The Centre for Development Cooperation (CCD) and several research groups of the Universitat Politècnica de Catalunya (UPC) are working together with the World Health Organization (WHO) to develop a global database on the situation and evolution of Chagas disease. This disease affects about ten million people worldwide, mostly in Latin America, and around 15,000 people in Catalonia.
Chagas disease is caused by the protozoan Trypanosoma cruzi, a parasite related to the African Trypanosoma that causes sleeping sickness (African trypanosomiasis). This infection is transmitted following the bite of a bloodsucking bug. The parasite enters the blood and is able to reach the heart, settle there and damage the heart muscle fibre. Up to 30% of patients have chronic heart disorders and up to 10% suffer from digestive, neurological or combined disorders. Much of the population is unaware of being infected with it until it becomes severe. The symptoms can be confused with those of other conditions, such as cardiovascular disease.
It is estimated that worldwide about ten million people are infected. They are concentrated mainly in Latin America, where the disease was initially confined, but it has now spread to other continents such as the United States and Europe, and is present in Catalonia because of immigration.
In endemic areas vector control (i.e. control of the agents that transmit the infection) is the most useful method for preventing the spread of Chagas disease. In other areas, screening must be carried out to prevent transmission of the infection through blood transfusion and organ transplantation, and care must be taken to prevent transmission from mothers to children.
Increasing the visibility of a neglected disease
In recent years, WHO has striven to highlight the incidence of the disease and to encourage states to combat it, but insufficient scientific information is available. For this reason, in 2013, WHO commissioned the UPC's Centre for Development Cooperation (CCD) to create a worldwide database to determine the real situation and evolution of Chagas disease, for which the two parties signed an agreement.
The project is led by the lecturers Alberto Abelló, Ruth Raventós and Oscar Romero of the Department of Service and Information System Engineering, who also belong to the Information Modelling and Processing research group.
The first result of the project was the design of a pioneering integral information system to make the disease visible, based on the bachelor's thesis of the student Jaume Viñas of the Barcelona School of Informatics. The results of the thesis, supervised by Alberto Abelló and Ruth Raventós, were presented in January under the title Building a Data Warehouse for the global WHO information and surveillance system to control/eliminate Chagas disease. These results were used to define the data to be gathered, the data gathering process and the structure of the data.
This database aims to build maps of different observed magnitudes with the information collected "on the number of people affected and treated, the consumption of drugs, preventive measures in blood transfusion and organ transplantation, vigilance in mother-child transmission, the presence of the transmitting vector (the 'kissing bug' found in Latin America), and pest control campaigns," says Professor Daniel López of the Department of Physics and Nuclear Engineering and a member of the Computational Biology and Complex Systems Research Group (BIOCOM) working on the project.
Two Argentine organisations are collaborating in the initiative: the Centre for Parasitic and Vector Studies of the Universidad Nacional de La Plata and the Regional Centre for Scientific Research and Technology Transfer (CRILAR/CONICET).
Now, WHO is seeking funding to implement this database and to establish the stable monitoring service that is needed in order to understand and explain the situation of the disease. Once the system is operational, the next challenge will be to use the data for prediction, i.e. to study how the disease will evolve if certain actions are performed, such as parasite elimination campaigns or diagnosis and treatment campaigns, for which mathematical models are needed.
To address this last stage, the CCD has requested the collaboration of the lecturers Daniel López and Clara Prats, also of the BIOCOM research group, and the lecturer Romualdo Pastor, a member of the Computer Simulation in Condensed Matter research group (SIMCON) and a specialist in the use of complex networks to study epidemics. The researchers are developing models to evaluate actions according to their cost and the possibility that they will reduce the disease.
According to WHO, Chagas disease is one of the 17 neglected diseases in the world. "Humanity has failed to pay attention to these important problems", says Daniel López. The disease has been treated successfully with drugs since the 1970s but the experts warn that the drugs are very toxic and great research efforts and investments must be made to reverse this situation.
Collaborating with the field of medicine
The project, currently at an early stage, is a long-term collaboration between WHO and the UPC. One of the main objectives is to achieve a close collaboration among the research groups of the University working on Chagas disease and to strengthen collaborations with specialists in the medical field. The conference held on 13 May at the UPC brought together experts in the field from the University and outside, and established new ties to advance the project.
Recently, The New England Journal of Medicine published the results of a clinical trial led by the Hospital de la Vall d'Hebron in Barcelona. The trial demonstrated that the new drug posaconazole is less effective for curing the disease than the classic treatment with benznidazole.
The experts consider that the publication of this study has once again brought the disease to the forefront. It is now time to increase the worldwide visibility and awareness of the importance of eradicating this disease, which causes approximately 14,000 deaths a year.