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1.
Rev Soc Bras Med Trop ; 53: e20190560, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32348431

RESUMO

INTRODUCTION: Congenital transmission (CT) of Trypanosoma cruzi has led to globalization of Chagas disease and its growing relevance as a public health problem. Although the occurrence of CT has been associated with several factors, its mechanisms are still unknown. This study aimed to analyze the geographical and familiar variables of mothers and their association with CT of Chagas disease in a population living in non-endemic areas of Argentina for the last decades. METHODS: We developed a retrospective cohort study in a sample of 2120 mother-child pairs who attended three reference centers in the cities of Buenos Aires, Santa Fe, and Salta between 2002 and 2015. RESULTS: The highest CT rates were observed in children born to Argentinean mothers (10.7%) and in children born to mothers from Buenos Aires (11.7%). Considering the areas of origin of the mothers, those from areas of null-low risk for vector-borne infection had higher CT rates than those from areas of medium-high risk (11.1% vs 8.2%). We also observed a significant intra-familiar "cluster effect," with CT rates of 35.9% in children with an infected sibling, compared to 8.2% in children without infected siblings (RR=4.4 95% CI 2.3-8.4). CONCLUSIONS: The associations observed suggest a higher CT rate in children born to mothers who acquired the infection congenitally, with familiar antecedents, and from areas without the presence of vectors. These observations are considered new epidemiological evidence about Chagas disease in a contemporary urban population, which may contribute to the study of CT and may also be an interesting finding for healthcare professionals.


Assuntos
Doença de Chagas/epidemiologia , Doença de Chagas/transmissão , Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos , Complicações Parasitárias na Gravidez/epidemiologia , Adolescente , Adulto , Animais , Argentina/epidemiologia , Feminino , Humanos , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Gravidez , Estudos Retrospectivos , Fatores de Risco , População Urbana , Adulto Jovem
3.
An. Fac. Cienc. Méd. (Asunción) ; 53(1): 81-92, 20200401.
Artigo em Espanhol | LILACS | ID: biblio-1095724

RESUMO

La tripanosomiasis americana o enfermedad de Chagas, producida por el protozoo hemoflagelado Trypanosoma cruzi. En Paraguay el principal vector Triatoma infestans ("vinchuca" o "chichã guasu") es considerado, en términos sociales y económicos, una de las enfermedades parasitarias más importantes que pueden desencadenar complicaciones graves cardiológicas. Durante el Periodo 2014 al 2017 en el Departamento de San Pedro se registraron 302 casos de Enfermedad de Chagas detectados por serología. El objetivo del estudio estuvo dirigido a investigar el nivel de conocimiento de la población que, por su forma de vida, presentan factores de riesgo. Se realizó una investigación cualitativa exploratoria, con enfoque hermenéutico. La población de estudio estuvo conformada por 41 familias que residen en comunidades del Departamento de San Pedro, que se encuentran entre 15 km a 40 km de zonas urbanas, a quienes se le realizo una entrevista semi-estructurada en profundidad. Entre los resultados obtenidos se evidenció que: La mayoría de los pobladores de la zona conocen al triatoma y lo pudieron observar cuando eran niños y algunos afirman haber sido picados, pudiendo así describir la morfología y otras características del vector; la mayoría desconoce la sintomatología producida por el T. cruzi, pero tienen un conocimiento básico relacionado a la enfermedad.


The american trypanosomiasis, also known as Chagas disease, is caused by an hemophlagelated protozoo called Trypanosoma cruzi. In Paraguay, the most relevant vector is Triatoma infestans (vinchuca or "chichã guasu") is considered, in social and economic terms, one of the most important parasitic diseases which may cause severe cardiological complications. Since 2014 till 2017, in San Pedro´s department, have been registered 302 cases of Chagas disease, all detected by serology. The objective of this study was directed to investigate the degree of knowledge of the population that, because of their lifestyles, presents risk factors. It has been made a qualitative-exploratory investigation, with hermeneutic focus. The population studied was made up for 41 families which reside in communities of San Pedro´s department, that are located around 15/40 km of urban zones. They all had a deep semi-structured interview. The results showed that: most of the settlers know triatoma and could observe it when they were children and also some of them affirm have been chopped, being able to describe the morphology and other characteristics of the vector. Most of the interviewed unknown the symptomatology produced by T. cruzi, but have the basic knowledge related with this disease.


