Acute Chagas disease in the state of Pará, Amazon Region: is it increasing?

Abstract

Acute Chagas disease (ACD) has a distinct epidemiological profile in the Amazon Region, with cases and outbreaks of Trypanosoma cruzi infection being possibly related to the ingestion of contaminated food. Data on ACD in the state of Pará retrieved from 2000 to 2016 from the Brazilian Notifiable Diseases Information System (SINAN) were evaluated. During this period, 2,030 of the 16,807 reported cases were confirmed, with a higher incidence between the months of August and December, thus characterising a seasonal pattern of acute infection, and coinciding with the higher production of “açaí”, one fruit likely involved in the oral transmission of the disease. Evaluation of the absolute numbers of confirmed ACD cases secondary to oral infection suggests that infection through this route increased during the 2010-2016 period, differing from what was recorded in terms of vectorial or other infection routes. These findings point to the need of intensifying strategies to prevent or substantially reduce oral transmission.

Landmarks of the Knowledge and Trypanosoma cruzi Biology in the Wild Environment

“…A contrasting transmission scenario was observed in the Amazon region, where contaminated açai fruit (Euterpe oleracea) juice was associated with the great majority of current cases in Brazil (Santos et al, 2018). In these outbreaks, the precariousness of local sanitary and educational conditions associated with the presence of infected bugs, eventually infesting the panniers used to transport the fruits, resulted in human cases, always in the more dry and hot period of the year, coinciding with both the açai harvest and the increased flying activities of the bugs (Xavier et al, 2014).…”

Oral Versus Intragastric Inoculation: Similar Pathways of Trypanosoma cruzi Experimental Infection? From Target Tissues, Parasite Evasion, and Immune Response

“…Number of notifications decreased at the time that the pan-American Health Organization registered the interruption of Triatoma infestans population in the area in 2006 ( 11 ); however, numbers still reached 1,539 new cases in the DATASUS from 2007 to 2014. Nowadays, oral transmission of Chagas disease is the most frequent transmission route in the Brazilian Amazon region ( 12 ). Food/beverages contamination with T. cruzi -infected insect excreta, macerate, or reservoir meal is responsible for oral transmission in one to more than a hundred cases (outbreaks).…”

Interdisciplinary network engagement in a non-formal education process to study foodborne Chagas disease puzzle in Brazilian Amazon

“…The state of Pará was responsible for about 66% of the cases (XAVIER et al, 2014) in Brazil and for more than 92% of cases in the northern region of the country, with a mortality rate of 6.2% between 2010 and 2011. This emergence is a complex and new phenomenon not yet completely understood (AGUILAR et al 2007;PINTO et al, 2013;SANTOS et al, 2018). It implicates the organization of interdisciplinary teams of researchers and health professionals besides clear and well-designed leadership.…”