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Sample records for chagas cardiopathy patients

  1. Acute Chagas' cardiopathy in a polar bear (Ursus maritimus in Guadalajara, Mexico

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    Jaime-Andrade G. J.

    1997-01-01

    Full Text Available We report a 24 year old female polar bear (Ursus maritimus who contracted Chagas' infection at the Guadalajara Zoo, in Jalisco, México, and died of acute Chagas' carditis 15 days later. The histopathological findings are described, as well as the presence of triatomines (Triatoma longipennis Usinger infected with Trypanosoma cruzi collected within 5 meters from the place where the animal lived in the city of Guadalajara.

  2. Risk factors for falls in hospitalized patients with ischemic cardiopathy

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    Nila Larisse Silva de Albuquerque; Milena Jamile de Assis Sisnando; Silvestre Péricles Cavalcante Sampaio Filho; Huana Carolina Cândido Morais; Marcos Venícios de Oliveira Lopes; Thelma Leite de Araujo

    2013-01-01

    This study aimed to identify the presence of the Nursing Diagnosis Risk for Falls in hospitalized patients with ischemic heart disease in Fortaleza, Ceará, Brazil. This was a descriptive and quantitative study. Data collection happened from July 2010 to February 2011, through interviews, physical examination and by consulting medical records. We used an instrument to investigate the clinical and socio-demographic profile of the patients and also a check-list consisting of the Nursing Diagnosi...

  3. Risk factors for falls in hospitalized patients with ischemic cardiopathy

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    Nila Larisse Silva de Albuquerque

    2013-05-01

    Full Text Available This study aimed to identify the presence of the Nursing Diagnosis Risk for Falls in hospitalized patients with ischemic heart disease in Fortaleza, Ceará, Brazil. This was a descriptive and quantitative study. Data collection happened from July 2010 to February 2011, through interviews, physical examination and by consulting medical records. We used an instrument to investigate the clinical and socio-demographic profile of the patients and also a check-list consisting of the Nursing Diagnosis risk factors. Of the 86 participants, 56.5% were male, mean age of 63.95 (±12.6 years. All the participants had more than two risk factors for falls, 46.5% presented six to nine concurrent risk factors. Among the investigated risk factors we identified: use of antihypertensive drugs (98.8%, visual impairment (66.3%, and sleeplessness (54.3%. Therefore, it is important for nurses to plan the care in order to prevent falls, especially for hospitalized patients with ischemic heart disease.

  4. Estudo pareado da cardiopatia chagásica no Rio Grande do Sul, Brasil Matched study of Chagas' cardiopathy in Rio Grande do Sul, Brazil

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    Giovanni Baruffa

    1985-12-01

    Full Text Available São estudados 666 pares de indivíduos, sendo 344 masculinos e 322 femininos, com sorologia positiva/negativa para doença de Chagas, obtidos em inquérito sorológico-eletrocardiográfico entre populações rurais não selecionadas de 17 municípios do sul Rio Grande do Sul, Brasil. Na análise dos eletrocardiogramas foram consideradas só as alterações sugestivas de cardiopatia chagásica: bloqueio átrio-ventricular de 1º, e 2º e 3º, BCRD isolado ou associado ao HBAE, HBAE isolado, extrasístoles ventriculares freqüentes e/ou polifocais e/ou bigeminadas e trigeminadas; alterações de ST e T; zonas eletricamente inativas. Com este critério apresentaram eletrocardiogramas alterados 201 pessoas soropositivas (30,2% e 66 soronegativas (9,9%. O gradiente de 20,3%, sendo 21,5% nos homens e 18,9% nas mulheres, mostrou-se significativo ao nível de p A study of 666 matched pairs (344 males and 322 females with positive/negative complement fixation test for Chagas' disease is reported. The pairs were obtained at random by a serological and eletrocardiographical study among rural people of an endemic area in Southern Rio Grande do Sul, Brazil (17 municipalities. Besides non specific ECG alterations, the following abnormalities suggestive of Chagas' aetiology were found: atrio-ventricular complete or incomplete block; right bundle branch block either isolated or in association with left hemiblock; frequent and/or polyfocal and/or bigeminated or trigeminated premature beats; abnormalities in ST and T; eletrically inactive areas. According to these criteria 201 seropositive (30.2% and 66 seronegative (9.9% individuals showed abnormal ECG signs. The 20.3% gradient, (21.5% in male and 18.9% in female pairs, of the matched pairs was significant at p < 0,001 level. According to these results, a significant prevalence of eletrocardiografical abnormalities suggesting chagastic cardiomiopathy occurs in seropositive individuals.

  5. O perfil dos portadores de doença de Chagas, com ênfase na forma digestiva, em hospital terciário de Ribeirão Preto, SP Features of Chagas' disease patients with emphasis on digestive form, in a tertiary hospital of Ribeirão Preto, SP

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    Mayra Mayumi Kamiji

    2005-08-01

    Full Text Available Para caracterizar o perfil clínico e demográfico dos portadores da forma digestiva da doença de Chagas atualmente atendidos no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, foram revistos 377 prontuários de pacientes com resultado positivo para reação sorológica para a doença de Chagas atendidos entre janeiro de 2002 a março de 2003. A idade mediana dos pacientes era de 67 anos e 210 (56% eram mulheres. Megaesôfago e/ou megacólon chagásicos estavam presentes em 135 pacientes, dos quais, 59% apresentavam cardiopatia. Para 49% dos pacientes com doença digestiva, havia prescrição de pelo menos dois medicamentos para tratamento de doença cardiovascular. Em 66 pacientes, foram detectadas comorbidades crônicas. A população de portadores da forma digestiva da doença de Chagas do HCFMRP é majoritariamente geriátrica e apresenta freqüência elevada de doenças cardiovasculares, o que sugere risco elevado das modalidades de tratamento cirúrgico do megaesôfago e megacólon.In order to characterize the demographic and clinical profile of patients with digestive manifestations of Chagas' disease, the medical records were reviewed of patients (n = 377 currently attended at Hospital das Clinicas da Faculdade de Medicina de Ribeirão Preto with positive serologic reaction for Chagas' disease and admitted from January 2002 to March 2003. Median age was 67 years and 210 (56% were women. Megaesophagus and/or megacolon were present in 135 patients, 59% of these had cardiopathy. For 49% of patients with digestive disease, at least two medical prescriptions of medicines for the treatment of cardiovascular diseases were found. In 66 patients, chronic comorbidities were detected. The population with digestive manifestation of Chagas' disease referred to HCFMRP is mostly geriatric, with an elevated frequency of cardiopathy, which may indicate a high risk for surgical approach to the treatment of chagasic megaesophagus and

  6. Lineage analysis of circulating Trypanosoma cruzi parasites and their association with clinical forms of Chagas disease in Bolivia.

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    Ramona del Puerto

    Full Text Available BACKGROUND: The causative agent of Chagas disease, Trypanosoma cruzi, is divided into 6 Discrete Typing Units (DTU: Tc I, IIa, IIb, IIc, IId and IIe. In order to assess the relative pathogenicities of different DTUs, blood samples from three different clinical groups of chronic Chagas disease patients (indeterminate, cardiac, megacolon from Bolivia were analyzed for their circulating parasites lineages using minicircle kinetoplast DNA polymorphism. METHODS AND FINDINGS: Between 2000 and 2007, patients sent to the Centro Nacional de Enfermedades Tropicales for diagnosis of Chagas from clinics and hospitals in Santa Cruz, Bolivia, were assessed by serology, cardiology and gastro-intestinal examinations. Additionally, patients who underwent colonectomies due to Chagasic magacolon at the Hospital Universitario Japonés were also included. A total of 306 chronic Chagas patients were defined by their clinical types (81 with cardiopathy, 150 without cardiopathy, 100 with megacolon, 144 without megacolon, 164 with cardiopathy or megacolon, 73 indeterminate and 17 cases with both cardiopathy and megacolon. DNA was extracted from 10 ml of peripheral venous blood for PCR analysis. The kinetoplast minicircle DNA (kDNA was amplified from 196 out of 306 samples (64.1%, of which 104 (53.3% were Tc IId, 4 (2.0% Tc I, 7 (3.6% Tc IIb, 1 (0.5% Tc IIe, 26 (13.3% Tc I/IId, 1 (0.5% Tc I/IIb/IId, 2 (1.0% Tc IIb/d and 51 (25.9% were unidentified. Of the 133 Tc IId samples, three different kDNA hypervariable region patterns were detected; Mn (49.6%, TPK like (48.9% and Bug-like (1.5%. There was no significant association between Tc types and clinical manifestations of disease. CONCLUSIONS: None of the identified lineages or sublineages was significantly associated with any particular clinical manifestations in the chronic Chagas patients in Bolivia.

  7. Does my patient have chronic Chagas disease? Development and temporal validation of a diagnostic risk score

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    Pedro Emmanuel Alvarenga Americano do Brasil; Sergio Salles Xavier; Marcelo Teixeira Holanda; Alejandro Marcel Hasslocher-Moreno; José Ueleres Braga

    2016-01-01

    Abstract: INTRODUCTION With the globalization of Chagas disease, unexperienced health care providers may have difficulties in identifying which patients should be examined for this condition. This study aimed to develop and validate a diagnostic clinical prediction model for chronic Chagas disease. METHODS This diagnostic cohort study included consecutive volunteers suspected to have chronic Chagas disease. The clinical information was blindly compared to serological tests results, and a ...

  8. Radioisotopic exploration of patients suffering from chronic Chagas' disease

    International Nuclear Information System (INIS)

    The importance of Chagas' disease - a histic and haematic parasitosis endemic in extensive areas of Latin America, with 60 million people exposed to it and 20 million infected - stems from the high sickness and mortality rates affecting mainly rural and fringe populations. Nevertheless, progressive urbanization of the disease due to population migration and blood transfusion is being observed. The authors studied 56 cases of patients with Chagas' disease, 45 of whom were detected asymptomatically when donating blood by immunoserological reactions involving complement fixation and haemagglutination. Radiotracers were used to explore ventricular function in 56 cases; oesophageal transit in 29 cases; the upper urinary tract in 25 cases; and bladder function in 22 cases. All four procedures were applied to 19 patients. In 40 patients a study was made of the left and right ventricular function, the left being found altered in 17% of the cases, the right ventricular function in 22% and both in 25%. In 26 cases (65%) anomalies were encountered in at least one of the two ventricles. Oesophageal transit was altered in 20 patients, 16 of them asymptomatically. In 6 of them it was prolonged, in 4 it was adynamic and in 10 cases uncoordinated. The upper urinary tract showed abnormalities (pyelic dilation, pyelo-ureteral dyskinesia, ureteral dyskinesia, ureteral dilation and/or vesico-ureteral reflux) in 22 patients, in all cases asymptomatically. Bladder function was abnormal in 18 asymptomatic patients, basically represented by a residual decompensated cystopathy with a hypotonicity of different degrees. Of the 45 patients without symptoms detected when donating blood, there was alteration of ventricular function in 49%, of oesophageal transit in 68%, of the upper urinary tract in 90%, and of bladder function in 78%, with an overall figure of 66% abnormal examinations from 106 radioisotopic studies

  9. Representações, mitos e comportamentos do paciente submetido ao implante de marcapasso na doença de Chagas Representations, myths, and behaviors among Chagas disease patients with pacemakers

