Circulation of Trypanosoma cruzi in triatomines and Didelphis sp. in urban areas: Transmission risk assessment in the Metropolitan Region.

The presence of Trypanosoma cruzi vectors in urban areas has been frequent, with colonization of homes and associated with reservoir animals that increase risk to humans, with simultaneous circulation of vectors and T. cruzi. The study aimed to describe the circulation of triatomines and T. cruzi in the Metropolitan Region of São Paulo, as well as evaluate risk situations. For analysis purposes, the triatomine notification information from January 2016 to July 2023 was used. While for Didelphis sp. collection with the aid of traps, notification information used was from 2019 to 2023. Information about triatomines came from spontaneous demand by the population and notification services were carried out by state field teams following defined protocols. 202 notifications were received with the capture of 448 triatomines. The positivity for T. cruzi observed was 60.5%. Regarding Didelphis sp., 416 animals were collected, 5.3% of which were positive for T. cruzi. There was overlapping areas of presence of infected triatomines and Didelphis sp., whose Discrete Typing Unit (DTU) was T. cruzi I. This work indicates the presence of infected vectors in urban areas, and the presence of a wild cycle of T. cruzi in didelphiids, reaffirming the need for and importance of vector surveillance work, through actions that can prevent the transmission of Chagas disease.

Monitoring Rhodnius neglectus (Lent, 1954) populations' susceptibility to insecticide used in controlling actions in urban areas northwest of São Paulo state.

BACKGROUND: Chagas disease (CD) is caused by the flagellate protozoan Trypanosoma cruzi and can be carried by different species of triatomines, including Rhodnius neglectus, which is wild, well distributed in Brazil, and has formed colonies in palm trees located in urban areas of municipalities in the state of São Paulo. Chemical control has been routinely used to reduce population density, but each year, there has been an increase in species dispersion and density. This study aimed to evaluate the susceptibility of insects to insecticides used in control. METHODS: The reference population was collected from Araçatuba municipality, Nilce Maia. Dilutions of deltamethrin were prepared and applied to the back of the first-stage nymphs, which were biologically synchronized. The control group received pure acetone only. Mortality was assessed after 72 h. RESULTS: The mortality rate with respect to diagnostic dose was 100%. The susceptibility profile observed for this population showed RR50 ranging from 1.76 to 3.632. CONCLUSIONS: The populations were susceptible to the insecticides tested. It is possible that the insecticide residual effect on this ecotope has decreased the lifespan, and controlling failures may be the cause of recolonization in this environment.

Acesso e direito à saúde para migrantes bolivianos em uma metrópole brasileira / Access and right to health for Bolivian migrants in a Brazilian metropolis

Resumo Este artigo analisa as condições de acesso do imigrante boliviano ao sistema de saúde brasileiro e a percepção do direito à saúde. É um estudo transversal de metodologia quantitativa e qualitativa, realizado de 2013 a 2015. Foi elaborado um questionário com perguntas fechadas respondidas por 633 bolivianos, e em relação ao acesso à saúde por 472 indivíduos bolivianos maiores de 18 anos. A abordagem qualitativa foi feita por meio da análise de conteúdo de entrevistas semiestruturadas com 55 sujeitos (bolivianos, profissionais de saúde, representantes de Secretarias de Saúde, Consulado da Bolívia, Defensoria Pública da União, Ministério Público Federal e Organizações Não Governamentais). Os bolivianos conhecem o Sistema Único de Saúde (SUS) e utilizam com frequência a Atenção Primária à Saúde (APS). Todavia, barreiras de acesso são descritas, como falta de documentação, condições de trabalho, procedimentos de média e/ou alta complexidades, dificuldades para entenderem o que é dito assim como para serem compreendidos, entre outras. Sobressai-se a obtenção do Cartão Nacional de Saúde (CNS) como porta de entrada para o acesso à saúde, desempenhando papel de integração social. O reconhecimento da Saúde como direito social destaca-se entre os entrevistados, apontado como valor humano e solidário. A garantia desse reconhecimento fica ameaçada quando não se apoia na consolidação de políticas sociais que visem o fortalecimento da proteção social universal.