Assuntos
Doença de Chagas/epidemiologia
4.
Am. j. trop. med. hyg ; 102(4): 800-803, Apr. 2020. ilus
Artigo em Inglês | Sec. Est. Saúde SP, SESSP-IIERPROD, Sec. Est. Saúde SP | ID: biblio-1095179

RESUMO

Chagas is a neglected disease endemic in Latin America. Vector transmission control had been aggressively performed. Recent entomological surveillance in Brazil has revealed natural infection rates ranging from 0.40% to 0.52%. Although serological surveys are complex to develop, they are important for disease control. In this study, we validated the use of saliva in ELISA commercial kits with a cohort of 100 patients with Chagas disease followed at Hospital das Clinicas in São Paulo, Brazil, and 50 healthy controls. Five ELISA kits for detecting antibodies against Trypanosoma cruzi were tested. The best discrimination between Chagas patients and controls was observed with the Wiener kit, which yielded a sensitivity of 97% and a specificity of 100%. Our findings reveal that the use of saliva may be an alternative to large-scale screening surveys in detecting T. cruzi antibodies; it is a noninvasive sample collection method potentially key to large-scale screening in children


Assuntos
Humanos , Trypanosoma cruzi/citologia , Brasil/epidemiologia , Doença de Chagas/epidemiologia
5.
PLoS Negl Trop Dis ; 14(3): e0007910, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32150562

RESUMO

Anthropogenic environmental alterations such as urbanization can threaten native populations as well as create novel environments that allow human pests and pathogens to thrive. As the number and size of urban environments increase globally, it is more important than ever to understand the dispersal dynamics of hosts, vectors and pathogens of zoonotic disease systems. For example, a protozoan parasite and the causative agent of Chagas disease in humans, Trypanosoma cruzi, recently colonized and spread through the city of Arequipa, Peru. We used population genomic and phylogenomic tools to analyze whole genomes of 123 T. cruzi isolates derived from vectors and non-human mammals throughout Arequipa to determine patterns of T. cruzi dispersal. The data show significant population genetic structure within city blocks-parasites in the same block tend to be very closely related-but no population structure among blocks within districts-parasites in neighboring blocks are no more closely related to one another than to parasites in distant districts. These data suggest that T. cruzi dispersal within a block occurs regularly and that occasional long-range dispersal events allow the establishment of new T. cruzi populations in distant blocks. Movement of domestic animals may be the primary mechanism of inter-block and inter-district T. cruzi dispersal.


Assuntos
Animais Domésticos/parasitologia , Doença de Chagas/epidemiologia , Doença de Chagas/parasitologia , Transmissão de Doença Infecciosa , Genótipo , Filogenia , Trypanosoma cruzi/isolamento & purificação , Animais , Doença de Chagas/transmissão , Vetores de Doenças , Humanos , Epidemiologia Molecular , Peru/epidemiologia , Trypanosoma cruzi/classificação , Trypanosoma cruzi/genética
7.
PLoS Negl Trop Dis ; 14(2): e0008067, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32069287