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    Claudia Magnani

    2007-07-01

    Full Text Available Estudo antropológico sobre o modo de incorporação e as repercussões do implante do marcapasso na vida do indivíduo portador da doença de Chagas. Foi realizada uma pesquisa etnográfica baseada no instrumento de entrevista aberta, buscando identificar a percepção do estado de saúde de um grupo de 15 pacientes portadores de cardiopatia Chagásica crônica que necessitaram de implante de marcapasso, atendidos no Ambulatório de Marcapasso do Hospital das Clínicas da Universidade Federal de Minas Gerais, em Belo Horizonte, Minas Gerais, Brasil. Utilizou-se o referencial da qualidade de vida para observar os recursos culturais, físicos e psicológicos que os pacientes utilizam para enfrentar, explicar e aceitar o processo de adoecimento, incluindo as representações mentais que constroem o sentido cultural da doença e definem as relações sociais. O estudo pretende contribuir para que os profissionais de saúde atendam seus pacientes em sua integralidade. A orientação decodificada e integrada no âmbito cultural assume um papel importante para evitar que a desinformação perpetue a difusão de mitos populares, que, por vezes, se tornam preconceitos e elementos sociais ativos de estigma do indivíduo portador de cardiopatia.This anthropological study aimed to evaluate the incorporation of pacemakers into the lives of individuals with Chagas disease. An ethnographic methodology was used, based on an open interview focusing on the personal perceptions of 15 patients with chronic Chagas cardiopathy who had required pacemaker implants at the Federal University Hospital in Belo Horizonte, Minas Gerais State, Brazil. As part of a broader quality of life analysis, the study investigated the cultural, physical, and psychological resources used by patients to confront, explain, and accept the disease process, including mental representations on the cultural perception of the illness and definition of social relations. The study was intended to

  10. Inflammation Enhances the Risks of Stroke and Death in Chronic Chagas Disease Patients

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    Guedes, Paulo Marcos Matta; de Andrade, Cléber Mesquita; Nunes, Daniela Ferreira; de Sena Pereira, Nathalie; Queiroga, Tamyres Bernadete Dantas; Machado-Coelho, George Luiz Lins; Nascimento, Manuela Sales Lima; Do-Valle-Matta, Maria Adelaide; da Câmara, Antônia Cláudia Jácome; Chiari, Egler; Galvão, Lúcia Maria da Cunha

    2016-01-01

    Ischemic strokes have been implicated as a cause of death in Chagas disease patients. Inflammation has been recognized as a key component in all ischemic processes, including the intravascular events triggered by vessel interruption, brain damage and repair. In this study, we evaluated the association between inflammatory markers and the death risk (DR) and stroke risk (SR) of patients with different clinical forms of chronic Chagas disease. The mRNA expression levels of cytokines, transcript...

  11. Aortic distensibility measured by pulse-wave velocity is not modified in patients with Chagas' disease

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    Arteaga Edmundo

    2006-06-01

    Full Text Available Abstract Background Experimental studies demonstrate that infection with trypanosoma cruzi causes vasculitis. The inflammatory lesion process could hypothetically lead to decreased distensibility of large and small arteries in advanced Chagas' disease. We tested this hypothesis. Methods and results We evaluated carotid-femoral pulse-wave velocity (PWV in 53 Chagas' disease patients compared with 31 healthy volunteers (control group. The 53 patients were classified into 3 groups: 1 16 with indeterminate form of Chagas' disease; 2 18 with Chagas' disease, electrocardiographic abnormalities, and normal systolic function; 3 19 with Chagas' disease, systolic dysfunction, and mild-to-moderate congestive heart failure. No difference was noted between the 4 groups regarding carotid-femoral PWV (8.4 ± 1.1 vs 8.2 ± 1.5 vs 8.2 ± 1.4 vs 8.7 ± 1.6 m/s, P = 0.6 or pulse pressure (39.5 ± 7.6 vs 39.3 ± 8.1 vs 39.5 ± 7.4 vs 39.7 ± 6.9 mm Hg, P = 0.9. A positive, significant, similar correlation occurred between PWV and age in patients with Chagas' disease (r = 0.42, P = 0.002, in controls (r = 0.48, P = 0.006, and also between PWV and systolic blood pressure in both groups (patients with Chagas' disease, r = 0.38, P = 0.005; healthy subjects, r = 0.36, P = 0.043. Conclusion Carotid femoral pulse-wave velocity is not modified in patients with Chagas' disease, suggesting that elastic properties of large arteries are not affected in this disorder.

  12. Does my patient have chronic Chagas disease? Development and temporal validation of a diagnostic risk score

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    Pedro Emmanuel Alvarenga Americano do Brasil

    2016-06-01

    Full Text Available Abstract: INTRODUCTION With the globalization of Chagas disease, unexperienced health care providers may have difficulties in identifying which patients should be examined for this condition. This study aimed to develop and validate a diagnostic clinical prediction model for chronic Chagas disease. METHODS This diagnostic cohort study included consecutive volunteers suspected to have chronic Chagas disease. The clinical information was blindly compared to serological tests results, and a logistic regression model was fit and validated. RESULTS The development cohort included 602 patients, and the validation cohort included 138 patients. The Chagas disease prevalence was 19.9%. Sex, age, referral from blood bank, history of living in a rural area, recognizing the kissing bug, systemic hypertension, number of siblings with Chagas disease, number of relatives with a history of stroke, ECG with low voltage, anterosuperior divisional block, pathologic Q wave, right bundle branch block, and any kind of extrasystole were included in the final model. Calibration and discrimination in the development and validation cohorts (ROC AUC 0.904 and 0.912, respectively were good. Sensitivity and specificity analyses showed that specificity reaches at least 95% above the predicted 43% risk, while sensitivity is at least 95% below the predicted 7% risk. Net benefit decision curves favor the model across all thresholds. CONCLUSIONS: A nomogram and an online calculator (available at http://shiny.ipec.fiocruz.br:3838/pedrobrasil/chronic_chagas_disease_prediction/ were developed to aid in individual risk estimation.

  13. Pupillary Light Reflexes are Associated with Autonomic Dysfunction in Bolivian Diabetics But Not Chagas Disease Patients.

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    Halperin, Anthony; Pajuelo, Monica; Tornheim, Jeffrey A; Vu, Nancy; Carnero, Andrés M; Galdos-Cardenas, Gerson; Ferrufino, Lisbeth; Camacho, Marilyn; Justiniano, Juan; Colanzi, Rony; Bowman, Natalie M; Morris, Tiffany; MacDougall, Hamish; Bern, Caryn; Moore, Steven T; Gilman, Robert H

    2016-06-01

    Autonomic dysfunction is common in Chagas disease and diabetes. Patients with either condition complicated by cardiac autonomic dysfunction face increased mortality, but no clinical predictors of autonomic dysfunction exist. Pupillary light reflexes (PLRs) may identify such patients early, allowing for intensified treatment. To evaluate the significance of PLRs, adults were recruited from the outpatient endocrine, cardiology, and surgical clinics at a Bolivian teaching hospital. After testing for Chagas disease and diabetes, participants completed conventional autonomic testing (CAT) evaluating their cardiovascular responses to Valsalva, deep breathing, and orthostatic changes. PLRs were measured using specially designed goggles, then CAT and PLRs were compared as measures of autonomic dysfunction. This study analyzed 163 adults, including 96 with Chagas disease, 35 patients with diabetes, and 32 controls. PLRs were not significantly different between Chagas disease patients and controls. Patients with diabetes had longer latency to onset of pupil constriction, slower maximum constriction velocities, and smaller orthostatic ratios than nonpatients with diabetes. PLRs correlated poorly with CAT results. A PLR-based clinical risk score demonstrated a 2.27-fold increased likelihood of diabetes complicated by autonomic dysfunction compared with the combination of blood tests, CAT, and PLRs (sensitivity 87.9%, specificity 61.3%). PLRs represent a promising tool for evaluating subclinical neuropathy in patients with diabetes without symptomatic autonomic dysfunction. Pupillometry does not have a role in the evaluation of Chagas disease patients. PMID:27044564

  14. Esophageal striated muscle contractions in patients with Chagas' disease and idiopathic achalasia

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    R.O. Dantas

    2002-06-01

    Full Text Available Chagas' disease causes degeneration and reduction of the number of intrinsic neurons of the esophageal myenteric plexus, with consequent absent or partial lower esophageal sphincter relaxation and loss of peristalsis in the esophageal body. The impairment of esophageal motility is seen mainly in the distal smooth muscle region. There is no study about esophageal striated muscle contractions in the disease. In 81 patients with heartburn (44 with esophagitis taken as controls, 51 patients with Chagas' disease (21 with esophageal dilatation and 18 patients with idiopathic achalasia (11 with esophageal dilatation we studied the amplitude, duration and area under the curve of esophageal proximal contractions. Using the manometric method and a continuous perfusion system we measured the esophageal striated muscle contractions 2 to 3 cm below the upper esophageal sphincter after swallows of a 5-ml bolus of water. There was no significant difference in striated muscle contractions between patients with heartburn and esophagitis and patients with heartburn without esophagitis. There was also no significant difference between patients with heartburn younger or older than 50 years or between men and women or in esophageal striated muscle contractions between patients with heartburn and Chagas' disease. The esophageal proximal amplitude of contractions was lower in patients with idiopathic achalasia than in patients with heartburn. In patients with Chagas' disease there was no significant difference between patients with esophageal dilatation and patients with normal esophageal diameter. Esophageal striated muscle contractions in patients with Chagas' disease have the same amplitude and duration as seen in patients with heartburn. Patients with idiopathic achalasia have a lower amplitude of contraction than patients with heartburn.

  15. Study of the hypothalamic - hypophyseal - thyroid axis by the administration of TRH to Chagas' disease patients

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    The TSH and T3 response to synthetic TRH was evaluated in two groups of patients: normal and with Chagas' disease, from the urban area of Sao Paulo (Brazil). Plasma T4, PBI and TSH values were within the normal range, when compared with those found in the controls: So were the thyroid uptakes of 2 and 24 hours; the basal levels of T3 where within the normal range except in three subjects whose values were higher than normal. After TRH administration the amount of TSH secretion in patients with Chagas' disease was increased when compared to normal ones, while T3 secretion was unaltered. It is suggested that in the Chagas' disease there is an increase in the pituitary TSH, while the thyroid reserve is preserved. This increase could be due to a difference in the regulation rate of TRH, which is determined by the neuronal degeneration caused by the disease itself. (author)

  16. [Pulmonary uptake of thallium-201 at rest and diastolic function in patients with ischemic cardiopathy and left ventricular dysfunction].

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    Marcassa, C; Galli, M; Imparato, A; Temporelli, P L; Giannuzzi, P

    1998-09-01

    An elevated thallium-201 lung uptake after stress is currently considered a marker of severe coronary artery involvement and related to adverse prognosis. The meaning of this scintigraphic finding on rest thallium-201 images is yet poorly investigated. We compared the thallium-201 lung uptake and the left ventricular diastolic function from mitral Doppler in 24 patients (64 +/- 10 years) with ischemic heart disease and severe left ventricular dysfunction (ejection fraction 28 +/- 10%). All patients underwent a 3-view planar rest-redistribution thallium-201 and 2D-echo studies within 6 days, while clinically stable. The amount of thallium-201 lung uptake was quantified as the ratio (L/H) between the activity in a left lung region of interest (L) and that observed in the left ventricle (H). From mitral Doppler, early (E) and late (A) filling velocities, the E/A ratio and the deceleration time of early filling (DecT) were calculated. An elevated L/H (> or = 0.54) was observed in 9 patients (37%). They showed a lower ejection fraction (20 +/- 4% vs 33 +/- 10% in patients with normal L/H; p < 0.01) and a higher wall motion score index (2.5 +/- 0.4 vs 2.1 +/- 0.4, p < 0.05). A significant inverse linear relation was observed between L/H and the left ventricular ejection fraction (r = -0.70); no significant relation was observed between L/H and left ventricular end-diastolic volumes or wall motion score index. A significant linear relation was also observed between L/H and E/A (r = 0.74; p < 0.001) as well as L/H and DecT (r = -0.61; p < 0.001); an even stronger, inverse, relation was found between L/H and A (r = -0.81; p < 0.001). An abnormal L/H identified 80% of patients with a restrictive filling pattern (specificity 93% and accuracy 88%, respectively). In conclusion, in stable patients with ischemic heart disease and ventricular dysfunction, L/H on rest thallium-201 images is closely correlated with Doppler indexes of left ventricular diastolic filling dynamic; an

  17. Upper esophageal sphincter pressure in patients with Chagas' disease and primary achalasia

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    Dantas R.O.

