MSF has now started diagnosing and treating people affected by Chagas disease in Arauca department. This Northeastern region of Colombia has one of the highest prevalence rates of Chagas in the country, with an estimated eight percent of the population infected. Caused by a parasite, Chagas disease can lead to serious health complications and even death. Until now, treatment has not been available in the country and, without screening programmes, many do not even know they are infected.
MSF has integrated Chagas screening and treatment into the healthcare services it already provides in the region. Through mobile clinics, MSF offers free medical consultations, mental health support, family planning and antenatal care to people living mostly in isolated villages where healthcare isn't available. In addition, the team now provides information about the risks of Chagas and encourages people to take a Chagas diagnosis test. After a patient is confirmed to have Chagas disease, they can be started on a two-month long course of treatment. The MSF team carries out regular medical follow-ups to check for side effects and any difficulties complying with the treatment.
Mobile clinic in the Colombian department of Tolima, distributing medication. Feb 03
Photo by Juan Victor Stienen/MSF
Chagas disease is endemic in most Latin American countries. It is caused by the parasite Trypanosoma cruzi and is mainly transmitted by the ‘kissing bug’, a blood-sucking insect, common in areas where people live in houses made of clay and straw bricks. Transmission is also possible from mother to child, through blood transfusions, organ transplants and contaminated food.
Patients with Chagas disease may live for years without presenting any symptoms. However, if left untreated, the disease can lead to serious heart and intestinal problems and even death. “Throughout our work in Arauca, we have seen people with serious cardiac complications related to Chagas. At that stage, there is little we can do […] as there is no evidence that treatment against the parasite at such an advanced state of the disease is effective. That is why we have to start actively diagnosing and treating the disease, so we can detect it early.” explained Oscar Bernal, MSF’s medical coordinator in Colombia.
“By doing active screening, we are able to detect the disease before the patient starts showing signs, when the treatment is more likely to be effective.”
People with Chagas disease in Colombia have few alternatives for treatment and many will die in silence. The fight against Chagas is currently focused on programmes to eradicate the insect that transmits the disease. Alhough prevention is important, health authorities must not ignore the needs of those already infected.
In July 2009, MSF launched an international campaign, calling on endemic countries to end neglect of Chagas sufferers and support diagnosis and treatment for those affected. “By offering treatment in Arauca, we hope to stimulate a national debate about Chagas and motivate authorities to not only recognise Chagas as a public health problem, but also to engage in screening and treatment programmes,” said Oscar Bernal.
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MSF has provided diagnosis and treatment to people suffering from Chagas in Honduras, Nicaragua, Guatemala and Bolivia, since1999. At the end of 2008, MSF had tested more than 60,000 people for Chagas and diagnosed 3,100 patients, of whom 2,800 successfully completed their treatment. MSF experience shows that diagnosing and treating Chagas in limited resource settings and remote areas is feasible. More information on MSF’s Chagas campaign is available at: www.chagas-break-the-silence.com.
MSF has worked in Colombia since 1985. Currently, it runs medical programmes in 17 out of 32 departments in Colombia. In addition to Chagas diagnosis and treatment, the range of services MSF provides includes: primary healthcare, mental-health programmes, mobile clinics in urban and rural areas, reproductive healthcare, emergency obstetric care and assistance to victims of sexual violence, antenatal care, water and sanitation, basic refurbishment of health facilities and emergency response.