Neglected tropical diseases and their significance for Europe - Chagas disease a little-noticed tropical disease
++ Kick off the week of action against neglected tropical diseases
Berlin, 25.01.2021 - To kick off the week of action against neglected tropical diseases, the German network under the patronage of Georg Kippels MdB, organised a webtalk on Chagas disease.
Thomas Jacobs, group leader at the Bernhard-Nocht-Institute for Tropical Medicine Hamburg (BNITM), regretted that the fight against Chagas disease was not receiving any attention. Much more resources - from research to access to medicines - were needed to contain the disease. In Europe in particular, the issue is ignored, even though the disease is spreading rapidly through migration. In Spain, it is estimated that between 48,000 and 90,000 people are infected. In Hamburg alone, where his institute is active, it is estimated that 200 to 1000 people are affected.
Dr Simone Kann, Chagas expert from the Medical Mission Institute in Würzburg, described the activities in Colombia, how important hygiene concepts, the fight against local intermediate hosts but also prevention among the rural population are. The insidious thing about Chagas disease is that it is often not visible for many years. The Mission Medical Institute has therefore developed a PCR-test that can be used to measure the pathogen load.
Ulrich Madeja, Head of NTD Program at Bayer pointed out the important cooperation of drug manufacturers with WHO, especially in the context of developing and implementing a regional action plan with partners under the leadership of WHO/PAHO. He stressed that most Chaga-sufferers do not have access to health systems. It is a disease of the poor.
Eric Chatelain, Head of Drug Discovery, DNDi stressed the importance of working with good studies that show the effectiveness of drugs. It is also important to develop new drugs that are better tolerated.
Prof Achim Hörauf, DNTDs spokesperson and Director of the Institute for Medical Microbiology, Immunology and Parasitology at the University Hospital in Bonn, summarised that one must be realistic and assume that the pathogens cannot be eradicated. The Corona virus has made it very clear how dynamic infectious diseases are. He therefore pleaded once again that national and international funds in this area should not be reduced, but rather increased, if we want to be prepared to combat infectious diseases in the coming decades. He emphasised that the fight against Chagas disease can only be successful if poverty is combated.
Two thirds of all new infectious diseases originate from animals. 60-70% of all new infectious diseases occurring in humans originate from animals: Chagas disease also has a zoonotic reservoir. It is one of the 20 neglected tropical diseases that the World Health Organisation (WHO) has put on its list with the aim of eliminating them. There is no vaccination against Chagas disease. According to WHO estimates, about 6 to 7 million people are infected worldwide, with the majority living in Latin America (about 4.6 million), followed by the USA with over 300,000 and Europe with about 80,000 infected people.
The risk of infection with neglected tropical diseases increases in Europe, particularly through the transmission of parasites from latently infected mothers to their unborn children or through blood supplies contaminated with Chagas pathogens.
One problem in fighting Chagas disease is that the infectious disease is usually not diagnosed in time because the symptoms are very unspecific at the beginning (symptoms like a cold). Without diagnosis or treatment, however, Chagas can lead to serious health complications, such as heart disease, some of which result in death.
Background on German activities in the field of Chagas
At the Bernhard-Nocht-Institute for Tropical Medicine in Hamburg, researchers are working on a study to find out more about the disease in Germany. They are dedicated to screening, research, prevention and education about Chagas disease. As part of this study, people of Latin American origin living in Germany will be informed about the disease. If necessary, the study participants can receive free diagnosis and treatment at the BNITM. The project also advocates for a change in the prevention policy of this disease for Latin American people.
The Medical Mission Institute Würzburg runs a large project against Chaga disease in rural areas of Colombia. The programme follows the "One Health Approach" and consists of three pillars: the medical part (disease screening, observed therapy, therapy success and patient follow-up), the surveillance part (screening for the transmitting insects, spray campaigns, programme initiations) and the education part (about Chagas, infectious diseases, hygiene, etc.). In addition, co-infections and other newly spreading infectious diseases (e.g. gastrointestinal infections, leishmaniasis, etc.) are also addressed. The overall system in which the disease develops and spreads is considered. It is about the connections between agriculture, veterinary medicine, human medicine and nutrition.
The German pharmaceutical company Bayer, for example, has been supporting the WHO in its fight against Chagas disease since 2004, with 1 million free tablets of Lampit (nifurtimox) per year and an additional 300,000 € per year for logistics and distribution.
The Institute of Medical Microbiology, Immunology and Parasitology at the University of Bonn is working with the Drugs for Neglected Disease Initiative (DNDi, Geneva) to develop the drug fexinidazole against Chagas disease, which was already approved for sleeping sickness in 2018.