Partial protection, and immunization, 171
Pasteur, Louis, 1, 3
Pasteur Institute (La Paz), 164
Patagonia, and species of triatomines, 193
Pathology, of Chagas’ disease:
acute phase and, 196-202;
autoimmune components of, 213-16;
heart disease and, 84-86;
length of exposure to Chagas’ disease and, 206;
variability of, 13-14;
zymodemes of T. cruzi and, 170. See also Symptoms
Paz Zamora, Jaime, xix, 125, 235 n.5
Peru:
archaeological evidence of Chagas’ disease from preceramic period, 22-23;
infestation of houses with T. infestans, 184;
smallpox epidemic of 1520s, 27
Petramina (insecticide), 44
Phagocytosis, and immune response to T. cruzi infection, 208-209
Phaseolus lunatus, 19
Pheromones, of T. infestans, 174
Pigs, as hosts for T. cruzi, 195
Pinches (Ecuador and Peru), 37
Pizarro, Francisco, 27
Pizarro, Pedro, 27
Plan International, 139, 235n.2
Plasmodium spp., 6
Plastering, of house walls and prevention of Chagas’ disease, 120, 234 n.12
Pless, M., 81
Plexes (nerve nets), 213-14
Policy, public:
AIDS, Chagas’ disease, and tuberculosis as medical priorities, 86;
recommendations for on Chagas’ disease, 105-116.
See also Public health
Political economy:
colonialsim and spread of Chagas’ disease, 28-29;
housing and physical proximity of vectors and hosts of Chagas’ disease in Bolivia, 88-106
Politics, religious motivation and agendas of health projects, 110. See also Policy; Political economy
Pongo (Bolivia), 47
Population, pre-Columbian of central Andes, 27
Potosí, Department of (Bolivia), case study of chagasic colon, 65-72
Poultry, and T. cruzi infection, 195
Poverty:
free market economics and increase of in urban Bolivia, 103-104, 105;
housing and Chagas’ disease in urban Bolivia, 101
Premature birth, and intrauterine T. cruzi infection, 61, 230n.8
Prevention, of Chagas’ disease:
call for activism, xvii-xviii;
housing and, 107-23, 124-33;
Culture Context Model for, 134-45;
recommendations on allocation of resources, xvii-xviii;
restoration of traditional culture in Bolivia and, 29
Prickly pear cactus, 43
Prieto, Marco Antonio, 136, 143, 148, 236n.3
Primary Chagas’ disease, 16
Primary health care, and Chagas’ control projects, 110, III
PROCOSI (Programa de Coordinación en Supervivencia Infantil), 234 n.10
Productivity, and socioeconomic costs of Chagas’ disease, 149-53
Pro-Habitat of Bolivia, xx, 127-28, 139, 235n.2
Project Concern, 131
Prosopisjuliflora, 19
Protozoa, species of pathogenic, 11. See also Trypanosoma cruzi
Proyecto Británico Cardenal Maurer (PBCM), 46, 107-23, 226, 233 n.1-2, 233 n.5, 234 n.9
Pseudocysts, 198
Public health:
religious motivations and political agendas in projects, 110;
scope of Chagas’s disease as problem in Latin America, xiii.
