Evolution of the clinical and epidemiological knowledge about Chagas disease 90 years after its discovery

Evolution and pathology in Chagas disease: a review

“…In one population of chronic patients, 57% mortality was related to Chagas disease, of which 58% had heart insufficiency, and 37.5% died suddenly (Prata 1999). The remaining deaths were related to the digestive forms associated with chronic disease.…”

Doença de Chagas: os 100 anos da descoberta e a atualidade do pensamento do seu descobridor

“…Na década de 30, diversos clínicos do interior do Brasil passaram a defender a idéia de que o megacólon e o megaesôfago tivessem causa chagásica (15) . Isto se confirmou em diversos trabalhos, destacando-se os de ETZEL (7) e o de AMORIM e CORREA-NETO (1) , os quais demonstravam ser o megaesôfago e o megacólon uma mesma doença, cujo achado histopatológico mais característico consiste na degeneração do plexo mientérico, encontrada em todo o trato digestório, e não apenas nos segmentos dilatados.…”

“…Caso único na história da medicina, Chagas descreveu, na mesma doença, o agente etiológico, o vetor, as manifestações clínicas das fases aguda e crônica, o reservatório na natureza (animais selvagens), vários aspectos da patogenia e inferiu o seu impacto socioeconômico (15) . Recebeu muitas críticas agressivas e invejosas pelo seu trabalho, mas também vários prêmios, títulos honoris causa e homenagens nacionais e internacionais, vindo a falecer em 1934, no Rio de Janeiro, aos 56 anos de idade.…”

Seroprevalence of Chagas disease in schoolchildren from two municipalities of Jequitinhonha Valley, Minas Gerais, Brazil; six years following the onset of epidemiological surveillance

“…The high seroprevalence of Chagas disease in women in procreative age reported by MONTOYA 22 in these municipalities also implies the possibility of vertical transmission of Chagas disease, reforcing the need of further investigation on this issue to prevent congenital T. cruzi infection. It is plausible to hypothesize that these children became infected by vectorial transmission since P. megistus still remains the major vector species detected in this region 22,25 . However, another hypothesis to be considered is the possibility of vertical transmission, since all mothers showed to be seropositive for Chagas disease and 5/5 of them presented positive hemoculture.…”

“…Although CARNEIRO et al 9 demonstrated that children seropositive for Chagas disease from other municipalities under epidemiological surveillance showed higher probability of having mother and relatives also seropositive, additional studies are necessary to elucidate the real mechanisms involved in the transmission, since congenital infection seems to be rare in Berilo and José Gonçalves de Minas 22 as well as in Minas Gerais State 15 and Brazil 25 .…”