Chagas disease(CD) is a parasitic disease caused by Trypanosoma cruzi mainly transmitted by vectors like triatomines (ex. kissing bugs) ^13. This disease is endemic to Latin America, affecting 8-10 million people with an average of 41,200 new cases every year^7. However, the disease now has spread worldwide, affecting 300000-400000 people annually in non-endemic countries^5. This is because, many people from endemic regions migrate to non-endemic countries and some of them unknowingly have CD. To add to this, there are over 150 possible vectors all over the world and this disease has no functional vaccine. ^13. Therefore, a minor population carrying CD could easily spread the disease to a completely new population.
CD presents itself in two stages- acute and chronic. The acute stage appears immediately and displays minor symptoms like fever and rashes lasting from a week to a month. However, if undiagnosed, this could lead to the chronic stage, which presents itself mostly after the age of 35^13. Therefore, CD is a prime example of pathogen-host interaction falling under the selection shadow category. This is specifically due to the chronic phase striking after 35, when an individual has usually passed sexual prime, thereby having lower selection pressures^6. The treatment with benznidazole is only affective when treated just after the onset of acute stage^7. Hence, it is necessary to understand the vector-pathogen-host relationship, study the organism’s evolutionary pattern of pathogenesis to predict the occurrence of CD in a country and on a larger scale, develop effective drugs for acute and chronic phases of the disease.
This would be done in three phases. Firstly, to be able to predict the occurrence of this disease in a country, it is important to collect data about possible vectors and number of affected individuals. Also, it is important to understand human emigration patterns from endemic regions and correlate it with data obtained from vectors. Secondly, using this data, we would observe individuals that stand as exceptions in their individual age groups from different countries and identify as to why, CD is less/ more prevalent in this age group in a country. This would help screen for mutations in the genome which if not mutated, would have usually prevented the occurrence of the disease in that age group. Using all the data obtained, it would be possible to formulate a medication for this disease, and prevent a possible epidemic.
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