Photomicrograph of Giemsa-stained Trypanosoma cruzi crithidia (CDC)Chagas in Latin America (A:Endemic zones)This child from Panama is suffering from Chagas disease manifested as an acute infection with swelling of the right eye (Romaña's sign). Source: CDC.Life cycle of Trypanosima cruzi. Source: CDC
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American trypanosomiasis

Chagas disease (also called American trypanosomiasis) is a human tropical parasitic disease which occurs in the Americas, particularly in South America. Its pathogenic agent is a flagellate protozoan named Trypanosoma cruzi, which is transmitted to humans and other mammals mostly by hematophagous insects of the subfamily Triatominae (Family Reduviidae). Those insects are known by numerous common names varying by country, including assassin bug, benchuca, vinchuca, kissing bug, chipo, barbeiro, et cetera. more...

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The most common insect species belong to the genera Triatoma, Rhodnius, and Panstrongylus. Other forms of transmission are possible, though, such as ingestion of food contaminated with parasites, blood transfusion and fetal transmission.

Trypanosoma cruzi is a member of the same genus as the infectious agent of African sleeping sickness, but its clinical manifestations, geographical distribution, life cycle and insect vectors are quite different.

History

The disease was named after the Brazilian physician and infectologist Carlos Chagas, who first described it in 1909, but the disease was not seen as a major public health problem in humans until the 1960s. He discovered that the intestines of Triatomidae harbored a flagellate protozoan, a new species of the Trypanosoma genus, and was able to prove experimentally that it could be transmitted to marmoset monkeys which were bitten by the infected bug.

Chagas named the pathogenic parasite that causes the disease Schizotrypanum cruzi (later renamed to Trypanosoma cruzi), after Oswaldo Cruz, the noted Brazilian physician and epidemiologist who fought successfully epidemics of yellow fever, smallpox, and bubonic plague in Rio de Janeiro and other cities in the beginning of the 20th century. Chagas’ work is unique in the history of medicine, because he was the only researcher so far to describe completely a new infectious disease: its pathogen, vector, host, clinical manifestations, and epidemiology. Nevertheless, he at least believed falsely until 1925, that the main infection route is by the sting of the insect and not by the feces, as it was proposed by his colleague Emile Brumpt 1915 and assured by Dias 1932, Cardoso 1938 and Brumpt himself 1939.

On another historical point of view, it has been hypothesized that Charles Darwin might have suffered from this disease as a result of a bite of the so-called Great Black Bug of the Pampas (vinchuca) (see Illness of Charles Darwin). The episode was reported by Darwin in his diaries of the Voyage of the Beagle as occurring in March 1835 to the east of the Andes near Mendoza. Darwin was young and in general good health though six months previously he had been ill for a month near Valparaiso, but in 1837, almost a year after he returned to England, he began to suffer intermittently from a strange group of symptoms, becoming very incapacitated for much of the rest of his life. Attempts to test Darwin's remains at the Westminster Abbey by using modern PCR techniques were met with a refusal by the Abbey's curator.

Epidemiology and geographical distribution

Chagas disease currently affects 16-18 million people, killing around 20,000 people annually and with some 100 million at risk of acquiring the disease. Chronic Chagas disease remains a major health problem in many Latin American countries, despite the effectiveness of hygienic and preventive measures, such as eliminating the transmitting insects, which have reduced to zero new infections in at least two countries of the region. With increased population movements, however, the possibility of transmission by blood transfusion has become more substantial in the United States . Also, T. cruzi has already been found infecting wild opossums and raccoons as far as North Carolina .

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Scholarship moves MLT toward dream to help Sudan
From Medical Laboratory Observer, 11/1/05

John Agou is the kind of person you want to help. A Sudanese native who experienced the loss of his parents and much of his village to political violence, Agou was determined to make his way to the United States. He nourishes a dream to complete his education and return to Sudan to help his people.

Today, Agou holds a job as a medical laboratory technician, thanks in part to a scholarship program created by Dade Behring Inc. With the help of this scholarship, he now has his associate degree and is working part time while continuing his college education. He is just one of dozens of students supported by the program since its start in 2003. Originally conceived as a way to help labs deal with a growing labor shortage, the program is also making a significant contribution to students like Agou.

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Fewer students enter field

Over the past decade, fewer students have graduated from two-year medical laboratory technician (MLT) programs, four-year medical technology (MT) programs, and even master's programs every year, creating a serious shortage of laboratory professionals. With half the current laboratory workforce--about 590,000 technologists and technicians--eligible for retirement by 2010, the U.S. Bureau of Labor Statistics projects a need for 12,000 new laboratory professionals annually through 2010 in the United States alone.

Dade Behring has recognized the strong connection between scholarship opportunities and the ability to rebuild the professional workforce. Over a five-year period (through 2008), the company is investing $1.25 million in an international scholarship program, which includes awards throughout the world addressing a full range of educational needs, from two-year to four-year and advanced degrees in clinical laboratory science (CLS).

"We believe in the diagnostics industry and its critical role in overall healthcare," says Jim Reid-Anderson, the company's chairman and CEO, "and we are proud to play a role in building the laboratory professionals of the future. We are privileged to be able to make the cost of education more affordable for students in clinical programs."

Scholarships will help

In the United States, there are two scholarship programs designed to help students challenged by the increasing cost of college education. Dade Behring awards 50 $1,000 scholarships each year to students enrolled in Clinical and Laboratory Standards Institute (CLSI)-approved, two-year CLT/MLT technician programs. Baccalaureate program support is provided yearly through 34 $2,500 Emil von Behring scholarships for students enrolled in CLSI-approved four-year CLS/MT technologist programs. Dade Behring has engaged independent agencies to administer Emil von Behring scholarship programs around the world.

In the United States, the Coordinating Council on the Clinical Laboratory Workforce, or CCCLW, administers the two-year MLT/CLT scholarship program, while the American Society for Clinical Pathology, or ASCP, is supporting the Emil von Behring scholarship program for four-year MT/CLS students. Regional professional organizations and universities are administering international scholarship programs throughout Latin America, Germany, Spain, Italy, France, Canada, China, and the United Kingdom.

Interested students can find scholarship applications and directions on the Dade Behring website at www.dadebehring.com. For more information, contact Connie DuBois, director, Public Relations at conniedubois@dadebehring.com.

RELATED ARTICLE: Facts about Sudan

Location: Northern Africa, bordering the Red Sea, between Egypt and Eritrea

Capital: Khartoum

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Languages: Arabic (official); Nubian; Ta Bedawie; diverse dialects of Nilotic, Nilo-Hamitic, Sudanic languages; English

People: 40,187,486 (est. July 2005)

Population below poverty line: 40% (est. July 2004)

People living with HIV/AIDS: 400,000

Infant mortality rate: 70.84 deaths/1,000 live births (est. 1999)

Major infectious diseases: Bacterial and protozoal diarrhea, hepatitis A, and typhoid fever; malaria, dengue fever, African trypanosomiasis (sleeping sickness); schistosomiasis; meningococcal meningitis

Adapted from: www.sudan.net/fact.shtml

COPYRIGHT 2005 Nelson Publishing
COPYRIGHT 2005 Gale Group

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