April 14, 2024 marks 115 years since the discovery of Chagas disease. Despite being more than a century old, the infection remains neglected, with no interest from the pharmaceutical industry in producing new treatments and vaccines, with the majority of those affected coming from more vulnerable areas.
The date also celebrates the five years of World Chagas Disease Day, declared during the 72nd World Health Assembly in 2019, after intense mobilization led by the International Federation of Associations of People Affected by Chagas Disease (Findechagas), which had support of the scientific and health community.
Type specimen, on which Arthur Neiva based the description of the species Triatoma brasiliensis, in 1911, is deposited in the Entomological Collection of IOC. Photo: Gutenberg Brito
At the forefront of the discovery that marked the history of medicine, the Oswaldo Cruz Institute (IOC/Fiocruz) and the Oswaldo Cruz Foundation (Fiocruz) participated in the movement to include the date in the world health calendar and break the silence about the disease. [Check testimonials of researchers from IOC about the importance of the date.]
Chosen as World Day, April 14th remembers the date in 1909 when the famous researcher Carlos Chagas identified the parasite trypanosoma cruzi, causing the infection, in a patient: the girl Berenice, aged 2, resident of the city of Lassance, in Minas Gerais.
The finding took Chagas further: he became the first researcher to describe the complete cycle of a disease, with the identification of the parasite, its vector and the damage caused by it.
Carlos Chagas (sitting on the right) in front of the house where, according to reports, he first became aware of the barbers. Photo: Casa de Oswaldo Cruz Collection (COC/Fiocroz)
Still in April, the new 'disease' (in the language of the time) was announced in a preliminary note in the journal Brazil-Médico. In August, Carlos Chagas published article about the complete cycle in the scientific magazine 'Memórias do Instituto Oswaldo Cruz', created by Oswaldo Cruz at the beginning of that year.
More than 100 years later, study led by scientists from IOC showed that the journal maintains a relevant role in disseminating scientific knowledge about Chagas disease.
Article by Carlos Chagas published in 'Memórias do Instituto Oswaldo Cruz' in 1909. Photos: Josué Damacena
Considered one of the most important in tropical medicine and parasitology on the international scene, the magazine published 571 articles on the disease from 1909 to 2020. Cited in 8% of published articles, Chagas disease remains the most frequent disease on the journal's pages.
O IOC operates uninterruptedly to face the challenges of Chagas disease, which has deep social roots.
The Unit maintains the largest and most diverse Triatomines Collection in the world, which houses specimens of all genera and most of the 160 species of the insect vector, popularly known as kissing bug.
There are also triatomines deposited in the Entomological Collection do IOC, including, for example, the standard specimen of the Triatoma brasiliensis, from which scientist Arthur Neiva described the species in 1911. Currently, the species is the main vector of Chagas disease in the Northeast.
Diversity of kissing bugs is observed in the Triatomine Collection of IOC. Photo: Gutenberg Brito
To facilitate the identification of vectors, experts annually update a collection of illustrated digital cards with the triatomine species present in different regions of the country.
In this field, the Guide to triatomines in Bahia, Iconographic Atlas of Triatomines in Brazil and primer on Triatoma brasiliensis, the main vector in the Northeast.
Recently, scientists and students have developed new tools to support the fight against the disease, such as the page 'Found a barber', the diagnostic kit NAT Chagas and social technology 'Chagas Express 21'.
With science and art activities and diagnostic offers, 'Expresso Chagas 21' promoted health education and tracking cases of Chagas disease in Ceará. Photos: Disclosure
Chagas disease affects between six and seven million people worldwide, according to the World Health Organization (WHO). In Brazil, there are around one million infected, according to the Ministry of Health.
The problem is the focus of the Interministerial Committee for the Elimination of Socially Determined Diseases (CIEDDS) of the Federal Government. The global and Brazilian goal is to eliminate the disease as a public health problem by 2030.
According to the Pubmed database, in the last five years, publications on Chagas disease led by or in collaboration with scientists from the IOC There are more than 200 articles with research results, twenty review works and six opinion texts, such as editorials and comments.
The search for new effective treatments against T. cruzi It is one of the most frequent topics in studies, considering that the two medications currently available to combat the parasite have many side effects.
