Os diferentes significados da certificação conferida ao Brasil como estando livre da doença de Chagas

Abstract

The article discusses Brazil's recent certification as free of Chagas disease transmission by Triatoma infestans, analyzing the various meanings ascribed to this position. Resulting mainly from measures by both the Chagas Disease Control Program (PCDCh) established in Brazil in 1975 and the Southern Cone Initiative launched in 1991, this certification has been interpreted in ways that lead to confusion between the elimination of Chagas disease transmission by T. infestans and eradication of the disease. The present status of vector transmission control in Brazil is discussed, with emphasis on the Northeast, in most States of which T. infestans is not the main species involved in transmission. The article highlights the need to broaden the discussion of the readings and consequences involved in the present control achievements in light of possible harm from misinterpretations that might jeopardize further efforts to control the disease.

Mortality due to Chagas disease in Brazil from 1979 to 2009: trends and regional differences

“…This vector is not frequent in the North and Northeast regions [15][16][17]; thus these regions did not benefit considerably from vector control actions performed in the last decades, as other vectors not affected by the intervention measures, such as Triatoma brasiliensis and Triatoma pseudomaculata, prevail in those areas [16,18]. In the Northeast region with the exception of Bahia state (an endemic area for T. infestans in the past), T. brasiliensis and T. pseudomaculata are native species with a center of endemism in the northeastern savannah region [16,17]. Interruption of transmission of Chagas disease by T. infestans had little effect on vector transmission in most states in the Northeast (Maranhão, Ceará, Rio Grande do Norte, Alagoas and Sergipe states) and other regions (Espírito Santo and Santa Catarina states).…”

Eliminação da transmissão da doença de Chagas pelo Triatoma infestans no Brasil: um fato histórico

“…A possibilidade de interpretações errôneas acerca do significado correto da certificação conferida ao Brasil, pela Organização Pan-americana da Saúde, nos leva à discussão de o quanto tais informações podem ser responsáveis pela desmobilização de toda a sociedade para um problema que está longe de ser controlado, com significativo prejuízo para as ações de controle, que buscam a participação ativa da população 13 . Faz-se necessário discutir, com maior atenção e profundidade, o controle da doença de Chagas no Brasil, buscando sempre o envolvimento de toda a sociedade, em especial da comunidade científica, pois esta desempenha um importante papel na disseminação, inclusive educacional, de informações fidedignas acerca da verdadeira situação de saúde relativa à doença de Chagas no país.…”

An entomoepidemiological investigation of Chagas disease in the state of Ceará, Northeast Region of Brazil

“…This phenomenon is characteristic not only of the State of Ceará, but also of other states in the Northeast Region of Brazil where T. infestans is not present. In these states the real threat of transmission of Trypanosoma cruzi comes from other peridomestic species such as, Triatoma brasiliensis, Triatoma pseudomaculata, Triatoma sordida and Panstrongylus megistus 3,4,5 . Therefore, continuous surveillance measures are recommended to avoid the recrudescence of Chagas disease in this region.…”