RESUMO

BACKGROUND: Antitrypanosomal treatment with Benznidazole (BZ) or Nifurtimox may be recommended for patients with chronic Chagas disease (CD) to reduce the onset or progression of symptoms. However, such treatment has limited efficacy and high level of toxic effects. In addition, the current cure biomarker (serology conversion) precludes any treatment assessment unless a prolonged follow-up is arranged. PCR is thus the most useful, alternative surrogate marker for evaluating responses to treatment. The aim of this study is to describe the usefulness of real-time PCR in monitoring BZ treatment within a large cohort of chronic CD cases in Barcelona. METHODOLOGY/PRINCIPAL FINDINGS: A total of 370 chronic CD patients were monitored with real-time PCR post-BZ treatment. The median follow-up was 4 years (IQR 2.2-5.3y), with a median of 3 clinical visits (IQR 2-4). Only 8 patients (2.2%) presented with at least one incident of positive real-time PCR after treatment and were therefore considered as treatment failure. Four of those failure patients had completed full course treatment, whereas the remaining cases had defaulted with a statistical difference between both groups (p = 0.02). Half of the failure patients had undergone less than 4 years of follow-up monitoring all presented with parasitemia before treatment. CONCLUSIONS/SIGNIFICANCE: BZ treatment failure was highly infrequent in our cohort. BZ discontinuation was a risk factor for positive real-time PCR results during clinical follow-up. Regular testing with real-time PCR during follow-up allows for early detection of treatment failure in patients with chronic CD.


Assuntos
Doença de Chagas/tratamento farmacológico , Doença de Chagas/epidemiologia , Nitroimidazóis/uso terapêutico , Reação em Cadeia da Polimerase em Tempo Real , Tripanossomicidas/uso terapêutico , Doença Crônica , Humanos , Estudos Retrospectivos , Espanha/epidemiologia
8.
PLoS Negl Trop Dis ; 14(1): e0007987, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31999721

RESUMO

INTRODUCTION: Control of triatomine infestation is a key strategy for the prevention of Chagas disease (CD). To promote this strategy, it is important to know which antecedents to behavioral change are the best to emphasize when promoting prevention. OBJECTIVE: The aim of this study was to determine predictors for intention to prevent home infestation based on the Health Belief Model (HBM), a commonly used health intervention planning theory. MATERIALS & METHODS: A cross-sectional study was conducted with 112 heads of household in six communities with endemic and high rates of triatomine infestation in Loja province, Ecuador. The data was collected by a questionnaire including perceived severity, susceptibility, benefits to action, barriers to action, and self-efficacy. These data were also used to predict actual infestation of homes. RESULTS: Community members reported strong intentions to prevent home infestation. HBM constructs predicted about 14% of the observed variance in intentions. Perceived susceptibility and severity did not predict behavioral intention well; perceived barriers to small-scale action that reduce likelihood of infestation and self-efficacy in participating in surveillance systems did. Self-efficacy and perception of barriers were equally powerful predictors. The HBM constructs, however, did not predict well actual infestation. CONCLUSION: The findings supported the HBM as a way to predict intentions to prevent infestation of the home by triatomine bugs. The findings highlight that messages emphasizing self-efficacy in participating in surveillance systems and overcoming barriers to small-scale action that reduce likelihood of infestation, rather than a focus on risk, should be central messages when designing and implementing educational interventions for CD. The gap between behavioral intention and actual infestation reveals the need to assess home practices and their actual efficacy to fully enact and apply the HBM.


Assuntos
Doença de Chagas/prevenção & controle , Controle de Insetos , População Rural , Triatominae , Animais , Doença de Chagas/epidemiologia , Estudos Transversais , Equador/epidemiologia , Características da Família , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde , Humanos , Fatores de Risco
9.
Acta Trop ; 201: 105188, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31545949

RESUMO

Triatoma petrocchiae is the newly member of the Triatoma brasiliensis species complex. This species overlaps with T. brasiliensis in geographic and ecotypic occupation in the sylvatic habitat because both inhabit rocky outcrops in the semi-arid portion of Brazilian northeast. In this region T. brasiliensis is the most important Chagas disease vector because it constantly colonizes domiciles. In contrast, T. petrocchiae is rarely found in peri or intradomiciliary habitats - reason why little is known about this species. Therefore, Here, we present information for the first time on. the T. petrocchiae ecotopes, genetic diversity, Trypanosoma cruzi prevalence/genotyping in comparison to T. brasiliensis. We found T. brasilensis (N = 223) and T. petrocchiae (N = 69) in co-habitation in rocky outcrops in three Districts of Paraíba and Rio Grande do Norte states. Forty-tree T. petrocchiae insects of eleven sampling spots (composing three geographic populations) were genotyped for the mitochondrial Cyt B gene and little geographic structure was observed. Tajima's D test suggested that species is evolving toward a mutation-drift equilibrium in our collection range. Sylvatic T. petrocchiae had 4% (3/68) of infected insects by T. cruzi, whereas T. brasiliensis had 26% (59/223). Fluorescent Fragment Length Barcoding demonstrated that all three T. petrocchiae harbored TcI whereas T. brasiliensis had TcI, but also TcIII, TcII/TcVI and T. rangeli genotype A, sometimes under mixed infections. None of infected T. petrocchiae were carrying mixed infections. However, this result should be confirmed using a larger pool of infected bugs. We here presented the first documentation of T. rangeli infecting T. brasiliensis. The finding of infected T. petrocchiae calls for constant vector monitoring because the epidemiologic scenario is dynamic and sylvatic vectors are progressively found in adaptation to anthropic environments.


