A new survey of the serology of human Trypanosoma cruziinfection in the Rio Negro microregion, Brazilian Amazon: a critical analysis

Coura, José Rodrigues; Marquez, Maurício Humberto Peña; Guerra, Jorge Augusto de Oliveira; Zauza, Patrícia Lago; Miguel, Julio Cesar; Pereira, João Baptista Borges

doi:10.1590/0074-0276130303

Cited by 8 publications

(6 citation statements)

References 13 publications

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“…These studies showed that the prevalence of chagasic infection ranged from 1-13%, with low morbidity in the chronic phase. In Amazonas, studies have reported a prevalence varying from 3.5 to 1.4%, depending on the region (11) (39) (40) . Coura et al (40) reported prevalences in the urban area of Barcelos, State of Amazonas; upon encountering a markedly low prevalence, they recommended that studies conducted in Amazonia should use at least two tests [indirect immunofl uorescence antibody test) (IFI) + enzyme-linked immunosorbent assay(ELISA)] and be verifi ed by Western blot (17) (27) (38) (40) .…”

Section: Chagas Disease In the State Of Amazonasmentioning

confidence: 99%

Chagas disease in the State of Amazonas: history, epidemiological evolution, risks of endemicity and future perspectives

Barbosa

Ferreira

Arcanjo

et al. 2015

Rev. Soc. Bras. Med. Trop.

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27www.scielo.br/rsbmt I www.rsbmt.org.br Revista da Sociedade Brasileira de Medicina Tropical 48(Suppl I):27-33, 2015http://dx.doi. org/10.1590/0037-8682-0258-2013 Review Article ABSTRACT Chagas disease (CD) is a parasitic infection that originated in the Americas and is caused by Trypanosoma cruzi.In the last few years, the disease has spread to countries in North America, Asia and Europe due to the migration of Latin Americans. In the Brazilian Amazon, CD has an endemic transmission, especially in the Rio Negro region, where an occupational hazard was described for piaçaveiros (piassaba gatherers). In the State of Amazonas, the fi rst chagasic infection was reported in 1977, and the fi rst acute CD case was recorded in 1980. After initiatives to integrate acute CD diagnostics with the malaria laboratories network, reports of acute CD cases have increased. Most of these cases are associated with oral transmission by the consumption of contaminated food. Chronic cases have also been diagnosed, mostly in the indeterminate form. These cases were detected by serological surveys in cardiologic outpatient clinics and during blood donor screening. Considering that the control mechanisms adopted in Brazil's classic transmission areas are not fully applicable in the Amazon, it is important to understand the disease behavior in this region, both in the acute and chronic cases. Therefore, the pursuit of control measures for the Amazon region should be a priority given that CD represents a challenge to preserving the way of life of the Amazon's inhabitants.

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Section: Chagas Disease In the State Of Amazonasmentioning

confidence: 99%

Chagas disease in the State of Amazonas: history, epidemiological evolution, risks of endemicity and future perspectives

Barbosa

Ferreira

Arcanjo

et al. 2015

Rev. Soc. Bras. Med. Trop.

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“…Thus, the patterns of serological diagnoses differ from those used in the classical endemic regions for Chagas disease in Brazil. Therefore, the recommendation is that serological evaluations of T. cruzi infection in the Amazon Region should be confirmed by at least two techniques with different principles, such as IIF on the serum, ELISAs and, when possible, Western blots ( Coura et al 2013 ).…”

Section: Discussionmentioning

confidence: 99%

“…More recently (2010/2011), a screening seroepidemiological study using IIF on blood collected in filter paper was performed with 4,480 residents in the study area. In this study, 221 were strongly reactive and were considered positive, while 302 were weakly reactive and were considered doubtful ( Coura et al 2013 ). Ferraroni et al (1977) were the first to serologically confirm chronic cases of Chagas infection among autochthonous patients in the municipality of Barcelos in the microregion of the Negro River, AM.…”

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Morbidity of Chagas heart disease in the microregion of Rio Negro, Amazonian Brazil: a case-control study

Coura

Viñas

Brum-Soares

et al. 2013

Mem. Inst. Oswaldo Cruz

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A case-control study on the morbidity of Chagas heart disease was carried out in the municipality of Barcelos in the microregion of the Rio Negro, state of Amazonas. One hundred and six individuals, who were serologically positive for Trypanosoma cruzi infection, as confirmed by at least two techniques with different principles, were matched according to age and sex with an equal number of seronegative individuals. The cases and controls were evaluated using an epidemiological questionnaire and clinical, electrocardiograph and echocardiograph examinations. In the seroepidemiological evaluation, 62% of the interviewees recognised triatomines and most of them confirmed that they had seen these insects in the piassava plantations of the riverside communities of the Negro River tributaries. Of the seropositive patients, 25.8% affirmed that they had been stung by the triatomines and 11.7% denied having been stung. The principal clinical manifestations of the seropositive individuals were palpitations, chest pain and dyspnoea upon effort. Cardiac auscultation revealed extrasystoles, bradycardia and systolic murmurs. The electrocardiographic alterations were ventricular extrasystoles, left and right bundle branch block, atrioventricular block and primary T wave alterations. The echocardiogram was altered in 22.6% of the seropositive individuals and in 8.5% of the seronegative individuals.