Abstract This paper analyzes the health care accessibility conditions afforded to Bolivian immigrants in the Brazilian health system and their perception of the right to health. This was a cross-sectional, quantitative and qualitative study carried out from 2013 to 2015. Data were collected by a questionnaire with closed questions answered by 633 Bolivian individuals; questions regarding access to health were answered by 472 immigrants over 18 years old. Semi-structured interviews conducted with 55 subjects (Bolivians, health professionals, representatives of Health Departments, Consulate of Bolivia, Public Defender's Office, Federal Public Prosecutor's Office and Non-Governmental Organizations) underwent content analysis. Most Bolivian immigrants know the Brazilian National Health System (SUS) and often use Primary Health Care; however, they described structural and systemic barriers to health accessibility, such as lack of documentation, working conditions, medium and high complexity procedures, language barriers, among others. The National Health Card (CNS) is an important gateway to access health care, playing a role of social integration. Interviewees recognize health as a social right, pointing it out as a human and solidary value. Ensuring this recognition, when not based on the consolidation of social policies aimed at strengthening universal social protection, is threatened.

Monitoring Rhodnius neglectus (Lent, 1954) populations' susceptibility to insecticide used in controlling actions in urban areas northwest of São Paulo state

ABSTRACT Background: Chagas disease (CD) is caused by the flagellate protozoan Trypanosoma cruzi and can be carried by different species of triatomines, including Rhodnius neglectus, which is wild, well distributed in Brazil, and has formed colonies in palm trees located in urban areas of municipalities in the state of São Paulo. Chemical control has been routinely used to reduce population density, but each year, there has been an increase in species dispersion and density. This study aimed to evaluate the susceptibility of insects to insecticides used in control. Methods: The reference population was collected from Araçatuba municipality, Nilce Maia. Dilutions of deltamethrin were prepared and applied to the back of the first-stage nymphs, which were biologically synchronized. The control group received pure acetone only. Mortality was assessed after 72 h. Results: The mortality rate with respect to diagnostic dose was 100%. The susceptibility profile observed for this population showed RR50 ranging from 1.76 to 3.632. Conclusions: The populations were susceptible to the insecticides tested. It is possible that the insecticide residual effect on this ecotope has decreased the lifespan, and controlling failures may be the cause of recolonization in this environment.

Colonization of Panstrongylus megistus (Hemiptera:Reduvidae:Triatominae) in an urban area and its association with Didelphis marsupialis in the metropolitan region of São Paulo.

INTRODUCTION: This communication reports the colonization of Panstrongylus megistus in an urban area of the municipality of Taboão da Serra in the metropolitan region of São Paulo. METHODS: After receiving a notification from the population, entomological research comprising active search, collection, identification, and examination of triatomines was conducted. Wild animals were captured and examined. RESULTS: A colony of triatomines was found to be associated with dogs in the backyard of the property. CONCLUSIONS: The colonization of P. megistus shows the potential for their occupation of artificial ecotopes, which may pose a risk to the human population.

Colonization of Panstrongylus megistus (Hemiptera: Reduvidae:Triatominae) in an urban area and its association with Didelphis marsupialis in the metropolitan region of São Paulo

Abstract INTRODUCTION: This communication reports the colonization of Panstrongylus megistus in an urban area of the municipality of Taboão da Serra in the metropolitan region of São Paulo. METHODS: After receiving a notification from the population, entomological research comprising active search, collection, identification, and examination of triatomines was conducted. Wild animals were captured and examined. RESULTS: A colony of triatomines was found to be associated with dogs in the backyard of the property. CONCLUSIONS: The colonization of P. megistus shows the potential for their occupation of artificial ecotopes, which may pose a risk to the human population.

Colonization by Panstrongylus megistus (Hemiptera, Reduviidae, Triatominae) in an urban park in the city of São Paulo

Abstract INTRODUCTION: This communication reports on the occurrence of colonization by Panstrongylus megistus in an urban park in the municipality of São Paulo, Brazil. METHODS: Entomological research includes active search for vectors based on notifications by the population and identification and examination of insects. RESULTS: A colony of triatomines was found to be associated with enclosed birds. CONCLUSIONS: The occurrence of P. megistus has already been reported in the city of São Paulo; however, reports of colonization by this species provide evidence of its potential for the occupation of artificial ecotopes, which may pose a risk to the human population.

Colonization by Panstrongylus megistus (Hemiptera, Reduviidae, Triatominae) in an urban park in the city of São Paulo.

INTRODUCTION: This communication reports on the occurrence of colonization by Panstrongylus megistus in an urban park in the municipality of São Paulo, Brazil. METHODS: Entomological research includes active search for vectors based on notifications by the population and identification and examination of insects. RESULTS: A colony of triatomines was found to be associated with enclosed birds. CONCLUSIONS: The occurrence of P. megistus has already been reported in the city of São Paulo; however, reports of colonization by this species provide evidence of its potential for the occupation of artificial ecotopes, which may pose a risk to the human population.

