Programa de Controle da Doença de Chagas no Estado de São Paulo: aspectos sorológicos e entomológicos de inquéritos entre escolares de ensino fundamental

Abstract

RESUMOComo parte de avaliação de medidas de controle de vetores, levadas a efeito no Estado de São Paulo, na década de 60, inquéritos sorológicos entre crianças escolares nascidas após sua aplicação foram realizados nos períodos abrangidos entre os anos 1968 e 1970, em todos os municípios do estado, à exceção dos da Grande São Paulo e, anualmente, de 1973 a 1983, em amostra selecionada a partir daqueles com as maiores soroprevalências para a infecção chagásica. No primeiro caso, a metodologia sorológica previu os exames à base da reação de fixação de complemento, em soros e, no segundo, a reação de imunofluorescência indireta, em eluatos de sangue total absorvido em papelfiltro. Presença de triatomíneos e sua condição de infecção por Trypanosoma cruzi, coligidas nos diversos municípios de acordo com o ano dos nascimentos dos escolares e da realização dos inquéritos, permitiram vislumbrar o quadro da infecção chagásica no Estado de São Paulo, naquelas épocas. A região de Sorocaba destacou-se das demais em termos sorológicos, sustentada pela presença do Triatoma infestans até o início da década de 70. Similarmente, a autoctonia dos casos foi aí observada de maneira preponderante, enquanto que em outras regiões do estado manteve-se um equilíbrio entre casos autóctones e importados. A análise dos dados revela que, ainda em 1974, a transmissão vetorial poderia registrar-se no estado. É importante destacar que, mesmo com falhas de cobertura, até o ano de 1997, não se observou mais sororreatividade para infecção chagásica nas idades inferiores a 15 anos, no Programa de Controle do Estado de São Paulo. Palavras-chaves: Doença de Chagas. Diagnóstico sorológico. Inquérito escolar. Triatomíneos. ABSTRACTTwo serological surveys were carried out to evaluate the effectiveness of measures put into effect in the State of São Paulo (Brazil) to control Chagas disease vectors. The first one, during the period from 1968 to 1970; the complement fixation reaction was performed on serum samples from school-children resident in all municipalities of the State of São Paulo, with the exception of the Greater São Paulo. The second one, annually, from 1973 to 1983, involving school-children resident in municipalities with high trypanosomiasis prevalence values; the indirect immuno-fluorescence test was performed on filter paper total blood eluates. Data on the occurrence of triatomines and their infection with Trypanosoma cruzi in each municipality formed the basis of insight into the epidemiological situation associated with the school-children's dates of birth. Most positive serological results, as well as the highest proportion of autochthonous cases associated with Triatoma infestans were observed in the region of Sorocaba until the early 1970s, while the proportions of both autochthonous and imported cases were kept in equilibrium elsewhere. It has been inferred that as recently as 1974, vectorial transmission of Chagas disease could still be observed in the State of São Paulo. We emphasize that, even rather lacking in coverage, no se...

Prevalence of Trypanosoma cruzi infection among Bolivian immigrants in the city of São Paulo, Brazil

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Integrated control of Chagas disease for its elimination as public health problem - A Review

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