    2000-01-01

    Full Text Available The most important component of the upper esophageal sphincter (UES is the cricopharyngeal muscle. During the measurement of sphincter pressure the catheter passed through the sphincter affects the pressure value. In Chagas' disease and primary achalasia there is an esophageal myenteric plexus denervation which may affect UES pressure. We measured the UES pressure of 115 patients with Chagas' disease, 28 patients with primary achalasia and 40 healthy volunteers. We used a round manometric catheter with continuous perfusion and the rapid pull-through method, performed in triplicate during apnea. Pressures were measured in four directions, and the direction with the highest pressure (anterior/posterior and the average of the four directions were measured. The highest UES pressure in Chagas' disease patients without abnormalities upon radiologic esophageal examination (N = 63 was higher than in normal volunteers (142.8 ± 47.4 mmHg vs 113.0 ± 46.0 mmHg, mean ± SD, P<0.05. There was no difference in UES pressure between patients with primary achalasia and patients with Chagas' disease and similar esophageal involvement and normal volunteers (P>0.05. There was no difference between patients with or without esophageal dilation. In the group of subjects less than 50 years of age the UES pressure of primary achalasia (N = 21 was lower than that of Chagas' disease patients with normal radiologic esophageal examination (N = 41, measured at the site with the highest pressure (109.3 ± 31.5 mmHg vs 149.6 ± 45.3 mmHg, P<0.01 and as the average of the four directions (64.2 ± 17.1 mmHg vs 83.5 ± 28.6 mmHg, P<0.05. We conclude that there is no difference in UES pressure between patients with Chagas' disease, primary achalasia and normal volunteers, except for patients with minor involvement by Chagas' disease, for whom the UES pressure at the site with the highest pressure was higher than the pressure of normal volunteers and patients with primary

  18. Effects of aspirin-triggered resolvin D1 on peripheral blood mononuclear cells from patients with Chagas' heart disease.

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    Ogata, Haline; Teixeira, Maxelle Martins; de Sousa, Rodrigo Cunha; da Silva, Marcos Vinícius; Correia, Dalmo; Rodrigues Junior, Virmondes; Levy, Bruce David; de Paula Rogério, Alexandre

    2016-04-15

    Chagas disease is caused by Trypanosoma cruzi (T. cruzi). In some patients with Chagas disease, symptoms progress to chronic chagasic cardiomyopathy. Endogenously, inflammation is resolved in the presence of lipid mediators such as aspirin-triggered RvD1 (AT-RvD1) which has anti-inflammatory and pro-resolution effects. Here, we demonstrated, for the first time, the effects of AT-RvD1 on T. cruzi antigen-stimulated peripheral blood mononuclear cells (PBMCs) from patients with Chagas heart disease. The levels of IFN-γ, TNF-α, IL-10, and IL-13 increased in PBMCs from cardiac-form Chagas patients in stage B1 (patients with fewer heart abnormalities) stimulated with T. cruzi antigen compared to those in non-stimulated PBMCs. AT-RvD1 reduced the IFN-γ concentrations in PBMCs from patients with Chagas disease stimulated with T. cruzi antigen compared to stimulated with T. cruzi antigen cells. AT-RvD1 treatment resulted in no observable changes in TNF-α, IL-10, and IL-13 levels. AT-RvD1 significantly decreased the percentage of necrotic cells and caused a significant reduction in the proliferation rate of T. cruzi antigen-stimulated PBMCs from patients with Chagas disease. These findings demonstrate that AT-RvD1 modulates the immune response in Chagas disease patients and might have potential to be used as an alternative approach for slowing the development of further heart damage. PMID:26927755

  19. Assessment and epidemiology of Chagas' disease in patients treated in Araguaina - Tocantins

    International Nuclear Information System (INIS)

    Chagas disease (AD) was described by Carlos Chagas in 1909. It is caused by a parasite T. cruzi, transmitted by bugs, by blood transfusion, vertical and orally. The DC has two phases: acute and chronic. The evolution to the cardiac form occurs in about 30% of chronic cases and is the largest cause of mortality in chronic Chagas disease. The aim of this study was to Chagas' disease in patients of Tocantins, compared with other heart patients and asymptomatic from the standpoint of non-invasive exams using radiant energies such as echocardiography and ECG and RX. The descriptive study included 80 patients, 20 chronic form of Chagas disease, 20 indeterminate, 20 with other heart diseases, and 20 controls. There was a prevalence of 9.5% of chagasic patients treated in outpatient cardiology at Araguaina Tocantins, and 7.3% in chronic and 2.21% in the indeterminate. Of the chronic patients in the study 50% had mega esophagus and megacolon 4 (20%). Most patients had no family history of AD, nor was a smoker or drinker. Major electrocardiographic abnormalities found refer to driving. The evaluation of ICT, the chronic chagasic showed that increased by 40% of patients, 40% had esophageal changes and 20% of patients had megacolon s. The echocardiogram was abnormal in 42%). 27% of patients had EF below 55% changed. Changes in segmental contractility and Asynchrony septum were found in 80% of chronic Chagas disease. In 80% of the patients was observed diastolic dysfunction. The valvular changes occurred in 75%. Electrocardiographic abnormalities occurred in 80% of patients with CCC, while the other heart had ECG changes. Arterial hypertension had an incidence of 45% in patients with CCC and 40% in FCI. The systolic and diastolic ventricular dysfunction was more prevalent in groups that had an abnormal ECG and arrhythmia. Observed that the group of chagasic decreased ejection fraction is correlated to a higher incidence of arrhythmias besides diastolic dysfunction and related

  20. Adult congenital cardiopathy: percutaneous treatment of a complex case

    International Nuclear Information System (INIS)

    Adult congenital cardiopathy is a clinical entity difficult to treat and diagnose. Since 1982 endovascular therapy changed its approach radically (1) and in the last years the design of new appliances and better balloon catheters facilitated the implementation of therapy to a greater number of patients (2). It is the election treatment for entities such as pulmonary valve stenosis (3), atrial septal defect (4) and persistent ductus arteriosus. We present the case of complex adult congenital cardiopathy that consisted of wide atrial septal defect,pulmonary valve stenosis with severe repercussion on the right ventricle, persistent PDA with severe calcification and pulmonary arterial hypertension and systemic essential arterial hypertension that were successfully treated through interventionist endovascular therapy in the Hospital Militar Central, in Bogota.

  1. Working conditions of Chagas' disease patients in a large Brazilian city

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    Maria Elena Guariento

    1999-04-01

    Full Text Available This study evaluated the working conditions of Chagas' disease patients in the city of Campinas, São Paulo, focusing on two-hundred-fifty patients with steady employment and treated at the University Hospital (HC-FCM/Unicamp: 98% were working-age and 77.6% were men. The origin of the patients reflected the migratory process occurring among this population. Most of the patients had limited professional skills, while 63.6% had not finished primary school and 21.6% were illiterate. However, 63.6% were regularly employed under duly processed work contracts. Their jobs were mainly in general services (21.6% and heavy industry (21.2%. Some 55% of the patients reported a monthly income less than or equal to U$100.00, and 40.4% reported having been fired at least once during the last ten years, in 8.9% of the cases because of a diagnosis of Chagas' disease. Of the patients undergoing pre-hiring physical examinations (57.2%, 9.1% were refused, 92.3% of whom due to positive serology for T. cruzi. Finally, 78.4% reported not belonging to a labor union. The study demonstrated the precarious working conditions and discrimination experienced by workers with Chagas' disease.

  2. Brain Chagas'disease: increasing differential diagnosis of brain mass in immunosuppressed patients - a case report and literature revision

    International Nuclear Information System (INIS)

    The authors present a case of Chagas'disease as tumor-like lesion of the brain, in a patient with Aids, simulating the lesions most frequently found in these patients, as toxoplasmosis, lymphoma and cryptococcosis. Furthermore, the case reported have peculiarity to be the only with lesion documented in cerebellum, and unusual due to be secondary by reactivation of chronic Chagas disease. Moreover, emphasize analysis of cerebrospinal fluid with realization of sorologic tests to Chagas's disease, as simple as effective method, to make use of biopsy with stereotaxia in unfinished cases and bad evolution. Finally, after a wide world literature review about Chagas'disease as a tumor-like lesion of the brain, emphasizing this publication as the first written in a radiology journal of specialty. (author). 40 refs., 3 figs., 1 tab

  3. Accurate real-time PCR strategy for monitoring bloodstream parasitic loads in chagas disease patients.

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    Tomas Duffy

    Full Text Available BACKGROUND: This report describes a real-time PCR (Q-PCR strategy to quantify Trypanosoma cruzi (T. cruzi DNA in peripheral blood samples from Chagas disease patients targeted to conserved motifs within the repetitive satellite sequence. METHODOLOGY/PRINCIPAL FINDINGS: The Q-PCR has a detection limit of 0.1 and 0.01 parasites/mL, with a dynamic range of 10(6 and 10(7 for Silvio X10 cl1 (T. cruzi I and Cl Brener stocks (T. cruzi IIe, respectively, an efficiency of 99%, and a coefficient of determination (R(2 of 0.998. In order to express accurately the parasitic loads: (1 we adapted a commercial kit based on silica-membrane technology to enable efficient processing of Guanidine Hydrochloride-EDTA treated blood samples and minimize PCR inhibition; (2 results were normalized incorporating a linearized plasmid as an internal standard of the whole procedure; and (3 a correction factor according to the representativity of satellite sequences in each parasite lineage group was determined using a modified real-time PCR protocol (Lg-PCR. The Q-PCR strategy was applied (1 to estimate basal parasite loads in 43 pediatric Chagas disease patients, (2 to follow-up 38 of them receiving treatment with benznidazole, and (3 to monitor three chronic Chagas heart disease patients who underwent heart-transplantation and displayed events of clinical reactivation due to immunosupression. CONCLUSION/SIGNIFICANCE: All together, the high analytical sensitivity of the Q-PCR strategy, the low levels of intra- and inter-assay variations, as well as the accuracy provided by the Lg-PCR based correction factor support this methodology as a key laboratory tool for monitoring clinical reactivation and etiological treatment outcome in Chagas disease patients.

  4. Health-related quality of life in patients with Chagas disease

    OpenAIRE

    Bruna Guimarães Oliveira; Mery Natali Silva Abreu; Claudia Drummond Guimarães Abreu; Manoel Otavio da Costa Rocha; Antonio Luiz Ribeiro

    2011-01-01

    INTRODUCTION: Chagas disease (ChD) is a chronic illness related to significant morbidity and mortality that can affect the quality of life (QoL) of infected patients. However, there are few studies regarding QoL in ChD. The objectives of this study are to construct a health-related QoL (HRQoL) profile of ChD patients and compare this with a non-ChD (NChD) group to identify factors associated with the worst HRQoL scores in ChD patients. METHODS: HRQoL was investigated in 125 patients with ChD ...

