infective agent from one host to another. The vectors in Chagas’ disease are triatomine insects, especially Triatoma infestans, or vinchucas.
vinchucas — A popular name in Andean countries for triatomine insects carrying the T. cruzi parasite.
volvulo (volvulus) — A twisting of the bowel upon itself, causing obstruction. Although a prolapsed mesentery is frequently the cause in high altitudes, this term has also been applied to megacolon symptoms associated with T. cruzi.
W Wankaris — A name given to semisedentary farmers, herders, and gatherers who lived at the Quebrada de Tarapaca (northern Chile, southern Andes) around A.D. 500 and whose mummies have been found with megasyndromes suggesting, although not proving, the existence of Chagas’ disease during those times. Chagas’ disease is still found in these regions; but it has less severe effects, suggesting a long-term adaptation to T. cruzi.
warmiyachaj — A woman diviner and ritualist in the Kallawaya region of Bolivia who performs rituals to the river to remove sicknesses.
X xenodiagnosis — A method of diagnosis in which an uninfected (sterile) vector is fed on a suspected host and later examined for the presence of the parasite. In the case of Chagas’ disease, this is done by placing about twenty-five sterile triatomine insects in a jar under the arm of a person and allowing the insects to blood feed for thirty minutes. Thirty and sixty days later, the feces of the bugs are inspected microscopically to see if they contain T. cruzi. This examination is usually done after someone has tested positive with ELISA tests; and it is effective in determining the parasites’ population size and strains (zymodeme). (See Appendix 12.)
Y yachaj — Quechua for diviner or soothsayer in the Andes; (yatiri is Aymara for the same). Literally, “one who knows.” Yachajkuna (pl.) and yatirinaca (pl.) perform divination rituals with coca leaves and the intestines of guinea pigs to determine causes of illness. They also perform rituals to remove the causes of the illness.
Yungas — Region of eastern Andean slopes from around 2,000 to 6,000 feet; it receives ample rainfall and is noted for its lush vegetation and production of fruits, vegetables, and coca leaves.
Z zymodemes — Classifications of T. cruzi based upon enzymatic profiles of parasite strains, over 100 of which have been classified. It is suggested that certain zymodemes prefer particular organs and manifest varying degress of sickness. Also referred to as isoenzymatic strains (IS) of T. cruzi. (See Appendix 12.)
AT — Padenosine triphosphate
CCH — Community and Child Health Project (1989-1994), sponsored by USAID- Bolivia and the Bolivian Secretariat of Health (SOH). This project included primary health care, nutritional care, vaccinations, water projects, maternal and child health care, and Chagas’ control in 1990.
CCCP — Cross-cultural community participation
CCT — Culture Context Triangle
CDC — Centers for Disease Control (Atlanta, Georgia)
CEDEC — Centro por Estudios por Desarollo Chuquisaca
CENDA — Centro de Comunicacion y Desarollo Andino, Cochabamba
CHW — Community Health Worker
DALYs — disability-adjusted life years
ECG — electrocardiography
Habitat — United Nations Center for Human Settlements
HICs — House Improvement Committees
IBBA — French/Bolivian Institute for High Altitude Biology and Parasitology, affiliated with Pasteur Institute in France.
IS — isoenzymatic strains of T. cruzi
MPSSP — Ministerio de Prevision Social y Salud Publica, Bolivia’s ministry of health until 1993, when its name was changed to Secretaria Nacional de Salud (SNS).
NGOs — Nongovernmental organizations, privately operated but often with funding from international agencies that are involved in development projects. Bolivia currently has over fifty NGOs working in public health matters.
PAHO — Pan American Health Organization
PBCM — Proyecto Britanico-Cardenal Mauer; name later changed to Cardenal Mauer (CM) after Britain discontinued funding this project in the Department of Chuquisaca.
PL. 480 — U.S. Public Law 480 allows for funds in host-country currency derived from the sale of U.S. agricultural products to be used in the host country in development projects. Some $2.5 million was provided to pilot projects of SOH/CCH Chagas program in Bolivia.
Pro-Habitat — United Nations Center for Human Settlements in Bolivia
PROCOSI — Programa de Coordinacion en Supervivencia Infantil Organizaciones Privadas Voluntarias, which assumes the role of coordinating NGOs in Bolivia by allocating funds contributed by USAID and other agencies and by evaluative studies.
SNS — Secretaria Nacional de Salud (Spanish name for Secretariat of HealthSOH)
SOH — Secretariat of Health. New name replacing MPSSP in 1993, after the Bolivian government enacted legislation to decentralize the administration of health from La Paz to regional locations.
SOH/CCH — Secretariat of Health (SOH) and Community and Child Health (CCH) Chagas Control Program in Bolivia (1991-1994), sponsored by USAID-Bolivia and the Bolivian Secretariat of Health.
USAID — United States Agency for International Development
VBC — Vector Biology and Control Project (USAID, Washington, D.C.)
WHO — World Health Organization
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