National Referral Centre for Tropical Diseases, Infectious Diseases Department, Hospital Universitario Ramón y Cajal, Insituto Ramón y Cajal de Investgación Sanitaria, Madrid, Spain.
Infectious Diseases Department, Hospital Universitario Vall d'Hebron, Barcelona, Spain; International Health Program of the Catalan Institute of Health, Barcelona, Spain.
Lancet. 2018 Jan 6;391(10115):82-94. doi: 10.1016/S0140-6736(17)31612-4. Epub 2017 Jun 30.
Chagas disease is an anthropozoonosis from the American continent that has spread from its original boundaries through migration. It is caused by the protozoan Trypanosoma cruzi, which was identified in the first decade of the 20th century. Once acute infection resolves, patients can develop chronic disease, which in up to 30-40% of cases is characterised by cardiomyopathy, arrhythmias, megaviscera, and, more rarely, polyneuropathy and stroke. Even after more than a century, many challenges remain unresolved, since epidemiological control and diagnostic, therapeutic, and prognostic methods must be improved. In particular, the efficacy and tolerability profile of therapeutic agents is far from ideal. Furthermore, the population affected is older and more complex (eg, immunosuppressed patients and patients with cancer). Nevertheless, in recent years, our knowledge of Chagas disease has expanded, and the international networking needed to change the course of this deadly disease during the 21st century has begun.
恰加斯病是一种源于美洲大陆的人兽共患寄生虫病，随着人口迁徙，其传播范围已超出原有地域。该病由原生动物克氏锥虫引起，于 20 世纪初被首次发现。急性感染一旦痊愈，患者可能发展为慢性疾病，其中高达 30-40%的病例表现为心肌病、心律失常、巨内脏，极少数情况下还会出现多发性神经病和中风。尽管已经过去了一个多世纪，许多挑战仍未得到解决，因为必须改进流行病学控制以及诊断、治疗和预后方法。特别是，治疗药物的疗效和耐受性并不理想。此外，受影响的人群更年长且更为复杂（例如，免疫抑制患者和癌症患者）。尽管如此，近年来，我们对恰加斯病的认识已经有所扩展，并且已经开始建立国际网络，以期在 21 世纪改变这种致命疾病的进程。
