Case-fatality From Orally-transmitted Acute Chagas Disease: A Systematic Review and Meta-analysis

Bruneto, Eduardo G; Fernandes-Silva, Miguel Morita; Toledo-Cornell, Cristina; Martins, Sílvia Marinho; Ferreira, João Marcos Bemfica Barbosa; Corrêa, Valeria Rita; Costa, Joicely Melo da; Pinto, Ana Yecê das Neves; Souza, Dilma do Socorro Moraes de; Pinto, Maria Carmelinda Gonçalves; Neto, José Albuquerque de Figueiredo; Ramos, Alberto Novaes; Maguire, James H.; Silvestre, Odílson Marcos

doi:10.1093/cid/ciaa1148

Cited by 18 publications

(43 citation statements)

References 37 publications

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“…No fatal cases were found in 16 of 32 (50%) outbreaks. The lethality (case‐fatality rate = 1%) in symptomatic cases is similar to that from other routes of infection [4] and may be due to the high prevalence of cardiac complications together with the absence of a successful early diagnosis and/or an adequate treatment.…”

Section: Resultsmentioning

confidence: 99%

“…The disease is extremely complex because the T. cruzi parasite can maintain its biological cycle in a large number of vector and reservoir species and has several transmission routes [2]. Although the most relevant route of transmission to humans is vectorial (>80% of recorded infections), numerous outbreaks of infection by oral transmission have been described in countries where CD is endemic [3, 4]. Vectorial transmission only occurs in countries where the triatomines are endemic or present.…”

Section: Introductionmentioning

confidence: 99%

“…However, since the discovery of CD, infection to humans has occurred predominantly through vectorial, vertical transmission and organ transplantation or blood transfusion, leaving oral transmission and the rest of the routes in the background. This has changed in recent decades, since of the more than 1000 acute cases of CD that occurred during the first 10 years of this century, up to 70% were related to oral transmission with a case‐fatality rate of 1% [3, 4]. Thus, human infection by T. cruzi is arguably re‐emerging as a foodborne disease, which must be analysed through a new multidisciplinary perspective to understand all its human, animal and environmental factors.…”

Section: Introductionmentioning

confidence: 99%

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Oral transmission of Chagas disease from a One Health approach: A systematic review

López‐García,

Gilabert

2023

Tropical Med Int Health

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ObjectiveTo analyse acute Chagas disease (CD) outbreaks through a qualitative systematic review and discuss the determinants for its prevention and control.MethodsReview of studies in which clinical cases of oral transmission were confirmed by parasitological and/or serological tests that included an epidemiological investigation of sources of infection, vectors and reservoirs.ResultsThirty‐two outbreaks (1965–2022) were analysed. The main foods involved in oral transmission outbreaks are homemade fruit juices. Different species of vectors were identified. Reservoirs were mainly dogs, rodents and large American opossums (didelphids).ConclusionUnder a One Health approach, environmental changes are one of the factors responsible of the rise of oral transmission of CD. Entomological surveillance of vectors and control of the changes in wild and domestic reservoirs and reinforcement of hygiene measures around food in domestic and commercial sites are needed.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Oral transmission of Chagas disease from a One Health approach: A systematic review

López‐García,

Gilabert

2023

Tropical Med Int Health

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“…Among the various transmission routes of the disease, the vector and oral routes stand out, the latter associated with acute outbreaks with a reported lethality for Latin America between 1 and 35% (14,15). In some countries of the Southern Cone, such as Brazil, Venezuela, Bolivia, Ecuador, Peru, Argentina, and French Guyana (16), cases of acute CD due to vector transmission and oral outbreaks have been described due to contamination of food with feces of wild triatomines or with secretions from reservoirs.…”