Above, microscopy analysis in research focusing on finding treatment for heart damage in chronic Chagas disease. Below, selenium capsules used in clinical studies. Photos: Gutemberg Brito
Other research looks at heart problems that occur in the chronic phase of the disease. After decades of untreated silent infection, about 30% of those infected develop heart damage, which can lead to death.
In 2021, researchers at IOC, in partnership with INI/Fiocruz, completed the first clinical trial evaluating the nutritional supplementation therapy with selenium. The study indicated potential benefit in a subgroup of patients with heart problems caused by chronic Chagas disease.
Scientists from the Institute contributed to the development of the Brazilian Society of Cardiology (SBC) guideline on the diagnosis and treatment of patients with Chagas disease cardiomyopathy for 2023.
The development of vaccines and treatments that can be used as chemoprophylaxis to prevent infection is also the target of studies.
Research also addresses methods for diagnosing the disease and detecting contamination in food.
More than 60 species of triatomines are known in Brazil and all of them can transmit the disease. T. cruzi.
The traditional form of contagion involves the bite of an infected kissing bug. During or after the bite, the insect usually defecates on the skin. When scratching the area, parasites that were eliminated in the vector's feces can come into contact with the injured area and penetrate the body.
In recent years, oral infection caused by ingestion of food contaminated with T. cruzi, has become the most common form of contagion in Brazil. This occurs when infected kissing bugs or their feces are accidentally crushed in the preparation of foods such as açaí, bacaba and sugarcane juice.
In field work, researchers from IOC investigate infection in domestic and wild animals to identify T. cruzi reservoirs. Photos: Collection
Studies published by the Institute contribute to mapping the distribution of triatomine species in Brazil and South America and to understanding Chagas disease transmission dynamics, guiding prevention actions.
Discoveries of new species in Argentina, Bolivia and Panama, as well as the identification of species in new locations in Brazil are topics of publications.
Many works discuss the taxonomy of vectors, addressing characteristics that allow differentiating species, including morphological and genetic aspects. They also analyze characteristics of hybrid insects, born from the crossing of different species.
Dorsal view of the male specimen of Panstrongylus noireaui, a new species described by researchers from IOC in partnership with scientists from Bolivia and Uruguay in 2022. Photo: Reproduction
Colonization of residences in urban areas, adaptation of the insect to different habitats and interaction between the vector and the T. cruzi are also analyzed, including mechanisms involved in the infection process, characteristics of the insect's immune response and the influence of the parasite's genetic subtypes on the process.
Wild and domestic animals that act as reservoirs of the parasite and can serve as a source of infection for kissing bugs are the target of research by the IOC.
Aspects of the biology of T. cruzi that can contribute to understanding Chagas disease and seeking new forms of treatment and prevention are revealed in articles.
One of the targets of research is the genetic variability of the parasite, including the sequencing of microorganisms isolated from different hosts and analyzes of the relationship between genetic subtypes of the parasite. T. cruzi, clinical manifestations of the disease and response to treatment.
The research also investigates the parasite's reaction to stress conditions, points out survival mechanisms and characterizes biochemical pathways and proteins important in the biology of the parasite. T. cruzi, which can serve as a therapeutic target.
On the left, image of the parasite trypanosoma janseni obtained by artificially colored scanning electron microscopy. Author: Rubem Menna-Barreto. On the right, image of two protozoa of T. cruzi obtained through scanning electron microscopy on the F electron microscopy platformiocruz, colored in image post-processing. Authors: Anissa Daliry and Maria de Nazaré Soeiro
After 115 years, there are still poorly understood aspects of the evolution of Chagas disease.
Soon after infection, patients may experience symptoms such as fever, malaise, swelling in the face or legs, among others. This period, called the acute phase of the disease, can also be asymptomatic.
After that, people usually go years without manifestations of the disease and many live their entire lives without complications despite the infection. T. cruzi.
However, about a third of patients develop heart problems due to chronic Chagas disease. Approximately one in ten presents with digestive, neurological or mixed complications.
Published studies contribute to understanding how Chagas disease causes damage to the body. The works address issues such as the cellular response to infection, the role of the immune system and vascular and neurological changes in acute and chronic cases, pointing out ways to search for treatments.