  5. Nuclear angiocardiographic evaluation of effect of the isosorbide dinitrate in chronic Chagas' patients

    International Nuclear Information System (INIS)

    The cardiovascular effects of a systemic vasodilator therapy (isosorbide dinitrate - ID) were studied in 13 normal individuals and in 40 chronic Chagas' patients, grouped as follows: 13 in the indeterminate phase of the disease; 14 with the chronic cardiac form and 13 presenting only clinical and laboratory findings of megaesophagus and/or megacolon (digestive form). The LV pump function was studied by means of radionuclide angiography in baseline condition and after 5-10 min of sublingual administration of 5mg of ID.Ejection fraction (EF), peak velocity of LV emptying (Vmax), heart rate (HR) and blood pressure BP) were determined under each condition. All groups showed comparable mean HR and BP values. Only the cardiac group exhibited lower values of EF and Vmax, as compared to normal controls. The vasodilator drug elicited significant comparable (p < 0.05) changes in HR (increase) and BP (decrease) in the four groups. In contrast to normal subjects, who had no significant changes in EF after ID, all the Chagas' groups showed statistically significant (p < 0.05) increases in EF after the vasodilator drug. A small insignificant increase in Vmax was observed in the four groups. These findings suggest that even in patients with Chagas's disease and clinically undetectable heart involvement there is some degree of reduction in ventricular performance, partially corrected by the unloading effects of vasodilador medication. (author)

  6. Impact of Helminth Infection on the Clinical and Microbiological Presentation of Chagas Diseases in Chronically Infected Patients

    Science.gov (United States)

    Salvador, Fernando; Sulleiro, Elena; Sánchez-Montalvá, Adrián; Martínez-Gallo, Mónica; Carrillo, Eugenia; Molina, Israel

    2016-01-01

    Abstract Background Helminth infections are highly prevalent in tropical and subtropical countries, coexisting in Chagas disease endemic areas. Helminth infections in humans may modulate the host immune system, changing the Th1/Th2 polarization. This immunological disturbance could modify the immune response to other infections. The aim of this study is to evaluate the relationship between clinical, microbiological and epidemiological characteristics of Chagas disease patients, with the presence of helminth infection. Methods A prospective observational study was conducted at Vall d’Hebron University Hospital (Barcelona, Spain). Inclusion criteria were: age over 18 years, diagnosis of Chagas disease, and not having received specific treatment for Chagas disease previously to the inclusion. The study protocol included Chagas disease assessment (cardiac and digestive evaluation, detection of T. cruzi DNA measured by PCR in peripheral blood), and helminth infection diagnosis (detection of IgG anti-Strongyloides stercoralis by ELISA, microscopic examination of stool samples from three different days, and specific faecal culture for S. stercoralis larvae). Results Overall, 65 patients were included, median age was 38 years, 75.4% were women and most of them came from Bolivia. Cardiac and digestive involvement was present in 18.5% and 27.7% of patients respectively. T. cruzi PCR was positive in 28 (43.1%) patients. Helminth infection was diagnosed in 12 (18.5%) patients. No differences were observed in clinical and epidemiological characteristics between patients with and without helminth infection. Nevertheless, the proportion of patients with positive T. cruzi PCR was higher among patients with helminth infection compared with patients without helminth infection (75% vs 35.8%, p = 0.021). Conclusions We observed a high prevalence of S. stercoralis infection among chronic Chagas disease patients attended in our tropical medicine unit. Strongyloidiasis was associated

  7. All-around care for patients with Chagas disease: a challenge for the XXI century

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    Wilson de Oliveira Jr

    2009-07-01

    Full Text Available In 1987, the University of Pernambuco's Oswaldo Cruz Hospital in Recife, Brazil opened its Chagas Disease and Heart Failure Outpatient Clinic with the aim of providing its patients all-around care through adoption of a biopsychosocial model of care. All-around care involves caring for the patient as a whole human being in the context of the biological, psychological and social factors present, which are an inherent part of the human condition. One prerequisite for the proposed model of care is the participation of a multidisciplinary team of trained technical staff committed to this framework. Although the main focus of the service is on care, teaching and research are also an important part of its work. The Pernambuco Association of Chagas Disease Patients is guided by the same model of care and has been carrying out educational activities relating to the disease, its treatment and support for patients and family members for several years. This Association plays an important role in advocating to public authorities on behalf of patients. The accumulated experience of the past 22 years has shown us that a broad vision of health care can help clinicians and policy makers to make decisions that are more in tune with the everyday reality of the patient, which in turn has a positive impact on adherence to treatment and quality of life.

  8. Health-related quality of life in patients with Chagas disease: a review of the evidence

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    Giovane Rodrigo Sousa

    2015-04-01

    Full Text Available Chagas disease (ChD, a neglected tropical disease caused by infection with the parasite Trypanosoma cruzi (T. cruzi, remains a serious public health issue in Latin America and is an emerging disease in several non-endemic countries, where knowledge of the condition and experience with its clinical management are limited. Regionally, the disease is the major cause of disability secondary to tropical diseases in young adults. Health-related quality of life (HRQoL impairment is common in patients with ChD, especially in those with Chagas dilated cardiomyopathy, the most severe manifestation of the disease, which frequently leads to heart failure. The aim of this review was to conduct a literature search for studies that have evaluated the determining factors of HRQoL in ChD patients. We included cross-sectional, case-control, cohort, and experimental studies, as well as clinical trials that evaluated the HRQoL in ChD patients aged 18 to 60 years and are presenting an explicit description of statistical analysis. Using a combination of keywords based on Descriptors in Health Sciences (DeCS and Medical Subject Headings (MeSH for searches in PubMed and the Scientific Electronic Library Online (SciELO, 148 studies were found. After exclusions, 12 studies were selected for analysis. Three main findings were extracted from these studies: 1 cardiac involvement is associated with a worse HRQoL in ChD patients; 2 HRQoL is associated with the patients' functional capacity; and 3 simple and inexpensive therapeutic measures are effective for improving HRQoL in ChD patients. Hence, ChD patients' functional capacity, the effectiveness of non-surgical conservative treatment, and cardiac involvement are important determining factors for the HRQoL in ChD patients.

  9. The BENEFIT trial: testing the hypothesis that trypanocidal therapy is beneficial for patients with chronic Chagas heart disease

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    J Antonio Marin-Neto

    2009-07-01

    Full Text Available Among the pathophysiological derangements operating in the chronic phase of Chagas disease, parasite persistence is likely to constitute the main mechanism of myocardial injury in patients with chronic chagasic cardiomyopathy. The presence of Trypanosoma cruzi in the heart causes a low-grade, but relentless, inflammatory process and induces myocardial autoimmune injury. These facts suggest that trypanocidal therapy may positively impact the clinical course of patients with chronic Chagas heart disease. However, the experimental and clinical evidence currently available is insufficient to support the routine use of etiologic treatment in these patients. The BENEFIT project - Benznidazole Evaluation for Interrupting Trypanosomiasis - is an international, multicenter, double-blind, placebo-controlled trial of trypanocidal treatment with benznidazole in patients with chronic Chagas heart disease. This project is actually comprised of two studies. The pilot study investigates whether etiologic treatment significantly reduces parasite burden, as assessed by polymerase chain reaction-based techniques and also determines the safety and tolerability profile of the trypanocidal drug in this type of chagasic population. The full-scale study determines whether antitrypanosomal therapy with benznidazole reduces mortality and other major cardiovascular clinical outcomes in patients with chronic Chagas heart disease.

  10. Histological and endoscopic features of the stomachs of patients with Chagas disease in the era of Helicobacter pylori

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    Fernanda Machado Fonseca

    2014-12-01

    Full Text Available Introduction Most studies that have evaluated the stomachs of patients with Chagas disease were performed before the discovery of Helicobacter pylori and used no control groups. This study compared the gastric features of chagasic and non-chagasic patients and assessed whether gastritis could be associated with Chagas disease. Methods Gastric biopsy samples were taken from patients who underwent endoscopy for histological analysis according to the Updated Sydney System. H. pylori infection was assessed by histology, 16S ribosomal ribonucleic acid (rRNA polymerase chain reaction (PCR, serology and the 13C-urea breath test. Patients were considered H. pylori-negative when all of these diagnostic tests were negative. Clinical and socio-demographic data were obtained by reviewing medical records and using a questionnaire. Results The prevalence of H. pylori infection (70.3% versus 71.7% and chronic gastritis (92.2% versus 85% was similar in the chagasic and non-chagasic groups, respectively; such as peptic ulcer, atrophy and intestinal metaplasia. Gastritis was associated with H. pylori infection independent of Chagas disease in a log-binomial regression model. However, the chagasic H. pylori-negative patients showed a significantly higher grade of mononuclear (in the corpus and polymorphonuclear (PMN (in the antrum cell infiltration. Additionally, the patients with the digestive form of Chagas disease showed a significantly lower prevalence of corpus atrophy than those with other clinical forms. Conclusions The prevalence of H. pylori infection and of gastric histological and endoscopic features was similar among the chagasic and non-chagasic patients. Additionally, this is the first controlled study to demonstrate that H. pylori is the major cause of gastritis in patients with Chagas disease.

  11. Effects of an exercise program on blood pressure in patients with treated hypertension and chronic Chagas' heart disease

    OpenAIRE

    Claudia Rosa de Oliveira; Andréa Silvestre de Sousa; Bráulio Santos; Paloma Hargreaves Fialho; Carla Cristiane Soares dos Santos; Juliana Rega de Oliveira; Marcus Vinícius Souza

    2012-01-01

    INTRODUCTION: Previous studies describe an imbalance of the autonomic nervous system in Chagas' disease causing increased sympathetic activity, which could influence the genesis of hypertension. However, patients undergoing regular physical exercise could counteract this condition, considering that exercise causes physiological responses through autonomic and hemodynamic changes that positively affect the cardiovascular system. This study aimed to evaluate the effects of an exercise program o...

  12. Case-control study of factors associated with chronic Chagas heart disease in patients over 50 years of age

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    Silvana de Araújo Silva

    2007-11-01

    Full Text Available A case-control study on chronic Chagas heart disease (CCHD was carried out between 1997 and 2005. Ninety patients over 50 years of age were examined for factors related to (CCHD. Fourty-six patients (51.1% with Chagas heart disease (anomalous ECG were assigned to the case group and 44 (48.9% were included in the control group as carriers of undetermined forms of chronic disease. Social, demographic (age, gender, skin color, area of origin, epidemiological (permanence within an endemic zone, family history of Chagas heart disease or sudden death, physical strain, alcoholism, and smoking, and clinical (systemic hypertension variables were analyzed. The data set was assessed through single-variable and multivariate analysis. The two factors independently associated with heart disease were age - presence of heart disease being three times higher in patients over 60 years of age (odds ratio, OR: 2.89; confidence interval of 95%: 1.09-7.61 - and family history of Chagas heart disease (OR: 2.833, CI 95%: 1.11-7.23. Systemic hypertension and gender did not prove to hold any association with heart disease, as neither did skin color, but this variable showed low statistical power due to reduced sample size.

  13. Cardiac Repolarization Abnormalities and Potential Evidence for Loss of Cardiac Sodium Currents on ECGs of Patients with Chagas' Heart Disease

    Science.gov (United States)

    Schlegel, T. T.; Medina, R.; Jugo, D.; Nunez, T. J.; Borrego, A.; Arellano, E.; Arenare, B.; DePalma, J. L.; Greco, E. C.; Starc, V.

    2007-01-01

    Some individuals with Chagas disease develop right precordial lead ST segment elevation in response to an ajmaline challenge test, and the prevalence of right bundle branch block (RBBB) is also high in Chagas disease. Because these same electrocardiographic abnormalities occur in the Brugada syndrome, which involves genetically defective cardiac sodium channels, acquired damage to cardiac sodium channels may also occur in Chagas disease. We studied several conventional and advanced resting 12-lead/derived Frank-lead ECG parameters in 34 patients with Chagas -related heart disease (mean age 39 14 years) and in 34 age-/gender-matched healthy controls. All ECG recordings were of 5-10 min duration, obtained in the supine position using high fidelity hardware/software (CardioSoft, Houston, TX). Even after excluding those Chagas patients who had resting BBBs, tachycardia and/or pathologic arrhythmia (n=8), significant differences remained in multiple conventional and advanced ECG parameters between the Chagas and control groups (n=26/group), especially in their respective QT interval variability indices, maximal spatial QRS-T angles and low frequency HRV powers (p=0.0006, p=0.0015 and p=0.0314 respectively). In relation to the issue of potential damage to cardiac sodium channels, the Chagas patients had: 1) greater than or equal to twice the incidence of resting ST segment elevation in leads V1-V3 (n=10/26 vs. n=5/26) and of both leftward (n=5/26 versus n=0/26) and rightward (n=7/26 versus n=3/26) QRS axis deviation than controls; 2) significantly increased filtered (40-250 Hz) QRS interval durations (92.1 8.5 versus 85.3 plus or minus 9.0 ms, p=0.022) versus controls; and 3) significantly decreased QT and especially JT interval durations versus controls (QT interval: 387.5 plus or minus 26.4 versus 408.9 plus or minus 34.6 ms, p=0.013; JT interval: 290.5 plus or minus 26.3 versus 314.8 plus or minus 31.3 ms; p=0.0029). Heart rates and Bazett-corrected QTc/JTc intervals

  14. Epidemiological characteristics of patients with Chagas Disease Características epidemiológicas dos pacientes com Doença de Chagas

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    Fabíola Adriane Souza Oliveira

    2010-11-01

    Full Text Available

    The Chagas Disease is an infection caused by Trypanosoma cruzy, transmitted to a hematophague insect, transfused blood or birth, with evolution divided in acute and chronic phases. Object: Analyses variables from patients with Chagas Disease (CD: age, gender, education, prevalence, and presence of co morbid and work. Methodology: The study region is constituted by many peripheral neighborhoods from Montes Claros City- Minas Gerais- Brazil. The study was made with 7150 registered people in the local health unit (Programa Saúde da Família, Tancredo Neves. The information about Chagas Disease was obtaining from ‘A’ files, this present in virtual information program. Take a part in the study only patients with the confirmed diagnostic of Chagas Disease in two diagnostic methods different. Results: The prevalence of Chagas Disease were 1% (86 patients, 60% of cases belong of female gender. The middle age at the men was 47,5 years and the woman was 48,6 years. The main occupation were: retired 9,3%, general services 51,1%, house-wife 17,4%, unemployment 18,5%, students 1,1% and autonomous 1,1%. The analysis of schooling demonstrates: 27,9% was illiterate, 68,6% does not have completely the primary school and 2,3% has completely the second school. The co morbid more seen were the Systemic Hypertension Arterial (SHA. Conclusion: The epidemiological profile in the study site is of the an adult patient with the age between 40-50 years, female gender, with schooling low, working in general services and with SHA were the co morbid.

