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An adobe house in Jujuy, Argentina.
Credit: Photo Stock
Accents
No End to Chagas Disease in Argentina
By Sebastián Lacunza

Non-governmental sources in Argentina report that Chagas disease is seeing an upswing.

BUENOS AIRES, 2 Feb (Tierramérica).- After two years of the government health program "Argentina justa, Argentina sin Chagas" (Fair Argentina, Chagas-Free Argentina) the fight against the endemic disease of that name is weakening, according to experts.

The disease transmitted by the protozoan Trypanosoma cruzi has no cure if it is not treated with an antiparasitic in its early stages.

In 95 percent of the cases in Argentina, transmission is through bites from the "vinchuca" (Triatoma infestans), a blood-sucking insect that nests in the cracks of adobe, cane or log homes -- common construction materials for humble rural dwellings in South America.

Other modes of transmission are blood transfusion, organ transplant, or via the placenta in pregnancy.

In 1911, the presence of the disease -- named for its discoverer, the Brazilian Carlos Chagas -- was verified in Argentina. One of the leading researchers of the disease, Argentine doctor Salvador Mazza, spent two decades beginning in 1926 studying its pathologenic, clinical, epidemiological and social aspects.

Chagas disease develops slowly, as the parasite can settle in the body tissues, mainly the heart, which leads to death in at least 30 percent of the cases. The initial infection symptoms studied by Mazza include fever, diarrhea, vomiting, difficulty breathing and convulsion.

In October 2006, the government of Néstor Kirchner (2003-2007) stated that there had been a worsening of Chagas due to the weakened cohesion and structure in efforts to fight the disease.

In that context, the Health Ministry launched the Federal Chagas Program, which set a goal of "interrupting transmission and minimizing the impact of its consequences in infected persons."

"Due to the numerous factors involved, to which are added economic and political factors, the disease has gone from being not only associated with poverty, to become a paradigm of mechanisms of secrecy and exclusion as a form of social and labor discrimination," states the program on its web site.

Sonia Tarragona, director general of the Fundación Mundo Sano (Healthy World Foundation), specializing in Chagas disease, told Tierramérica that the government's efforts "are good, but there still has been no significant change" and the statistical information available is limited.

The problem is part of what are known as "neglected diseases", Tarragona said.

The connection between Chagas and poverty, she said, means "there is no interest on the part of the pharmaceutical industry in developing vaccines or medications. Who are they going to sell the vaccine to if nobody can buy it?"

Chagas disease can be found in a vast area ranging from the southern United States to northern Argentina and Chile, with cases totaling 15 million.

Argentina's Health Ministry calculates there are 2.5 million people infected in that country, but just 25 percent develop the disease.

It is recorded in 19 of Argentina's 23 provinces. Of those, seven are in a critical situation, with vinchucas found in more than five percent of homes. Those provinces include the poorest: Formosa, Chaco and Santiago del Estero, in the north.

From Chaco, Rolando Rivas, head of the Nelson Mandela Social Studies and Research Center, based in the provincial capital Resistencia, told Tierramérica that the area needs health testing, "especially among the indigenous and criolle population."

"The disease is part of the dark health statistics. There is no will to change things," he charged.

Rivas recounted, based on official data, that between 2001 and 2003, during Argentina's devastating economic and social crisis, "not one single house was fumigated in Chaco, despite the fact that the national government had sent insecticides."

"From 2000 to 2006, medications were distributed to just 167 patients, when Chaco probably has at least 60,000 ill," he said.

Arising from a change in administration in the provincial government, Rivas reported that in "the second half of 2008, after many setbacks, there was better fumigation of El Impenetrable forest -- which includes part of Chaco, Santiago del Estero and Salta -- with the arrival of brigades from the national ministry."

Nevertheless, he warned that "anti-vinchuca" housing is necessary -- with finished floors and walls -- and that fumigation must continue.

Tarragona said the biggest problems in fighting Chagas disease in Argentina is the disparity in carrying out prevention policies in the different provinces, coordinated by the federal government, and the lack of follow-up in fumigation of the highest-risk housing units -- the only on-the-ground preventative measure.

The biggest challenge facing the epidemiologists is that a high percentage of the infected population is not aware of the fact, because the disease can be asymptomatic for years.

Furthermore, because the infected people tend to be impoverished rural dwellers with little education and limited access to health services, they unwittingly promote the propagation of the vinchucas and the transmission of the disease.

In the region, Brazil and Uruguay were able to stop the vinchuca vector. But in Argentina, according to unofficial figures, there has been a resurgence in provinces that had once been able to halt transmission. Bolivia and Paraguay are facing the same trends as Argentina.

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