Evolution of Chagas’ disease in Brazil. Epidemiological perspective and challenges for the future: a critical review

Aims: This paper aimed to provide a critical review of the evolution of Chagas’ disease in Brazil, its magnitude, historical development and management, and challenges for the future. Methods: A literature search was performed using PubMed, SciELO and Google Scholar and throughout collected articles’ references. Narrative analysis was structured around five main themes identified: vector transmission, control program, and transfusion, oral and congenital transmission. Results: In Brazil, the Chagas’ disease Control Program was fully implemented in the 1980s, when it reached practically all the endemic areas, and in 1991, the Southern Cone Initiative was created, aiming to eliminate the disease transmission through eliminating the Triatoma infestans and controlling blood banks. As a result, the prevalence of chagasic donors in blood banks reduced from 4.4% in the 80s to 0.2% in 2005. In 2006, PAHO certified the interruption of transmission of Chagas’ disease through this vector in Brazil. However, there are still challenges, such as the domiciliation of new vector species, the need for medical care of the infected individuals, the prevention of alternative mechanisms of transmission, the loss of political concern regarding the disease and, the weakening of the control program. Conclusion: Despite the progress towards control, there are still many challenges ahead to maintain and expand such control and minimise the risk of re-emergence

SEROLOGICAL DETECTION OF HEPATITIS A VIRUS IN FREE-RANGING NEOTROPICAL PRIMATES (Sapajus spp., Alouatta caraya) FROM THE PARANÁ RIVER BASIN, BRAZIL

Nonhuman primates are considered as the natural hosts of Hepatitis A virus (HAV), as well as other pathogens, and can serve as natural sentinels to investigate epizootics and endemic diseases that are of public health importance. During this study, blood samples were collected from 112 Neotropical primates (NTPs) (Sapajus nigritus and S. cay, n = 75; Alouatta caraya, n = 37) trap-captured at the Paraná River basin, Brazil, located between the States of Paraná and Mato Grosso do Sul. Anti-HAV IgG antibodies were detected in 4.5% (5/112) of NTPs, specifically in 6.7% (5/75) of Sapajus spp. and 0% (0/37) of A. caraya. In addition, all samples were negative for the presence of IgM anti-HAV antibodies. These results suggest that free-ranging NTPs were exposed to HAV within the geographical regions evaluated

Occurrence and distribution of triatomines (Hemiptera: Reduviidae) in municipalities of the Northeastern region of Minas Gerais State, Brazil

Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Laboratório de Triatomíneos e Epidemiologia da Doença de Chagas. Belo Horizonte, MG, Brazil/ Universidade Federal dos Vales do Jequitinhonha e Mucuri. Grupo de Extensão e Pesquisa em Saúde Coletiva Jequi. Diamantina, MG, Brazil.Prefeitura de Diamantina. Superintendência Regional de Saúde de Diamantina. Diamantina, MG, Brazil.Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Laboratório de Triatomíneos e Epidemiologia da Doença de Chagas. Belo Horizonte, MG, Brazil/ Universidade Federal dos Vales do Jequitinhonha e Mucuri. Grupo de Extensão e Pesquisa em Saúde Coletiva Jequi. Diamantina, MG, Brazil.Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Laboratório de Triatomíneos e Epidemiologia da Doença de Chagas. Belo Horizonte, MG, Brazil.INTRODUCTION: Triatomines are targeted for the control of Chagas disease in endemic areas of Brazil. METHODS: Data regarding triatomines captured during 2001-2008 in 34 municipalities in the Northeast of Minas Gerais were analyzed. RESULTS: In total, 11,187 triatomines from eight species were captured, mostly in henhouses and bedrooms. Trypanosomes were found in 203 samples. Main species were Triatoma sordida, Panstrongylus megistus, and Triatoma vitticeps. The number of P. megistus adults was positively correlated with temperature and precipitation, whereas the number of nymphs followed the inverse pattern. CONCLUSIONS: Occurrence of triatomines in domiciles indicates the need for sustained entomological surveillance

Phlebotominae (Diptera: Psychodidae) de Lagoas, município de Buriticupu, Amazônia Maranhense. I - Riqueza e abundância relativa das espécies em área de colonização recente Sand flies (Diptera: Psychodidae) of Lagoas, municipal district of Buriticupu, Amazonia of Maranhão. I - Richness and relative abundance of the species in area of recent colonisation

Este estudo determinou a riqueza de espécies e a abundância relativa dos flebotomíneos da comunidade de Lagoas, em Buriticupu, na Amazônia Maranhense. O estudo consistiu na captura de formas adultas com auxílio de armadilhas luminosas tipo CDC e armadilha de Shannon, das 18 às 6 horas, uma vez por mês, de dezembro/95 a janeiro/97, em ambiente florestal e extraflorestal (peri e intradomicílios). No total, capturou-se 9.392 espécimens (4.302 machos e 5.090 fêmeas) distribuídos em 38 espécies (1 Brumptomyia e 37 Lutzomyia). A riqueza e abundância de espécies foram maiores na mata, seguida do peri e intradomicílio. Na mata, as espécies mais freqüentes foram Lutzomyia whitmani (64,9%), L. migonei (27%) e L. serrana (3,6%). No peridomicílio, predominaram L. evandroi (55,4%), L. whitmani (33,4%) e L. migonei (6,4%) e no intra, L. evandroi (97,9%). O predomínio no ambiente silvestre resulta das potencialidades ainda encontradas nas glebas remanescentes da floresta tão explorada pelas atividades madeireira e agropecuária. Por outro lado, a peridomiciliação de 7,7% das espécies reverteu-se de grande importância epidemiológica, haja visto a existência de pacientes com leishmanioses que julgam ter adquirido a infecção nas proximidades de suas habitações.<br>In this study the diversity of the species and relative abundance of the sand flies in the Amazonian community of Lagoas, in Buriticupu, Maranhão State, was determined. The study consisted of adult sandflies captured with CD light-traps, Shannon-trap and manual aspiration tube, between 18 PM and 6 AM, once a month, from December/95 to January/97, in a forest fragment and in the domestic environment (peri and intra). In all, 9,393 specimens were captured (4,302 males and 5,140 females) distributed among 38 species (1 Brumptomyia and 37 Lutzomyia). The diversity and abundance of species was higher in the forest, followed by the peri and intra. The predominance in the wild ambient is a consequence of the potentialities found in the remaining fragments of the forest which have survived the lumber yard exploitation and agricultural activities. In the forest environment Lutzomyia whitmani (64.9%), L. migonei (27%) and L. serrana (3.6%) were the most frequent species. In the peri and intra domicile L. evandroi predominated (55.4% and 97.9%). The species, L. whitmani (33.4%) and L. migonei (6.4%), were important in the peri domicile. The peridomestic habit of 7.7% of the sand flies showed the greatest epidemiologic importance, due to the existence of patients with leishmaniasis ulcers, who believe they were infected near their habitations