Abstract
In countries with endemic Chagas disease, coinfection involving Trypanosoma cruzi and HIV is expected to become more frequent. There is a clear need to structure a comprehensive care network aimed at dealing with this situation, with mobilization going from primary care to care at the highest level of technological complexity. The objective of this study was to describe the Brazilian response to the challenges of Chagas disease: the history, current issues, and future of the Brazilian Network for attending and studying T. cruzi/HIV coinfection. This descriptive study reviewed technical documents relating to the basis and structuring process of the Brazilian network for attending and studying T. cruzi/HIV coinfection. The process of setting up the network was marked by technical and political debates in technical-scientific meetings going back to the 1990s. This process made it possible to expand and focus on different aspects of comprehensive care for Chagas disease in Brazil, regardless of the associated immunosuppressive conditions. These meetings produced a structure of national technical guidelines and standards, health care and research protocols and research priorities, along with mobilization and awareness-raising among HIV/AIDS reference centers regarding occurrences of coinfection. The creation of the Brazilian network was a milestone for the country in terms of integration of control programs, with the reference point of quality of care and comprehensiveness. The possibility of extending this network to form a Latin American network is seen as a strategy for dealing more effectively with this condition.
Highlights
In countries with endemic Chagas disease, coinfection involving Trypanosoma cruzi and HIV is expected to become more frequent
The present paper aims at describing the historical perspective, current, and future issues relating to the experience of constructing the National Network for attending and studying T. cruzi/HIV coinfection, as the Brazilian response to the new challenges of Chagas disease since the control of the most important vector Triatoma infestans, in 2006 [9]
We reviewed technical documents related to the basis and structuring process of the Brazilian network for attending and studying T. cruzi /HIV coinfection
Summary
In countries with endemic Chagas disease, coinfection involving Trypanosoma cruzi and HIV is expected to become more frequent. Results: The process of setting up the network was marked by technical and political debates in technical-scientific meetings going back to the 1990s This process made it possible to expand and focus on different aspects of comprehensive care for Chagas disease in Brazil, regardless of the associated immunosuppressive conditions. The acutestage clinical condition (“a new morbid entity among humans”) was described in 1911 [2], while the chronic cardiac form was described a few years later, in 1916 [3] It was only in the 1960s that Latin American institutions demonstrated that the causing agent Trypanosoma cruzi might behave as an opportunist pathogen in patients with natural or induced immunosuppression. This event is recognized as relatively rare [4]
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