The Swiss Institute for Tropical and Public Health (Swiss TPH), in collaboration with the World Health Organization and other partners, carried out a comprehensive review of Chagas disease in Switzerland. Although typically found in Latin America, Chagas disease affects between 2,000 and 4,000 people in Switzerland. The review, published yesterday in the Swiss Medical Weekly, highlights the need to improve screening and healthcare strategies to eliminate Chagas disease in Switzerland.
Chagas disease, caused by the parasite Trypanosoma cruzi, affects between 7 and 8 million people worldwide, mainly in Latin America. The parasite can be transmitted through triatomines, through food, blood transfusions and organ donations, as well as from mother to child during pregnancy and childbirth. Chagas disease has two phases: in the acute phase, in the first 2 months, symptoms are mild or absent, although some may have fever, headache or swelling at the site of the bite. Decades later, in the chronic phase, up to a third of infected individuals develop cardiovascular, digestive and/or neurological problems. Advanced cases can cause cardiac complications such as arrhythmias and sudden death. Chagas disease is classified as a neglected tropical disease (NTD) by the World Health Organization (WHO).
Between 2,000 and 4,000 people affected in Switzerland
A review published yesterday in the Swiss medical weekly now sheds light on the prevalence, challenges and management of Chagas disease. The study found that an estimated 2,000 to 4,000 people are affected by this tropical disease. Although most cases are due to migration, the study also shows that Chagas disease can be transmitted in Switzerland through mother-child transmission during pregnancy and childbirth. The vector, the triatomine insect, is not present in Europe. “A major problem with Chagas disease is that it is often underdiagnosed, especially in non-endemic regions,” said Pablo Martínez de Salazar, senior scientific collaborator at Swiss TPH and last author of the study. “In fact, many cases remain undiagnosed or undetected for years, which could lead to serious cardiac or digestive complications if left untreated.” Factors such as limited awareness among healthcare professionals, the absence of nationwide screening programs, and barriers to access to healthcare, especially for undocumented immigrants, contribute to this underdiagnosis.
Establishment of the Swiss Chagas Network
To address these issues, the study team established the Swiss Chagas Network to eliminate Chagas disease as a public health problem through coordinated measures. The network aims to interrupt transmission and provide appropriate clinical treatment to people living with Chagas disease in Switzerland. Key priorities include integrating screening into prenatal and pediatric care for early detection and prevention of mother-to-child transmission during pregnancy and childbirth. In accordance with international guidelines, the Swiss Society of Gynecology and Obstetrics recently published an expert letter on Detection, prevention and treatment of congenital Chagas disease.
“It will be essential to carry out systematic screening in Latin American immigrants, focusing on women of reproductive age, pregnant women and children,” said Mar Velarde, scientific collaborator at Swiss TPH and co-author of the article. “If appropriate measures are taken, Switzerland will be well positioned to achieve the targets of the WHO roadmap for neglected tropical diseases by 2030 and could become a model for other countries.” The roadmap establishes global objectives to prevent, control, eliminate and eradicate different NTDs by 2030.
About the study
The study was led by Swiss TPH in collaboration with the WHO, Unisanté, the University of Lausanne, the Faculty of Health Sciences (HESAV), the University of Applied Sciences and Arts of Western Switzerland (HES-SO), the University of Zurich, the University of Basel, the University Hospital of Geneva and the University of Geneva. The coordination of the study was supported by the R. Geigy Foundation.
Swiss experience of HSCT in Chagas disease
Swiss TPH has a long tradition of work related to neglected tropical diseases, from basic research to training, diagnosis, treatment and elimination efforts. Regarding Chagas disease, Swiss TPH is involved in drug discovery, development, epidemiology, diagnosis, monitoring and disposal.