    A Doença de Chagas (DC é uma infecção causada pelo Trypanosoma cruzi, transmitida por um inseto hematófago, adquirida por transfusão sanguínea ou congenitamente, com evolução dividida em fase aguda e crônica. Objetivo: Analisar as seguintes variáveis dos pacientes portadores da Doença de Chagas (DC: idade, sexo, escolaridade, prevalência, comorbidades associadas e ocupação. Metodologia: A região do

  15. Hipocontratilidade do esôfago em pacientes com doença de chagas e pacientes com acalásia idiopática Esophageal hypotensive contractions in patients with Chagas' disease and patients with primary achalasia

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    Roberto Oliveira DANTAS

    2000-01-01

    Full Text Available Em pacientes com esofagopatia chagásica e pacientes com acalásia, a amplitude das contrações esofágicas está diminuída. Como nem todas as deglutições são seguidas de contrações com baixa amplitude, avaliamos o número de contrações com amplitude abaixo de 30 mm Hg em 40 voluntários assintomáticos, 99 pacientes com doença de Chagas e 14 pacientes com acalásia idiopática. Cada paciente ou voluntário realizou 10 deglutições de 5 mL de água e o registro das contrações foi feito a 5 cm, 10 cm e 15 cm proximal ao esfíncter inferior do esôfago. Neste registro foi utilizado o método manométrico com perfusão contínua. O número de contrações com hipocontratilidade foi maior nos pacientes com doença de Chagas e pacientes com acalásia do que nos voluntários (P The esophageal contraction amplitude is low in patients with Chagas' disease and patients with primary achalasia but not every swallow is followed by low contraction amplitude. We evaluated the number of low contraction amplitude in 40 normal volunteers, 99 Chagas' disease patients and 14 patients with primary achalasia. Each subject performed 10 swallows of a 5 mL bolus of water and the esophageal motility was measured at 5, 10 and 15 cm above the lower esophageal sphincter by the manometric method with continuous perfusion. The amplitude of contraction was considered to be low when its value was below 30 mm Hg. There was a hypotensive contraction when the amplitude was low or when the contraction failed. The number of hypotensive contractions was higher in patients with Chagas' disease and patients with achalasia than in healthy volunteers (P <0.05. Patients with Chagas' disease and abnormal esophageal radiological examination but without dilation had more frequent hypotensive contraction than patients with normal esophageal radiologic examination (P <0.01. The same results were obtained for subjects with three or more hypotensive contractions (P <0.01. The

  16. Use of a Chagas Urine Nanoparticle Test (Chunap) to Correlate with Parasitemia Levels in T. cruzi/HIV Co-infected Patients

    Science.gov (United States)

    Castro-Sesquen, Yagahira E.; Gilman, Robert H.; Mejia, Carolina; Clark, Daniel E.; Choi, Jeong; Reimer-McAtee, Melissa J.; Castro, Rosario; Valencia-Ayala, Edward; Flores, Jorge; Bowman, Natalie; Castillo-Neyra, Ricardo; Torrico, Faustino; Liotta, Lance; Bern, Caryn; Luchini, Alessandra

    2016-01-01

    Background Early diagnosis of reactivated Chagas disease in HIV patients could be lifesaving. In Latin America, the diagnosis is made by microscopical detection of the T. cruzi parasite in the blood; a diagnostic test that lacks sensitivity. This study evaluates if levels of T. cruzi antigens in urine, determined by Chunap (Chagas urine nanoparticle test), are correlated with parasitemia levels in T. cruzi/HIV co-infected patients. Methodology/Principal Findings T. cruzi antigens in urine of HIV patients (N = 55: 31 T. cruzi infected and 24 T. cruzi serology negative) were concentrated using hydrogel particles and quantified by Western Blot and a calibration curve. Reactivation of Chagas disease was defined by the observation of parasites in blood by microscopy. Parasitemia levels in patients with serology positive for Chagas disease were classified as follows: High parasitemia or reactivation of Chagas disease (detectable parasitemia by microscopy), moderate parasitemia (undetectable by microscopy but detectable by qPCR), and negative parasitemia (undetectable by microscopy and qPCR). The percentage of positive results detected by Chunap was: 100% (7/7) in cases of reactivation, 91.7% (11/12) in cases of moderate parasitemia, and 41.7% (5/12) in cases of negative parasitemia. Chunap specificity was found to be 91.7%. Linear regression analysis demonstrated a direct relationship between parasitemia levels and urine T. cruzi antigen concentrations (p 105 pg was chosen to determine patients with reactivation of Chagas disease (7/7). Antigenuria levels were 36.08 times (95% CI: 7.28 to 64.88) higher in patients with CD4+ lymphocyte counts below 200/mL (p = 0.016). No significant differences were found in HIV loads and CD8+ lymphocyte counts. Conclusion Chunap shows potential for early detection of Chagas reactivation. With appropriate adaptation, this diagnostic test can be used to monitor Chagas disease status in T. cruzi/HIV co-infected patients. PMID:26919324

  17. Longitudinal study of the indirect immunofluorescence and complement fixation tests for diagnosis of chagas' disease in immunosuppressed patients submitted to renal transplantation

    OpenAIRE

    José Fernando de Castro Figueiredo; Adhemar Mário Fiorillo; Agenor Spallini Ferraz

    1993-01-01

    Clinical and serological follow-up of 7 patients submitted to renal transplantation and presenting positive serological reactions to Chagas 'disease before immunossupression did not show significant changes in indirect immunofluorescence and complement fixation titres for Chagas ' disease, or signs and symptoms indicating exacerbation of the disease during follow- up. In addition, 18 of 66 recipients of renal transplants considered to be non-chagasic before immunosuppression showed at least o...

  18. Health-related quality of life in patients with Chagas disease

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    Bruna Guimarães Oliveira

    2011-04-01

    Full Text Available INTRODUCTION: Chagas disease (ChD is a chronic illness related to significant morbidity and mortality that can affect the quality of life (QoL of infected patients. However, there are few studies regarding QoL in ChD. The objectives of this study are to construct a health-related QoL (HRQoL profile of ChD patients and compare this with a non-ChD (NChD group to identify factors associated with the worst HRQoL scores in ChD patients. METHODS: HRQoL was investigated in 125 patients with ChD and 21 NChD individuals using the Medical Outcomes Study 36-item Short-Form (SF-36 and the Minnesota Living with Heart Failure Questionnaire (MLWHFQ. Patients were submitted to a standard protocol that included clinical examination, ECG, Holter monitoring, Doppler echocardiogram and autonomic function tests. RESULTS: HRQoL scores were significantly worse among the ChD group compared to the NChD group in the SF-36 domains of physical functioning and role-emotional and in the MLWHFQ scale. For the ChD group, univariate analysis showed that HRQoL score quartiles were associated with level of education, sex, marital status, use of medication, functional classification and cardiovascular and gastrointestinal symptoms. In the multivariate analysis, female sex, fewer years of education, single status, worst functional classification, presence of cardiovascular and gastrointestinal symptoms, associated illnesses, Doppler echocardiographic abnormalities and ventricular arrhythmia detected during Holter monitoring were predictors of lower HRQoL scores. CONCLUSIONS: ChD patients showed worse HRQoL scores compared to NChD. For the ChD group, sociodemographic and clinical variables were associated with worst scores.

  19. Rapidly Progressing Chagas Cardiomyopathy.

    Science.gov (United States)

    Hollowed, John; McCullough, Matthew; Sanchez, Daniel; Traina, Mahmoud; Hernandez, Salvador; Murillo, Efrain

    2016-04-01

    Chagas disease, caused by the parasiteTrypanosoma cruzi, can cause a potentially life-threatening cardiomyopathy in approximately 10-40% of afflicted individuals. The decline in cardiac function characteristically progresses over the course of many years. We report a case of Chagas disease in which the patient experienced an atypical rapid deterioration to severe cardiomyopathy over the course of 16 months. This case argues the need for increased routine surveillance for patients with confirmedT. cruziinfection, who are determined to be at high-risk for worsening cardiomyopathy. PMID:26856912

  20. Chagas Disease

    Science.gov (United States)

    Chagas disease is caused by a parasite. It is common in Latin America but not in the United States. ... nose, the bite wound or a cut. The disease can also spread through contaminated food, a blood ...

  1. Determinação do peptídeo natriurético cerebral humano em portadores da doença de Chagas Measurement of human brain natriuretic peptide in patients with Chagas' disease

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    Railton Bezerra de Melo

    2005-02-01

    Full Text Available OBJETIVO: Determinar os níveis séricos do peptídeo natriurético cerebral (PNB em pacientes com cardiopatia chagásica crônica e em indivíduos com sorologia positiva para doença de Chagas sem comprometimento cardíaco, e correlacionar os níveis de PNB com o grau de comprometimento cardíaco, dimensões cardíacas, presença de marcapasso e fração de ejeção. MÉTODOS: Concentrações séricas de PNB foram determinadas através do Triage® - BNP Test, produzido pela BIOSITE®. Foi avaliado o PNB sérico de 25 indivíduos do ambulatório de doença de Chagas do Hospital Universitário Oswaldo Cruz, distribuídos em 2 grupos, um, G1; composto por 13 portadores de sorologia positiva para doença de Chagas, assintomáticos e sem cardiopatia detectável pelo eletrocardiograma, radiografia do tórax e ecocardiograma, o outro, G2; por 12 portadores da doença de Chagas com comprometimento cardíaco. RESULTADOS: Níveis significativamente mais elevados de PNB foram detectados nos pacientes chagásicos com comprometimento cardíaco: (G1=4,4±4,4 pg/ml, G2=293,0±460,2 pg/ml pOBJECTIVE: To measure the serum levels of brain natriuretic peptide (BNP in patients with chronic chagasic heart disease and in individuals with positive serology for Chagas' disease and no heart impairment, and to correlate the serum BNP levels with the degree of cardiac impairment, cardiac dimensions, presence of a pacemaker, and ejection fraction. METHODS: Serum BNP concentrations were determined by use of the Triage - BNP Test produced by BIOSITE. Serum BNP was assessed in 25 patients from the Chagas' disease outpatient clinic of the Hospital Universitário Oswaldo Cruz, who were divided into 2 groups as follows: 1 G1 - comprising 13 assymptomatic patients with positive serology for Chagas' disease and no heart disease detectable on electrocardiography, chest X-ray, and echocardiography; and 2 G2 - comprising 12 patients with Chagas' disease and heart impairment. RESULTS

  2. Defective production of interleukin 2 in patients with Chagas' disease: purified IL-2 augments in vitro response in patients with chagasic cardiomyopathy

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    Luis Briceno

    1996-10-01

    Full Text Available The production of interleukin 2 (IL-2 by peripheral blood mononuclear cells, from patients with different clinical forms of Chagas disease and healthy controls, was evaluated after stimulation with Trypanosoma cruzi antigen, PPD and PHA. PHA induced higher production of IL-2 in infected patients than healthy controls. No diferences were found between infected groups. With PPD the trend was similar, the only difference was that asymptomatic infected patients (INF showed higher levels of IL-2 production than patients with cardiomyopathy (CDM. With T. cruzi antigen, most patients showed little or no IL-2 production at 24 hr, a peak at 48 hr and an abrupt fall at 72 hr. A similar pattern of IL- 2 production was observed in INF and CDM. To evaluate the physiologic relevance of the deficit in IL-2 production, we studied the effect of non-mitogenic concentratios of IL-2 in the proliferative response to specific antigens. The addition of IL-2 only enhanced the proliferative response of CDM patients. These observations suggest that patients suffering Chagas' disease, particularly CDM, have a significant reduction in the capacity to produce IL-2. These findings could be of importance in the pathogenesis of Chagas' disease.

