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Venezuela: the hidden Chagas disease

A little-known illness is on the rise in Venezuela.

"All those control programs have really been abandoned," said Dr. Julio Urbina, professor emeritus at the Venezuelan Institute of Scientific Research, who has developed Prosaconazole, a drug that in trials in Spain has proved to be one of the most effective treatments for the chronic stage of Chagas. "A fumigation program has to be extensive, sustained and managed by well-trained people - and this is what is not happening."

The government appears to be sensitive to such accusations. It has been secretive about the details of the recent outbreak in Antimano which is located less than 10 miles from the Presidential Palace. The new cases appeared to hit home that the disease, which was previously believed to be under control, is once again on the rise.

Last month, the local government health authority in Anzoategui state said it would be charging Dr. Antonio Morocoimo of the Center for Investigation of Tropical Medicine at the University of the East with spreading fear and panic after he published details of an investigation that found 60 percent of the kissing bugs studied in the wild carried the Chagas parasite.

Yet amid accusations of neglect, Venezuela is seen internationally as a pioneer in the prevention and treatment of Chagas. A control program begun in the 1950s involving coordinated fumigation has been emulated elsewhere on the continent.

Urbina’s treatment, meanwhile, is undergoing clinical trials in Brazil and Argentina, though the Venezuelan government has yet to grant a license in his home country.

Many of the problems causing the spread of Chagas can be related to the difficulties of diagnosing the disease, said Guido Nunez-Mujica, a molecular biologist from Merida, who is developing an instrument that he believes could dramatically decrease the prevalence of diseases such as Chagas.

The LavAmp is a cheap, portable “DNA Xerox machine” that Nunez-Mujica hopes will allow doctors in rural areas to be able to diagnose patients without having to wait for test results from Caracas.

Up until now the DNA-testing technique the LavAmp uses has not been widely available because of the size and cost of the equipment. Nunez-Mujica has managed to shrink the size of the LavAmp and hopes to bring the cost down from $3,000 to $300 with each test costing $0.25. “This machine at this price and being portable it would be possible to have one of these if not in every laboratory at least in every large hospital.”

In the meantime, however, sufferers of Chagas in Venezuela will have to contend with the drugs that are available. Emily Cordova already has her 11-year-old brother Alejandro as an example of how harsh the treatment can be.

He was hospitalized for 15 days in January 2009 after the treatment appeared not to have worked. He also suffers from violent mood swings, fevers and inflammation of the face, she said.

Cordova said that initially she felt angry with the school and with the cook who had prepared the guava juice (who also contracted the disease) but had now come to terms with her fate. “At first I didn’t want to tell people,” she said, describing how she had been teased at school. “Now I say it with pride.”

http://www.globalpost.com/dispatch/venezuela/100610/chagas-disease