Vice President, Clinical Development, Renova Therapeutics, Inc., Carlsbad, CA.
Am J Med. 2020 Nov;133(11):1262-1265. doi: 10.1016/j.amjmed.2020.05.022. Epub 2020 Jun 24.
Chronic human infection by the protozoan parasite Trypanosoma cruzi, known as Chagas disease, results in heart failure and death in 20%-30% of affected individuals. Recognition and treatment of the infection are difficult. Disease control requires elimination of the vector, the reduviid bug, that infests housing of poor quality in endemic areas. In South America, control has largely succeeded in the Southern Cone countries-Argentina, Chile, Uruguay, southern Brazil and São Paulo, and Paraguay-but lags severely in the Northern Triangle (Central American) countries: El Salvador, Honduras, and Guatemala. Surges in poverty and violence in Central America have increased immigration of persons at risk for Chagas disease to the United States, and immigrants to the United States with Chagas disease face multiple barriers to obtaining effective care. These include issues with financing and payment for health care, limited effectiveness of screening and diagnosis, limited effectiveness of available treatment, and lack of provider awareness, public health education, and research. Each of these barriers presents a unique public health challenge.
人体被原生动物寄生虫克氏锥虫（Trypanosoma cruzi）慢性感染，即恰加斯病（Chagas disease），在 20%-30%的感染者中会导致心力衰竭和死亡。这种感染难以识别和治疗。疾病控制需要消灭在流行地区劣质住房中滋生的吸血臭虫（reduviid bug）。在南美洲，南锥体国家（阿根廷、智利、乌拉圭、巴西南部和圣保罗以及巴拉圭）的控制已基本取得成功，但中美洲北部三角地区（萨尔瓦多、洪都拉斯和危地马拉）的控制严重滞后。中美洲贫困和暴力的激增导致感染恰加斯病的高危人群移民到美国，而移民到美国的恰加斯病患者在获得有效治疗方面面临多种障碍。这些障碍包括医疗保健的融资和支付问题、筛查和诊断效果有限、现有治疗方法效果有限以及提供者意识、公共卫生教育和研究的缺乏。这些障碍中的每一个都提出了一个独特的公共卫生挑战。
