Deforestation, and environment of Bolivia, 155
Delgadillo, Francisco, 65, 66
Delgado, J., 52, 54
Deltametrina (Pirotroides), 44
Detection, of acute Chagas’ disease, 201-202
Diagnostic tests, for Chagas’ tests, 217-19. See also Xenodiagnosis
Diarrhea, and Chagas’ disease, 49, 68. See also Colon
Diary of the Beagle (Darwin), 9
Di Noia, Javier M., 168
Direct agglutination test (DA and 2-MEDA), 219
Direct ingestion, and transmission of T. cruzi, 62-64
Direct tests, for diagnosis of Chagas’ disease, 217, 218
Disability-adjusted life years (DALYs), 150
Diseases, of Old World origin and Spanish conquest of Inca, 27
Diviners:
Culture Context Model for Chagas’ prevention and, 136;
Kallawaya herbalists and Chagas’ disease, 30-45
D0870 (drug), 225
Dogs, infection with T. cruzi, 47, 194-95
Dominguez, A., 200
Donkeys, as hosts for T. cruzi, 195
Dosages, of nifurtimox and benznidazole, 50, 220
Drugs. See Chemotherapy
Drum and Stethoscope: Integrating Ethnomedicine and Biomedicine in Bolivia (Bastien, 1992), xvii
E
Ecology:
animals as hosts for T. cruzi, 194;
of Chuquisaca (Bolivia), 111;
Inca empire and, 25;
of Potosí (Bolivia), 65, 67;
vectorial transmission of T. cruzi and, 192. See also Climate; Environment
Economics:
chagasic heart disease and, 84;
cost of nifurtimox, 71;
Cultural Context Model for Chagas’ prevention and, 138;
decreased productivity due to Chagas’ disease, 149-53;
development and distribution of vaccines for T. cruzi, 172;
housing and Chagas’ disease in urban Bolivia, 10-104;
housing and exchange in Bolivia, 92-94;
interdisciplinary approach to prevention of Chagas’ disease, 147-48
Education, on Chagas’ disease:
biomedicine and ethnomedicine in Bolivia, 34;
children and T. infestans, 54, 56, 115-16;
concientización (consciousness-raising) and, 113-15, 122, 234 n.8;
women and, 115-16
Eggs, of T. infestans, 175
El Alto (Bolivia), 99
Electrocardiogram (ECG), and chagasic heart disease, 81, 82, 84, 165, 197, 203
ELISA test, 217, 219
El Salvador, and house infestation with T. infestans, 184
Empacho. See Colon
Endangered species, and triatomes in Andes and Amazon, 51
Entamoeba histolytica, 1
Entomology, and examination of houses in Bolivia for T. infestans, 88-89
Environment:
Culture Context Model for Chagas’ prevention, 142-43;
epidemiology of Chagas’ disease and, 182-83;
spread of Chagas’ disease in Andes and, 22-24, 154-57. See also Altitude; Climate; Ecology
Epidemiology, of Chagas’ disease:
in Bolivia, 46-64;
climate and, 182-83;
immune system and, 87
Epimastogotes, of T. cruzi, 160-61
Epitopes, 215
Eratyrus mucronatus, 191
Erythrocytic cycle, of malaria, 4
Esophagus, and Chagas’ disease:
cases of in Brazil, 231 n.7;
case study of in Chuquisaca (Bolivia), 75-76;
pathology of, 232 n.8-9
Estrada de Ferro Central do Brasil (Central Railroad of Brazil), 5-6
Ethics, biomedical:
ethnomedicine and, 34;
Indians as trial subjects for research in Bolivia, 228-29 n.2
Ethnicity:
housing and urbanization in Bolivia, 97-101;
epidemiology of Chagas’ disease in rural Bolivia, 47. See also Aymara; Guarani; Mestizos; Quechua; Race
Ethnobotany, 149
Ethnomedicine:
Chagas’ disease and Andean, 30-45;
Culture Context Model for Chagas’ prevention, 141;
integration with biomedicine in Bolivia, xvi-xvii;
interdisciplinary approach to prevention of Chagas’ disease, 146-49
Ethnophysiology. See Humoral theory
Eucalyptus leaves, 44
Evasive strategies, of T. cruzi, 212-13, 229 n.2
EVI antibodies, 215
F
FAB (antigen-binding fragment) and Fc (crystallizable fragment), 212-13