Awareness of Chagas disease and socioeconomic characteristics of Bolivian immigrants living in Sao Paulo, Brazil.

In this study which is part of a research project on Chagas disease (CD) among Bolivian immigrants in Sao Paulo, we describe socioeconomic characteristics, knowledge of CD and implications for acess to health care. We applied a structured questionnaire to a sample of 472 Bolivian adults (> 18 years) living in Sao Paulo and enrolled at the Barra Funda School Health Center. Participants' median age was 28.5 years, 75.0% were from the Bolivian department of La Paz, and >90% worked in the garment industry. Respondents had lived in Sao Paulo for a median of 5.8 years. Only 169 (35.8%) were familiar with CD, while roughly half (50.4%) had lived in natural materials houses in Bolivia, 225 (47.7%) indicated familiarity with the vector, 23.9% had seen the vector in their homes in Bolivia, and 6.4% reported having been bitten by a triatomine bug. Factors associated with awareness of CD were analyzed by chi square tests, and those with p values <0.25 were included in a multivariable logistic regression model. In the multivariable logistic regression analysis, having a relative with CD (OR=4.3, 95% CI=1.5-12.0), having lived in a house with mud or wood walls (OR=0.4, 95% CI=0.2-0.8), and having heard of the triatomine bug, or vinchuca, (OR=10.0, 95% CI=5.1-19.5) were significantly associated with awareness of CD. This study shows a low familiarity with CD among Bolivian migrants living in Sao Paulo, Brazil. Raising awareness of the disease through specific communication strategies should be an essential component of public health programs to reduce the burden of CD in this and other vulnerable populations.

Sistema Escorpio/Sucen ­ uma inovação para a saúde pública do estado de São Paulo / Escorpio System/Sucen ­ an innovation for the public health of the state of São Paulo

O escorpionismo, ou acidente escorpiônico, é o envenenamento provocado pelo escorpião quando este injeta veneno em uma pessoa através do ferrão, sendo as crianças e os idosos os mais vulneráveis a complicações.1 No Brasil, as notificações do Sistema Nacional de Agravos de Notificação (Sinan) registraram 86.419, 91.476 e 124.077 casos nos anos de 2015, 2016 e 2017, respectivamente (dados provisórios do Sinan 26-06-2018). As incidências nesses anos variaram entre 40 e 60 casos/100 mil habitantes, sendo as maiores nas regiões Nordeste (97,9/100 mil hab) e Sudeste (62,7/100 mil hab.), no ano de 2017. Dada a situação epidemiológica do escorpionismo no Estado de São Paulo, que desde 2016 está em ascensão, e o progressivo(AU)

Occurrences of triatomines (Hemiptera: Reduviidae) and first reports of Panstrongylus geniculatus in urban environments in the city of Sao Paulo, Brazil.

This note reports on occurrences of triatomine species in the city of Sao Paulo, Brazil, registered between 1988 and 2017. Records of triatomines captured in Sao Paulo are based on specimens received spontaneously from Health Surveillance Centers, Health Centers and Zoonosis Control Centers in the city as well as from citizens. Species were identified morphologically at the Public Health Entomology Laboratory, Faculty of Public Health, University of Sao Paulo, where the triatomines, which are vectors of Chagas disease, were tested for Trypanosoma cruzi infection. The first reported occurrence of triatomine bugs in urban Sao Paulo was in 1988. The specimen, which was captured in Jardim Sao Luiz district, was from the genus Panstrongylus and was registered as Panstrongylus sp. but was not sexed. Since this first recorded occurrence, the following species have been found in the city: Panstrongylus geniculatus (2 occurrences), P. megistus (15 occurrences), Triatoma infestans (1 occurrence) and T. sordida (3 occurrences). In this paper, the importance of reporting occurrences of triatomine bugs in the city of Sao Paulo, one of the largest metropolis in the world, is discussed with an emphasis on P. megistus. The occurrences discussed here indicate the importance of entomological surveillance for these vectors even in urban centers although the possibility of vector transmission of Chagas disease in these centers is very low.

Interdisciplinary approach at the primary healthcare level for Bolivian immigrants with Chagas disease in the city of São Paulo.