  3. Ventricular arrhythmias in Chagas disease

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    Marco Paulo Tomaz Barbosa

    2015-02-01

    Full Text Available Sudden death is one of the most characteristic phenomena of Chagas disease, and approximately one-third of infected patients develop life-threatening heart disease, including malignant ventricular arrhythmias. Fibrotic lesions secondary to chronic cardiomyopathy produce arrhythmogenic substrates that lead to the appearance and maintenance of ventricular arrhythmias. The objective of this study is to discuss the main clinical and epidemiological aspects of ventricular arrhythmias in Chagas disease, the specific workups and treatments for these abnormalities, and the breakthroughs needed to determine a more effective approach to these arrhythmias. A literature review was performed via a search of the PubMed database from 1965 to May 31, 2014 for studies of patients with Chagas disease. Clinical management of patients with chronic Chagas disease begins with proper clinical stratification and the identification of individuals at a higher risk of sudden cardiac death. Once a patient develops malignant ventricular arrhythmia, the therapeutic approach aims to prevent the recurrence of arrhythmias and sudden cardiac death by the use of implantable cardioverter defibrillators, antiarrhythmic drugs, or both. In select cases, invasive ablation of the reentrant circuit causing tachycardia may be useful. Ventricular arrhythmias are important manifestations of Chagas cardiomyopathy. This review highlights the absence of high-quality evidence regarding the treatment of ventricular arrhythmias in Chagas disease. Recognizing high-risk patients who require specific therapies, especially invasive procedures such as the implantation of cardioverter defibrillators and ablative approaches, is a major challenge in clinical practice.

  4. Evolução fatal da co-infecção doença de Chagas/Aids: dificuldades diagnósticas entre a reagudização da miocardite e a miocardiopatia chagásica crônica Fatal evolution of Chagas'disease/Aids co-infection: diagnostic difficulties between myocarditis reactivation and chronic chagasic myocardiopathy

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    Eros Antonio de Almeida

    2009-04-01

    positive. Specific treatment for Trypanosoma cruzi was administered, consisting of benznidazole, but the course of treatment was not completed because the patient died due to cardiopathic complications. The necropsy showed the usual stigmas of chronic Chagas cardiopathy, such as fibrosing myocarditis and a decreased number of neurons in the digestive system. There were no amastigote forms of Trypanosoma cruzi in any of the tissue samples studied. Therefore, reactivation of Chagas disease was not demonstrated but, rather, the natural evolution of chronic Chagas cardiopathy was demonstrated.

  5. Assessment and epidemiology of Chagas' disease in patients treated in Araguaina - Tocantins; Avaliacao e epidemiologia da cardiopatia chagasica em pacientes atendidos em Araguaina - Tocantins

    Energy Technology Data Exchange (ETDEWEB)

    Correa, Valeria Rita

    2010-07-01

    Chagas disease (AD) was described by Carlos Chagas in 1909. It is caused by a parasite T. cruzi, transmitted by bugs, by blood transfusion, vertical and orally. The DC has two phases: acute and chronic. The evolution to the cardiac form occurs in about 30% of chronic cases and is the largest cause of mortality in chronic Chagas disease. The aim of this study was to Chagas' disease in patients of Tocantins, compared with other heart patients and asymptomatic from the standpoint of non-invasive exams using radiant energies such as echocardiography and ECG and RX. The descriptive study included 80 patients, 20 chronic form of Chagas disease, 20 indeterminate, 20 with other heart diseases, and 20 controls. There was a prevalence of 9.5% of chagasic patients treated in outpatient cardiology at Araguaina Tocantins, and 7.3% in chronic and 2.21% in the indeterminate. Of the chronic patients in the study 50% had mega esophagus and megacolon 4 (20%). Most patients had no family history of AD, nor was a smoker or drinker. Major electrocardiographic abnormalities found refer to driving. The evaluation of ICT, the chronic chagasic showed that increased by 40% of patients, 40% had esophageal changes and 20% of patients had megacolon s. The echocardiogram was abnormal in 42%). 27% of patients had EF below 55% changed. Changes in segmental contractility and Asynchrony septum were found in 80% of chronic Chagas disease. In 80% of the patients was observed diastolic dysfunction. The valvular changes occurred in 75%. Electrocardiographic abnormalities occurred in 80% of patients with CCC, while the other heart had ECG changes. Arterial hypertension had an incidence of 45% in patients with CCC and 40% in FCI. The systolic and diastolic ventricular dysfunction was more prevalent in groups that had an abnormal ECG and arrhythmia. Observed that the group of chagasic decreased ejection fraction is correlated to a higher incidence of arrhythmias besides diastolic dysfunction and

  6. Assessment of esophageal dynamics by radionuclide scintigraphy a potential method for early diagnosis of aperistalsis in patients with Chagas disease

    International Nuclear Information System (INIS)

    The esophageal transit time of a sup(99m) Tc labelled test drink (swallow to arrival at the cardia) - TTE - and the time elapsed from swallow to opening of the cardia - TDAC - were assessed by scintigraphy in 40 healthy volunteers (Group I) and in 106 patients with Chagas disease. Sequential images of tracer esophageal transit were obtained by scintigraphy chamber. A time/activity curve in the region of the cardia was obtained by a multichannel analyzer, from which the 2 parameters were calculated. The assessment of TTE and TDAC by scintigraphic technique is proposed as a screening test for early recognition of esophageal motor disorders as well as for follow-up studies after treatment. (M.A.C.)

  7. Value of the Qrs-T Angle in Predicting the Induction of Ventricular Tachyarrhythmias in Patients with Chagas Disease

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    Hugo Bizetto Zampa

    2014-12-01

    Full Text Available Background: The QRS-T angle correlates with prognosis in patients with heart failure and coronary artery disease, reflected by an increase in mortality proportional to an increase in the difference between the axes of the QRS complex and T wave in the frontal plane. The value of this correlation in patients with Chagas heart disease is currently unknown. Objective: Determine the correlation of the QRS-T angle and the risk of induction of ventricular tachycardia / ventricular fibrillation (VT / VF during electrophysiological study (EPS in patients with Chagas disease. Methods: Case-control study at a tertiary center. Patients without induction of VT / VF on EPS were used as controls. The QRS-T angle was categorized as normal (0-105º, borderline (105-135º or abnormal (135-180º. Differences between groups for continuous variables were analyzed with the t test or Mann-Whitney test, and for categorical variables with Fisher's exact test. P values < 0.05 were considered significant. Results: Of 116 patients undergoing EPS, 37.9% were excluded due to incomplete information / inactive records or due to the impossibility to correctly calculate the QRS-T angle (presence of left bundle branch block and atrial fibrillation. Of 72 patients included in the study, 31 induced VT / VF on EPS. Of these, the QRS-T angle was normal in 41.9%, borderline in 12.9% and abnormal in 45.2%. Among patients without induction of VT / VF on EPS, the QRS-T angle was normal in 63.4%, borderline in 14.6% and abnormal in 17.1% (p = 0.04. When compared with patients with normal QRS-T angle, those with abnormal angle had a fourfold higher risk of inducing ventricular tachycardia / ventricular fibrillation on EPS [odds ratio (OR 4; confidence interval (CI 1.298-12.325; p = 0.028]. After adjustment for other variables such as age, ejection fraction (EF and QRS size, there was a trend for the abnormal QRS-T angle to identify patients with increased risk of inducing VT / VF during

  8. Transplante cardíaco (TC: a experiência do portador da doença de Chagas Trasplante cardíaco (TC: la experiencia del portador de la enfermedad de Chagas Heart transplantation: the experience of patients with Chagas disease

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    Maria Lúcia Araújo Sadala

    2009-09-01

    ógicos abarcaron: la selección de los pacientes; las entrevistas; el análisis de los datos, indicando las unidades de significado y el análisis individual; la búsqueda de convergencias de los discursos; el análisis hermenéutico de las convergencias. Del análisis de los datos emergieron los siguientes temas: el tiempo vivido por el receptor, portador de la Enfermedad de Chagas; la concepción del TC que tiene el portador de Chagas; el cuidado en la trayectoria del TC.Successful heart transplantation in patients with Chagas disease depends on special care to be provided during all phases of the transplantation process, and requires specific and rigorous follow-up by the health care team. Recipients must be aware of the permanence of the trypanosome in their organisms as well as of the possibility of infection reactivation after transplantation. Therefore, the patient's knowledge regarding this condition and his active participation in his own treatment are of utmost importance. This study aimed at investigating heart transplantation as experienced by patients with Chagas disease, seeking to understand the meanings that they attribute to such an experience. The methodological procedures included: patient selection; interviews; data analysis, indication of the meaning units and individual analysis; search for discourse convergence; and hermeneutic analysis of convergences. From the data analysis, the following themes emerged: the time lived by recipients with Chagas Disease; the conception of heart transplantation presented by patients with Chagas Disease; and care in the course of heart transplantation.

  9. Exercise-induced ventricular arrhythmias and vagal dysfunction in Chagas disease patients with no apparent cardiac involvement

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    Henrique Silveira Costa

    2015-04-01

    Full Text Available INTRODUCTION : Exercise-induced ventricular arrhythmia (EIVA and autonomic imbalance are considered as early markers of heart disease in Chagas disease (ChD patients. The objective of the present study was to verify the differences in the occurrence of EIVA and autonomic maneuver indexes between healthy individuals and ChD patients with no apparent cardiac involvement. METHODS : A total of 75 ChD patients with no apparent cardiac involvement, aged 44.7 (8.5 years, and 38 healthy individuals, aged 44.0 (9.2 years, were evaluated using echocardiography, symptom-limited treadmill exercise testing and autonomic function tests. RESULTS : The occurrence of EIVA was higher in the chagasic group (48% than in the control group (23.7% during both the effort and the recovery phases. Frequent ventricular contractions occurred only in the patient group. Additionally, the respiratory sinus arrhythmia index was significantly lower in the chagasic individuals compared with the control group. CONCLUSIONS : ChD patients with no apparent cardiac involvement had a higher frequency of EIVA as well as more vagal dysfunction by respiratory sinus arrhythmia. These results suggest that even when asymptomatic, ChD patients possess important arrhythmogenic substrates and subclinical disease.