Assuntos
Doença de Chagas/transmissão , Insetos Vetores/parasitologia , Simpatria , Triatoma/parasitologia , Trypanosoma cruzi/genética , Animais , Brasil/epidemiologia , Doença de Chagas/epidemiologia , Ecossistema , Variação Genética , Genótipo , Epidemiologia Molecular , Prevalência
10.
Am J Trop Med Hyg ; 102(2): 294-297, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31872798

RESUMO

Chagas disease, caused by the vector-borne parasite Trypanosoma cruzi, remains one of the most significant neglected tropical diseases affecting the Americas. Identifying high-risk populations is important for understanding Chagas disease transmission and directing public health resources. We recently hypothesized that Texas hunters may be at an elevated risk for contracting Chagas disease because of opportunities for vector exposure and contact with blood of infected reservoirs. To assess their unique exposure risks, we conducted a statewide screening program of Texas hunters. A total of 885 study participants were interviewed and tested for T. cruzi infection; 18 screened positive on a rapid, point-of-care test; however, none were found positive through confirmatory testing. We did find a high prevalence of reported direct contact with wildlife blood as well as triatomine and other arthropod disease vectors. This large-scale screening program represents a novel approach to better understand the vector-borne disease risk in this unique population.


Assuntos
Doença de Chagas/epidemiologia , Insetos Vetores/parasitologia , Triatoma/parasitologia , Adolescente , Adulto , Animais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Prevalência , Texas/epidemiologia , Trypanosoma cruzi , Adulto Jovem
11.
Rev Soc Bras Med Trop ; 52: e20180541, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31800918

RESUMO

INTRODUCTION: Chagas disease is a major public health problem that is endemic in Brazil and Latin America. This study aimed to determine the socioeconomic, demographic, and clinical characteristics of 171 patients (mean age, 45 years; female, 65%) with Chagas disease at Hospital Universitário de Brasília, Federal District, Brazil. METHODS: We implemented this cross-sectional study using a clinical epidemiological questionnaire, electrocardiography, echocardiography, and quantitative detection of Trypanosoma cruzi DNA in blood using qRT-PCR. RESULTS: Among the patients, 26.3% had a full elementary education, and 13.2% were illiterate. Most (63.6%) were economically classified as class C, and 51.5% were born in Bahia state. A total of 62.0% participants reported previous contact with the triatomine bug. The clinical forms of the disease were indeterminate (69.51%), cardiac (15.24%), digestive (10.37%), and mixed (4.88%). The most common electrocardiographic abnormality was complete right bundle branch block in association with a divisional anterosuperior block. Only 14.6% of the patients complied with benznidazole medication for at least 60 days, and 164 of them were assessed by echocardiography. The parasite load was positive in 56% of the patients. CONCLUSIONS: Chagas disease affected mostly women, with the indeterminate chronic form of the disease.