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confidence: 99%

Clinical and Epidemiological Characterization of Acute Chagas Disease in Casanare, Eastern Colombia, 2012–2020

et al. 2021

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Background: Chagas disease (CD), caused by the protozoan Trypanosoma cruzi, is considered a public health problem in Latin America. In Colombia, it affects more than 437,000 inhabitants, mainly in Casanare, an endemic region with eco-epidemiological characteristics that favor its transmission. The objective of this study was to describe the clinical and epidemiological characteristics of the cases of acute CD in Casanare, eastern Colombia, in the period 2012–2020.Methods: In the present study, 103 medical records of confirmed cases of acute CD were reviewed. The departmental/national incidence and fatality were compared by year; the climatological data of mean temperature, relative humidity, and precipitation per year were reviewed and plotted at IDEAM (Colombian Meteorology Institute) concerning the number of cases of acute CD per month, and it was compared with the frequency of triatomines collected in infested houses by community surveillance. Univariate, bivariate, and multivariate analyses were performed, comparing symptoms and signs according to transmission routes, complications, and age groups.Results: The incidence was 3.16 cases per 100,000 inhabitants, and the fatality rate was 20% in the study period. The most frequent symptoms included: fever 98.1%, myalgia 62.1%, arthralgia 60.2%, and headache 49.5%. There were significant differences in the frequency of myalgia, abdominal pain, and periorbital edema in oral transmission. The main complications were pericardial effusion, myocarditis, and heart failure in the group over 18 years of age. In Casanare, TcI Discrete Typing Unit (DTU) has mainly been identified in humans, triatomines, and reservoirs such as opossums and dogs and TcBat in bats. An increase in the number of acute CD cases was evidenced in March, a period when precipitation increases due to the beginning of the rainy season.Conclusions: The results corroborate the symptomatic heterogeneity of the acute phase of CD, which delays treatment, triggering possible clinical complications. In endemic regions, clinical suspicion, diagnostic capacity, detection, and surveillance programs should be strengthened, including intersectoral public health policies for their prevention and control.

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“…Systematic screening of pregnant women has not yet been implemented and remains an important challenge in the fight against Chagas disease. Finally, we have not included the oral transmission route because although this is of great importance these events are less frequent, with a different transmission dynamic that leads to outbreaks with a high proportion of acute cases and high mortality [48][49][50], whereas we have focused on the endemic epidemiological situation.…”

Section: (A) Limitationsmentioning

confidence: 99%

From serological surveys to disease burden: a modelling pipeline for Chagas disease

Ledien,

Cucunubá,

Parra-Henao

et al. 2023

Phil. Trans. R. Soc. B

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In 2012, the World Health Organization (WHO) set the elimination of Chagas disease intradomiciliary vectorial transmission as a goal by 2020. After a decade, some progress has been made, but the new 2021–2030 WHO roadmap has set even more ambitious targets. Innovative and robust modelling methods are required to monitor progress towards these goals. We present a modelling pipeline using local seroprevalence data to obtain national disease burden estimates by disease stage. Firstly, local seroprevalence information is used to estimate spatio-temporal trends in the Force-of-Infection (FoI). FoI estimates are then used to predict such trends across larger and fine-scale geographical areas. Finally, predicted FoI values are used to estimate disease burden based on a disease progression model. Using Colombia as a case study, we estimated that the number of infected people would reach 506 000 (95% credible interval (CrI) = 395 000–648 000) in 2020 with a 1.0% (95%CrI = 0.8–1.3%) prevalence in the general population and 2400 (95%CrI = 1900–3400) deaths (approx. 0.5% of those infected). The interplay between a decrease in infection exposure (FoI and relative proportion of acute cases) was overcompensated by a large increase in population size and gradual population ageing, leading to an increase in the absolute number of Chagas disease cases over time. This article is part of the theme issue ‘Challenges and opportunities in the fight against neglected tropical diseases: a decade from the London Declaration on NTDs’.

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Case-fatality From Orally-transmitted Acute Chagas Disease: A Systematic Review and Meta-analysis

Cited by 18 publications

References 37 publications

Oral transmission of Chagas disease from a One Health approach: A systematic review

Oral transmission of Chagas disease from a One Health approach: A systematic review

Clinical and Epidemiological Characterization of Acute Chagas Disease in Casanare, Eastern Colombia, 2012–2020

From serological surveys to disease burden: a modelling pipeline for Chagas disease

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