s decision-making body – agreed to designate 14 April as World Chagas Day.
Chagas disease is named after Carlos Ribeiro Justiniano Chagas, a Brazilian physician and researcher who discovered the disease in 1909.

Improving awareness and promoting health-seeking behaviour

The disease is poorly understood by health professionals in non-endemic areas, with many who consider it to be a tropical disease restricted to some territories of Latin America. Similarly, patients infected with T.cruzi in non-endemic areas may not be aware of their condition which can lead to further transmission through non-vectorial routes of transmission.
This year is the first opportunity for the global community to better understand and make visible the health, psycho-social and economic dimensions of this long-forgotten and ignored disease. 

Today is World Chagas Disease Day. Although discovered more than a century ago, Chagas disease continues to remain ignored. Once confined to rural regions of some Latin American countries where it affected mostly the poor, Chagas disease has today spread to continents due to population movement, migration and travel patterns. To stop its spread, better diagnostics, improved awareness about the disease as well as health-seeking behaviours need to be promoted.