Assuntos
Doença de Chagas/epidemiologia , Trypanosoma cruzi/genética , Adulto , Idoso , Brasil/epidemiologia , Doença de Chagas/parasitologia , Estudos Transversais , DNA de Protozoário/genética , Ecocardiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Carga Parasitária , Reação em Cadeia da Polimerase em Tempo Real , Fatores Socioeconômicos , Trypanosoma cruzi/isolamento & purificação , Adulto Jovem
12.
PLoS Negl Trop Dis ; 13(12): e0007430, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31841558

RESUMO

The transmission of Trypanosoma cruzi to humans is determined by multiple ecological, socio-economic and cultural factors acting at different scales. Their effects on human infection with T. cruzi have often been examined separately or using a limited set of ecological and socio-demographic variables. Herein, we integrated the ecological and social dimensions of human infection risk with the spatial distribution patterns of human and vector (Triatoma infestans) infection in rural communities of the Argentine Chaco composed of indigenous people (90% Qom) and a creole minority. We conducted serosurveys in 470 households aiming at complete population enumeration over 2012-2015. The estimated seroprevalence of T. cruzi prior to the implementation of an insecticide spraying campaign (2008) was 29.0% (N = 1,373 in 301 households), and was twice as large in Qom than creoles. Using generalized linear mixed models, human seropositive cases significantly increased with infected triatomine abundance, having a seropositive household co-inhabitant and household social vulnerability (a multidimensional index of poverty), and significantly decreased with increasing host availability in sleeping quarters (an index summarizing the number of domestic hosts for T. infestans). Vulnerable household residents were exposed to a higher risk of infection even at low infected-vector abundances. The risk of being seropositive increased significantly with house infestation among children from stable households, whereas both variables were not significantly associated among children from households exhibiting high mobility within the communities, possibly owing to less consistent exposures. Human infection was clustered by household and at a larger spatial scale, with hotspots of human and vector infection matching areas of higher social vulnerability. These results were integrated in a risk map that shows high-priority areas for targeted interventions oriented to suppress house (re)infestations, detect and treat infected children, and thus reduce the burden of future disease.


Assuntos
Doença de Chagas/epidemiologia , Doença de Chagas/transmissão , Transmissão de Doença Infecciosa , Relações Interpessoais , População Rural , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Argentina/epidemiologia , Criança , Pré-Escolar , Economia , Grupos Étnicos , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Soroepidemiológicos , Topografia Médica , Triatominae/crescimento & desenvolvimento , Adulto Jovem
13.
Rev Chilena Infectol ; 36(5): 599-606, 2019 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-31859801

RESUMO

BACKGROUND: Zoonoses are infections caused by all types of etiological transmissible agents from vertebrate animals to humans. During the last decades, the risk to health caused by different zoonoses has been a consequence of the natural distribution of the different etiological agents and by the emergence and reemergence of these diseases. AIM: To study the distribution of the risk of mortality of the four main zoonoses in continental Chile, based on national mortality data, with the objective of visualizing geographically where to focus the control efforts of these diseases. METHODS: Relative risk was estimated by means of Bayesian Statistics. RESULTS: The distribution in Chile of the main zoonoses was obtained. DISCUSSION/CONCLUSION: The risk maps obtained show a parasitic disease transmitted by high-risk vectors in the north, Chagas disease; a parasitic disease of biological communities in which man is an accidental host, associated with livestock areas, more prevalent in the south, hydatidosis; a bacterial disease transmitted by vertebrates, especially by rodents, where water is an important vehicle, dominant in the center, leptospirosis; and a viral disease transmitted by rodents, very dominant in the south, the hantavirus infection.


Assuntos
Doença de Chagas/epidemiologia , Equinococose/epidemiologia , Síndrome Pulmonar por Hantavirus/epidemiologia , Leptospirose/epidemiologia , Zoonoses/epidemiologia , Animais , Doença de Chagas/etiologia , Chile/epidemiologia , Equinococose/etiologia , Feminino , Geografia , Síndrome Pulmonar por Hantavirus/etiologia , Humanos , Leptospirose/etiologia , Masculino , Prevalência , Medição de Risco , Fatores de Risco , Zoonoses/etiologia
14.
Rev Med Chil ; 147(6): 683-692, 2019 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-31859820

