The Future of Chagas Disease at the ASTMH Annual Meeting

New biomarkers of therapeutic response, innovative diagnostic and treatment tools, increased cures among women and children, and the inclusion of the USA in the list of endemic countries are among the anticipated outcomes of current research on Chagas disease. These developments were highlighted at the annual meeting of the American Society of Tropical Medicine and Hygiene (ASTMH) held in New Orleans from November 13–17.

The Chagas Coalition participated in the ASTMH meeting to advocate for elevating Chagas disease on the agenda of the world’s most important global health events. This year, multiple scientific sessions and satellite events provided insights into the promising future of combating this neglected disease.

Advancing Tools to Verify a Cure for Chagas Disease

One of the most critical tools under research is the identification of biomarkers to monitor disease progression and therapeutic response in patients with Chagas disease. A pre-meeting organized by the Drugs for Neglected Diseases Initiative (DNDi) convened experts to define essential components for advancing biomarker research. These discussions are essential for reaching a consensus on the key requirements for effective biomarkers.

Current evidence demonstrates the efficacy of antiparasitic treatments—nifurtimox and benznidazole—particularly in early stages of infection and among young individuals, children, and newborns. However, the absence of reliable biomarkers to confirm the cure of chronic Chagas patients after treatment remains a significant gap. During the ASTMH meeting, the potential role of lipids as biomarkers was discussed in a scientific session featuring key Chagas Coalition organizations, including DNDi and ISGlobal.

Innovative Diagnostic and Testing Strategies

The development of new diagnostic tools continues to drive progress, encouraging health decision-makers to integrate rapid diagnostic tests into national and regional guidelines. Traditional diagnostic protocols, which rely on a second test for confirmation, face challenges such as false positives and negatives that vary by region.

These issues were a focus of a dedicated session featuring experts from DNDi, the University of California, and CONICET. The session explored advancements in diagnostic assays and strategies, underscoring the need for adaptable tools to address regional variations and improve diagnostic accuracy.

From Rapid Diagnosis to Shortened Treatment Schemes

The standard treatment for Chagas disease currently involves approximately two months of benznidazole or nifurtimox therapy, which requires medical supervision due to potential side effects. Researchers—many affiliated with Chagas Coalition organizations—are investigating shorter treatment regimens that reduce risks while maintaining efficacy.

The ASTMH meeting also hosted a session on improving treatments for neglected diseases in children, with experts like Dr. Jaime Altcheh from Ricardo Gutierrez Children’s Hospital discussing prospects for pediatric care. While pediatric formulations of nifurtimox and benznidazole are available, they are underutilized despite increased efforts to prevent mother-to-child transmission. These formulations significantly improve treatment adherence among children, making it imperative for countries and civil society to demand their widespread availability.

Is the US and endemic country for Chagas disease?

The US Chagas Research Consortium organized a session on the current state of Chagas disease in the United States. Presentations highlighted evidence of local transmission to humans and animals, as well as the presence of the disease vector across large areas of the southern US. Despite these findings, the US is not typically included in the list of endemic countries.

This exclusion likely contributes to the neglect of Chagas disease domestically, even though the US has the highest estimated number of cases outside Latin America. Currently, Chagas disease in the US is treated as a migrant health issue rather than a domestic health concern. Recognizing endemicity could shift this approach and elevate its priority in public health strategies. Further updates on this topic will be shared very soon exclusively through the Chagas Coalition’s website and social media channels.

The ASTMH Annual Meeting brings together global health professionals and representatives from public and private organizations worldwide. It remains a leading forum for scientific exchange on neglected tropical diseases like Chagas disease, fostering collaboration and innovation to address these critical health challenges.