April 14, 2024 marks 115 years since the discovery of Chagas disease. Despite being more than a century old, the infection remains neglected, with no interest from the pharmaceutical industry in producing new treatments and vaccines, with the majority of those affected coming from more vulnerable areas.
The date also celebrates the five years of World Chagas Disease Day, declared during the 72nd World Health Assembly in 2019, after intense mobilization led by the International Federation of Associations of People Affected by Chagas Disease (Findechagas), which had support of the scientific and health community.
Type specimen, on which Arthur Neiva based the description of the species Triatoma brasiliensis, in 1911, is deposited in the Entomological Collection of IOC. Photo: Gutenberg Brito
At the forefront of the discovery that marked the history of medicine, the Oswaldo Cruz Institute (IOC/Fiocruz) and the Oswaldo Cruz Foundation (Fiocruz) participated in the movement to include the date in the world health calendar and break the silence about the disease. [Check testimonials of researchers from IOC about the importance of the date.]
Chosen as World Day, April 14th remembers the date in 1909 when the famous researcher Carlos Chagas identified the parasite trypanosoma cruzi, causing the infection, in a patient: the girl Berenice, aged 2, resident of the city of Lassance, in Minas Gerais.
The finding took Chagas further: he became the first researcher to describe the complete cycle of a disease, with the identification of the parasite, its vector and the damage caused by it.
Carlos Chagas (sitting on the right) in front of the house where, according to reports, he first became aware of the barbers. Photo: Casa de Oswaldo Cruz Collection (COC/Fiocroz)
Still in April, the new 'disease' (in the language of the time) was announced in a preliminary note in the journal Brazil-Médico. In August, Carlos Chagas published article about the complete cycle in the scientific magazine 'Memórias do Instituto Oswaldo Cruz', created by Oswaldo Cruz at the beginning of that year.
More than 100 years later, study led by scientists from IOC showed that the journal maintains a relevant role in disseminating scientific knowledge about Chagas disease.
Article by Carlos Chagas published in 'Memórias do Instituto Oswaldo Cruz' in 1909. Photos: Josué Damacena
Considered one of the most important in tropical medicine and parasitology on the international scene, the magazine published 571 articles on the disease from 1909 to 2020. Cited in 8% of published articles, Chagas disease remains the most frequent disease on the journal's pages.
O IOC operates uninterruptedly to face the challenges of Chagas disease, which has deep social roots.
The Unit maintains the largest and most diverse Triatomines Collection in the world, which houses specimens of all genera and most of the 160 species of the insect vector, popularly known as kissing bug.
There are also triatomines deposited in the Entomological Collection do IOC, including, for example, the standard specimen of the Triatoma brasiliensis, from which scientist Arthur Neiva described the species in 1911. Currently, the species is the main vector of Chagas disease in the Northeast.
Diversity of kissing bugs is observed in the Triatomine Collection of IOC. Photo: Gutenberg Brito
To facilitate the identification of vectors, experts annually update a collection of illustrated digital cards with the triatomine species present in different regions of the country.
In this field, the Guide to triatomines in Bahia, Iconographic Atlas of Triatomines in Brazil and primer on Triatoma brasiliensis, the main vector in the Northeast.
Recently, scientists and students have developed new tools to support the fight against the disease, such as the page 'Found a barber', the diagnostic kit NAT Chagas and social technology 'Chagas Express 21'.
With science and art activities and diagnostic offers, 'Expresso Chagas 21' promoted health education and tracking cases of Chagas disease in Ceará. Photos: Disclosure
Chagas disease affects between six and seven million people worldwide, according to the World Health Organization (WHO). In Brazil, there are around one million infected, according to the Ministry of Health.
The problem is the focus of the Interministerial Committee for the Elimination of Socially Determined Diseases (CIEDDS) of the Federal Government. The global and Brazilian goal is to eliminate the disease as a public health problem by 2030.
According to the Pubmed database, in the last five years, publications on Chagas disease led by or in collaboration with scientists from the IOC There are more than 200 articles with research results, twenty review works and six opinion texts, such as editorials and comments.
The search for new effective treatments against T. cruzi It is one of the most frequent topics in studies, considering that the two medications currently available to combat the parasite have many side effects.