RESUMO

BACKGROUND: Reproductive number (R0)-maps estimate risk zones of vector-borne diseases and geographical distribution changes under climate change. AIM: To map R0 aiming to estimate the epidemiological risk of Chagas disease in Chile, its distribution and possible changes due to the global climate change. MATERIAL AND METHODS: We used a relationship between R0 and entomological parameters of vectors as function of environmental variables, to map the risk of Chagas disease in Chile, under current and projected future environmental conditions. RESULTS: We obtained a geographical R0 estimation of Chagas disease in Chile. The highest R0averages correspond to the Central-Northern regions of Chile. T. cruzi transmission area could increase in the future due to climate changes. Independent of the future condition, both for optimistic and pessimistic climate change scenarios, the area of potential risk for Chagas disease transmission would increase. The estimated R0 values suggest that, if a control of T. infestans is not maintained, Chagas disease endemic status will persist or increase, independently of the climate change scenarios. CONCLUSIONS: Mapping R0 values is an effective method to assess the risk of Chagas disease. The eventual increase in the transmission area of the disease is worrisome.


Assuntos
Doença de Chagas/epidemiologia , Mudança Climática/estatística & dados numéricos , Vetores de Doenças , Medição de Risco/métodos , Animais , Dióxido de Carbono , Doença de Chagas/transmissão , Chile/epidemiologia , Feminino , Geografia , Humanos , Masculino , Fatores de Risco , Estatísticas não Paramétricas , Temperatura , Triatoma , Trypanosoma cruzi
15.
Biomedica ; 39(4): 769-784, 2019 12 01.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31860187

RESUMO

Introduction. Trypanosoma cruzi is mainly transmitted by vectors. Other pathways such as oral and congenital transmission have become increasingly relevant. Objective. To evaluate T. cruzi infections in post-partum women and their newborns who attended the Hospital Universitario Dr. Luis Razetti (Barcelona, Anzoátegui state, Venezuela). Materials and methods. A prospective cross-sectional study was undertaken from May, 2015, to August, 2016. ELISA, MABA and IFI assays were used to determine the infection in 1,200 post-partum women. The newborns of seropositive women were then examined for T. cruzi by PCR amplification and serological tests at nine months old. The prevalence of the parasitic infection in post-partum women and their newborns was then estimated. To establish the relationship between risk factors and infection, the chi-square test (c2) and the probability ratio (OR) was applied. Results. A total of 78 women were identified as seropositive (6.50 %) (CI 95%: 5.10-7.89%), and parasitic DNA was detected in six of their newborns (9.09%). Nine months after birth eleven infants were examined, and all were found to be serologically negative. Risk factors detected were pregnancy duration (OR: 0,36; CI95%: 0,15-0,84), where the patients lived at present (OR: 0,34; CI95%: 0,24-0,62) or previously (OR: 2,50; CI95%: 1,38-4,52) and having relatives with Chagas disease (OR: 1,75; CI95%: 1,02-3,01). Conclusions. Seroprevalence for T. cruzi infection in young post-partum women in rural areas was high. The detection of parasite DNA at birth was not indicative of congenital Chagas disease.


Assuntos
Doença de Chagas/epidemiologia , Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos , Trypanosoma cruzi/isolamento & purificação , Adolescente , Adulto , Antígenos de Protozoários/isolamento & purificação , Doença de Chagas/diagnóstico , Doença de Chagas/transmissão , Estudos Transversais , DNA de Protozoário/isolamento & purificação , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Lactente , Recém-Nascido , Período Pós-Parto , Gravidez , Prevalência , Estudos Prospectivos , Fatores de Risco , Trypanosoma cruzi/genética , Trypanosoma cruzi/imunologia , Venezuela/epidemiologia , Adulto Jovem
16.
Rev Soc Bras Med Trop ; 52: e20190270, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31778401

RESUMO

INTRODUCTION: Trypanosomes can infect humans and animals. This is the first record of the occurrence of Trypanosoma evansi in Rondônia. METHODS: Blood samples were collected from 7 dogs and 22 humans. Furthermore, triatomines and tabanids were collected. RESULTS: It was observed that 42.8% of the dogs tested positive for T. evansi and 14.3% presented mixed infection; 15% of the triatomines tested positive for flagellates identified as T. cruzi TCI (3 specimens), T. cruzi TCI, and T. rangeli (1 specimen), and one with T. cruzi TCV. Two tabanids were infected with T. theileri. CONCLUSIONS: These findings may benefit vector control strategies.


