Chagas Disease: Epidemiology, Diagnosis, Treatment and Global Challenges

Chagas disease, caused by Trypanosoma cruzi, remains one of the most important tropical diseases despite more than a century of study. The disease affects about 6-8 million people worldwide, including regions where it was not previously endemic due to globalization and migration. Transmission of the pathogen is through vectors (triatom bugs), blood transfusions, organ transplants, and vertically from mother to child. Chagas disease includes two phases: acute, often asymptomatic, and chronic, which may be accompanied by severe cardiologic and gastroenterologic complications. Chronic cardiomyopathy, as one of the most severe manifestations, significantly impairs the quality of life of patients and requires significant resources for treatment, including heart transplantation. Diagnosis of the disease ranges from parasitologic methods in the acute phase to serologic tests in the chronic phase. Current treatment approaches include the use of benznidazole and nifurtimox, which are effective in the early stages but are limited due to side effects. Prospects for therapy include the use of gene therapy, vaccines and combined methods (vaccination and chemotherapy). Prevention of transmission, especially through donated blood and organs, remains important, it has already been successfully implemented in a number of countries. The epidemiologic features, clinical manifestations, modern methods of diagnostics and treatment of Chagas disease, as well as promising directions of its study are considered in the article. Special attention is paid to the global spread of the disease and control measures in non-endemic regions.