  10. Do Archaea and bacteria co-infection have a role in the pathogenesis of chronic chagasic cardiopathy?

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    Maria de Lourdes Higuchi

    2009-07-01

    Full Text Available Chronic cardiopathy (CC in Chagas disease is a fibrotic myocarditis with C5b-9 complement deposition. Mycoplasma and Chlamydia may interfere with the complement response. Proteolytic enzymes and archaeal genes that have been described in Trypanosoma cruzi may increase its virulence. Here we tested the hypothesis that different ratios of Mycoplasma, Chlamydia and archaeal organisms, which are frequent symbionts, may be associated with chagasic clinical forms. MATERIALS AND METHODS: eight indeterminate form (IF and 20 CC chagasic endomyocardial biopsies were submitted to in situ hybridization, electron and immunoelectron microscopy and PCR techniques for detection of Mycoplasma pneumoniae (MP, Chlamydia pneumoniae(CP, C5b-9 and archaeal-like bodies. RESULTS: MP and CP-DNA were always present at lower levels in CC than in IF (p < 0.001 and were correlated with each other only in CC. Electron microscopy revealed Mycoplasma, Chlamydia and two types of archaeal-like bodies. One had electron dense lipid content (EDL and was mainly present in IF. The other had electron lucent content (ELC and was mainly present in CC. In this group, ELC correlated negatively with the other microbes and EDL and positively with C5b-9. The CC group was positive for Archaea and T. cruzi DNA. In conclusion, different amounts of Mycoplasma, Chlamydia and archaeal organisms may be implicated in complement activation and may have a role in Chagas disease outcome.

  11. Disfunção endotelial venosa em pacientes com doença de Chagas sem insuficiência cardíaca Venous endothelial dysfunction in Chagas' disease patients without heart failure

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    Rodrigo Della Méa Plentz

    2006-06-01

    Full Text Available OBJETIVO: Analisar a função endotelial venosa em pacientes chagásicos sem insuficiência cardíaca. MÉTODOS: O grupo Chagas (G1 foi composto por quatorze mulheres e dois homens com idade de 46 ± 2,7 anos, e o grupo controle (G0, por sete mulheres e um homem, pareados em idade, peso, altura. A Técnica de Complacência da Veia Dorsal da Mão foi utilizada para avaliação da função endotelial venosa. Foram infundidas doses crescentes de fenilefrina para se obter pré-constrição de 70% do basal; a seguir, foram administradas acetilcolina e nitroprussiato de sódio para avaliar as respostas de venodilatação, respectivamente, dependentes e independentes do endotélio. RESULTADOS: Não houve variação entre os valores hemodinâmicos nos grupos durante o experimento. A dose média de fenilefrina necessária para pré-constrição da veia foi significativamente maior no G1 (1116 ± 668,2 ng/ml, comparada à do G0 (103 ± 28 ng/ml p = 0,05. A resposta de venodilatação máxima dependente do endotélio foi significativamente menor no grupo G1 (65,5 ± 8%, comparada à do G0 (137 ± 20 % p = 0,009. Não houve diferença nas respostas de venodilatação independente do endotélio entre os grupos. CONCLUSÃO: Pacientes com doença de Chagas sem insuficiência cardíaca apresentam disfunção endotelial venosa.OBJECTIVE: To analyze the venous endothelial function in Chagas' disease patients without heart failure. METHODS: The Chagas' disease Group (G1 was composed by 14 women and 2 men aged 46 ± 2,7 and the Control Group (G0 by 7 women and 1 man matched by age, weight and height. Dorsal Hand Vein Compliance Technique was used to evaluate the venous endothelial function. Crescent doses of phenylephrine were infused to get a 70% pre-constriction of the vein; after that, acetylcholine and sodium nitroprusside were respectively administrated to analyze the endothelium-dependent and -independent venodilation. RESULTS: No significant systemic

  12. Chagas Disease: No Longer Exotic

    Centers for Disease Control (CDC) Podcasts

    2008-04-03

    This podcast is designed to inform health care providers about Chagas disease, diagnosis, and treatment and to assist in identifying infected patients.  Created: 4/3/2008 by National Center for Zoonotic, Vector-Borne, and Enteric Diseases (NCZVED).   Date Released: 4/8/2008.

  13. Carlos Chagas Discoveries as a Drop Back to Scientific Construction of Chronic Chagas Heart Disease

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    Reinaldo B. Bestetti

    2016-01-01

    Full Text Available Abstract The scientific construction of chronic Chagas heart disease (CCHD started in 1910 when Carlos Chagas highlighted the presence of cardiac arrhythmia during physical examination of patients with chronic Chagas disease, and described a case of heart failure associated with myocardial inflammation and nests of parasites at autopsy. He described sudden cardiac death associated with arrhythmias in 1911, and its association with complete AV block detected by Jacquet's polygraph as Chagas reported in 1912. Chagas showed the presence of myocardial fibrosis underlying the clinical picture of CCHD in 1916, he presented a full characterization of the clinical aspects of CCHD in 1922. In 1928, Chagas detected fibrosis of the conductive system, and pointed out the presence of marked cardiomegaly at the chest X-Ray associated with minimal symptomatology. The use of serological reaction to diagnose CCHD was put into clinical practice in 1936, after Chagas' death, which along with the 12-lead ECG, revealed the epidemiological importance of CCHD in 1945. In 1953, the long period between initial infection and appearance of CCHD was established, whereas the annual incidence of CCHD from patients with the indeterminate form of the disease was established in 1956. The use of heart catheterization in 1965, exercise stress testing in 1973, Holter monitoring in 1975, Electrophysiologic testing in 1973, echocardiography in 1975, endomyocardial biopsy in 1981, and Magnetic Resonance Imaging in 1995, added to the fundamental clinical aspects of CCHD as described by Carlos Chagas.

  14. Aspectos epidemiológicos, clínicos e parasitológicos da doença de Chagas em Mato Grosso do Sul Epidemiological, clinical and parasitological aspects of Chagas' disease in Mato Grosso do Sul State

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    Maurício Antonio Pompilio

    2005-12-01

    Full Text Available Com o objetivo de avaliar aspectos epidemiológicos, clínicos e parasitológicos da doença de Chagas crônica, em pacientes do Hospital Universitário da Universidade Federal de Mato Grosso do Sul, realizamos um estudo seccional envolvendo 120 chagásicos e 120 controles não-chagásicos, de ambos os sexos, com idades de 16 a 82 anos. Os aspectos epidemiológicos foram avaliados por questionário, a cardiopatia por exame clínico, eletrocardiograma convencional, radiologia e ecodopplercardiograma e a presença de Trypanosoma cruzi no sangue por xenodiagnóstico e teste da reação em cadeia da polimerase. Os resultados mostraram predominância de alóctones com baixa escolaridade e referência de contato prévio com triatomíneos entre os chagásicos. Abortamento espontâneo foi mais freqüente nas mulheres chagásicas. A cardiopatia devido ao componente chagásico foi estimada em 20,2%. Apresentou-se com 7,5% de cardiomegalia, 6,2% de aneurisma de ventrículo esquerdo e com predominância de dispnéia, palpitações e hipertensão arterial. O xenodiagnóstico foi positivo em 26,1% dos chagásicos enquanto a PCR foi positiva em 53,7%. A análise dos resultados indicou que a doença de Chagas no grupo estudado apresenta características clínicas e parasitológicas que revelam peculiaridades regionais.With the objective of evaluating epidemiologic, clinical and parasitologic aspects of chronic Chagas' disease in patients from the University Hospital of the Federal University of Mato Grosso do Sul, a cross-sectional study was performed with groups of 120 chagasic and non-chagasic patients aged from 16 to 82 years. Epidemiologic aspects were evaluated by means of a questionnaire, cardiopathy by clinical examination, conventional electrocardiogram, radiology and Doppler echocardiograms (only in chagasic patients and the presence of Trypanosoma cruzi in the blood stream by way of xenodiagnosis and polymerase chain reaction test. The results

  15. Perfil clínico de pacientes chagásicos e não-chagásicos portadores de marca-passo cardíaco artificial Clinical profile of Chagas and non-Chagas' disease patients with cardiac pacemaker

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    Leonor Garcia Rincon

    2006-06-01

    Full Text Available O objetivo do estudo foi comparar pacientes chagásicos e não-chagásicos com marca-passo cardíaco artificial uni ou bicameral quanto à fração de ejeção do ventrículo esquerdo, o limiar de estimulação ventricular e a incidência de arritmias cardíacas. Entre janeiro/2001 e novembro/2002 foram avaliados 45 pacientes chagásicos e 35 não-chagásicos portadores de marca-passo quanto à história clínica, radiografia do tórax, ecocardiograma, Holter 24h e análise telemétrica do marca-passo. Embora os chagásicos fossem mais jovens, os dois grupos foram semelhantes quanto a variáveis radiológicas e o limiar de estimulação ventricular direito. Os chagásicos apresentaram menor fração de ejeção do ventrículo esquerdo ao ecocardiograma e maior incidência de arritmia ventricular ao Holter 24h. Observou-se correlação positiva entre a baixa fração de ejeção do ventrículo esquerdo e a intensidade da arritmia ventricular ao Holter 24h. Em pacientes com marca-passo, a doença de Chagas está associada a marcadores cardíacos de prognóstico adverso.The aim of this study was to compare Chagas and non-Chagas' disease patients using single or dual-chamber pacemaker in relation to the ejection fraction of the left ventricle, the ventricular stimulation threshold and the occurrence of ventricular arrhythmia. From January, 2001 to November, 2002, 45 Chagas' disease patients and 35 non-Chagas' disease patients, all pacemaker users, were evaluated considering clinical history, echocardiographic study, Holter monitoring and analysis of the pacemaker telemetry data. Chagas' disease patients were significantly younger, but both groups were similar when chest X-Ray variables and right ventricular stimulation threshold were analyzed. Chagas' disease patients had a lower left ventricular ejection fraction and more frequent ventricular arrhythmia during Holter monitoring. A positive correlation between the low ejection fraction of the left

  16. Chagas Disease Cardiomyopathy: Immunopathology and Genetics

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    Edecio Cunha-Neto

    2014-01-01

    Full Text Available Chagas disease, caused by the protozoan Trypanosoma cruzi, is endemic in Latin America and affects ca. 10 million people worldwide. About 30% of Chagas disease patients develop chronic Chagas disease cardiomyopathy (CCC, a particularly lethal inflammatory cardiomyopathy that occurs decades after the initial infection, while most patients remain asymptomatic. Mortality rate is higher than that of noninflammatory cardiomyopathy. CCC heart lesions present a Th1 T-cell-rich myocarditis, with cardiomyocyte hypertrophy and prominent fibrosis. Data suggest that the myocarditis plays a major pathogenetic role in disease progression. Major unmet goals include the thorough understanding of disease pathogenesis and therapeutic targets and identification of prognostic genetic factors. Chagas disease thus remains a neglected disease, with no vaccines or antiparasitic drugs proven efficient in chronically infected adults, when most patients are diagnosed. Both familial aggregation of CCC cases and the fact that only 30% of infected patients develop CCC suggest there might be a genetic component to disease susceptibility. Moreover, previous case-control studies have identified some genes associated to human susceptibility to CCC. In this paper, we will review the immunopathogenesis and genetics of Chagas disease, highlighting studies that shed light on the differential progression of Chagas disease patients to CCC.

  17. Clinical and pathological assessment of 82 patients with cardiovascular diseases undergoing autopsy at the Hospital das Clínicas of the Faculdade de Medicina de Botucatu from 1988 to 1993

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    Reinaldo Ayer de Oliveira

    2000-10-01

    Full Text Available OBJECTIVE: To evaluated the clinical diagnostic, efficiency for basic death causes in patients dying of circulatory disease and de relative frequency of those diseases. METHODS: Analysis of medical record data of 82 patients, ages from 16 to 84 years old (68 over 40 years old, whose died of circulatory disease and had undergone necropsy in the period from 1988 to 1993 years in the University Hospital of Medicine Faculty of Botucatu-UNESP, Br. RESULTS: The functional class of patients were III or IV, in 78%, and 81.7% needed urgent hospitalization. By the clinical judgment the death were by ischemic heart disease in 32 (21 acute myocardial infarction, Chagas'disease in 12, valvopathy in 11, cardiomyopathy in 7, heart failure with no specification of cardiopathy in 11 and other causes in 9. At the necropsy the death cause was ischemic heart disease in 34 patients, valvopathy in 10, Chagas'disease in 10, cardiomyopathy in 5, and heart failure with no specification of cardiopathy in 2.The concordance taxes were in thhe same order: 94,6%, 90,0%, 83.3%, 71.4% and 28.5%. CONCLUSION: There was a great efficiency of clinical diagnosis for death cause in a general university hospital. The ischemic heart disease were the main causes of death.

