A thematic series of the magazine 'Memories of the Oswaldo Cruz Institute' marks the 113 years of the discovery of Chagas disease. With the theme 'Chagas disease: reflections on the past, challenges and opportunities for the future', the publication brings together 16 articles that cover everything from the description of the disease, considered a milestone in Brazilian science, to the goals established by the World Health Organization (WHO) for 2030 with the objective of eliminating the disease as a public health problem . Diagnostic methods, treatments, vaccines and disease control policies are among the topics discussed in the papers.
With five debate tables, the publication was launched during the event 'World Chagas Disease Day 2022: reflections and challenges for the future', promoted by the Fiocruz, this Monday, April 18. The launch session can be seen at f channeliocruz on YouTube. Access the full event schedule.
To deepen the issues, each article in the thematic series has two commentary texts. According to the editors, the expectation is to support future research, health systems and public policies related to Chagas disease, reflecting on the knowledge acquired and what effectively needs to be done to advance.
The thematic series is edited by Angela Junqueira, a researcher at the Laboratory of Parasitic Diseases at the Oswaldo Cruz Institute (IOC/Fiocruz); Pedro Albajar-Viñas, head of the WHO Chagas Disease Control Program; Wilson Savino, coordinator of Regional and National Integration Strategies at the Oswaldo Cruz Foundation (Fiocruz); and Juliana de Meis, researcher at the Thymus Research Laboratory of IOC, who passed away last year, whose contribution is highlighted in memoriam.
Chagas disease was discovered by physician Carlos Chagas, a researcher at the then Manguinhos Institute, on April 14, 1909. At once, the researcher identified the parasite trypanosoma cruzi, which causes the infection, and the insects that transmit the disease, called triatomines and popularly known as kissing bugs. A few months after the announcement of the discovery, an article on the complete cycle of the disease was published in the journal 'Memoirs of the Instituto Oswaldo Cruz'.
According to WHO, Chagas disease affects approximately 7 million people worldwide. In 2019, after intense mobilization of carriers of the infection, the entity declared April 14 as World Chagas Disease Day, with the aim of raising awareness about the disease, which is associated with poverty and is considered a neglected disease.
Learn more about the texts published in the thematic series:
The discovery of Chagas disease and the first research carried out on the subject are discussed in the article 'The history of Chagas disease: reflections on science in action'. Signed by researchers from Casa de Oswaldo Cruz (COC/Fiocruz), the text analyzes events from a historical and sociological perspective, reflecting on the processes by which science is produced. Among other conclusions, the authors highlight that the studies on the disease, which produced recognition of Brazilian science, had, from the beginning, “close ties with a larger social project: raising awareness of the population and seeking solutions for the serious public health problem” .
'Why don't we have a vaccine against Chagas disease yet? ' In the article that has this question as its title, four authors present their analyzes on the challenges for the production of immunizers against the disease. Recalling the history of research and public policies in science and health, four Brazilian specialists, including two researchers from Fiocruz, address key issues for the development of antiparasitic vaccines, ranging from experimental models to production and distribution costs.
Researchers from five countries analyze Chagas disease control strategies developed in Latin America in partnership with the Pan American Health Organization (PAHO) since the 1990s. In the article 'Chagas disease control-surveillance in the Americas: multinational initiatives and the practical impossibility of interrupting the vectorial transmission of the trypanosoma cruzi', the scientists also assess the challenges to reach the goal of eliminating Chagas disease as a public health problem by 2030, established by the WHO. The text has the participation of researchers from Paraguay, Brazil, Guatemala, Colombia and Argentina.
Strategies that contributed to advances in the control of Chagas disease in the Southern Cone of the Americas are analyzed in an article that points out lessons for coping with other diseases, such as Covid-19. Authored by the Center for Technological Development in Health (CDTS/Fiocruz), the text 'The meaning of a neglected tropical disease: lessons from a paradigmatic case of successful translation' highlights the role of innovative developing countries, with a history of investing in health education and research, in combating neglected diseases and points out that this established capacity can be the basis for facing public health emergencies.
