Why do we still have not a vaccine against Chagas disease?

This review does not intend to convey detailed experimental or bibliographic data. Instead, it expresses the informal authors' personal views on topics that range from basic research on antigens and experimental models for Trypanosoma cruzi infection to vaccine prospects and vaccine production. The review also includes general aspects of Chagas' disease control and international and national policies on the subject. The authors contributed equally to the paper.

Acute Chagas Disease Caused by Trypanosoma cruzi TcIV and Transmitted by Panstrongylus geniculatus: Molecular Epidemiological Insights Provided by the First Documented Autochthonous Case in Rondônia, Southwestern Amazonia, Brazil.

Recurrent outbreaks of oral infection and isolated cases characterize the new epidemiological scenario of Chagas disease (CD) in the Brazilian Amazon. Acute Chagas disease (ACD) is common in Pará and Amazonas, Northeastern and Northwestern Brazilian Amazonia. In the present study, we describe the first molecularly characterized autochthonous case of ACD in Rondônia, Southwestern Amazonia. The patient, a 39-year-old male resident in the small city of Cujubim, presented typical ACD symptoms: fever, asthenia, myalgia, progressive dyspnea, swelling of the legs, and tiredness at minimal efforts, all compatible with ACD and indicative of cardiac involvement. A thick blood drop test revealed trypomastigote forms of Trypanosoma cruzi genotyped as TcIV. An epidemiological investigation ruled out oral infection, and support for vectorial transmission included the finding of Panstrongylus geniculatus positive for T. cruzi (TcIII and TcIV) inside the tent used by the patient when harvesting forest timber, and a circular cutaneous lesion resembling a chagoma of inoculation. Treatment with benznidazole led to blood parasite clearance as confirmed by molecular tests. Altogether, our findings fitted well into the ecological scenario where deforestation and colonization of forested areas represent an important risk factor to the adaptation of P. geniculatus to human habitats, favoring vectorial transmission of CD in the Amazonian region.

Why do we still have not a vaccine against Chagas disease?

This review does not intend to convey detailed experimental or bibliographic data. Instead, it expresses the informal authors' personal views on topics that range from basic research on antigens and experimental models for Trypanosoma cruzi infection to vaccine prospects and vaccine production. The review also includes general aspects of Chagas' disease control and international and national policies on the subject. The authors contributed equally to the paper.

Why do we still have not a vaccine against Chagas disease?

This review does not intend to convey detailed experimental or bibliographic data. Instead, it expresses the informal authors’ personal views on topics that range from basic research on antigens and experimental models for Trypanosoma cruzi infection to vaccine prospects and vaccine production. The review also includes general aspects of Chagas’ disease control and international and national policies on the subject. The authors contributed equally to the paper.

Perspectives of vaccination in Chagas disease revisited.

The perspectives for a Chagas Disease vaccine 30 years ago and today are compared. Antigens and adjuvants have improved, but logistic problems remain the same. Sterilizing vaccines have not been produced and animal models for chronic Chagas have not been developed. Vector control has been successful and Chagas incidence has come to a halt. We do not have a population candidate to vaccination now in Brazil. And if we had, we would not know how to evaluate the success of vaccination in a short time period. A vaccine may not seem important at the moment. However, scientific reasons and incertitudes about the future recommend that a search for a vaccine be continued.

Perspectives of vaccination in Chagas disease revisited

The perspectives for a Chagas Disease vaccine 30 years ago and today are compared. Antigens and adjuvants have improved, but logistic problems remain the same. Sterilizing vaccines have not been produced and animal models for chronic Chagas have not been developed. Vector control has been successful and Chagas incidence has come to a halt. We do not have a population candidate to vaccination now in Brazil. And if we had, we would not know how to evaluate the success of vaccination in a short time period. A vaccine may not seem important at the moment. However, scientific reasons and incertitudes about the future recommend that a search for a vaccine be continued.

Doenças tropicais / Tropical diseases

Discutem-se os componentes biogeográfico e econômico das doenças tropicais, ou, em sentido mais amplo, das doenças definidas como negligenciadas pela OMS. Doenças tropicais surgem graças a um conjunto de fatores biológicos, ecológicos e evolutivos que condicionam a sua ocorrência exclusivamente às proximidades do Equador, entre os trópicos de Câncer e Capricórnio. Nesse sentido, reconhece-se que há, de fato, uma "fatalidade tropical". Porém, a perpetuação das doenças tropicais em países aí situados depende fundamentalmente da precária situação econômica vigente e é conseqüência direta do subdesenvolvimento.

