Claudia Nieto. Photo credit: Jean Andrews/Ohio University.
It starts with parasites, thriving in the triatomine bugs that crawl in through the walls of poorly constructed homes, generally in rural areas of South and Central America. The bugs come out at night to feed on human blood. They leave behind feces near the open wound, laden with the parasite, which are smeared into the bloodstream by unsuspecting humans scratching a bug bite. This smear leads to Chagas disease. Between 7 million to 8 million people are infected worldwide with the potentially lethal disease, according to the World Health Organization (WHO).
The only thing worse than the disease itself is the fact that most people have never heard of it. This is exactly what Claudia Nieto, Ohio University doctoral student in the Individual Interdisciplinary Program (IIP), is trying to address.
Chagas disease is included in a category labeled by WHO as “Neglected Tropical Diseases” or NTDs.
“NTD is a category created by the WHO for a group of 17 diseases that mainly affect people living in poverty in tropical areas that have historically received very little scientific, political and economic attention,” Nieto says.
Nieto, who is studying public health and communication, with a bachelor’s degree in communication and journalism, is working on a project called the Healthy Living Initiative. Her specific project is focused on helping design effective health promotion strategies for prevention and control of the silent killer, and to change the way mainstream society views these marginalized diseases.
Chagas, and NTDs at large, require more than just prevention and a cure. Nieto is trying to put together concise research that can clearly link how the situation of poverty faced by those afflicted with the disease can affect its transmission patterns.
More specifically, Nieto is working on finding the specific socioeconomic factors involved in the spread of the disease that can be identified, so researchers and communicators can react accordingly.
Chagas bears two traits that make it substantially more challenging to prevent than most diseases: its impoverished demographic and its delayed effects.
The disease typically afflicts members of impoverished communities who lack the political, social or economic power to curate funding for prevention, treatment and research.
Chagas has mild initial health effects. Its chronic effects, however, include the enlargement of vital organs such as the heart and liver. These symptoms can lead to deaths that are often misattributed to other causes. The disease loses the recognition for the threat it poses, Nieto notes.
“So people basically are going to think they died because of a heart attack, but what they actually have is Chagas disease,” Nieto says.
In Nieto’s opinion, given the biological and socioeconomic complexities of the disease, combating it will require professionals from multiple academic disciplines, not just those in the health world.
Mario Grijalva, Nieto’s adviser, agrees that Chagas needs well-rounded researchers such as those in IIP programs to adequately combat the disease. Grijalva is a professor of biomedical sciences and director of the Tropical Disease Institute at the Ohio University Heritage College of Osteopathic Medicine who has studied Chagas disease for several decades.
“It is very important that we have highly specialized people that can bridge the gap between researchers, health care providers and the public health sector using effective communication strategies,” Grijalva says. “We need people who can connect the dots.”