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Epidemic Control Toolkit
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Chagas disease (and chronic complications)

Chagas disease (and chronic complications)

Last update: 2023-06-21

Key facts


Direct or indirect contact with the parasite (reservoir is triatomine bugs, and the parasite is spread through their faeces/poop), mother-to-newborn transmission, blood transfusion

  • Triatomine bugs spread Chagas disease through their poop
    • They bite people, usually at night, and then leave waste (poop) near the bite mark. If the poop enters the bite, the person can get Chagas disease (direct contact)
  • Eating undercooked or unwashed food that is infected with poop from the triatomine bug (indirect contact)
  • If a pregnant woman has Chagas, the disease can be transmitted to the newborn around the time of birth
  • Other transmission modes exist but these rarely cause epidemics (for example during blood transfusion or vertical mother-child transmission)

Most vulnerable to severe consequences

  • Elderly
  • Newborns
  • People with chronic medical conditions (such as arthritis, high blood pressure, diabetes, heart disease, etc.) 
  • People who have weakened immune systems (for example, people living with HIV/AIDS or cancer)

Early symptoms: ** In most cases, symptoms are absent or very mild. **

  • Skin lesions
  • Purple swelling of one eyelid
  • Fever 
  • Enlarged lymph nodes
  • Headache 
  • Body aches, muscle pain, swelling
  • Pale skin 
  • Difficulty breathing
  • Abdominal pains
  • Chest pain

Chronic symptoms

  • Chest pain
  • Stomach problems (difficulty eating or passing faeces/poop)
  • Confusion, dizziness

What can you do to prevent and control an epidemic?

Reservoir control and prevention

  • Elimination of triatomine bugs (for example, spraying dwellings or surrounding areas with insecticides)
  • Promote household and community clean-up campaigns to prevent bug infestation
  • Prevent triatomine bites by advocating the use of:
    • Insect screens on windows and doors and 
    • Personal protection (application of repellents, wearing long sleeved clothes)
    • Bed nets 

Monitoring the community and identifying sick people 

  • Identify people in the community with suspected Chagas disease

Treatment and management

  • Rapidly detect and refer serious cases to health facilities
  • Refer all pregnant women with suspected infection to health facilities
  • Provide psychosocial support to the sick person and their family members

Food hygiene and safety

  • Promote cooking meat and other animal products thoroughly
  • Promote thorough cleaning, cooking and storage of food
    • Cover and store food safely (protected from insect/animal contamination)
    • Use clean utensils and storage containers

Social mobilization and health promotion

  • Find out the specific advice being given by health and other relevant authorities 
  • Model following this advice and inform community members of current health practice advice 
  • Offer support and encouragement to follow the advice  
    • Try to gain understanding about if and why health practice advice is not being followed  
  • With the advice of your supervisor and health authorities, work with communities to overcome barriers to following health advice and recommended practices
  • Identify if there are any community spaces where women give birth and engage with traditional birth attendants to share information about the disease transmission and prevention modes

Mapping and community assessment

  • Make a map of the community.
  • Mark the following information on the map:
    • How many people have fallen sick with chagas disease? Where?
    • How many people have died? Where? When?
    • Who and where are the vulnerable people?
    • Where are the local health facilities and services? (Include traditional healers)
    • Where do women give birth? (include traditional birth attendants)
  • Record the following information on the back of the map:
    • When did people start to fall sick with Chagas disease? 
    • How many people live in the affected community? How many are pregnant women?
    • How common is it for people to live in houses with insect screens on windows and doors? 
    • How common is it for people to sleep under bed nets?
    • Are children badly affected by Chagas disease? Are there other groups (specific ages, occupations, geographic areas, etc.) that are badly affected? 
    • What are the community’s habits, practices and beliefs regarding use of repellents, sprays, etc?
    • Have the authorities established a vector control programme?
    • Is a social mobilization or health promotion programme in place?
    • Which sources do people use/trust the most for information?
      • Are there rumours or misinformation about Chagas disease? What are the rumours?