The Kiss of Death

(megacolon), caused by T. cruzi infection.

meningoencephalitis — Inflammation of the brain and its meninges. T. cruzi frequently causes this during the acute phase of Chagas’ disease, especially in children, either killing them or leaving lasting effects.

mesa — A traditional Andean ritual in which foods symbolic of people, places, and intentions are offered to earth shrines.

mestizo — Refers to middle- and upper-class Bolivians who have completely adopted Western dress, traditions, and the Spanish language. Mestizo is a broad category that includes many Bolivians who are not campesinos and cholos. Bolivia is a highly class-stratified country with many classes determined by race, ethnicity, language, dress, economics, politics, and appearance; however, campesino and cholo classes predominate and are very well defined.

metacyclic trypomastigotes — A stage of T. cruzi which develops from the epimastigote stage within the triatomine’s intestine and is infective to animals and humans. Immediately after introduction into the bite site or mucuous membranes, metacyclic trypomastigotes penetrate a variety of cells and become transformed within these cells into amastigotes. After several divisions, the parasite transforms into trypomastigotes that are released into the bloodstream. These trypomastigotes are different from metacyclic trypomastigotes and are taken up by triatomines, where they then transform into epimastigotes and eventually metacyclic trypomastigotes.

microlevel processes — Smaller units of social analysis, such as the community, family, and individual, that relate to diseases.

mountain-body metaphor — Kallawaya Andeans understand parts of their body as relating to places on their ayllu mountain; therefore, if they ritually feed earth shrines corresponding to these parts, their bodies will be healthy.

muerto subito (sudden death) — A term frequently used by Bolivians to describe death caused by heart failure brought about by Chagas’ disease. A person suddenly drops dead and a drop of blood emits from the nose.

myxoedema — A decreased function of the thyroid gland, accompanied by swelling, anemia, lethargy, slow speech, mental apathy, et cetera. Carlos Chagas considered this to be one of the most characteristic manifestations of the acute form of Chagas’ disease.

N

neuron cell — A nerve cell; the structural and functional unit of the nervous system. Neuron cells function in the initiation and conduction of impulses for organic processes. T. cruzi prefers to inhabit neuron cells, consequently impairing the conduction of impulses to the organs related to the neuron cells.

nifurtimox (synonyms: Bayer 2502, Lampit) — A drug commonly used to treat Chagas’ disease. Nifurtimox is a 5-nitrofuran derivative with antiprotozoal activity; it is also used to treat leishmaniasis and African trypanosomiasis.

nymphs — Refers to triatomines going through one of five nymph stages before becoming adults, at which time they grow wings. During the nymph stages, triatomines crawl. The nymphal stages can take anywhere from four to forty-eight months depending on the temperature, humidity, and frequency and volume of blood meals. Nymphs can imbibe between six and twelve times their own weight in blood. Nymphs become infected with T. cruzi and spread Chagas’ disease.

P

Panstrongylus megistus — Triatomines that belong to the genus Panstrongylus; they are vectors of T. cruzi.

parasite — A plant or animal that lives upon or within another living organism in order to absorb nutrients from the host. Parasites include multi-celled and single-celled animals, fungi, bacteria, and, possibly, viruses. Parasites can be pathogenic (disease causing) or nonpathogenic.

Parasitemia — The condition of being actively infected by a parasite. This occurs early in Chagas’ disease but is very difficult to detect, even with microscopic analysis. Also refers to the acute phase of the disease, with intense inflammatory reactions manifested in high fever, chagomas, Romana’s sign, lymphadenopathy, hepatomegaly, splenomegaly, myocarditis, and meningoencephalitis.

parasitic cycle — Refers to the parasite, vector, and host relationship.

parasitic protozoas — Unicellular animals that infect and live off many species of vertebrates and invertebrates and that have adapted to life in nearly all available sites within the body of the host. There are about 10,000 different protozoan parasites. Some of the disease-causing parasitic protozoa include those in the genera Plasmodium (malaria), Trypanosoma (Chagas’ disease, African sleeping sickness), and Entamoeba (amebic dysentery). Parasitic protozoa greatly influence humans, society, and culture.

partial immunity — A condition in which people infected with T cruzi will usually not suffer another acute attack if they remain infected. One implication is that it may not be wise to rid someone of T. cruzi parasites if that person is likely to be infected again and possibly suffer the deadly effects of another acute phase. The presence of the parasite inhibits strong infections from newly colonizing parasites.

pathogen — A microorganism or substance capable of producing a disease.

patrilineal descent — A social grouping held together by descent through the father.

peridomicile — Areas outside the house including corrals, animal shelters, sheds, and walls.

pilot project — A project developed primarily to serve as a model for future projects. For example, houses may be improved in one village by development workers to show peasants how they can replicate these endeavors. The success of a pilot project is indicated by the degree to which it is replicated.

political economy — The relationship of political-economic factors in bringing into physical proximity parasites, vectors, and hosts. Houses can become “sick” because of overarching economic and political problems that cause impoverishment, migration, and low productivity.

prevalence — The number of cases or people infected with a disease at a specific time within a well-defined area.

privatization — Refers to pressure from capitalistic Western nations on Andean nations and communities to divest state-owned enterprises and community-held property and allow for private enterprises and individuals to buy and maintain them.

promotores — Spanish for community health workers.

protozoa — A phylum comprising the simplest animal forms-single-celled organisms ranging in size from 1.5um to 50mm. Of the 66,000 known species, 10,000 are parasitic and 56,000 are free-living. They are found in every ecological niche.

pyrethroid insecticides — Chemical insecticides synthesized to resemble extracts of pyrethrum, a plant- derived compound used for centuries for insect control in the Andes and Asia.

Q

qollas — An indigenous word used to refer to highland Aymara and Quechua speakers of Bolivia, as distinguished from cambas, another indigenous word used to refer to Guaranis and others who live in lower regions of Bolivia, especially those in the Department of Santa Cruz.

Quechuas — A civilization and ethnic group who speak the Quechua language, which was spread at the Inca conquest, and live in the valleys and highlands of the Andean mountains of Chile, Bolivia, Ecuador, and Peru.

R

Reduviid — From Reduviidae, a large family of predaceous insects, sometimes referred to as assassin bugs; most members are insectivores. One subfamily, the Triatominae, is found mainly in the Americas; its members are hematophagous and vectors of Chagas’ disease.

reinfestation — The reappearance of insect vectors from an outside source in a location from which they had previously been eliminated by control measures.

residentes — A term used by rural peasants to refer to friends and relatives living in urban areas.