See also Education; Policy, public; Prevention
Pyrethrum, 4
Q
Qaqachaka (Oruro, Bolivia), 90
Quechua (Bolivia):
adaptation to environment, 142-43;
attitudes toward T. infestans, 56;
colonization and migration of, 96;
housing in urban Bolivia and, 100, 101
Quinine, and malaria, 4
R
Rabies virus, 1
Rabinovitch, J. E., 176
Race, and class system in Bolivia, 132. See also Ethnicity
Radanil. See Benznidazole
Rahimtoola, S. H., xxii
Rain forest, destruction of in Bolivia, 155
Rake, Gregory, 233n.3
Rats, as hosts for T. cruzi, 194, 195
Reed, Walter, 8
Regalsky, Pablo, 92, 104, 136, 143, 147, 153, 236 n.4, 236 n.8
Regenerator (herbal remedy), 39-42, 44
Religion, as motivation in health projects, 110
Repolarization disorders, 204
Reproductive cycle:
of Triatoma infestans, 174-75;
of Trypanosoma cruzi, 161
Reservoir hosts:
animals and T. cruzi, 194-95;
vectorial transmission of T. cruzi and, 192
Residentes (residents):
health education and, 132;
housing in urban Bolivia and, 100
Respiratory infections, and ethnomedicine in Bolivia, 68
Restorative proctocolectomy, 74-75
Rheumatic fever, 85
Rhodniuspallescens, 186, 189
Rhodniusprolixus, as vector for T. cruzi:
defecation rate, 59, 177;
feeding activities of, 176;
importance of compared to other species of vectors, 186, 188, 189, 191;
pheromones in feces of, 174;
roof thatching and, 97
Ritual:
Kallawaya herbalists and misfortune ritual for Chagas’ disease, 30-34;
roof thatching in Bolivia and, 91
Rivas, Daniel, 109, 113
Rochagan. See Benznidazole
Rodents, as hosts for
T. cruzi, 194-95
Romaña’s Sign, 7, 8, 16, 49, 108, 196-97
Roofs, of houses:
alternative low-cost methods, 234n.14;
ceramic tile and Chagas’ control, 120;
thatching as habitat for triatomines, 97;
thatching of as ritual in Bolivia, 91
Rotan palm tree, 40
Rothhammer, F., 19
Rural areas, epidemiology of Chagas’ disease in Bolivia, 47
Ruta chalapensis, 43
S
Sajjra wayra (troublesome wind), 69
Samay (breath), 37-38
Sánchez, Daniel O., 168
Sánchez de Lozada, Gonzalo, 103, 104
Sangre de Drago (Croton roborensis), as herbal medicine, 40, 130
Satureja boliviana, 43
Sayaña (house), 92-93, 96, 140
Sayre, as herbal medicine, 37
Schaudinn, F., 1
Schizodemes, and T. cruzi strains, 163
Schizotrypanum, 159
Schofield, C. J., 237 n.1
Schurria octoarustica, 43
Seasonality, and vectorial transmission of
T. cruzi, 192-93
Secretariat of Health (SOH, Bolivia), xx, 67, 128, 182, 233n.2, 235n.2, 236n.1
Sensano, Ruth, xviii, 46, 107-23, 135, 148
Serological methods, for diagnosis of Chagas’ disease, 219
Serum neutralization, 211
Shamans, and Culture Context Model for Chagas’ prevention, 135
Side effects:
of benznidazole, 222-23;
of gentian violet, 224;
of nifurtimox, 221
Sleeping sickness:
Chagas’ disease compared to, 10-11;
discovery of causative agent, 1;
discovery of Chagas’ disease and, 13
Smallpox, 27
Social factors:
economic impact of chronic Chagas’ disease, 84, 149-53;
spread of Chagas disease in Andes, 22-24.
See also
Class; Culture
Sociology, and interdisciplinary approach to prevention of Chagas’ disease, 147
SOH/CCH Chagas Control Pilot Program, 182, 233n.2, 235n.2, 236n.1, 236n.7
; Spain, colonialism and T. infestans, 26-28
Spartumjunceum, 42
Spiders, as predator of T. infestans, 43
Spirituality, and Culture Context Model for Chagas’ prevention, 140
Spontaneous abortion, and Chagas’ disease, 61, 230 n.8
Standen, V., 19
Stewart, George, 162, 198, 236-37n.1
Strains, of T. cruzi:
adaptation in Andes and, 20;
classification of and impact on pathology, 163-65;
clinical manifestations and, 81;
colon pathology and, 22;
complement-mediated lysis and, 212;
immunization and, 171;
nifurtimox and, 221;
susceptibility of triatomine vectors to infection and, 162
Stress testing, and ECG abnormalities, 203
Stumpy trypomastigotes, 161
Suarez, J. A., 200
Sucre, Department of (Bolivia), 22, 81-82, 227
Surface membrane, of T. cruzi, 166-70
Surgery, for chagasic megacolon, 74
Swiss Tropical Institute, 225
Sylvatic animals, as hosts for T. cruzi, 194
Symbols, in Kallawaya misfortune ritual, 33
Symptoms, of Chagas’ disease:
acute phase and, 49;
case study of chagasic esophagus, 75-76;
case study of enlarged colon, 20-22, 65-77;
case study of heart disease, 78-87;
chronic heart disease and, 203-204;
Kallawaya herbalists and interpretation of, 34-36;
progression of, 16-18.