Assuntos
Anticorpos Antiprotozoários/sangue , Doença de Chagas/epidemiologia , Insetos Vetores/parasitologia , Rhodnius/parasitologia , Trypanosoma/isolamento & purificação , Animais , Brasil/epidemiologia , Doença de Chagas/diagnóstico , Doença de Chagas/parasitologia , Cães , Inquéritos Epidemiológicos , Humanos , Trypanosoma/classificação
17.
Parasit Vectors ; 12(1): 478, 2019 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-31610815

RESUMO

BACKGROUND: Mepraia gajardoi and Mepraia spinolai are endemic triatomine vector species of Trypanosoma cruzi, a parasite that causes Chagas disease. These vectors inhabit arid, semiarid and Mediterranean areas of Chile. Mepraia gajardoi occurs from 18° to 25°S, and M. spinolai from 26° to 34°S. Even though both species are involved in T. cruzi transmission in the Pacific side of the Southern Cone of South America, no study has modelled their distributions at a regional scale. Therefore, the aim of this study is to estimate the potential geographical distribution of M. spinolai and M. gajardoi under current and future climate scenarios. METHODS: We used the Maxent algorithm to model the ecological niche of M. spinolai and M. gajardoi, estimating their potential distributions from current climate information and projecting their distributions to future climatic conditions under representative concentration pathways (RCP) 2.6, 4.5, 6.0 and 8.5 scenarios. Future predictions of suitability were constructed considering both higher and lower public health risk situations. RESULTS: The current potential distributions of both species were broader than their known ranges. For both species, climate change projections for 2070 in RCP 2.6, 4.5, 6.0 and 8.5 scenarios showed different results depending on the methodology used. The higher risk situation showed new suitable areas, but the lower risk situation modelled a net reduction in the future potential distribution areas of M. spinolai and M. gajardoi. CONCLUSIONS: The suitable areas for both species may be greater than currently known, generating new challenges in terms of vector control and prevention. Under future climate conditions, these species could modify their potential geographical range. Preventive measures to avoid accidental human vectorial transmission by wild vectors of T. cruzi become critical considering the uncertainty of future suitable areas projected in this study.


Assuntos
Doença de Chagas/transmissão , Mudança Climática , Insetos Vetores/fisiologia , Triatominae/fisiologia , Trypanosoma cruzi/fisiologia , Animais , Área Sob a Curva , Doença de Chagas/epidemiologia , Chile/epidemiologia , Humanos , Umidade , Insetos Vetores/parasitologia , Modelos Biológicos , Filogeografia , Curva ROC , Chuva , Medição de Risco , Temperatura , Triatominae/parasitologia
18.
Int. j. cardiovasc. sci. (Impr.) ; 32(5): 546-550, Sept-Oct. 2019. ilus
Artigo em Inglês | LILACS | ID: biblio-1040097

RESUMO

We present a case of a female adolescent with severe acute Chagas myocarditis, acquired by oral transmission in an endemic area in the Brazilian western Amazon, who had electrocardiographic changes normalized after empirical treatment with the antiparasitic drug benznidazole combined with conventional treatment for severe heart failure


Assuntos
Humanos , Feminino , Criança , Cardiomiopatia Chagásica , Doença de Chagas/epidemiologia , Eletrocardiografia/métodos , Volume Sistólico , Trypanosoma cruzi , Ecocardiografia/métodos , Insuficiência Cardíaca , Antiparasitários/uso terapêutico
19.
PLoS Negl Trop Dis ; 13(9): e0007447, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31557155

