In Bolivia, health workers use cell phones to eradicate Chagas disease

Last year in Bolivia, hundreds of houses were fumigated in the municipalities of Omereque, Pasorapa and Aiquile in coordination with the national Chagas program. (Credit: MSF)

Health workers are using a new technology in Bolivia to better track the location and eradication efforts of Chagas, a neglected but deadly parasitic disease that affects the most impoverished regions of Latin America.

Doctors Without Borders (MSF) development the technology, called eMOCHA, which can be used by any health worker with a mobile phone. The idea is that a central information system to track the locations of the triatomine bug that transmits the infection would prevent infections. MSF collaborated with Bolivia’s Ministry of Health and Johns Hopkins University to put the technology to use.

With real-time information, a better map emerges telling health officials where people might need treatment, and allows someone to schedule fumigation. Beyond that, eMOCHA allows health workers to log additional data, such as the number of family members in a home or the number of times it has been fumigated.

“We have made quite good progress with eMOCHA, the information is received quickly,” said Humberto Castellón, a control technician for MSF, in a video released by the humanitarian-aid organization.

“Previously what happened was, once the leader received a report, he had to complete some forms and these forms were generally slow to reach either the supervisor or here at the hospital,” he added. “It could take up to a month, and usually the report wasn’t followed up.”

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Bolivia’s Ministry of Health estimates around 33 percent of the population is infected with Chagas, though MSF said the figure is closer to 40 percent. eMOCHA is already being used in the Narciso Campero province, and MSF hopes to expand it to all municipalities across Bolivia.

Preventing the transmission of Chagas is currently the best tool available in controlling and eventually eradicating the disease because the illness, just like the insect itself, is difficult to detect. People can be infected for years – even decades – without knowing it, as there may be no symptoms as the parasite slowly reproduces inside the person, causing irreversible damage to the heart, intestines and brain. Many people with Chagas lose the ability to easily swallow, breathe and walk, eventually dying of heart disease.

According to MSF, which has been treating Chagas patients for nearly two decades, diagnosing the disease is made even more complicated by the diagnostic tests themselves. Doctors need to perform two or three blood tests to determine whether the patient is infected with Chagas, and the tests are inadequate, expensive and in short supply. For years, health organizations have been calling for cheaper and more efficient diagnostic tests for the disease.

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The disease is typically transmitted by the infected feces of triatomine bugs, or ‘kissing bugs,’ which live in the walls and roofs of mud and straw housing common in rural areas and urban slums across the continent. The disease can also be transmitted through blood transfusions, organ transplants, breastfeeding and before or during birth.

Chagas is found almost exclusively in the Americas and is endemic in 21 countries. Several countries greatly reduced contagion through fumigation and by building homes of concrete, which triatomine bugs can’t penetrate. According to the World Health Organization (WHO) Chagas still affects approximately 6 million to 8 million people and causes around 12,000 deaths every year.

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Lisa Nikolau

Lisa Nikolau is a Madrid-based reporter for Humanosphere, covering gender equality, indigenous rights and poverty in Latin America and worldwide. Find her on Twitter at @lisanikolau, email lisa.nikolau@humanosphere.org or see her latest work at www.lisanikolau.com