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Acknowledgments
Introduction
Personal Awareness of Chagas’ Disease
Review of the Literature
From the Microscope to the Telescope
CHAPTER ONE
Discovering Chagas’ Disease
Malaria Closes Brazilian Ports
Railroad Stop at Lassance
Darwin’s Disease
Discovering the Parasite
Progression of Chagas’ Disease
CHAPTER TWO
Early Andean Disease
Long-Term Adaptation of T. cruzi
Enlarged Colons in Bolivia: A Case of Empacho
The Spread of Chagas’ Disease in the Andes
Inca Expansion and the Spread of Chagas’ Disease
Inca Housing and Settlement
Spanish Conquest and Vinchucas
Conclusion
CHAPTER THREE
Jampiris and Yachajs: Andean Ethnomedicine
Misfortune Ritual: Dispelling Chagas’ Disease
Interpreting Symptoms and Locating Causality
Traditional Herbal Cures
An Herbal Cure?
Parasiticides: Nifurtimox and Benznidazole
CHAPTER FOUR
The Crawling Epidemic: Epidemiology
Epidemiology of Chagas’ Disease in Bolivia
Treatment of Chagas’ Disease
Infestation with T. infestans
Adaptation of Bolivians and Bugs
Contamination through the Feces
Infection through Blood Transfusions
Transmission through Birth
Oral and Organ Transmission
Epidemiological Reflections
CHAPTER FIVE
Cólico miserere: Enlarged Colon
Juana
Chagasic Colonopathy
Esophageal Problems
An Afterthought
CHAPTER SIX
Bertha: Mal de Corazon
The Burden of a Weakened Heart in the Andes
Pathology of Chronic Disease
Reflections on the Epidemiology of the Immune System
CHAPTER SEVEN
Culture and Political Economy of Homes
House Tour with an Entomologist
The House: A Vertical Entity
The House: An Economy of Exchange
Migration
Temporary Housing
Colonization
Urbanization: Class and Ethnic Distinctions
Political Economy
Efforts at Incorporation
Suggestions
CHAPTER EIGHT
Pachamama Snatched Her: Getting Involved
Charismatic Leadership versus Bureaucratic Technicians
Model for Chagas’ Control in Bolivia
Infrastructure for Chagas’ Control
Peasants’ Awareness of Chagas’ Disease
Concientización: Education
Children and Women
House Improvement Committees
House Improvement
Community Participation
Cross-Cultural Community Participation
Conclusion
CHAPTER NINE
Sharing Ideas
Development of Teaching Aids
Stratified Classes
CHAPTER TEN
Culture Context Model for Chagas’ Control
Oscar Velasco, M.D., coauthor
Spokes of Culture Context
Future Hope
CHAPTER ELEVEN
Solutions
Interdisciplinary Approach
Decreased Productivity
Increased Productivity
Land Holdings
Environment
Appendices
APPENDIX 1
Trypanosoma cruzi
APPENDIX 2
Strains of T. cruzi
APPENDIX 3
Immunization against T. cruzi
APPENDIX 4
Triatoma infestans
APPENDIX 5
House Infestation in Bolivia
APPENDIX 6
House Infestation in Latin America
APPENDIX 7
Vector Species of T. cruzi in the Americas
APPENDIX 8
Hosts for T. cruzi
APPENDIX 9
Acute Chagas’ Disease
APPENDIX 10
Chronic Heart Disease
APPENDIX 11
Immune Response
George Stewart, coauthor
APPENDIX 12
Diagnostic Tests
APPENDIX 13
Chemotherapy
APPENDIX 14
Baseline Studies in Chuquisaca
Glossary
Abbreviations
References
Index
Copyright