BACKGROUND/METHODS: In a pioneering cross-sectional study among Bolivian immigrants in the city of São Paulo, Brazil, the epidemiological profile, clinical manifestations and morbidity of Chagas disease were described. The feasibility of the management of Chagas disease at primary healthcare clinics using a biomedical and psychosocial interdisciplinary approach was also tested. Previously, a Trypanosoma cruzi (T. cruzi) infection rate of 4.4% among 633 immigrants was reported. The samples were screened using two commercial enzyme-linked immunoassay (ELISA) tests generated with epimastigote antigens, and those with discrepant or seropositive results were analyzed by confirmatory tests: indirect immunofluorescence (IFI), TESA-blot and a commercial recombinant ELISA. PCR and blood cultures were performed in seropositive patients. RESULTS: The majority of the 28 seropositive patients were women, of whom 88.89% were of child-bearing age. The predominant clinical forms of Chagas disease were the indeterminate and atypical cardiac forms. Less than 50% received the recommended antiparasitic treatment of benznidazole. An interdisciplinary team was centered on primary healthcare physicians who applied guidelines for the management of patients. Infectologists, cardiologists, pediatricians and other specialists acted as reference professionals. Confirmatory serology and molecular biology tests, as well as echocardiography, Holter and other tests, were performed for the assessment of affected organs in secondary healthcare centers. The published high performance of two commercial ELISA tests was not confirmed. CONCLUSION: An interdisciplinary approach including antiparasitic treatment is feasible at the primary healthcare level for the management of Chagas disease in Bolivian immigrants. The itinerant feature of immigration was associated with a lack of adherence to antiparasitic treatment and was considered a main challenge for the clinical management of this population. This approach is recommended for management of the infected population in endemic and nonendemic areas, although different strategies are needed depending on the severity of the disease and the structure of the healthcare system.

Colonization of palm trees by Rhodnius neglectus and household and invasion in an urban area, Araçatuba, São Paulo State, Brazil.

The objective of this study is to report on the colonization of palm trees by Rhodnius neglectus, its invasion in an urban area, in Araçatuba - São Paulo, and the control and surveillance measures that have been put in place. Domiciliary triatomine searches occurred in apartments upon the inhabitants' notification. The collected insects were identified and examined for natural infection and food sources with a precipitin test. To search the palm trees, tarps were used to cover the floor, and a "Munck" truck equipped with a tree-pruning device was utilized. Chemical control was performed with the utilization of a manual compression. In 2009, 81 specimens of Rhodnius neglectus were collected from the domiciles by the population. The precipitin test revealed a presence of human blood in 2.7% of the samples. Entomological studies were carried out in these domiciles and in those located within a radius of 200 meters. The search performed in the palm trees resulted in the capture of 882 specimens of triatomines, negative for tripanosomatids. Mechanical and chemical controls were carried out. New searches conducted in the palm trees in the same year resulted in the capture of six specimens. The mechanical and chemical controls of the palm trees, together with the population's work, proved to be effective, therefore preventing these insects' colonization of the city's domiciles.

Vigilância epidemiológica da doença de Chagas no estado de São Paulo no período de 2010 a 2012 / Epidemiological Surveillance of Chagas disease in the State of São Paulo, Brazil, 2010-2012

Objetivo: descrever os indicadores da vigilância epidemiológica da doença de Chagas no estado de São Paulo, Brasil. Métodos: foi realizado estudo descritivo dos indicadores entomológicos e epidemiológicos obtidos a partir das atividades desenvolvidas pela Superintendência de Controle de Endemias (Sucen) no período de 2010 a 2012. Resultados: foram realizadas 3.867 notificações de insetos, dos quais 72,0 por cento eram triatomíneos; das 2.785 notificações de triatomíneos recebidas, as pesquisas realizadas nos atendimentos resultaram no encontro do vetor em 746 domicílios; onde foram coletados 15.634 exemplares de triatomíneos, 3,4 por cento deles positivos para Trypanosoma cruzi; a espécie mais coletada foi a Triatoma sordida, predominantemente no peridomicílio; não foi constatada reação positiva para T. cruzi em qualquer das amostras de morador examinadas. Conclusão: apesar do elevado número de notificações de triatomíneos e da constatação de positividade para T. cruzi nesses vetores, não foram encontradas evidências de transmissão da doença de Chagas.

