Currently, Chagas' disease control consists mainly of chemical warfare against the insect vector. However, a number of risk factors, such as poor hygiene and clutter, can facilitate the persistence of triatomine breeding sites. Relying on the premise that communities at risk of Chagas have little knowledge about the disease, the authors defined the extent of knowledge that is considered optimal and determined how much is known, on average, by the inhabitants of two areas in Argentina showing different epidemiologic trends. Risk factors in both areas were identified. The optimal extent of knowledge was defined in accordance with 25 "basic concepts" surrounding the disease, and from these questionnaires were constructed for evaluating average knowledge about the disease. Results obtained showed that risk factors were linked primarily with the type of dwelling construction and with clutter, as well as with limited knowledge about the disease. There was little basic knowledge about Chagas, with an inability, for example, to identify the vector and describe the mode of transmission. Increasing people's knowledge about the disease would be an important step in the fight against Chagas and would give the inhabitants of endemic areas a better understanding of their situation as well as the chance to develop behaviors that would allow them to assume responsibility for their own welfare.

in which a video (spot) to boost awareness and raise the profile of Chagas disease issues was designed and developed. This study was of qualitative nature and analyzed information that was gathered from 38 questionnaires that had been answered by individuals affected by the disease and by specialists on this disease. The information from each group was classified according to factors that they associated with the word Chagas, along with the difficulties, adversities, challenges, objectives and achievements relating to the disease. The COMUNICAÇÃO SAÚDE EDUCAÇÃOresponses, reports and anecdotes relating to each of these factors were analyzed. The conclusions emphasize the need to know and make known the difficulties that people affected by Chagas disease experience, bearing in mind that the realities are manifested differently depending on the context.

With the objective of providing an insightful analysis of Chagas disease in the world, the authors share their collective reflections about the current situation of this public health problem in: rural environments of Latin America; urban environments of endemic and non-endemic areas everywhere; and, at a global level. A perspective based on the 'Democracy and Health Promotion' axis allowed the development of an innovative update about Chagas disease as a model of a complex socio-environmental health problem, with a key set of elements that goes beyond biomedical aspects. The authors created a dialogue between the fundamental elements of the Curitiba Statement on Health Promotion and Equity and crucial aspects of a reflection on the reality of Chagas disease today that at the same time challenges the different actors involved. With that reference, the call to promote a 'critical analysis of viabilities and opportunities for action, considering the potentialities and barriers imposed by the complexity of social movements in the present context of recedes and the loss of rights' was emphasized repeatedly. Finally, on the occasion of the recent creation of the Technical Group on Information, Education and Communication to control Chagas disease, WHO Department of Control of Neglected Tropical Diseases, the authors share reflections to propose an inclusive and transformative approach of health promotionwhat we hope is a new horizon for people affected, directly and indirectly, by Chagas disease.

Hablar de Chagas es hablar de una problemática compleja, definida por elementos de carácter biomédico, epidemiológico, sociocultural y político, que se conjugan dinámicamente. En este trabajo buscamos identificar y analizar las representaciones sobre Chagas de los integrantes del equipo de salud de un centro de atención periurbano de la ciudad de La Plata, Argentina. Mediante un abordaje cualitativo, se realizaron entrevistas semiestructuradas y se analizaron las respuestas con la técnica del análisis de contenido. Los resultados mostraron que la mayor parte de las personas entrevistadas no contempla al Chagas como una problemática en su contexto laboral cotidiano y manifiestan un fuerte sesgo biologicista en su formación profesional. Con este trabajo señalamos la urgente necesidad de reflexionar críticamente en torno a la formación de los profesionales de la salud en relación a problemáticas socioambientales complejas de importancia regional, como lo es el Chagas.

Chagas is a complex, multidimensional phenomenon in which political, economic, environmental, biomedical, epidemiological, psychological, and sociocultural factors intersect. Nonetheless, the hegemonic conceptualisation has long envisioned Chagas as primarily a biomedical question, while ignoring or downplaying the other dimensions, and this limited view has reinforced the disease's long neglect. Integrating the multiple dimensions of the problem into a coherent approach adapted to field realities and needs represents an immense challenge, but the payoff is more effective and sustainable experiences, with higher social awareness, increased case detection and follow-up, improved adherence to care, and integrated participation of various actors from multiple action levels. Information, Education, and Communication (IEC) initiatives have great potential for impact in the implementation of multidimensional programs of prevention and control successfully customised to the diverse and complex contexts where Chagas disease persists.

Presentamos un análisis de materiales didácticos e informativos sobre dengue, elaborados por Ministerios de Salud y Educación de diferentes jurisdicciones de Argentina. Realizamos un análisis de contenido indagando dimensiones de la salud, modelos didácticos, modelos epidemiológicos y concepciones acerca de participación. Inferimos que la perspectiva dominante tuvo una fuerte impronta biomédica, desde un modelo epidemiológico lineal multicausal. El eje principal fue el “manejo de criaderos”, acciones para reducir los recipientes domésticos con agua en los que se cría el mosquito Aedes aegypti. Si bien la participación de la comunidad apareció como central, la concepción subyacente fue de pseudoparticipación (la comunidad como ejecutora de recomendaciones, sin injerencia en las decisiones). Finalmente, si bien en las fundamentaciones de las propuestas didácticas inferimos una intencionalidad constructivista, en la mayoría de las actividades identificamos un modelo de transmisión-recepción.

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DescriptoresEnfermedad de Chagas, epidemiologia. Cardiopatias, diagnostico. Formas de contagio. Cardiopatía chagásica. ResumenEl objetivo del trabajo fue comparar el grado de compromiso cardíaco entre dos poblaciones de chagásicos, con residencia permanente en área endémica y con exposición ocasional al parásito y con contagio por vía no vectorial (transfusional, connatal, y otras). Los resultados mostraron que los infectados ocasionales presentan menor presencia de cardiopatía; y cuando presentan cardiopatía, tienen menor prevalencia de miocardiopatía dilatada que los infectados con residencia permanente en el área endémica. También se plantea el rol del parásito, la cantidad de infecciones, los mecanismos inmuno-patogénicos desarrollados, la calidad de vida y el tipo de tareas laborales en la diferente evolución de estos pacientes. AbstractThe aim of the study was to compare the degree of cardiac compromise between two patient groups infected with Chagas' disease, A) those permanently residing in endemic areas and B) those sporadically exposed to the parasite and indirectly (non-vector) infected (transfusion , mother-to-child transmission, etc. INTRODUCCIÓNLa población que vive expuesta al riesgo de contraer la enfermedad de Chagas en zonas endémicas de América Latina es de aproximadamente 90 millones de personas, de las cuales se estima que, al menos 18 millones ya están infectadas por el Trypanosoma cruzi. En Argentina, para una población estimada en el año 1997 de 35 millones de habitantes, se calculaba en siete millones la población en riesgo de contraer la infección, con una prevalencia del 7,5%, es decir, 2.640.000 individuos con serología reactiva para Chagas. 5 Los estudios de seguimiento longitudinal demuestran que entre el 70% y el 80% de los pacientes chagásicos permanecen durante toda su vida en la forma indeterminada, asintomáticos y sin lesiones aparentes, sólo con la serología positiva. Entre el 20% y 30% restante evolucionan hacia el daño crónico, donde aproximadamente una tercera parte de ellos presenta complicaciones dado lo avanzado de las