Editing Chagas disease (section)

==Prevention==
[[File:Bungalow_at_Bird_of_Paradise.jpg|thumb|alt=A net hanging over a bed|[[Bed net]]s can be used in endemic areas to prevent bites from triatomine bugs.<ref name="PD7"/>]]

Efforts to prevent Chagas disease have largely focused on [[vector control]] to limit exposure to triatomine bugs. Insecticide-spraying programs have been the mainstay of vector control, consisting of spraying homes and the surrounding areas with residual insecticides.<ref name=Cueto2015>{{cite journal|journal=Acta Tropica |volume=149 |date=September 2015 |pages=70–85 |title=Insecticide resistance in vector Chagas disease: Evolution, machanisms, and management |vauthors=Mougabure-Cueto G, Picollo MI |doi=10.1016/j.actatropica.2015.05.014|pmid=26003952 |hdl=11336/61521 |hdl-access=free }}</ref> This was originally done with [[organochlorine]], [[organophosphate]], and [[carbamate]] insecticides, which were supplanted in the 1980s with [[pyrethroid]]s.<ref name=Cueto2015/> These programs have drastically reduced transmission in [[Brazil]] and [[Chile]],<ref name=PD7/> and eliminated major vectors from certain regions: ''Triatoma infestans'' from Brazil, Chile, [[Uruguay]], and parts of [[Peru]] and [[Paraguay]], as well as ''Rhodnius prolixus'' from [[Central America]].<ref name="Nunes2018"/> Vector control in some regions has been hindered by the development of [[insecticide resistance]] among triatomine bugs.<ref name=Cueto2015/> In response, vector control programs have implemented alternative insecticides (e.g. [[fenitrothion]] and [[bendiocarb]] in [[Argentina]] and [[Bolivia]]), treatment of domesticated animals (which are also fed on by triatomine bugs) with pesticides, pesticide-impregnated paints, and other experimental approaches.<ref name=Cueto2015/> In areas with triatomine bugs, transmission of {{nowrap|''T. cruzi''}} can be prevented by sleeping under [[bed net]]s and by housing improvements that prevent triatomine bugs from colonizing houses.<ref name=PD7/>

Blood transfusion was formerly the second-most common mode of transmission for Chagas disease.<ref name=Angheben2015/> {{nowrap|''T. cruzi''}} can survive in refrigerated stored blood, and can survive freezing and thawing, allowing it to persist in whole blood, [[packed red blood cells]], [[granulocyte]]s, [[cryoprecipitate]], and [[platelet]]s.<ref name=Angheben2015/> The development and implementation of [[blood bank]] screening tests have dramatically reduced the risk of infection during a blood transfusion.<ref name=Angheben2015>{{cite journal|journal=Blood Transfusion |date=October 2015 |volume=13 |issue=4 |pages=540–50 |doi=10.2450/2015.0040-15 |vauthors=Angheben A, Boix L, Buonfrate D, et al. |title=Chagas disease and transfusion medicine: a perspective from non-endemic countries|pmid=26513769 |pmc=4624528 }}</ref> Nearly all [[blood donation]]s in Latin American countries undergo Chagas screening.<ref name=Angheben2015/> Widespread screening is also common in non-endemic nations with significant populations of immigrants from endemic areas, including the United Kingdom (implemented in 1999), Spain (2005), the United States (2007), France and Sweden (2009), Switzerland (2012), and Belgium (2013).<ref name=Lidani2019>{{cite journal|journal=Frontiers in Public Health |date=July 2019 |volume=7 |page=166 |doi=10.3389/fpubh.2019.00166 |title=Chagas disease: from discovery to a worldwide health problem |vauthors=((Lidani KCF)), Andrade FA, Bavia L, et al.|pmid=31312626 |pmc=6614205 |doi-access=free }}</ref> Serological tests, typically [[ELISA]]s, are used to detect antibodies against {{nowrap|''T. cruzi''}} proteins in donor blood.<ref name=Angheben2015/>

Other modes of transmission have been targeted by Chagas disease prevention programs. Treating {{nowrap|''T. cruzi''}}-infected mothers during pregnancy reduces the risk of congenital transmission of the infection.<ref name=Messenger2018/> To this end, many countries in Latin America have implemented routine screening of pregnant women and infants for {{nowrap|''T. cruzi''}} infection, and the [[World Health Organization]] recommends screening all children born to infected mothers to prevent congenital infection from developing into chronic disease.<ref name=WHO2019/><ref name=Bonney2014>{{cite journal|journal=Parasite |date=March 2014 |volume=21 |issue=11 |doi=10.1051/parasite/2014012 |title=Chagas disease in the 21st century: a public health success or an emerging threat |vauthors=Bonney KM|page=11 |pmid=24626257 |pmc=3952655 }}</ref> Similarly to blood transfusions, many countries with endemic Chagas disease screen organs for transplantation with serological tests.<ref name="Molina2018"/>

There is no vaccine against Chagas disease.<ref name=Santi2022/> Several experimental vaccines have been [[Animal testing|tested in animals]] infected with {{nowrap|''T. cruzi''}} and were able to reduce parasite numbers in the blood and heart,<ref>{{cite journal |journal=PLOS Neglected Tropical Diseases |date=January 2019 |volume=13 |issue=1 |page=e0006985 |doi=10.1371/journal.pntd.0006985 |pmid=30703092 |title=A therapeutic preconceptional vaccine against Chagas disease: A novel indication that could reduce congenital transmission and accelerate vaccine development |vauthors=Dumonteil E, Herrera C, Buekens P |pmc=6354953 |doi-access=free }}</ref> but no vaccine candidates had undergone [[clinical trial]]s in humans as of 2016.<ref>{{cite journal|title=Status of vaccine research and development of vaccines for Chagas disease |vauthors=Beaumier CM, Gillespie PM, Strych U, et al. |journal=Vaccine |volume=34 |issue=26 |date=June 2016 |pages=2996–3000 |doi=10.1016/j.vaccine.2016.03.074|pmid=27026146 |doi-access=free }}</ref>