New opportunities for diagnosis and control of Chagas Disease to reach the 2030 goals for elimination

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Background

Chagas Disease (ChD) was first described by Carlos Chagas in 1909 in Minas Gerais (Brazil); he discovered microorganisms, which were later named Trypanosoma cruzi, within insects called "barbeiros" or kissing bugs that fed on humans. First, he showed that these kinetoplastids could infect animals experimentally, and later, he found a sick 2-year-old girl with the infection, thus discovering the disease. Today, more than 100 years since its discovery, vector transmission is still a reality, together with other routes of transmission such as blood transfusions, oral contamination, organ transplants, and from mother to child during pregnancy. This has broadened the traditional niche of ChD from rural to urban centers and from Latin America to the rest of the world, through human migration patterns. Currently, it is estimated that 70 million people are at risk of vector infection, and more than 7 million people are infected with T. cruzi worldwide and over 1 million suffer from ChD-related heart or digestive disease. However, only a small percentage have access to testing, and even fewer have access to specific anti-parasitic treatments.

Historically, the focus for control of ChD was based on measures directed toward the vector. Today, with globalization and advances achieved in vector control, the focus has widened to include the prevention of infection from blood transfusions and mother-to-child transmission, which can occur both in endemic and non-endemic countries. Yet, still today, 113 years after the discovery of T. cruzi, children from untreated mothers are still being born with ChD all over the world, and most people with the infection lack access to testing and treatment. Therefore, to advance in the control and elimination of ChD both in endemic and non-endemic areas, we need to incorporate ChD into the regular health system and move from the traditional view of the disease to a wider approach that includes access to diagnosis and treatment where affected individuals live.

Persistent neglect and complex access barriers pose major challenges to achieving global objectives for eliminating ChD as a public health problem. Diverse approaches are called for to better understand and address the roadblocks to controlling this neglected disease. Therefore, in this Research Topic, we aim to collect studies that through old or new approaches, provide tools and strategies for prompt diagnosis and early treatment of ChD that can be integrated into the primary health system in order to:
- identify how many people are affected by ChD and where they live;
- interrupt mother-to-child transmission of T. cruzi in endemic and non-endemic areas;
- identify access barriers for the implementation of these types of approaches.

We welcome the submissions of Brief Research Report, Clinical Trial, Methods, Mini Review, Opinion, Original Research, Perspective, and Review articles.

Keywords: triatomines, diagnosis, treatment, endemic and non-endemic areas

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