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Epidemiology of Chagas' disease in Latin America and Argentina

Chagas’ disease is an important health problem in these areas of the world. In America, Chagas’ disease is observed from the south of the United States to the south of Argentina. According to the World Health Organization (WHO) there are 100 million people at the risk of infection with 10—12 million people infected and 50,000 deaths per year, the majority due to dilated myocarditis.4 Urban migration transformed Chagas’ disease into a health problem in nonendemic countries. In the United States (US) approximately 50,000 to 100,000 Latin American residents have evidence of chronic T. cruzi infection5 and in the last years many multifactorial associated cases were diagnosed in the United States, Canada, and Europe.6 According to estimates, the prevalence of T. cruzi in Latin American immigrants is 16/1000 in Australia, 9/1000 in Canada, 25/1000 in Spain, and 8—50/1000 in the United States.7 The rural and urban migration, the contamination of donated blood products, intravenous drug abuse, laboratory accidents, and congenital transmission increase the diagnosis of this parasitosis in great cities. Since 2007, blood transfusions have been screened for Chagas’ disease in the United States.8

In Argentina, there are 7 million people exposed to the risk of T. cruzi infection with approximately 2.5—3 million infected and 400,000 patients with different grades of cardiomyopathy.4 Cardiac involvement become evident 20—30 years after the first infection but 5—10% of the patients can develop symptomatic myocarditis in the acute phase of the disease.9

According to the Centers for Diseases Control and Prevention (CDC) of the United States, only 3 of the 12 diseases defining AIDS opportunistic infections are parasitoses: toxoplasmosis, cryptosporidiosis, and isosporidiosis. In endemic areas, reactivation of T. cruzi infection should be included among the potential opportunistic pathogens indicative of AIDS.4

 
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