The increasing complexity of Chagas disease transmission contexts is discussed in the article 'Different epidemiological profiles and scenarios: past, present and future'. Prepared by researchers from six countries, the work maps the current distribution of triatomine vectors, points out changes in the habits of some species of the insect and discusses the different possible routes of transmission of the infection. Led by scientists from Argentina, the publication has the collaboration of researchers from the René Rachou Institute (Fiocruz-Minas), in Brazil, and institutions in China, Vietnam, France and Mexico.
Advances and challenges in the diagnosis of Chagas disease are discussed in the article 'Parasitological, serological and molecular diagnosis of acute and chronic Chagas disease: from the field to the laboratory', prepared by researchers from Argentina, Spain and Switzerland. Considering the difficulties in confirming the disease at different stages of infection and in different epidemiological scenarios, the researchers discuss the limitations and potential of different tests and exam combinations, pointing out gaps in knowledge and highlighting the importance of expanding access to diagnosis for control of Chagas disease.
Examples of tools to understand the multiple dimensions of Chagas disease, including social, environmental, political and cultural factors, in addition to the biomedical aspect, are presented in the article 'The multidimensional understanding of Chagas disease. Contributions, approaches, challenges and opportunities from and beyond the area of Information, Education and Communication'. Written by researchers from Argentina, Brazil, Chile, Switzerland and Catalonia, the text highlights the relevance of including information, education and communication approaches in building more effective and sustainable strategies for controlling the disease.
In partnership with researchers from Argentina, Guatemala and Colombia, scientists from Fiocruz-Minas and the Wild Health Information Center of Fiocruz point out opportunities and challenges for fighting Chagas disease considering the sustainable development goals (SDGs) proposed by the UN as part of the 2030 Agenda. In the article 'Chagas disease in the context of the 2030 agenda: global warming and vectors', the researchers point out that climate change may facilitate the dispersal of insect vectors of Chagas disease. However, the commitments made by countries to achieve the SDGs have the potential to contribute positively to disease prevention and control.
Based on the literature review, researchers from Switzerland, Brazil and Argentina discuss the difficulties encountered in taking substances analyzed in pre-clinical tests to trials with patients in the article 'The translational challenge in the development of drugs for Chagas disease'. Considering the limitations of available treatments, the researchers reinforce the need to develop new therapies for the infection and discuss how recent technological advances can contribute to overcoming obstacles in drug research and development.
With the aim of eliminating Chagas disease as a public health problem, the WHO proposes to interrupt, by 2030, four forms of transmission of the disease. T. cruzi: through vectors, blood transfusion, organ transplantation and congenital – when the parasite passes from mother to child during pregnancy. In the article 'Emerging and reemerging forms of transmission of trypanosoma cruzi', researchers from Brazil and Switzerland discuss strategies and challenges to achieve this target. The authors also address other routes of infection, such as food contamination, which currently represents the main cause of acute illness in several countries.
Globalization, which has increased the flow of migrations on the planet, has made Chagas disease a problem that is not restricted to Latin America, where transmission by vectors is traditionally recorded. Considering that the place where the infection is diagnosed can influence the therapeutic approach, researchers compare the treatments offered to patients in the Americas and Europe, pointing out challenges in each context. The article 'Critical analysis of the treatment of Chagas disease in different countries' was authored by the Instituto Nacional de Infectologia Evandro Chagas (INI/Fiocruz) and the Fiocruz-Minas, in addition to other institutions in Brazil, Spain, Italy, the United States and Argentina.
Challenges faced by migrants with the T. cruzi, who may or may not develop Chagas disease, are discussed in the article 'Population movements, borders and Chagas disease', prepared by researchers from Chile, Argentina, Catalonia and Switzerland. Highlighting that the problem has psychological, socioeconomic and anthropological aspects, which go beyond biomedical issues, the authors start from experiences reported by migrants, marked by inequalities and exclusions, to discuss limitations and strengths of health systems, social policies and theme approach models.