RESUMO

BACKGROUND: Chagas disease (CD) affects over 300,000 people in the United States, but fewer than 1% have been diagnosed and less than 0.3% have received etiological treatment. This is a significant public health concern because untreated CD can produce fatal complications. What factors prevent people with CD from accessing diagnosis and treatment in a nation with one of the world's most advanced healthcare systems? METHODOLOGY/PRINCIPAL FINDINGS: This analysis of barriers to diagnosis and treatment of CD in the US reflects the opinions of the authors more than a comprehensive discussion of all the available evidence. To enrich our description of barriers, we have conducted an exploratory literature review and cited the experience of the main US clinic providing treatment for CD. We list 34 barriers, which we group into four overlapping dimensions: systemic, comprising gaps in the public health system; structural, originating from political and economic inequalities; clinical, including toxicity of medications and diagnostic challenges; and psychosocial, encompassing fears and stigma. CONCLUSIONS: We propose this multidimensional framework both to explain the persistently low numbers of people with CD who are tested and treated and as a potential basis for organizing a public health response, but we encourage others to improve on our approach or develop alternative frameworks. We further argue that expanding access to diagnosis and treatment of CD in the US means asserting the rights of vulnerable populations to obtain timely, quality healthcare.


Assuntos
Doença de Chagas/epidemiologia , Assistência à Saúde , Doença de Chagas/diagnóstico , Doença de Chagas/parasitologia , Doença de Chagas/terapia , Humanos , Saúde Pública , Trypanosoma cruzi/fisiologia , Estados Unidos/epidemiologia
20.
Acta Trop ; 200: 105167, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31513762

RESUMO

It is not currently known which individuals with chronic Chagas disease (ChD) will develop cardiopathy in a determined period and which will be maintained asymptomatic with normal routine laboratory tests all their lives. The parasite burden is a factor that could explain this different evolution. The objective of this study was to quantify Trypanosoma cruzi burden by real-time PCR in blood (qPCR-B) and dejections of triatomines fed by xenodiagnosis (qPCR-XD) in 90 individuals with chronic ChD untreated, classified according to XD results and the presence or absence of cardiopathy. All individuals came from hyperendemic areas of Chile and participated in the study under Informed Consent. The standard qPCR curves for qPCR-B and qPCR-XD were elaborated with a mixture of known concentrations of T. cruzi strains, performing DNA serial dilutions (1/10) with a dynamic range between 105 and 10-1 parasite equivalents/mL. The TaqManⓇ detection system was applied in a Stratagene Mx3000P thermocycler (Agilent Technologies, USA) with cruzi 1 and cruzi 2 satellite primers. 22.2% and 15.6% of cases with cardiopathy or without cardiopathy were XD positive. There was no significant difference between the groups. The positivity of qPCR-B and qPCR-XD in the positive XD group was 82.35% and 100%, respectively, while in the negative XD group was 55.26% and 42.10%, respectively. A superior qPCR value in chronic ChD patients with and without cardiopathy was determined for qPCR in cases with positive XD and positive qPCR-XD. The receiver operating characteristic (ROC) curve analyses show better accuracy for detecting parasite burden (area under the curve, AUC) for qPCR-XD in comparison to qPCR-B. That is to say, major performance in DNA samples obtained of positive XD (gold standard for viable T. cruzi) detected and quantified by qPCR-XD. A high percentage of cases with XD and qPCR-XD positive (80-100%) have result concordant with qPCR-B. In absence of XD, future challenges are especially related to the low parasitic load of chronic ChD patients treated with trypanocidal drugs and post-therapy parasitological evaluations by qPCR-B. Finally, no statistically significant differences were found between presence or absence of cardiopathy and XD, qPCR-B or qPCR-XD.


Assuntos
Doença de Chagas/complicações , Doença de Chagas/parasitologia , Cardiopatias/etiologia , Carga Parasitária , Triatoma/parasitologia , Trypanosoma cruzi/isolamento & purificação , Xenodiagnóstico/métodos , Adulto , Fatores Etários , Idoso , Animais , Doença de Chagas/sangue , Doença de Chagas/epidemiologia , Chile/epidemiologia , Doença Crônica/epidemiologia , Testes Diagnósticos de Rotina , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase em Tempo Real/métodos , Tripanossomicidas , Trypanosoma cruzi/genética
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