Doença de Chagas em Lassance, MG: Reavaliação clínico-epidemiológica 90 anos após a descoberta de Carlos Chagas

Abstract

The history and present situation of Chagas' disease in Lassance (the county where Carlos Chagas discovered American trypanosomiasis) were studied through a historical analysis and clinical and epidemiological research performed from 1999 to 2001. Lassance was an important focus of Chagas' disease from Carlos Chagas up until the 1980's, because of intensive infestation in dwellings by Panstrongylus megistus and Triatoma infestans, two important species which were efficiently controlled in the last twenty years. Human Chagas' disease was important in the past but today is only residual, affecting basically the more elderly age groups. The general prevalence is about 5.03% and no infected individuals are found below 20 years of age. The clinical and epidemiologic profile of the seropositive individuals studied is that expected in areas with interrupted transmission, most of these presenting the indeterminate or benign cardiac form of chronic Chagas' disease. Some cases of digestive Chagas' disease also seem to exist. Mortality due to the disease is still significant, affecting chiefly older age groups. The municipality still remains infested by Triatoma sordida, in low densities and high dispersion, non infected by T. cruzi and restricted to peridomestic foci. In conclusion, Lassance is now free of Chagas' disease transmission and must improve medical attention for the remaining infected individuals, as well as to maintain a permanent epidemiological surveillance against native Triatominae.

2 nd Brazilian Consensus on Chagas Disease, 2015

“…It has a benign nature and low evolutionary potential in the short and medium term (19) (191) . With the reduced incidence of acute Chagas disease and improved clinical management, the duration of survival of patients with chronic Chagas disease has increased, reflecting a tendency to proportional reduction of ICF with advanced age (19) (189) (192) (193) (194) . On the other hand, since the last Brazilian Consensus in 2005 (20) , no applicable strategy of clinical or complementary evaluation to the classic concept of ICF has been proposed.…”

Evaluation of the Chagas Disease Control Program in Açucena Municipality, Rio Doce Valley, State of Minas Gerais, Brazil

“…The serological survey in the Municipality of Lassance in 1999 6 , considered the cradle of Chagas disease discovery, found no infected individuals younger than 20 years old in the study population. Two similar studies in Berilo and José Gonçalves de Minas, Jequitinhonha Valley, MG, that used similar methodologies but evaluated different samples and age groups revealed prevalences of infection of 0.17 13 and 0.04% 10 when ES was fi rst implanted in the region (1997) and after six and half years (2003), respectively.…”

“…The Chagas Disease Control Program (CDCP) is mainly focused on the interruption of vectorial transmission due to the large number of wild triatomine species with domiciliation potential 4,5 . The CDCP focuses its activities on the identifi cation of triatomine infestations and the spraying of residual insecticides in all infested houses 6 .…”

I Diretriz Latino-Americana para o Diagnóstico e Tratamento da Cardiopatia Chagásica

“…In 1999, for that same age group, the prevalence of T. cruzi-infected individuals was 0.04%. In 2005, the screening of Brazilian blood banks showed 100% assessment of the samples regarding a possible T. cruzi infection, with only 0.21% seropositivity 14 .…”