Fabulation, and immune response to T. cruzi, 212, 213
Feces, of T. infestans, 58-59, 174, 177-78
Fetus, maternal transmission of T. cruzi, 61, 230-31 n.8. See also Congenital transmission
Fever, and Chagas’ disease:
acute phase and, 49;
as cultural illness, 68;
Kallawaya herbalists and, 38
Figaroa, Ciro, 50
Flax seeds, 42
Flight, of T. infestans, 56, 174
Food, contamination of with T. cruzi, 62
Forde, R. M., 1
Foundations, of houses and Chagas’ prevention, 120
France, and Chagas’ disease, 94
Frasch, Alberto, 168
Free market economy, and poverty in urban Bolivia, 103-104, 105
Freire, Paulo, 234 n.8
Fryer, Michelle L., 116
G
García Meza, Luis, 233 n.2
Garret, Laurie, 155
Gelbard, Robert, xix, xx
Gemio alario, Abraham, 179-80
Gender, inequality and Chagas’ disease in Bolivia, 116
Genetic variability, of T. cruzi strains, 163
Gentian violet, and blood contaminated with T. cruzi, 60, 223-24
Glycoproteins, on surface of T. cruzi, 168-70
Goats, as hosts for T. cruzi, 195
Goldbaum, M., 94
González, J., 165
González, Silverio, 147
Gregg, Linda, 148
Guarani tribes (Bolivia), 96, 97, 126, 140
Guatemala, infestation of houses with T. infestans, 184
Guayusa, and herbal medicine, 37
Guinea pigs, 194, 195
Gutiérrez, Ronald, 148
H
Hagar, J. M., xxii
Hartenberger, Paul, xix, xx
Healers of the Andes: Kallawaya Herbalists and Their Medicinal Plants (Bastien, 1987), xvii
Health:
biomedical definition of illness, 40;
Culture Context Model for Chagas’ prevention, 141;
immunopathic medicine and paradigm of, 87;
World Health Organization’s definition of, 144-45. See also Public health
Heart block, 79, 203, 204, 232 n.3
Heart disease, Chagas’:
acute phase and, 197;
case study of in Bolivia, 78-87;
cardiac pathologies, 232n.3-4;
Darwin and, 10, 11;
morbidity in rural areas of Bolivia, 47;
symptoms of chronic, 203-204;
underdiagnosis of in U.S., xxii
Herbal medicine:
exports of from Bolivia, 111-52;
interdisciplinary approach to prevention of Chagas’ disease, 149;
Kallawaya-Bolivian medicinal plants
and AIDS, cancer, Chagas’ disease, and tuberculosis, xvii;
Kallawaya herbalists and Chagas’ disease in Bolivia, 30-45
HIV, Chagas’ disease and spread of in Latin America, 86. See also AIDS
Honduras, infestation of houses with T. infestans, 184
Horses, as hosts for T. cruzi, 195
Hosts, and animal reservoirs for T. cruzi, 194-95
House Improvement Committees (HICs), 116-17
Housing:
baseline studies of Chagas’ disease in Chuq
uisaca, 226-27;
cooperatives in Bolivia and, 152;
cultural and political economy of Bolivia and physical proximity of vectors and hosts of Chagas’ disease, 88-106;
Culture Context Model for Chagas’ prevention and, 138, 140;
Inca and T. infestans, 26;
prevention programs for Chagas’ disease and, 107-23, 124-33;
statistics on infestation of with T. infestans in Bolivia and Latin America, 179-83, 184-85
Howard, J. E., 230 n.6
Huaca (earth shrine), 157
Huarochiri legends, 156-57
Humoral theory:
chagasic esophagus and T. cruzi infection in Bolivia, 76;
ethnomedicine in Latin America and, 68, 72;
Kallawaya herbalists and explanation of Chagas’ disease, 35, 38-39
Hydraulics, physiological. See Humoral theory
Hypertrophy, of colon, 72
Hypoxia, 80, 82, 83, 204
I
Ileostomy, 74, 75
Ilex guayusa, 37
Illness: biomedical definition of, 40
Immune system, and Chagas’ disease:
acute phase and, 200-201;
children in Bolivia and, 48;
epidemiology and, 87;
heart disease and, 85, 86;
immune response to T. cruzi infection, 205-16;
progression of, 6
Immunization, against T. cruzi, 166-72
Immunoglobulins:
detection of acute phase of Chagas’ disease, 201-202;
immune response to T. cruzi infection and, 208, 209
Immunopathic medicine, and paradigm of health, 87
Immunosuppression: immunization for T. cruzi and, 171
Inca:
archaeological evidence of Chagas’ disease in mummies, 24, 27;
expansion and spread of Chagas’ disease, 24-26;
housing and settlement, 26;
Spanish conquest, 26-28
Indirect haemagglutination test (IHA), 219
Indirect immunofluorescent antibody test (IFAT), 211, 219
Indirect tests, for diagnosis of Chagas’ disease, 217-19
Indole alkaloids, 44
Infants:
Chagas’ disease and low birth weight, 61-62;
nifurtimox and benznidazole for treatment of Chagas’ disease in, 224. See also Congenital transmission
Inflammation:
acute Chagas’ disease and, 196;
immune response to T. cruzi and, 213-14
Infrastructure, for Chagas’ control projects, 112-13
Insecticides:
DDT and, 34;
plant derivatives as, 43-44;
slow-release in paint, 120, 234 n.13
Instar, and life stages of triatomines, 174-78
Instituto Boliviano de Biologia de Altura (IBBA), 63-64, 164, 199, 217
Instituto Nacional de Reforma Agraria (INRA), 154
Instituto Venezolano de Investigaciones Ceintíficas, 225
Interdisciplinary approach, to prevention of Chagas’ disease, 146-49
Intracellular amastigotes, 212
Intracellular hiding, by T. cruzi, 212-13
Intrauterine T. cruzi infection, 61
Isoenzymic strains, of T. cruzi, 162
Ivermac, 225
J
Jampiris (herbalists), and Chagas’ disease, 30-45
Janssen Research Foundation, 225
Jáuregui, Pedro, 78, 79-80, 81, 82-83, 203
Jivaros (Brazil), 37
K
Kallawaya herbalists:
biomedicine and, xvi-xvii;
Chagas’ disease and, xix, 30-45;
environment and, 143;
Inca empire, 26;
mountain-body metaphor and homes, 90
Kinetoplastida, 159
Kissing bugs, origin of term, 7. See also Triatoma infestans
Köberle, Fritz, 200
Koch, Robert, 1
Kolata, Alan, 146-47
Kuritsky, Joel, xix, xx, 235n.5
L
Labor, division of by gender in Bolivia, 116
Laboratories: transmission of T. cruzi to technicians, 63-64
Laminin sepharose affinity column, 216
Land tenure:
housing in urban areas of Bolivia and, 99;
status of reform in Bolivia, 153-54;
Western versus Andean concepts of property rights and, 104-105
La Paz (Bolivia), 97, 99
Lassance (Brazil), 5-6
Latent Chagas’ disease, 16
Latex agglutination, 219
Latin America:
economic and social costs of Chagas’ disease, 149-53;
export of blood for transfusions, 59;
geographic distribution of Chagas’ disease, xiv;
house infestation with T. infestans, 184-85;
scope of Chagas’ disease as public health problem, xiii. See also specific countries
Leadership, of prevention programs, 109-10
Leishmania braziliensis, 217
Leishmania major, 168
León, Cieza de, 27
Leprosy, 86
Levi-Strauss, Claude, 90
Lewellyn, Charles, xx
Ley de Participación Popular (Law of Popular Participation), 104, 153, 154
Life cycle: of Triatoma infestans, 173-78; of Trypanosoma cruzi, 159-62, 166-67
Life span, of T. infestans, 175
Linum usitatissimum, 42
Lipochagomas, 49-50
Lipopeptido phosphoglycan (LPPG), 168-69
Lippia triphylla, 42
Livestock, infection of with Chagas’ disease, 148. See also Animals
Lizards, as predators of T. infestans, 43
London School of Hygiene and Tropical Medicine, 225
Luca, Manuel de, 40, 149
Lyme disease, xv
Lymph nodes, and acute Chagas’ disease, 198
Lymphocytes, 198
Lytic antibodies (LA), 210-11
M
Macrophages:
acute phase of Chagas’ disease and, 198;
immune response to T. cruzi infection and, 208, 209, 210, 215
Malaria, 3-6
Marsden, Philip D., xx, 176, 237 n.1
Martinez, Freddy, 109, 113
Marx, Karl, 234 n.8