Above, microscopy analysis in research focusing on finding treatment for heart damage in chronic Chagas disease. Below, selenium capsules used in clinical studies. Photos: Gutemberg Brito
Other research looks at heart problems that occur in the chronic phase of the disease. After decades of untreated silent infection, about 30% of those infected develop heart damage, which can lead to death.
In 2021, researchers at IOC, in partnership with INI/Fiocruz, completed the first clinical trial evaluating the nutritional supplementation therapy with selenium. The study indicated potential benefit in a subgroup of patients with heart problems caused by chronic Chagas disease.
Scientists from the Institute contributed to the development of the Brazilian Society of Cardiology (SBC) guideline on the diagnosis and treatment of patients with Chagas disease cardiomyopathy for 2023.
The development of vaccines and treatments that can be used as chemoprophylaxis to prevent infection is also the target of studies.
Research also addresses methods for diagnosing the disease and detecting contamination in food.
More than 60 species of triatomines are known in Brazil and all of them can transmit the disease. T. cruzi.
The traditional form of contagion involves the bite of an infected kissing bug. During or after the bite, the insect usually defecates on the skin. When scratching the area, parasites that were eliminated in the vector's feces can come into contact with the injured area and penetrate the body.
In recent years, oral infection caused by ingestion of food contaminated with T. cruzi, has become the most common form of contagion in Brazil. This occurs when infected kissing bugs or their feces are accidentally crushed in the preparation of foods such as açaí, bacaba and sugarcane juice.
In field work, researchers from IOC investigate infection in domestic and wild animals to identify T. cruzi reservoirs. Photos: Collection
Studies published by the Institute contribute to mapping the distribution of triatomine species in Brazil and South America and to understanding Chagas disease transmission dynamics, guiding prevention actions.
Discoveries of new species in Argentina, Bolivia and Panama, as well as the identification of species in new locations in Brazil are topics of publications.
Many works discuss the taxonomy of vectors, addressing characteristics that allow differentiating species, including morphological and genetic aspects. They also analyze characteristics of hybrid insects, born from the crossing of different species.
Dorsal view of the male specimen of Panstrongylus noireaui, a new species described by researchers from IOC in partnership with scientists from Bolivia and Uruguay in 2022. Photo: Reproduction
Colonization of residences in urban areas, adaptation of the insect to different habitats and interaction between the vector and the T. cruzi are also analyzed, including mechanisms involved in the infection process, characteristics of the insect's immune response and the influence of the parasite's genetic subtypes on the process.
Wild and domestic animals that act as reservoirs of the parasite and can serve as a source of infection for kissing bugs are the target of research by the IOC.
Aspects of the biology of T. cruzi that can contribute to understanding Chagas disease and seeking new forms of treatment and prevention are revealed in articles.
One of the targets of research is the genetic variability of the parasite, including the sequencing of microorganisms isolated from different hosts and analyzes of the relationship between genetic subtypes of the parasite. T. cruzi, clinical manifestations of the disease and response to treatment.
The research also investigates the parasite's reaction to stress conditions, points out survival mechanisms and characterizes biochemical pathways and proteins important in the biology of the parasite. T. cruzi, which can serve as a therapeutic target.
On the left, image of the parasite trypanosoma janseni obtained by artificially colored scanning electron microscopy. Author: Rubem Menna-Barreto. On the right, image of two protozoa of T. cruzi obtained through scanning electron microscopy on the F electron microscopy platformiocruz, colored in image post-processing. Authors: Anissa Daliry and Maria de Nazaré Soeiro
After 115 years, there are still poorly understood aspects of the evolution of Chagas disease.
Soon after infection, patients may experience symptoms such as fever, malaise, swelling in the face or legs, among others. This period, called the acute phase of the disease, can also be asymptomatic.
After that, people usually go years without manifestations of the disease and many live their entire lives without complications despite the infection. T. cruzi.
However, about a third of patients develop heart problems due to chronic Chagas disease. Approximately one in ten presents with digestive, neurological or mixed complications.
Published studies contribute to understanding how Chagas disease causes damage to the body. The works address issues such as the cellular response to infection, the role of the immune system and vascular and neurological changes in acute and chronic cases, pointing out ways to search for treatments.
The non-profit reproduction of the text is allowed as long as the source is cited (Comunicação / Instituto Oswaldo Cruz)
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