Abstract
The epidemiological situation of Chagas disease in Brazil was substantially altered in the last decades, partially as a consequence of the control measures implemented and partially due to the environmental, economical and social changes that took place in the country. Domicile vector transmission was interrupted when caused by Triatoma infestans and importantly controlled when associated with native species of the vector. Transfusion transmission is no longer a problem since generalized screening of blood donors came into routine. Congenital transmission, although still possible, mainly in some areas, also tends to disappear due to the control in the vector and transfusion transmission. The primordial mechanisms of transmission directly related to the enzootic cycle, as the one caused by vectors outside the homes, or by sporadic entrance of vectors in the domicile, in addition to the oral transmission, started to become relevant in the generation of new infections by Trypanosoma cruzi. The new challenges in facing Chagas disease include: a) to preserve the excellent level of control that was achieved; b) to develop new technologies and methods of surveillance and control capable of reducing the risk of cases associated to enzootic transmission; c) to provide adequate medical attention to patients with the infection or the disease in its chronic stage.
Highlights
The epidemiological situation of Chagas disease in Brazil was substantially altered in the last decades, partially as a consequence of the control measures implemented and partially due to the environmental, economical and social changes that took place in the country
A situação epidemiológica da doença de Chagas no país foi substancialmente alterada, como resultado das ações de controle e, também, em função de mudanças resultantes de transformações ambientais e de ordem econômica e social
A transmissão vetorial por Triatoma infestans, vetor introduzido, foi interrompida e, por espécies autóctones, foi grandemente reduzida; por via transfusional a transmissão apenas será possível por eventuais falhas na triagem de candidatos à doação de sangue, desde que se logrou a cobertura integral na seleção de doadores; a transmissão congênita, ainda que possível ocorre em níveis pouco importantes, a não ser no Estado do Rio Grande do Sul, pelo que indicam os dados colhidos no recente inquérito de soro-prevalência em menores de cinco anos de idade
Summary
The epidemiological situation of Chagas disease in Brazil was substantially altered in the last decades, partially as a consequence of the control measures implemented and partially due to the environmental, economical and social changes that took place in the country. E-mail: atcrs@uol.com.br a transmissão vetorial domiciliar por visitação[3]; e, também, por via oral, com um número crescente de casos de doença de Chagas aguda sendo conhecidos, especialmente na região amazônica[4,5,6,7].
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