The international humanitarian organization Médecins Sans Frontières (MSF) has started to diagnose and treat people affected by Chagas disease in Arauca department, Northeastern Colombia.  The region has one of the highest prevalence rates of Chagas in the country, with an estimated eight per cent of the population infected.

Caused by a parasite, Chagas disease can lead to serious health complications and even death. Yet, to date treatment is not readily available in the country and without screening programs many people do not even know they are infected.

MSF has integrated Chagas screening and treatment into its primary healthcare services in the region. Through its mobile clinics, MSF offers free medical consultations, mental health support, family planning and antenatal care to people living in isolated villages without access to healthcare.

MSF also 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 are given a medical check up and started on a two-month treatment. The MSF team carries out periodic medical follow ups to check for side effects and any difficulties complying with the treatment. Even though there is a possibility of negative side effects from the drugs used to treat the disease, MSF’s work in the region has shown that these effects are manageable.

Chagas disease is endemic in most Latin American countries. It is caused by the trypanosoma cruzi parasite and transmitted mainly by the ‘kissing bug,’ a blood-sucking insect common in rural areas and city outskirts where people live in adobe houses made of clay and straw bricks. Transmission of the disease is also possible from mother to child, through blood transfusions, organ transplants and contaminated food. Patients with Chagas disease may go years without presenting symptoms. If left untreated, however, the disease can lead to serious health problems, including heart and intestinal complications and even death.

“Throughout our work in Arauca, we have seen people with serious cardiac complications related to Chagas. At that stage, however, there is little we can do to treat the infection, as there is no clinical 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,” explains 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,” says Bernal.

People with Chagas disease in Colombia have little alternative when trying to find treatment, and many will die in silence. The fight against the disease is focused on programs to eradicate the insect that transmits the disease. Though prevention is important, health authorities must not ignore the needs of those who are already infected.

In July 2009, MSF launched an international campaign calling on endemic countries to end the neglect of Chagas sufferers and support diagnosis and treatment for affected people. “By starting offering treatment in our project in Arauca, we hope to promote a national debate about Chagas and stimulate authorities to recognize Chagas as a public health problem and engage in screening and treatment programs,” says Bernal.

MSF has provided diagnosis and treatment to people suffering from Chagas in Honduras, Nicaragua, Guatemala and Bolivia, since 1999. 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 programs 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 programs, mobile clinics in urban and rural areas, reproductive healthcare, antenatal care, emergency obstetric care, assistance to survivors of sexual violence, water and sanitation services, basic refurbishment of health facilities and emergency response activities.