See also Pathology
Synanthropic animals, and triatomines, 194
Syphilis, 6, 217
T
Tabacal (Cochabamba, Bolivia), 81
Taber, C.W., 228 n.1
Tapia, Gonzalo, 229 n.6
Tarija, Department of (Bolivia), 95, 124-33, 176, 182, 183
Tawantinsuyo (Inca empire), 25
Taxonomy, of Trypanosoma cruzi, 159-62
T-cells, 199, 210, 232 n.6
T. cruzi. See Trypanosoma cruzi
Teaching aids, for Chagas’ prevention programs, 130-32
Technology, and Culture Context Model for Chagas’ prevention, 142
Temporality, and Culture Context Model for Chagas’ prevention, 140-41
Tertiary Chagas’ disease, 16
Tibayrenc, M., 164
T. infestans. See Triatoma infestans
Tobacco, as traditional cure for Chagas’ disease, 36-37
Tonn, Bob, xx, 229 n.3
Treatment. See Chemotherapy
Triatoma brasiliensis, 186, 188, 189
Triatoma dimidiata, 177, 184, 186, 188, 189
Triatomaguasyana, 51
Triatoma infestans (T. infestans):
adaptation of in Bolivia, 52-58, 187-88;
archaeological evidence of, 24;
Chagas’s discovery of Chagas’ disease and, 6-9;
efficiency of as vector, 159-60;
epidemiology of Chagas’ disease in Bolivia, 46-64;
housing and physical proximity of with parasites and hosts in Bolivia, 88-106, 179-83;
Inca empire and spread of, 25;
life cycle of, 173-78;
slow-release insecticide paints, 120, 234 n.12-13;
Spanish conquest and colonialism, 26-28;
strains of T. cruzi and, 164
Triatoma maculata, 189
Triatoma melanocephala, 51
Triatoma oswaldoi, 15
Triatoma patagonica, 193
Triatoma pseudomaculata, 189
Triatoma rubrofasciata, 187
Triatoma sordida, 51, 59, 186, 188, 189
Triatoma venosa, 51, 189
Triatominae, subfamily, 190-91
Trypanosoma brucei group, 1, 13, 160, 166, 212, 225
Trypanosoma conorrhini, 187
Trypanosoma cruzi (T. cruzi):
adaptation of in Bolivia, 52-58;
adaptation to gut of T. infestans, 176;
animal reservoirs and hosts for, 194-95;
author’s first impression of, xiii;
chemotherapy and evasive strategies of, 229 n.2;
discovery of by Chagas, 11;
forms of, 12;
housing and physical proximity of with vectors and hosts in Bolivia, 88-106;
immune response to infection with, 205-16;
immunization against, 166-72;
Inca empire and spread of, 25;
long-term adaptation of in Andes, 20;
parasitic cycle of, 15;
strains of, 163-65;
taxonomy and life cycle of, 159-62;
vector species of in the Americas, 186-93.
See also Chagas’ disease
Trypanosoma minasensi, 11
Trypanosoma rangeli, 160, 162, 187, 190, 217
Trypanosomatidae, 159
Trypanosoma vespertilionis, 187
Copyright
©1998 by The University of Utah Press
All rights reserved
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Printed on acid-free paper
LIBRARY OF CONGRESS CATALOGING-IN-PUBLICATION DATA
Bastien, Joseph William, 1935-
The kiss of death: Chagas’ disease in the Americas / Joseph
William Bastien.
p. cm.
Includes bibliographical references and index.