Objective: to describe epidemiological surveillance indicators of Chagas disease in the State of São Paulo, Brazil. Methods: this was a descriptive study of entomological and epidemiological indicators obtained based on activities undertaken by the Endemic Disease Control Department (SUCEN) between 2010-2012. Results: there were 3,867 notifications of insects, of which 72.0 per cent were triatomines. Of the 2,785 triatomine notifications received, the vector was subsequently found in 746 households visited, 15,634 specimens of triatomines were collected, 3.4 per cent were positive for Trypanosoma cruzi. Triatoma sordida was the most collected species and was predominantly found in housebold surroundings. Sample household residents had no positive reaction for T. cruzi. Conclusion: despite the high number of triatomine notifications and T. cruzi positive results in these vectors, no evidence was found of Chagas’ disease transmission.

COLONIZATION OF PALM TREES BY Rhodnius neglectus AND HOUSEHOLD AND INVASION IN AN URBAN AREA, ARAÇATUBA, SÃO PAULO STATE, BRAZIL / Colonização de palmeiras por Rhodnius neglectus e invasão domiciliar em área urbana, Araçatuba, São Paulo, Brasil

The objective of this study is to report on the colonization of palm trees by Rhodnius neglectus, its invasion in an urban area, in Araçatuba - São Paulo, and the control and surveillance measures that have been put in place. Domiciliary triatomine searches occurred in apartments upon the inhabitants' notification. The collected insects were identified and examined for natural infection and food sources with a precipitin test. To search the palm trees, tarps were used to cover the floor, and a “Munck” truck equipped with a tree-pruning device was utilized. Chemical control was performed with the utilization of a manual compression. In 2009, 81 specimens of Rhodnius neglectus were collected from the domiciles by the population. The precipitin test revealed a presence of human blood in 2.7% of the samples. Entomological studies were carried out in these domiciles and in those located within a radius of 200 meters. The search performed in the palm trees resulted in the capture of 882 specimens of triatomines, negative for tripanosomatids. Mechanical and chemical controls were carried out. New searches conducted in the palm trees in the same year resulted in the capture of six specimens. The mechanical and chemical controls of the palm trees, together with the population's work, proved to be effective, therefore preventing these insects' colonization of the city's domiciles.

O objetivo deste trabalho é relatar a colonização de palmeiras por Rhodnius neglectus, sua invasão em área urbana, na cidade de Araçatuba - São Paulo, o controle e as medidas de vigilância instituídas. As pesquisas de triatomíneos nos domicílios ocorreram nos apartamentos quando da notificação pelo morador. Os insetos coletados foram identificados, examinados quanto à infecção natural e teste de precipitina. Na pesquisa das palmeiras foram utilizados lonas para forração do chão e caminhão Munck equipado com moto poda. O controle químico foi realizado com a utilização de compressor manual. No ano de 2009, foram coletados pela população 81 exemplares de Rhodnius neglectus em domicílios. O teste de precipitina acusou presença de sangue humano em 2,7% das amostras. Pesquisas entomológicas foram realizadas nestas edificações e naquelas situadas em um raio de 200 metros onde ocorreram as invasões. A pesquisa realizada nas palmeiras resultou na captura de 882 exemplares de triatomíneos, negativos para tripanosomatídeos. Foi realizado controle mecânico e químico. Novas pesquisas realizadas nas palmeiras avaliadas no mesmo ano resultaram na coleta de seis exemplares. Os controles mecânicos e químicos das palmeiras aliado ao trabalho de participação popular mostraram-se factíveis impedindo a colonização destes insetos nos domicílios da cidade.

Magnitude and trend of American Tegumentary Leishmaniasis in the State of São Paulo, Brazil, 1975 to 2008.

The aim of this study was to analyze the magnitude and trend of American Tegumentary Leishmaniasis (ATL) in the State of São Paulo from 1975 to 2008. An ecological study that classified municipalities according to the magnitude of transmission was performed. From 1975 to 1985, 1,281 cases of ATL were registered in 45 municipalities, rising to 258 municipalities and 4,093 cases from 1986 to 1995; and reaching 385 municipalities and 7,604 cases from 1996 to 2008. Lutzomyia intermedia s.l. was collected in most of the entomological surveys. In the classification of municipalities according to magnitude, 67.5% were observed to have a "small magnitude," 19.2% "moderate magnitude" and 13.3% "high magnitude." The highest incidences of ATL have been restricted to underserved areas close to the Atlantic forest. There was an increase in the number of municipalities with small occurrence of cases and expansion in the area of risk.

