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The Kiss of Death

Page 40

by Joseph William Bastien


  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

 

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