Institutos de pesquisa em saúde / Health research institutes

Ao fim do século 19, em seguida aos avanços na assepsia cirúrgica e no esclarecimento do papel de microorganismos como causadores de moléstias infecciosas, foram criados em escala mundial "institutos de pesquisa com os objetivos de conduzir pesquisa sobre as causas, prevenção e tratamento de homens e animais e de desenvolver produtos preventivos e curativos como vacinas e antitoxinas". Para atingir esses objetivos os institutos recrutaram os melhores cientistas disponíveis em todos os lugares. Este foi um período fulgurante para a pesquisa sublinhado por inúmeras descobertas sobre as doenças infecciosas. Passada essa fase, os institutos entraram em depressão e até mesmo insolvência. Muitos se recuperaram, alguns não. Muitos ainda sofrem de uma "crise de identidade". Neste ensaio analisamos o destino dos institutos de pesquisa em saúde no Brasil, as causas de seu sucesso e eventuais fracassos e as medidas possíveis de ajudá-los a contornar suas presentes dificuldades.

Malária, maleita, paludismo / Malaria, paludism

Fornece dados sobre a malária, doença considerada como um dos principais flagelos da humanidade. Enfoca a doença , sua transmissäo e sua história, no mundo e no Brasil. (MAM)

Malaria control in an agro-industrial settlement of Rondônia (Western Amazon region, Brazil)

A malaria control pilot project was developed in the Urupá agro-industrial farm that is situated in the State of Rondônia (Western Amazon Region, Brazil). Around 180 inhabitants had been surveyed for the past five years. The control measures were based on (1) training a community agent to perform on the spot microscopical diagnosis of malaria and to treat the uncomplicated cases of malaria; (2) limiting the use of insecticides to a short period before the high transmission season. This resulted in a significant reduction in the time between the onset of clinical symptoms and specific chemotherapy which fell from 3.5 to 1.3 days. In relation to the previous three reference years the total number of malaria cases was reduced to 50 in the first year and to 25 in the second year. The introduction of these measures coincided with pronounced reduction in the frequency of Plasmodium falciparum infections but this was less marked for P. vivax infections. In the second year of the pilot experiment there was no P. falciparum transmission on the farm. During the last decade there was a general decrease in the endemicity of malaria in the State of Rondônia. The linear regression coefficient values indicate that the decline was more pronounced in Urupá than in the general municipality and that the falciparum malaria API in Urupá farm is significantly lower than in the general municipality of Candeias were the farm is situated.

A malária encenada no grande teatro social / Malaria staged in the great social theater

Aborda os conflitos que permearam a história da malária a partir do século XVII. Mostra que, graças à importäncia da malária como um dos maiores inimigos da humanidade, problemas de natureza puramente médica transpuseram os limites da medicina e interessaram a distintos segmentos sociais. Em conseqüência, diferenças médicas de opiniäo foram transferidas para o grande público de uma maneira distorcida e ampliada. Isto deu origem a disputas de natureza religiosa, social, política e até racial. Desta forma, ao longo da história da malária, assistimos a uma auto-interessada manifestaçäo dos fatos por grupos antagônicos, objetivando a preservaçäo de seus preconceitos mais do que a soluçäo dos problemas médicos reais da malária. (AU)

Trypanosomatid protozoa in fruit of solanaceae in southeastern Brazil

Fruits of cultivated and indigenous Solanaceae from Southeastern Brazil have been examined for the presence of trypanosomatid flagellates. The 14 species found infected were: Capsicum annum, C. praetermissum, Lycopersicon esculentum, Nicandra physaloides, Physalis angulata, Solanum sp., S. americanum, S. concinnum, S. diflorum, S. erianthum, S. gilo, S. robustum, S. variable and S. viarum. The pentatomid hemipteran Arvelius albopunctatus experimentally transmitted flagellates to fruits of some species. Cultures of flagellates were obtained form fruits of eight species of Salonaceae and from A. albopunctatus