Report of the informal consultation on chagas disease in the Western Pacific

Overview

Chagas disease used to be a public health problem specific to Latin America but has evolved into a global issue. Because migrants' and travellers'' movements are continuously increasing, Chagas disease cases have been reported in 19 nonendemic countries outside Latin America, including Japan and Australia. A meeting to review the global management of Chagas disease in 2007 recommended establishing an initiative of controlling it in nonendemic countries. Sessions and consultations have been organized in different parts of the world on ways to address this issue. In the Western Pacific Region, an informal consultation held in Nagasaki, Japan, was the first opportunity to revise intensively the evolving situation with regard to Chagas disease. This consultation was organized jointly by WHO’s Department of Control of Neglected Tropical Diseases, the Western Pacific Regional Office and the Institute of Tropical Medicine of Nagasaki University.

A total of 10 advisers and seven observers from Australia, China, Japan, Viet Nam and Thailand participated. Their expertise varies from health care to blood transfusion, epidemiology, medical entomology, drug development and international cooperation. Participants were from governments, Red Cross Blood Services, the research centre and universities. The objectives of the informal consultation were to update and analyse the epidemiological situation of Chagas disease, to discuss the risk of transmission in nonendemic countries and to plan for the next steps on how to address Chagas disease in the Western Pacific Region. Information was shared through a series of presentations on the situations of the four participating countries as well as on Chagas disease vector in Asia, WHO recommendations on screening for transfusion transmissible infections, Japan’s activities in drug development and vector control in Central America.

In the group discussion, three questions were raised: whether Chagas disease was becoming a public health problem, how to deal with the cases and what to do as the next steps. These questions were discussed extensively and answered in terms of case detection and health care, prevention of transmission and vector surveillance and control.

The following were the conclusions of the consultation:

• Chagas disease has a high potential of becoming a public health problem in the Western Pacific Region.
• Sufficient data is available to declare that Chagas disease is a high potential problem, which requires further investigations and actions.
• Participants agree that the countries of the Western Pacific Region should actively participate in the Initiative of Chagas Disease Non-endemic Countries.

As a general recommendation, it is desirable to develop a network for information-sharing and improved coordination among governments, relevant stakeholders and partners working on blood services, organ transplantation centres, information and surveillance systems, travel medicine, health care systems and others.