Brazilian researchers discuss the possible origins of the genetic diversity of the T. cruzi and the association of different genotypes of the parasite with mammals that act as reservoirs and with insect vectors. The article 'Genetic diversity of the trypanosoma cruzi: impact on transmission cycles and on Chagas' disease' still debates the available evidence on the connection between the genotypes of T. cruzi and the clinical manifestations of Chagas disease, emphasizing the role of the patients' immune response in the progression of the disease.
The most serious manifestation of Chagas disease, heart alterations caused by T. cruzi can lead to heart failure, thromboembolism and arrhythmia. In the article 'Prognosis of chronic Chagas heart disease and other pending clinical challenges', researchers from nine Brazilian institutions, including the INI/Fiocruz, discuss the exams that can help evaluate the evolution of the disease and the most recent treatment proposals, including heart transplantation. Challenges in the management of acute cases of heart disease caused by infection by ingestion of food contaminated with T. cruzi and issues associated with the aging of chronic Chagas disease carriers are also addressed in the text.
The history of mobilization of people affected by Chagas disease is narrated in the article 'How people affected by Chagas disease have struggled with their negligence: History, associative movement and World Chagas Disease Day'. With testimonials from participants of carrier associations created in several countries, the text addresses from the founding of the first entity, in Recife, in 1987, to the declaration of World Chagas Disease Day, in 2019, when the 72nd World Health Assembly endorsed the proposal led by the carrier movement. Among the authors of the text are the International Federation of Associations of People Affected by Chagas Disease (Findechagas), associations based in different states of Brazil, Spain and Italy; science and health institutions in Brazil, including COC/Fiocruz, from Spain and Ecuador, in addition to the WHO, in Switzerland.
Access the page of thematic series and check out the 16 publications.
A thematic series of the magazine 'Memories of the Oswaldo Cruz Institute' marks the 113 years of the discovery of Chagas disease. With the theme 'Chagas disease: reflections on the past, challenges and opportunities for the future', the publication brings together 16 articles that cover everything from the description of the disease, considered a milestone in Brazilian science, to the goals established by the World Health Organization (WHO) for 2030 with the objective of eliminating the disease as a public health problem . Diagnostic methods, treatments, vaccines and disease control policies are among the topics discussed in the papers.
With five debate tables, the publication was launched during the event 'World Chagas Disease Day 2022: reflections and challenges for the future', promoted by the Fiocruz, this Monday, April 18. The launch session can be seen at f channeliocruz on YouTube. Access the full event schedule.
To deepen the issues, each article in the thematic series has two commentary texts. According to the editors, the expectation is to support future research, health systems and public policies related to Chagas disease, reflecting on the knowledge acquired and what effectively needs to be done to advance.
The thematic series is edited by Angela Junqueira, a researcher at the Laboratory of Parasitic Diseases at the Oswaldo Cruz Institute (IOC/Fiocruz); Pedro Albajar-Viñas, head of the WHO Chagas Disease Control Program; Wilson Savino, coordinator of Regional and National Integration Strategies at the Oswaldo Cruz Foundation (Fiocruz); and Juliana de Meis, researcher at the Thymus Research Laboratory of IOC, who passed away last year, whose contribution is highlighted in memoriam.
Chagas disease was discovered by physician Carlos Chagas, a researcher at the then Manguinhos Institute, on April 14, 1909. At once, the researcher identified the parasite trypanosoma cruzi, which causes the infection, and the insects that transmit the disease, called triatomines and popularly known as kissing bugs. A few months after the announcement of the discovery, an article on the complete cycle of the disease was published in the journal 'Memoirs of the Instituto Oswaldo Cruz'.
