Ecoepidemiology, short history and control of Chagas disease in the endemic countries and the new challenge for non-endemic countries

Abstract

Chagas disease is maintained in nature through the interchange of three cycles: the wild, peridomestic and domestic cycles. The wild cycle, which is enzootic, has existed for millions of years maintained between triatomines and wild mammals. Human infection was only detected in mummies from 4,000-9,000 years ago, before the discovery of the disease by Carlos Chagas in 1909. With the beginning of deforestation in the Americas, two-three centuries ago for the expansion of agriculture and livestock rearing, wild mammals, which had been the food source for triatomines, were removed and new food sources started to appear in peridomestic areas: chicken coops, corrals and pigsties. Some accidental human cases could also have occurred prior to the triatomines in peridomestic areas. Thus, triatomines progressively penetrated households and formed the domestic cycle of Chagas disease. A new epidemiological, economic and social problem has been created through the globalisation of Chagas disease, due to legal and illegal migration of individuals infected by Trypanosoma cruzi or presenting Chagas disease in its varied clinical forms, from endemic countries in Latin America to non-endemic countries in North America, Europe, Asia and Oceania, particularly to the United States of America and Spain. The main objective of the present paper was to present a general view of the interchanges between the wild, peridomestic and domestic cycles of the disease, the development of T. cruzi among triatomine, their domiciliation and control initiatives, the characteristics of the disease in countries in the Americas and the problem of migration to non-endemic countries.

2 nd Brazilian Consensus on Chagas Disease, 2015

“…João Carlos Pinto Dias [1] , Alberto Novaes Ramos Jr [2] , Eliane Dias Gontijo [3] , Alejandro Luquetti [4] , Maria Aparecida Shikanai-Yasuda [5] , José Rodrigues Coura [6] , Rosália Morais Torres [3] , José Renan da Cunha Melo [3] , Eros Antonio de Almeida [7] , Wilson de Oliveira Junior [8] , Antônio Carlos Silveira [9] , Joffre Marcondes de Rezende [10] , Fabiane Scalabrini Pinto [11] , Antonio Walter Ferreira [12] , Anis Rassi [13] , Abílio Augusto Fragata Filho [14] , Andréa Silvestre de Sousa [15] , Dalmo Correia [16] , Ana Maria Jansen [6] , Glaucia Manzan Queiroz Andrade [3] , Constança Felícia De Paoli de Carvalho Britto [6] , Ana Yecê das Neves Pinto [17] , Anis Rassi Junior [13] , Dayse Elisabeth Campos [18] , Fernando Abad-Franch [1] , Silvana Eloi Santos [3] , Egler Chiari [19] , Alejandro Marcel Hasslocher-Moreno [15] , Eliane Furtado Moreira [20] , Divina Seila de Oliveira Marques [21] , Eliane Lages Silva [22] , José Antonio Marin-Neto [23] , Lúcia Maria da Cunha Galvão [19] , Sergio Salles Xavier [24] , Sebastião Aldo da Silva Valente [17] , Noêmia Barbosa Carvalho [25] , Alessandra Viana Cardoso [26] , Rafaella Albuquerque e Silva [26] , Veruska Maia da Costa [26] , Simone Monzani Vivaldini …”

“…Hospital das Clínicas, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia, Goiás, Brasil. [11]. Hospital das Clínicas, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil.…”

Evolution of Chagas’ disease in Brazil. Epidemiological perspective and challenges for the future: a critical review

“…4 In 1988 Brazilian legislation started requiring blood donors to be registered and blood samples to be tested individually for infectious diseases with high sensitivity tests, 19,28 and in 1991 the Southern Cone Initiative (INCOSUR) was created by Brazil, Argentina, Chile, Paraguay, Uruguay and Bolivia, aiming to reduce and eliminate transfusion transmission through the strengthening of the blood banks and control of the donors (Table 1). 10,15,19 It has been argued that the high proportion of inconclusive reactions was caused mainly by the high percentage of first-time donors, and could also be related to the frequent changes in the brands of the screening tests, a result of the tendering rules to which public blood banks are subjected. 31 Ferreira-Silva 20 analysed the differences between commercial ELISA tests from two laboratories and showed that the sensitivity and specificity levels of tests from different manufacturers differed considerably.…”

“…and to implement surveillance and control methods. 15,27 However, there is very little evidence that concrete action has so far been taken. 15 In 2007, the Brazilian Health…”

“…15 However, the uncontrolled deforestation in that region may lead to domiciliation of vectors. It is, therefore, important to improve surveillance and education in this area to track possible domestic infestations, to rapidly identify and treat cases of oral transmission, and to improve food-handling practices, preventing outbreaks of oral transmission.…”