Magnitude e tendência da Leishmaniose Tegumentar Americana no Estado de São Paulo, Brasil, 1975 a 2008 / Magnitude and trend of American Tegumentary Leishmaniasis in the State of São Paulo, Brazil, 1975 to 2008

O objetivo deste estudo foi analisar a magnitude e tendência da Leishmaniose Tegumentar Americana (LTA) no Estado de São Paulo entre 1975 e 2008. Foi conduzido um estudo ecológico que categorizou os municípios segundo a magnitude da transmissão. No período de 1975 a 1985, 45 municípios foram responsáveis pelo registro de 1.281 casos de LTA, passando a 258 municípios e 4.093 casos entre 1986 e 1995, e a 385 municípios e 7.604 casos entre 1996 a 2008. O vetor Lutzomyia intermedia s.l. foi coletado na maioria das pesquisas entomológicas. Na classificação dos municípios segundo a magnitude pode-se verificar que 67,5% possuíam "pequena magnitude", 19,2% "média magnitude" e 13,3% "grande magnitude". As maiores incidências de LTA permanecem restritas a algumas áreas carentes e próximas à Mata Atlântica. Houve aumento no número de municípios com pequena ocorrência de casos e ampliação da área de risco.

The aim of this study was to analyze the magnitude and trend of American Tegumentary Leishmaniasis (ATL) in the State of São Paulo from 1975 to 2008. An ecological study that classified municipalities according to the magnitude of transmission was performed. From 1975 to 1985, 1,281 cases of ATL were registered in 45 municipalities, rising to 258 municipalities and 4,093 cases from 1986 to 1995; and reaching 385 municipalities and 7,604 cases from 1996 to 2008. Lutzomyia intermedia s.l. was collected in most of the entomological surveys. In the classification of municipalities according to magnitude, 67.5% were observed to have a "small magnitude," 19.2% "moderate magnitude" and 13.3% "high magnitude." The highest incidences of ATL have been restricted to underserved areas close to the Atlantic fo-rest. There was an increase in the number of municipalities with small occurrence of cases and expansion in the area of risk.

Busca ativa de triatomíneos em área com ausência de notificações como subsídio à estratégia de vigilância entomológica no Estado de São Paulo / Active search of triatomines in area without report of bugs for the population as a subsidy of entomolgical survellance in the state of São Paulo

Avaliações das notificações de triatomíneos pela população em áreas de maior dispersão da espécie Panstrongylus megistus apontaram que as mesmas não têm ocorrido, ou acontecem de forma bastante esporádica. Para monitorar a situaçãofoi proposta realização de busca ativa em localidades destas áreas. O critério para a estimativa da amostra das localidades considerou a positividade observada no intra e peridomicílios em imóveis pesquisados no período de 1990 a 1999. Nos anos de 2008 e 2009 foram pesquisadas as unidades domiciliares de 110 localidades, totalizando 4466 domicílios com 20 positivos, perfazendo uma positividade de 0,04% para intradomicílio e 0,4% para o peridomicílio.Coletaram-se 136 exemplares de triatomíneos, 90,4% referentes à espécie Triatoma sordida e 9,6% a Panstrongylus megistus, concentrados noperidomicílio (92,3%). Todos os exemplares examinados foram negativos para Trypanosoma cruzi. Os resultados permitem afirmar que a estratégia de vigilância está sendo conduzida de maneira eficaz, e que, embora se constate a presença de focos de triatomíneos no peridomicílio, não ocorre à instalação de colônias na intradomicílio. Os trabalhos de educação em saúde devem ser intensificados visando manter a população motivada a identificar a presença desses insetos, encaminhar às áreas competentes para a confirmação e controle de eventuais focos de infestação

[Control Program of Chagas disease in São Paulo, Brazil: the control and surveillance of vector transmission]. / Programa de Controle da Doença de Chagas no estado de São Paulo, Brasil: o controle e a vigilância da transmissão vetorial.

The control of the vectors of Chagas' disease in the State of Sao Paulo are discussed, mainly those activities that led to the elimination of Triatoma infestans. Secondary factors that helped the control such as rural exodus are also analyzed. The article shows that since 1965 the control became a campaign with different phases due to the epidemiological situation, the acquired knowledge and the entomological surveillance. After 25 years of work, the elimination of all the focus of Triatoma infestans was finally reached and the campaign was ended. However, due to the possibility of reintroduction of the vector in rural areas by passive transportation besides the presence of secondary vectors (Triatoma sordida and Panstrongylus megistus) in several localities, the vector control activities were not interrupted and the surveillance is continuous.