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“…AMCHA - Chagas disease in the Amazon Region can be characterised by the following patterns: (i) an enzooty exchanged by wild vectors, which may be transmitted to humans when either they invade the wild ecotope or when the vectors and wild animals, especially marsupials, invade human homes, a situation that characterises an anthropozoonosis ( Coura et al 1993 , 2002 , Coura & Junqueira 2012 ), (ii) an endemic disease through oral transmission of T. cruzi by means of consumption of juices and other uncooked foods and foods contaminated by the faeces and urine of wild triatomines or odoriferous secretion of marsupials, thereby causing acute outbreaks of the disease ( Valente et al 1999 , 2009 , Pinto et al 2003 , 2008 , Coura 2006 , Coura & Junqueira 2012 , Souza-Lima et al 2013 ) and (iii) a professional disease among people who work in plant extraction, especially piassava gatherers, who suffer attacks by wild triatomines ( Rhodnius brethesi ) ( Brum-Soares et al 2010 , Coura & Junqueira 2012 , Coura et al 2013 ). The AMCHA began officially in 2004, at a meeting held in Manaus, Brazil, after a preparatory meeting held in Palmari, on the border of Brazil and Colombia in 2002, promoted by European Community Latin America Triatominae ( Guhl & Schofield 2004 ).…”

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Chagas disease: control, elimination and eradication. Is it possible?

Coura

2013

Mem. Inst. Oswaldo Cruz

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From an epidemiological point of view, Chagas disease and its reservoirs and vectors can present the following characteristics: (i) enzooty, maintained by wild animals and vectors, with broad occurrence from southern United States of America (USA) to southern Argentina and Chile (42ºN 49ºS), (ii) anthropozoonosis, when man invades the wild ecotope and becomes infected with Trypanosoma cruzi from wild animals or vectors or when the vectors and wild animals, especially marsupials, invade the human domicile and infect man, (iii) zoonosis-amphixenosis and exchanged infection between animals and humans by domestic vectors in endemic areas and (iv) zooanthroponosis, infection that is transmitted from man to animals, by means of domestic vectors, which is the rarest situation in areas endemic for Chagas disease. The characteristics of Chagas disease as an enzooty of wild animals and as an anthropozoonosis are seen most frequently in the Brazilian Amazon and in the Pan-Amazon region as a whole, where there are 33 species of six genera of wild animals: Marsupialia, Chiroptera, Rodentia, Edentata (Xenarthra), Carnivora and Primata and 27 species of triatomines, most of which infected with T. cruzi . These conditions place the resident populations of this area or its visitors - tourists, hunters, fishermen and especially the people whose livelihood involves plant extraction - at risk of being affected by Chagas disease. On the other hand, there has been an exponential increase in the acute cases of Chagas disease in that region through oral transmission of T. cruzi , causing outbreaks of the disease. In four seroepidemiological surveys that were carried out in areas of the microregion of the Negro River, state of Amazonas, in 1991, 1993, 1997 and 2010, we found large numbers of people who were serologically positive for T. cruzi infection. The majority of them and/or their relatives worked in piassava extraction and had come into contact with and were stung by wild triatomines in that area. Finally, a characteristic that is greatly in evidence currently is the migration of people with Chagas disease from endemic areas of Latin America to non-endemic countries. This has created a new dilemma for these countries: the risk of transmission through blood transfusion and the onus of controlling donors and treating migrants with the disease. As an enzooty of wild animals and vectors, and as an anthropozoonosis, Chagas disease cannot be eradicated, but it must be controlled by transmission elimination to man.

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A new survey of the serology of human Trypanosoma cruziinfection in the Rio Negro microregion, Brazilian Amazon: a critical analysis

Cited by 8 publications

References 13 publications

Chagas disease in the State of Amazonas: history, epidemiological evolution, risks of endemicity and future perspectives

Chagas disease in the State of Amazonas: history, epidemiological evolution, risks of endemicity and future perspectives

Morbidity of Chagas heart disease in the microregion of Rio Negro, Amazonian Brazil: a case-control study

Chagas disease: control, elimination and eradication. Is it possible?

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