The Kiss of Death

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by Joseph William Bastien


  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

  ¥

  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

  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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  4

  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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  5

  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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  7

  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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  9

  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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  10

  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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  11

  5. Scientists discussed below discount floripondio as an insecticide.

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  12

  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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