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Chagas disease: control, elimination and eradication. Is it possible?
Memorias Do Instituto Oswaldo Cruz
|January 10, 2014
Summary
Chagas disease is a zoonotic disease maintained by wild animals and vectors, frequently occurring as an anthropozoonosis in the Amazon. Control focuses on eliminating transmission to humans, as eradication is not feasible.
Area of Science:
- Epidemiology
- Infectious Diseases
- Parasitology
Background:
- Chagas disease, caused by Trypanosoma cruzi, presents complex epidemiological patterns including enzooty, anthropozoonosis, zoonosis-amphixenosis, and zooanthroponosis.
- The Pan-Amazon region harbors numerous wild animal species and triatomine vectors infected with T. cruzi, posing risks to local populations and visitors.
Purpose of the Study:
- To describe the epidemiological characteristics of Chagas disease in wild and domestic settings.
- To highlight the increased risk of oral transmission and outbreaks in the Brazilian Amazon.
- To address the challenges posed by Chagas disease migration to non-endemic countries.
Main Methods:
- Review of epidemiological patterns of Chagas disease.
- Analysis of wild animal and triatomine vector species in the Pan-Amazon.
- Examination of seroepidemiological survey data from the Negro River microregion, Amazonas.
- Consideration of Chagas disease transmission dynamics in endemic and non-endemic regions.
Main Results:
- Chagas disease is frequently observed as an enzooty and anthropozoonosis in the Brazilian Amazon, with 33 wild animal species and 27 triatomine species identified.
- Seroepidemiological surveys revealed a high prevalence of T. cruzi infection, particularly among piassava extractors exposed to wild triatomines.
- Oral transmission of T. cruzi has led to an exponential increase in acute Chagas disease cases and outbreaks in the region.
- International migration of infected individuals presents new challenges for blood transfusion safety and patient management in non-endemic countries.
Conclusions:
- Chagas disease, characterized by its enzootic and anthropozoonotic nature, cannot be eradicated.
- Control strategies must focus on eliminating transmission pathways to humans, particularly in high-risk areas like the Amazon.
- Public health initiatives are needed to manage the growing burden of Chagas disease in both endemic and non-endemic settings due to migration.
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