Building the research effort to squash Chagas disease
—and the bugs that carry it

Called “kissing bugs” because of the way they often bite lips to suck the blood of their victims, triatomine insects carry within them a vicious protozoan parasite that infects millions in the Americas and causes Chagas disease.

A controversial journal article published this past May describes the spread of Chagas as “the new AIDS” for the lack of attention it receives, just like the early days of the HIV/ AIDS epidemic.

Mario Grijalva, Ph.D. (’97), professor of microbiology and director of the Tropical Disease Institute (TDI), has long made this deadly disease a top priority. He recently received a National Institutes of Health (NIH) grant to expand the Center for Infectious Disease Research (CIDR) in Ecuador, a joint facility of OU-HCOM and the Pontificia Universidad Católica del Ecuador (PUCE) in Quito.

Each year since 1999, Dr. Grijalva has led a team of more than 30 researchers, scientists, medical students and other students to Ecuador to join forces with about 70 local professionals and students to study the transmission, diagnosis and treatment of Chagas. During his most recent trip to Ecuador this past summer, Dr. Grijalva and his team worked with local authorities in three villages in Loja province, conducting research into designing a new housing model that is impervious to the triatomine insects, as home invasion is one of the main causes of infection. In addition, Katy Kropf, D.O. (’02), assistant professor of family medicine, and David Drozek, D.O. (’83), assistant professor of surgery, participated in bringing clinical care and Chagas disease screening to around 700 people in four additional villages.

Beyond insects, Chagas can be transmitted from mother to child and from contaminated blood transfusions. The World Health Organization has cited Dr. Grijalva’s previous efforts to improve testing procedures as an example for best practices and guidelines for blood supply safety.

The Centers for Disease Control estimate that between 8 and 11 million people in Mexico, Central America and South America are infected with Chagas disease, mainly in rural, underserved populations and especially those living in poverty. In Ecuador, some 200,000 are infected, and as many as 300,000 have Chagas in the United States. A chronic disease that can be deadly if untreated, Chagas can lead to cardiac and intestinal complications like cardiomyopathy, the gradual deterioration of the myocardium, which causes heart failure.

The five-year, $750,000 NIH grant will significantly expand researchers’ work. Called the Global Infectious Diseases Training grant from the Fogarty International Center at the NIH, it will help increase the critical mass of researchers in Ecuador that is needed to obtain biological and clinical information to improve current disease control efforts, and it will implement a new training program in infectious disease research.

“Multidisciplinary research is going to be necessary to improve Chagas disease control efforts in Ecuador,” said Dr. Grijalva. “With this grant and together with PUCE, we can conduct that research. We also mean to substantially increase the country’s research capacity with a training program that will build a corps of infectious disease researchers and well-trained technical personnel.”

The new program will be housed in a 90,000 square foot building that is currently under construction by PUCE on its new campus near Quito. Slated to open in late 2013, the four story facility will house the labs and offices of 22 principal investigators, associated staff and research trainees, including those currently located at CIDR. Its mission is to be one of the most advanced research facilities in South America, Dr. Grijalva said.

“One of the very nice things is to see how all these seeds I’ve planted for a very long time are starting to grow and bear fruit,” Dr.Grijalva said. “Those researchers that I have been training for so many years are already researchers on their own right. Now my role is to facilitate so their projects are a success.”

The new program means expanded opportunities for OU-HCOM medical students, faculty and researchers to travel to Ecuador to provide clinical care and conduct research, Dr. Grijalva said. The NIH funding will support four post-doctoral fellows who will join CIDR staff and help implement a master’s degree program at PUCE and provide funding for a student from Ecuador to earn a Ph.D. from Ohio University as well.

The partners are also making global awareness an integral part of their strategy for fighting the disease. They hosted the second national meeting on infectious disease and tropical medicine research on June 20 to 22 at PUCE. Approximately 500 researchers, scientists, governmental officials and students attended, travelling from the United States, Europe and other Latin American countries.

“We need to raise awareness and promote the improvement of health care, research and acceptance of the problem by getting people working together and talking with one another,” Dr. Grijalva said. “This was a meeting of the minds and a way to encourage collaboration.”