Chagas Disease (American Trypanosomiasis or Kissing Bug Disease) (cont.)
What is the treatment for Chagas disease?
Treatment for Chagas disease often depends on the phase of the disease and the age of the patient. Acute-phase treatment centers on killing the T. cruzi parasites with antiparasitic drugs. The prescription medications benznidazole (Rochagan, Ragonil) and nifurtimox (Lampit) may eliminate or reduce the number of parasites in the body. Some investigators suggest that drug-resistant parasites occur and others suggest these drugs of choice never eliminate all of the parasites. However, the CDC recommends drug treatment for "all people diagnosed with an acute (Chagas) infection, congenital infection, and for those with suppressed immune systems, and for all children with chronic infection. Adults with chronic infection may also benefit from treatment." The U.S. Centers for Disease Control and Prevention (CDC) advises caution about treating adults over 50 years of age and recommends that treatment plans for older adults be individualized. Both of these antiparasitic drugs are available in Central and South America. In the United States, however, the drugs can be obtained only through the CDC.
During the intermediate or indeterminate phase, the vast majority of adult patients obtain no antiparasitic treatments; however, children in this stage of disease should continue drug therapy. The situation with adults may change as new investigations with antiparasitic drug treatments are being done in South America.
Antiparasitic drug therapy of the chronic phase in adults is controversial. As quoted above, the CDC says adults with chronic infection may benefit from drug treatment, but most experts suggest there is no benefit to adults with chronic-phase Chagas disease. However, treatment of the symptoms of chronic Chagas disease is often necessary and can be life-prolonging or lifesaving. For example, pacemaker placement or even cardiac transplantation can be lifesaving to some patients who develop arrhythmias or cardiomyopathy. Surgical resection of the gastrointestinal tract may help alleviate some gastrointestinal problems. In addition, there are many medications available to treat specific arrhythmias and other bowel problems that may be seen in chronic Chagas disease; cardiac and gastrointestinal consultants often can help manage chronic-phase Chagas disease. Medication for the treatment of Chagas disease is available only through the CDC.