Abstract.A clinical, parasitologic, and serologic study carried out between 1988 and 1996 on 59 acute-phase patients in areas of western Venezuela where Chagas' disease is endemic showed 19 symptomatic patterns or groups of symptoms appearing in combination with different frequencies. The symptomatic pattern with the highest frequency was that showing simultaneously fever, myalgia, headache, and Romaña's sign, which was detected in 20% of the acute-phase patients. Asymptomatic individuals and patients with fever as the only sign of the disease made up 15% and 11.9% of the total acute cases, respectively. Statistical correlation analysis revealed that xenodiagnosis and hemoculture were the most reliable and concordant of the five parasitologic methods used; these two methods also showed the highest proportions in detecting any clinical symptomatic pattern in acute-phase patients. A similar high reliability and concordance was obtained with a direct agglutination test, an indirect immunofluorescent antibody test, and an ELISA as serologic tests, which also showed a higher proportion of positive detection of clinical patterns than parasitologic methods (P Ͻ 0.001). It is recommended that individuals coming from endemic areas showing mild and/or severe clinical manifestations should be suspected of being in contact or having been in contact with Trypanosoma cruzi, be referred for parasitologic and serologic evaluations to confirm the presumptive clinical diagnosis of acute Chagas' disease, and start specific treatment. The epidemiologic implications of the present findings are discussed and the use of similar methodology to evaluate other areas where Chagas' disease is endemic is suggested.Shortly after describing Trypanosoma cruzi, the etiologic agent of American trypanosomiasis, Carlos Chagas created the basis for future study of the disease that was named after him. He was the first to recognize the role that triatomine bugs play in the transmission of the infection and provided information about its pathology, symptomatology, epidemiology, and geographic distribution.

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Belminus ferroae (Hemiptera: Reduviidae) was collected from houses in the localities of San Alberto and Santa Catalina in the municipality of Toledo, Department of Norte de Santander, Colombia. Precipitin tests revealed that the main hosts of B. ferroae are insects belonging to the order Blattodea, whose haemolymph serves as food (89.43%). A low rate of haematophagy was indicated on rodents, dogs and humans (7.32%) and no natural infection with Trypanosoma cruzi was found by either microscopic examination or polymerase chain reaction. The finding of B. ferroae inside houses, feeding primarily on Blattodea with only a minor tendency to feed on vertebrate blood, is indicative of both the evolutionary path from predator to blood-sucker taken by Triatominae and their tendency to adapt from silvatic to domestic habitats.

Summaryobjectives To examine the presence of intestinal protozoan and helminth infections and their association with clinical signs and symptoms in children in Trujillo, Venezuela.methods Conventional microscopic methods (thick-smear, saline and iodine solutions) were used to identify parasites in stool samples of 301 children attending day care centres. A subgroup of 45 children was evaluated clinically and parasitologically five times during a 1-month period using conventional methods and the Kinyoun acid-fast stain for Cryptosporidium identification.results The point prevalence of protozoan infections was 21% for Giardia duodenalis, 1.0% for Entamoeba histolytica/dispar, 4% for Entamoeba coli, 16% for Blastocystis hominis, and 89% for Cryptosporidium parvum. Prevalence of helminth infection was 11% for Ascaris lumbricoides, 10% for Trichuris trichiura, 0.3% for Strongyloides stercoralis, and 1.3% for Hymenolepis nana. Over a 1-month time frame, new infections were observed at a rate of 11% for G. duodenalis, 4% for E. histolytica/dispar, 7% for A. lumbricoides, 11% for T. trichiura, 0% for S. stercoralis, and 2% for H. nana. Intestinal symptoms (diarrhoea, vomiting, gas, stomach pain, and loss of appetite) were associated with presence of one or more of C. parvum or B. hominis organisms in stool samples.conclusions Intestinal parasitic infections contribute significantly to the enteric disease burden experienced by this group of children. The organisms most strongly implicated by this study are common and difficult-to-treat protozoan pathogens.

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