Das Américas para o mundo: o desafio da globalização da doença de Chagas.

Abstract

Chagas disease is caused by the protozoan Trypanosoma cruzi and can be transmitted to humans by a triatomine vector (only in Latin America), from mother to child, transfusion, transplant or orally. After an acute phase of several weeks, the disease progresses asymptomatically for decades. Approximately 40 % of the subjects in this phase progress to the chronic phase, which is characterized by progressive heart failure with severe arrhythmias and/or dilations of the digestive tract. The movement of an increasingly number of migrants from Latin America to Europe establishes Chagas disease as a public health problem in this region. In Portugal the number of Latin American immigrants has increased year after year. Brazil is highlighted as the main country of origin. However, the number of Latin American residents with Chagas disease in Portugal is unknown. The World Health Organization recommends screening tests for T. cruzi to prevent transmission in non-endemic countries. This prevention would be made at the level of blood transfusions, organ transplantation and vertical transmission. However, only a few European countries perform systematic screening for Chagas disease. In Portugal there are nine confirmed cases of Chagas disease, which compared to the estimated number of existing cases constitutes a huge discrepancy. Two epidemiological studies for detection of T. cruzi were made in our country, one of which is still ongoing. These studies have not, to date, found positive cases. Chagas disease is still a neglected disease, poorly understood by most of the health professionals and diagnosis and treatment are still far from ideal. The challenges established by its globalization may help in moving forward towards its erradication