Maurer, Cardinal, 107
Mayda, Evaristo, 131, 144, 233 n.3, 236 n.5
Maynas (Peru), 37
Measles, 27
Medical history, and discovery of Chagas’ disease, 1-18
Megacolon, 72-75
Megaesophagus, 75
Melisa officinalis, 42
Melogno, Roberto, 141, 236n.6
Mendez Acufia, Johnny, 73-74
Meningoencephalitis:
acute phase of Chagas’ disease and, 197;
AIDS and T. cruzi infection, 229 n.1;
Chagas’ disease in children and, 48
Mestizos: herbal medicine and, 39;
housing in urban areas and, 99, 101
Metacyclic trypanosomes, of T. cruzi, 58-59, 160, 161, 162, 212
Midwives, and Culture Context Model for Chagas’ prevention, 136
Migration, of humans:
housing and spread of Chagas’ disease, 94-95;
as vectors of ecological exchange, 23-24
Milk, contamination of with T. cruzi, 62, 178
Ministry of Public Health (Bolivia), 217
Misqui (Bolivia), 104
Misfortune ritual, of Kallawaya herbalists, 30-34
Model, for Chagas’ control in Bolivia, 110-12
Molecular mimicry, by T. cruzi, 214
Monckeberg, J. G., 200
Monocytes, and T. cruzi infection, 208-209
Mortality rates, for Chagas’ disease:
acute phase and, 197;
children and, 48;
congenital transmission and, 60-62
Mosquitos, and Chagas’ research on malaria, 4
&nbs
p; Mountain of the Condor: Metaphor and Ritual in an Andean Ayllu (Bastien, 1978), xvi
Mucins, 168
Multiform chagasic syndrome, 203
Mummies, and archaeological evidence of Chagas’ disease in Andes, 19, 24, 27, 164, 206
Myocarditis, 197, 203-204, 213, 216
Myosin, 86, 232 n.7
N
National Academy of Medicine (Brazil), 16
National Chagas’ Control Committee (Bolivia), xviii
National University at Cochabamba, 52
Natural resistance, to T. cruzi, 205-207
Nervous system:
chronic stage of Chagas’ disease and, 85;
neuronal degeneration during acute phase of Chagas’ disease, 213-14
Nicotiana spp., 37
Nifurtimox, and treatment of Chagas’ disease:
cost of, 71;
dosages of, 50, 220;
efficacy of, 224;
ethnomedicine and, 45;
maternal transmission to fetus, 61;
recommendations on use of, 220-22
Nitroimidazole (2-amino-5-[methyl-5-nitro2-imidazolyl]-1, 3, 4 thiadiazole), 223
Noel Kempf Preserve (Bolivia), 155
Nongovernmental organizations (NGOs), and Culture Context Model for Chagas’ prevention, 143-44
North American Free Trade Agreement (NAFTA), 103
Nufiez, L., 19
Nurses, as principal biomedical personnel in rural Bolivia, 67. See also Community health workers
Nutrition, and resistance of infants to T. cruzi, 62
Nymphs, of T. infestans, 174, 175, 176
O
Obligate bloodsucking, and T. infestans, 173
Opossums (Didelphis marsupialis), 163, 189, 195
Opsonization, and phagocytosis of T. cruzi, 209
Oral transmission, of T. cruzi, 62-64
Organ transplants, and transmission of T. cruzi, 62, 63
Ortloff, Charles, 146-47
Oswaldo Cruz Institute, 2, 12, 14
P
Pacemaker, and chagasic heart disease, 80, 83
Pacha Kuteq Yupanki (Inca king), 25
Pachamama (Mother Earth), 109-10
Paints, and slow-release insecticide, 120, 234 n.12-13
Paleopathology, 24
Pan American Health Organization, xiii
Panstrongulus lignarius, 189
Panstrongylus megistus, as vector for T. cruzi:
defecation rate, 59;
feeding activities, 176;
importance of compared to other species of vectors, 186, 188, 189, 191;
sylvatic zymodemes and, 163
Papaya juice, 42
Paraguay, infestation of houses with T. infestans, 184
Parasites:
herbal medicines and parasiticides, 37, 45;
HIV and, 207
Parasiticides, and herbal medicines, 37, 45.
See also Benznidazole; Nifurtimox
Pariya Qaqa (Igneous Rock), 155
Partial immunity, and acute phase of Chagas’ disease, 197, 207-10
The Kiss of Death Page 40
