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Title: Chagas disease in the Amazon Region
Authors: Aguilar, Hugo Marcelo
Abad-Franch, Fernando
Dias, João Carlos Pinto
Angela Junqueira, Cristina Veríssimo
Coura, José Rodrigues
Affilliation: Fundação Oswaldo Cruz. Instituto Leônidas e Maria Deane. Manaus, AM, Brasil.
Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Belo Horizonte, MG, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.
Abstract: The risk that Chagas disease becomes established as a major endemic threat in Amazonia (the world´s largest tropical biome, today inhabited by over 30 million people) relates to a complex set of interacting biological and social determinants. These include intense immigration from endemic areas (possibly introducing parasites and vectors), extensive landscape transformation with uncontrolled deforestation, and the great diversity of wild Trypanosoma cruzi reservoir hosts and vectors (25 species in nine genera), which maintain intense sylvatic transmission cycles. Invasion of houses by adventitious vectors (with infection rates > 60%) is common, and focal adaptation of native triatomines to artificial structures has been reported. Both acute (~ 500) and chronic cases of autochthonous human Chagas disease have been documented beyond doubt in the region. Continuous, low-intensity transmission seems to occur throughout the Amazon, and generates a hypoendemic pattern with seropositivity rates of ~ 1-3%. Discrete foci also exist in which transmission is more intense (e.g., in localized outbreaks probably linked to oral transmission) and prevalence rates higher. Early detection-treatment of acute cases is crucial for avoiding further dispersion of endemic transmission of Chagas disease in Amazonia, and will require the involvement of malaria control and primary health care systems. Comprehensive eco-epidemiological research, including prevalence surveys or the characterization of transmission dynamics in different ecological settings, is still needed. The International Initiative for Chagas Disesae Surveillance and Prevention in the Amazon provides the framework for building up the political and scientific cooperation networks required to confront the challenge of preventing Chagas disease in Amazonia.
Keywords: Chagas disease
Trypanosoma cruzi
Issue Date: 2007
Citation: AGUILAR, Hugo Marcelo et al. Chagas disease in the Amazon Region. Memória do Instituto Oswaldo Cruz, Rio de Janeiro, v. 102, suppl. 1, p. 47-55, 2007.
ISSN: 0074-0276
Copyright: open access
Appears in Collections:IOC - Artigos de Periódicos
MG - IRR - Artigos de Periódicos
AM - ILMD - Artigos de Periódicos

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