02639nas a2200217   4500000000100000008004100001653003200042653005400074653001900128100001500147700001600162700001400178700001300192700001300205245007800218856007800296300001000374490000600384520201700390022001402407       2014                            d10aNeglected Tropical Diseases10aLondon Declaration on Neglected Tropical Diseases10aChagas disease1 aTarleton R1 aGürtler RE1 aUrbina JA1 aRamsey J1 aViotti R00aChagas disease and the london declaration on neglected tropical diseases.  uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4191937/pdf/pntd.0003219.pdf  ae32190 v83 a<p>American trypanosomiasis is a chronic parasitosis caused by the kinetoplastid parasite <em>Trypanosoma cruzi</em> and is highly prevalent among a large variety of marsupial and placental mammals autochthonous to the American continent. The infection is naturally transmitted by blood-feeding Reduviid insects, but transmission by oral contamination, transplacentally, or by blood transfusion or issue transplantation is also common. The human disease is known as “Chagas disease” for the Brazilian physician who described it over a century ago. The human invasion of natural ecotopes as well as the establishment of the vectors in human dwellings associated with poor socioeconomic conditions makes Chagas disease a major public health hazard from the United States to Argentina. As such, the disease is a zoonosis that has afflicted humanity since its earliest presence in the New World and is still the largest parasitic disease burden on the American continent <a aria-expanded="false" aria-haspopup="true" class="bibr popnode tag_hotlink tag_tooltip" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4191937/#pntd.0003219-Hotez1" id="__tag_405367072" rid="pntd.0003219-Hotez1" role="button">[1]</a>, <a aria-expanded="false" aria-haspopup="true" class="bibr popnode tag_hotlink tag_tooltip" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4191937/#pntd.0003219-Urbina1" id="__tag_405367060" rid="pntd.0003219-Urbina1" role="button">[2]</a>. Recently, increased international migrations have spread the infection to nonendemic areas, including Western Europe, Australia, and Japan, where transmission is restricted to congenital and transfusion or solid organ transplant. In most infected individuals, a highly effective immune response controls the initial infection but fails to eradicate it. The consequential lifelong infection and associated inflammatory response result in symptomatic cardiac and digestive disease, significant morbidity, and eventually death in 30%–40% of patients.</p>
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