ISBN 0-87480-559-7 (alk. paper)
1. Chagas’ disease--Bolivia--Epidemiology. 2. Chagas’ disease--Latin America--Epidemiology. 3. Chagas’ disease--Social aspects--Bolivia. 4. Chagas’ disease--Social aspects-Latin America. 5. Chagas’ disease--Bolivia--Prevention. 6. Chagas’ disease--Latin America--Prevention. 7. Housing and health--Bolivia. 8. Housing and health--Latin America. 9. Public health surveillance--Bolivia. 10. Public health surveillance--Latin America.
I. Title.
RA6
4
4.C26B37 1998
614.5’33dc21 98-18279
Notes
1
1. This research is summarized in the following articles and books: concerning Aymara rituals (Bastien 1989), Kallawaya herbal curing (Bastien 1982, 1983a, 1983b), ethnophysiology (Bastien 1985), Kallawaya herbalists (Bastien 1987), cultural perceptions of neonatal tetanus and programming implications (Bastien 1988), integration of ethnomedicine and biomedicine (Bastien 1992), and training of community health workers (Bastien 1990).
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2
2. Some of these positions were coordinator with Project Concern for community health workers and biomedical personnel of the Department of Oruro, Bolivia, (Bastien 1987b, 1990a); educator with Project Concern for diarrhea control and oral rehydration therapy (Bastien 1987a: 81-84); researcher with Resources for Child Health concerning prevention of neonatal tetanus (Bastien 1988); anthropologist working with Bolivian radio schools (1990); and ethnologist advisor to USAID projects: Community and Child Health (1987a, 1991), Bolivian Forestation Project (1995), and Chagas Control Project, Bolivia (1991).
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3. The acronym in Spanish is SNS/CCH, Programa Piloto de Control de Chagas; in English it is SOH/CCH, Chagas Control Pilot Project.
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1. For the medical history of Chagas’ disease see Chagas 1909, 1911, 1921, 1922, 1988; Chagas Filho 1959, 1968, 1988, 1993; Kean 1977; and Lewinsohn 1979, 1981.
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2. “La vinchuca incommode beaucoup ceux qui voyagent de Mendoza á BuenosAyres… C’est un escarbot ou scarabée, dont le corps est ovale e très-aplati, et qui devient gros comme un grain de raisin, du sang qu’il suce… Cet insect ne sort que de nuit; les individus ailés peuvent avoir cinq lignes de long, et volent; ce qui n’arrive pas aux petit.”
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3. Concerning the debate whether Darwin had Chagas’ disease see Browne 1995:280; Keynes 1988:315; Goldstein 1989:586-601; and Woodru
ff 1965.
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1. Castor oil is a fixed oil expressed from the seed of the croton plant, Croton tiglium. Although commonly used fifty years ago in biomedicine, Taber’s Cyclopedic Medical Dictionary (1985:400) says, “Action: Drastic cathartic, externally as a rubefacient. This chemical has no place in medicine and should not be used.”
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2. Biomedical ethics in Bolivia at the time treated lightly the fact that doctors used Indians as trial subjects. The most noted transgression was a La Paz oculist’s experiments on Aymara Indians, who were noted for their excellent vision, in the early development stages of radial kerometry. In other Latin American countries, prisoners have been experimentally infected with T. cruzi and treated with potential remedies (G. Stewart, interview, 1993).
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3. This name is purposely withheld for legal reasons. One of Bolivia’s most reputed naturalists, Jaime Zalles, claims that the patented formula from Regenerator has had millions of dollars in drug sales. I have been unable to verify this.
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4. As one example: “Fifth Case.- Margarita Vidaurre. First analysis from Laboratorio de Salud Pública on October 24, 1966. Complement Fixation: positive. Second analysis from Laboratorio de Salud Pública on July 12, 1970, negative.”
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5. Scientists discussed below discount floripondio as an insecticide.
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6. Leading this research are Dr. Gonzalo Tapia, director, and biologist Jose Luis Alcázar, both ofProyecto Chagas of the Universidad Mayor San Simon, Cochabamba; Dr. Gene Bourdy of Instituto Boliviano de Biología de Altura (IBBA); and botanist Suzanna Arrazola of the Herbario, Cochabamba.
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The Kiss of Death Page 41
