An agreement to facilitate and strengthen access to diagnosis and treatment of patients with Chagas and other diseases of public health interest has been signed by the Colombian Ministry of Health and Social Protection and the non-profit research and development organization Drugs for Neglected Diseases initiative (DNDi).
The agreement, signed during the celebration of World Chagas Day, concerns the development of a pilot programme for validation of the Roadmap of care for Chagas disease, currently under way in four departments (or states) of Colombia. The partnership also includes the implementation of a new diagnostic system developed by the Colombian National Institute of Health (INS), which recently published a new public health surveillance protocol to guide actors in the health system in providing comprehensive care for Chagas patients.
As a part of the partnership, Colombia has already achieved increases of 1,455% and 1,129% in the number of patients obtaining access to Chagas diagnosis in the municipalities of Támara and Nunchía, (Casanare department), respectively. The results are part of the Pilot Project to Eliminate Barriers to Access for Chagas Patients that has just completed its first year. The project has also made major strides in the municipality of Soatá (Boyacá). Once validated, the Chagas Roadmap will be extended to the rest of the country.
In addition to these important strides in patient care, the Ministry of Health has taken measures through the plan for interruption of household transmission by the main Chagas vector (known in English as “kissing bug” and locally as “pito”). The goal for 2021 is to have 106 municipalities certified as household transmission-free. At present, 33 municipalities have been certified by the Pan American Health Organization (PAHO).
The INS has also done outstanding work through the National Program for the Prevention, Control, and Treatment of Chagas Disease, which convenes research groups, academic institutions, and civil society to achieve results that will back decision-making in public health and serve as evidence for patient care protocols, in addition to the Network for Knowledge Management, Research, and Innovation in Chagas Disease, designed as the framework for research in this parasitic disease to help meet the goals of the Ten-Year Public Health Plan for 2012-2021.
According to the World Health Organization (WHO), Chagas disease affects more than six million persons worldwide, most of whom in Latin America. In Colombia, approximately 4,800,000 persons are at risk of infection, of whom 438,000 are infected, with an estimated 5,274 new cases every year. Of these, according to reports by the Colombian National Institute of Health, fewer than 1,000 are receiving treatment.
According to data from the Ministry of Health and Social Protection, an average of 25 cases in the acute phase and 1,000 cases in the chronic phase are diagnosed per year in Colombia. The WHO estimates 131,388 cases of Chagas cardiopathy in Colombia.
Chagas is a silent disease caused by infection with the parasite Trypanosoma cruzi, transmitted mainly by contact with fecal matter of infected kissing bugs or pitos (the insect vector). Approximately 30% of persons that are infected go on to develop the disease. The most frequently affected organs are the heart and to a lesser extent the digestive tract, especially the colon and/or esophagus.
Bringing Chagas disease care to a remote Colombian region
Photo credit: Felipe Abondano-DNDi