According to WHO, Chagas disease affects approximately 7 million people worldwide. In 2019, after intense mobilization of carriers of the infection, the entity declared April 14 as World Chagas Disease Day, with the aim of raising awareness about the disease, which is associated with poverty and is considered a neglected disease.
Learn more about the texts published in the thematic series:
The discovery of Chagas disease and the first research carried out on the subject are discussed in the article 'The history of Chagas disease: reflections on science in action'. Signed by researchers from Casa de Oswaldo Cruz (COC/Fiocruz), the text analyzes events from a historical and sociological perspective, reflecting on the processes by which science is produced. Among other conclusions, the authors highlight that the studies on the disease, which produced recognition of Brazilian science, had, from the beginning, “close ties with a larger social project: raising awareness of the population and seeking solutions for the serious public health problem” .
'Why don't we have a vaccine against Chagas disease yet? ' In the article that has this question as its title, four authors present their analyzes on the challenges for the production of immunizers against the disease. Recalling the history of research and public policies in science and health, four Brazilian specialists, including two researchers from Fiocruz, address key issues for the development of antiparasitic vaccines, ranging from experimental models to production and distribution costs.
Researchers from five countries analyze Chagas disease control strategies developed in Latin America in partnership with the Pan American Health Organization (PAHO) since the 1990s. In the article 'Chagas disease control-surveillance in the Americas: multinational initiatives and the practical impossibility of interrupting the vectorial transmission of the trypanosoma cruzi', the scientists also assess the challenges to reach the goal of eliminating Chagas disease as a public health problem by 2030, established by the WHO. The text has the participation of researchers from Paraguay, Brazil, Guatemala, Colombia and Argentina.
Strategies that contributed to advances in the control of Chagas disease in the Southern Cone of the Americas are analyzed in an article that points out lessons for coping with other diseases, such as Covid-19. Authored by the Center for Technological Development in Health (CDTS/Fiocruz), the text 'The meaning of a neglected tropical disease: lessons from a paradigmatic case of successful translation' highlights the role of innovative developing countries, with a history of investing in health education and research, in combating neglected diseases and points out that this established capacity can be the basis for facing public health emergencies.
The increasing complexity of Chagas disease transmission contexts is discussed in the article 'Different epidemiological profiles and scenarios: past, present and future'. Prepared by researchers from six countries, the work maps the current distribution of triatomine vectors, points out changes in the habits of some species of the insect and discusses the different possible routes of transmission of the infection. Led by scientists from Argentina, the publication has the collaboration of researchers from the René Rachou Institute (Fiocruz-Minas), in Brazil, and institutions in China, Vietnam, France and Mexico.
Advances and challenges in the diagnosis of Chagas disease are discussed in the article 'Parasitological, serological and molecular diagnosis of acute and chronic Chagas disease: from the field to the laboratory', prepared by researchers from Argentina, Spain and Switzerland. Considering the difficulties in confirming the disease at different stages of infection and in different epidemiological scenarios, the researchers discuss the limitations and potential of different tests and exam combinations, pointing out gaps in knowledge and highlighting the importance of expanding access to diagnosis for control of Chagas disease.
Examples of tools to understand the multiple dimensions of Chagas disease, including social, environmental, political and cultural factors, in addition to the biomedical aspect, are presented in the article 'The multidimensional understanding of Chagas disease. Contributions, approaches, challenges and opportunities from and beyond the area of Information, Education and Communication'. Written by researchers from Argentina, Brazil, Chile, Switzerland and Catalonia, the text highlights the relevance of including information, education and communication approaches in building more effective and sustainable strategies for controlling the disease.
In partnership with researchers from Argentina, Guatemala and Colombia, scientists from Fiocruz-Minas and the Wild Health Information Center of Fiocruz point out opportunities and challenges for fighting Chagas disease considering the sustainable development goals (SDGs) proposed by the UN as part of the 2030 Agenda. In the article 'Chagas disease in the context of the 2030 agenda: global warming and vectors', the researchers point out that climate change may facilitate the dispersal of insect vectors of Chagas disease. However, the commitments made by countries to achieve the SDGs have the potential to contribute positively to disease prevention and control.
Based on the literature review, researchers from Switzerland, Brazil and Argentina discuss the difficulties encountered in taking substances analyzed in pre-clinical tests to trials with patients in the article 'The translational challenge in the development of drugs for Chagas disease'. Considering the limitations of available treatments, the researchers reinforce the need to develop new therapies for the infection and discuss how recent technological advances can contribute to overcoming obstacles in drug research and development.
With the aim of eliminating Chagas disease as a public health problem, the WHO proposes to interrupt, by 2030, four forms of transmission of the disease. T. cruzi: through vectors, blood transfusion, organ transplantation and congenital – when the parasite passes from mother to child during pregnancy. In the article 'Emerging and reemerging forms of transmission of trypanosoma cruzi', researchers from Brazil and Switzerland discuss strategies and challenges to achieve this target. The authors also address other routes of infection, such as food contamination, which currently represents the main cause of acute illness in several countries.
Globalization, which has increased the flow of migrations on the planet, has made Chagas disease a problem that is not restricted to Latin America, where transmission by vectors is traditionally recorded. Considering that the place where the infection is diagnosed can influence the therapeutic approach, researchers compare the treatments offered to patients in the Americas and Europe, pointing out challenges in each context. The article 'Critical analysis of the treatment of Chagas disease in different countries' was authored by the Instituto Nacional de Infectologia Evandro Chagas (INI/Fiocruz) and the Fiocruz-Minas, in addition to other institutions in Brazil, Spain, Italy, the United States and Argentina.
Challenges faced by migrants with the T. cruzi, who may or may not develop Chagas disease, are discussed in the article 'Population movements, borders and Chagas disease', prepared by researchers from Chile, Argentina, Catalonia and Switzerland. Highlighting that the problem has psychological, socioeconomic and anthropological aspects, which go beyond biomedical issues, the authors start from experiences reported by migrants, marked by inequalities and exclusions, to discuss limitations and strengths of health systems, social policies and theme approach models.
Brazilian researchers discuss the possible origins of the genetic diversity of the T. cruzi and the association of different genotypes of the parasite with mammals that act as reservoirs and with insect vectors. The article 'Genetic diversity of the trypanosoma cruzi: impact on transmission cycles and on Chagas' disease' still debates the available evidence on the connection between the genotypes of T. cruzi and the clinical manifestations of Chagas disease, emphasizing the role of the patients' immune response in the progression of the disease.
The most serious manifestation of Chagas disease, heart alterations caused by T. cruzi can lead to heart failure, thromboembolism and arrhythmia. In the article 'Prognosis of chronic Chagas heart disease and other pending clinical challenges', researchers from nine Brazilian institutions, including the INI/Fiocruz, discuss the exams that can help evaluate the evolution of the disease and the most recent treatment proposals, including heart transplantation. Challenges in the management of acute cases of heart disease caused by infection by ingestion of food contaminated with T. cruzi and issues associated with the aging of chronic Chagas disease carriers are also addressed in the text.
The history of mobilization of people affected by Chagas disease is narrated in the article 'How people affected by Chagas disease have struggled with their negligence: History, associative movement and World Chagas Disease Day'. With testimonials from participants of carrier associations created in several countries, the text addresses from the founding of the first entity, in Recife, in 1987, to the declaration of World Chagas Disease Day, in 2019, when the 72nd World Health Assembly endorsed the proposal led by the carrier movement. Among the authors of the text are the International Federation of Associations of People Affected by Chagas Disease (Findechagas), associations based in different states of Brazil, Spain and Italy; science and health institutions in Brazil, including COC/Fiocruz, from Spain and Ecuador, in addition to the WHO, in Switzerland.
Access the page of thematic series and check out the 16 publications.
The non-profit reproduction of the text is allowed as long as the source is cited (Comunicação / Instituto Oswaldo Cruz)
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