  18. Avaliação do metabolismo dos fosfatos de alta energia em pacientes com doença de Chagas Evaluation of the metabolism of high energy phosphates in patients with Chagas' disease

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    Ana Maria Betim Paes Leme

    2010-08-01

    Full Text Available FUNDAMENTO: Anormalidades do metabolismo miocárdico têm sido observadas em pacientes com insuficiência cardíaca de diferentes etiologias. A espectroscopia por ressonância magnética (ERM com fósforo 31 é uma técnica não invasiva que permite a detecção de alterações metabólicas miocárdicas. OBJETIVO: Determinar o metabolismo de repouso dos fosfatos de alta energia em pacientes portadores de doença de Chagas (DC pela ERM com fósforo 31. MÉTODOS: Foram estudados 39 pacientes com DC, sendo 23 com função ventricular preservada (Grupo FP e 16 com disfunção ventricular (Grupo DV, avaliados pela ecodopplercardiografia. A ERM da região anterosseptal foi realizada nos 39 pacientes e em 8 indivíduos normais (Grupo C, por meio de um aparelho Phillips de 1,5 Tesla, obtendo-se a relação fosfocreatina/trifosfato de adenosina beta (PCr/β-ATP miocárdicos. RESULTADOS: Os níveis cardíacos de PCr/β-ATP estavam reduzidos no Grupo DV em relação ao Grupo FP, e estes apresentaram níveis reduzidos em relação ao Grupo C (Grupo DV: 0,89 ± 0,31 vs Grupo FP: 1,47 ± 0,34 vs Grupo C: 1,88 ± 0,08, p BACKGROUND: Abnormalities in myocardial metabolism have been observed in patients with heart failure of different etiologies. Magnetic resonance spectroscopy (MRS with phosphorus-31 is a noninvasive technique that allows detection of myocardial metabolic changes. OBJECTIVE: To determine the resting metabolism of high-energy phosphates in patients with Chagas' disease (CD by MRS with phosphorus-31. METHODS: We studied 39 patients with CD, 23 with preserved ventricular function (PF Group and 16 with ventricular dysfunction (VD Group, assessed by Doppler echocardiography. MRS of the anterosseptal region was performed in 39 patients and 8 normal subjects (C Group through a Phillips 1.5 Tesla device, obtaining the phosphocreatine/beta-adenosine triphosphate myocardial ratio (PCr/β-ATP. RESULTS: The levels of cardiac PCr/β-ATP were reduced in VD

  19. Multicenter randomized trial of cell therapy in cardiopathies – MiHeart Study

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    Oliveira Sérgio A

    2007-01-01

    Full Text Available Abstract Background Cardiovascular diseases are the major cause of death in the world. Current treatments have not been able to reverse this scenario, creating the need for the development of new therapies. Cell therapies have emerged as an alternative for cardiac diseases of distinct causes in experimental animal studies and more recently in clinical trials. Method/Design We have designed clinical trials to test for the efficacy of autologous bone marrow derived mononuclear cell therapies in four different cardiopathies: acute and chronic ischemic heart disease, and Chagasic and dilated cardiomyopathy. All trials are multicenter, randomized, double-blind and placebo controlled. In each trial 300 patients will be enrolled and receive optimized therapy for their specific condition. Additionally, half of the patients will receive the autologous bone marrow cells while the other half will receive placebo (saline with 5% autologous serum. For each trial there are specific inclusion and exclusion criteria and the method for cell delivery is intramyocardial for the chronic ischemic heart disease and intracoronary for all others. Primary endpoint for all studies will be the difference in ejection fraction (determined by Simpson's rule six and twelve months after intervention in relation to the basal ejection fraction. The main hypothesis of this study is that the patients who receive the autologous bone-marrow stem cell implant will have after a 6 month follow-up a mean increase of 5% in absolute left ventricular ejection fraction in comparison with the control group. Discussion Many phase I clinical trials using cell therapy for cardiac diseases have already been performed. The few randomized studies have yielded conflicting results, rendering necessary larger well controlled trials to test for efficacy of cell therapies in cardiopathies. The trials registration numbers at the NIH registry are the following: Chagasic cardiomyopathy (NCT00349271

  20. Multicenter randomized trial of cell therapy in cardiopathies – MiHeart Study

    Science.gov (United States)

    Tura, Bernardo R; Martino, Helena F; Gowdak, Luis H; dos Santos, Ricardo Ribeiro; Dohmann, Hans F; Krieger, José E; Feitosa, Gilson; Vilas-Boas, Fábio; Oliveira, Sérgio A; Silva, Suzana A; Bozza, Augusto Z; Borojevic, Radovan; de Carvalho, Antonio C Campos

    2007-01-01

    Background Cardiovascular diseases are the major cause of death in the world. Current treatments have not been able to reverse this scenario, creating the need for the development of new therapies. Cell therapies have emerged as an alternative for cardiac diseases of distinct causes in experimental animal studies and more recently in clinical trials. Method/Design We have designed clinical trials to test for the efficacy of autologous bone marrow derived mononuclear cell therapies in four different cardiopathies: acute and chronic ischemic heart disease, and Chagasic and dilated cardiomyopathy. All trials are multicenter, randomized, double-blind and placebo controlled. In each trial 300 patients will be enrolled and receive optimized therapy for their specific condition. Additionally, half of the patients will receive the autologous bone marrow cells while the other half will receive placebo (saline with 5% autologous serum). For each trial there are specific inclusion and exclusion criteria and the method for cell delivery is intramyocardial for the chronic ischemic heart disease and intracoronary for all others. Primary endpoint for all studies will be the difference in ejection fraction (determined by Simpson's rule) six and twelve months after intervention in relation to the basal ejection fraction. The main hypothesis of this study is that the patients who receive the autologous bone-marrow stem cell implant will have after a 6 month follow-up a mean increase of 5% in absolute left ventricular ejection fraction in comparison with the control group. Discussion Many phase I clinical trials using cell therapy for cardiac diseases have already been performed. The few randomized studies have yielded conflicting results, rendering necessary larger well controlled trials to test for efficacy of cell therapies in cardiopathies. The trials registration numbers at the NIH registry are the following: Chagasic cardiomyopathy (NCT00349271), dilated cardiomyopathy (NCT

  1. The epidemiologic profile and prevalence of cardiopathy in Trypanosoma cruzi infected blood donor candidates, Londrina, Paraná, Brazil Perfil epidemiológico e prevalência de cardiopatia em candidatos a doador de sangue infectados por Trypanosoma cruzi, Londrina, Paraná, Brasil

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    Divina Seila de Oliveira-Marques

    2005-12-01

    Full Text Available To describe the epidemiologic profile and prevalence of cardiopathy in 163 Trypanosoma cruzi serum positive blood donor candidates, a descriptive study was carried out between August, 1996 and November, 1997 at the Londrina State University Chagas Disease Outpatient Clinic. The profile found was: young, average age 42.95 ± 8.62 years; male (65%; Caucasian (84%; low level of schooling; low family income; agricultural worker (26%; born in the state of Paraná (67%; from rural areas (85%; migrated to the city (85%; and the vector as the main mechanism of transmission. During the clinical characterization a chronic cardiac form was found in 38% of the patients and classified as cardiac suggestive form in 21% and little suggestive of Chagas disease in 17%. No significant difference was found among age group distribution, sex and the presence of cardiac symptoms in patients with or without cardiopathy. This study emphasizes the importance of expanding medical services to areas with a greater prevalence of infected individuals, in a hierarchical manner and aiming at decentralization.Objetivando-se traçar o perfil epidemiológico e a prevalência de cardiopatia, realizou-se estudo descritivo em 163 candidatos a doador de sangue infectados por Trypanosoma cruzi, atendidos no período de agosto de 1996 a novembro de 1997 no ambulatório de doença de Chagas do Hospital de Clínicas da Universidade Estadual de Londrina. O perfil epidemiológico foi de paciente jovem, média de idade de 42,95 ± 8,62 anos, sexo masculino (65%, raça branca (84%, baixa escolaridade, baixa renda familiar, agricultor (26%, natural do estado do Paraná (67%, de zona rural (85%, residindo atualmente em zona urbana (85%, sendo o vetorial o principal mecanismo de transmissão. A forma crônica cardíaca, encontrada em 38% foi classificada em forma cardíaca sugestiva de doença de Chagas em 21% e pouco sugestiva em 17% dos pacientes. Não houve diferença significativa na

  2. Immunosuppression and Chagas disease: a management challenge.

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    María-Jesús Pinazo

    Full Text Available Immunosuppression, which has become an increasingly relevant clinical condition in the last 50 years, modifies the natural history of Trypanosoma cruzi infection in most patients with Chagas disease. The main goal in this setting is to prevent the consequences of reactivation of T. cruzi infection by close monitoring. We analyze the relationship between Chagas disease and three immunosuppressant conditions, including a description of clinical cases seen at our center, a brief review of the literature, and recommendations for the management of these patients based on our experience and on the data in the literature. T. cruzi infection is considered an opportunistic parasitic infection indicative of AIDS, and clinical manifestations of reactivation are more severe than in acute Chagas disease. Parasitemia is the most important defining feature of reactivation. Treatment with benznidazole and/or nifurtimox is strongly recommended in such cases. It seems reasonable to administer trypanocidal treatment only to asymptomatic immunosuppressed patients with detectable parasitemia, and/or patients with clinically defined reactivation. Specific treatment for Chagas disease does not appear to be related to a higher incidence of neoplasms, and a direct role of T. cruzi in the etiology of neoplastic disease has not been confirmed. Systemic immunosuppressive diseases or immunosuppressants can modify the natural course of T. cruzi infection. Immunosuppressive doses of corticosteroids have not been associated with higher rates of reactivation of Chagas disease. Despite a lack of evidence-based data, treatment with benznidazole or nifurtimox should be initiated before immunosuppression where possible to reduce the risk of reactivation. Timely antiparasitic treatment with benznidazole and nifurtimox (or with posaconazole in cases of therapeutic failure has proven to be highly effective in preventing Chagas disease reactivation, even if such treatment has not been

  3. Formas encefalopaticas de enfermedad de Chagas cronica observadas en Argentina Encephalopathic form of chronic Chagas' disease observed in Argentine

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    Miguel Eduardo Jorg

    1981-12-01

    Full Text Available Se describen las características clínicas y las manifestaciones dominantes en 22 enfermos observados entre 1963 y 1978 sobre un total de 420 con neuropatías diversas examinados en el area central Norte de la Argentina; afectados por una encefalopatía crónica, que, por hallazgos de laboratorio (demostración del parasito en sangre o en su defecto confirmacion por mas de una prueba serológica positiva y por las correlaciones anatomoclínicas, puede ser imputada a la infección por el Trypanosoma cruzi. En la mitad o mas de los enfermos, son salientes las siguientes manifestaciones: disprosexia y confusión en 81,8%; cefalea y confusión en 72,7%; debilitamiento de reflejos músculo-tendinosos y trastornos del lenguaje en 63,6%; dispraxias en 59%; trastornos de la marcha y crisis mioclónicas en 54,5%; bradicinesias en 50%. En menor escala se encontraron: parestesias, ideas delirantes, perturbaciones cerebelares, crisis de vertigo, diplopia, lipotimias,humor fluctuante. Las menos frecuentes: disautonomia y excitacion. En 8 se hallaron evidencias semiologicas de cardiopatias y en 2 de compromiso digestivo grosero. Se analiza el alcance de esta casuistica en relación a los hallazgos anatomopatológicos en casos mortales y con referencia a lo ya conocido sobre la forma neuropatologica de la enfermedad de Chagas cronica.Among 420 patientes found with diverse subacute and chronic neuropathies, 22 were diagnosed as cases of true trypanosomic encephalopathy by means of the demonstration of parasites in blood (by xenodiagnosis or hemoculture or through serologic tests. In 50% or more of those patientes, following semiologic elements were prevalente: dysprosexia and depression in 81.8%; cephalea and confusion in 72.7%; weakness of muscular-tendineous reflexes and speech disturbance in 63.6% dispraxies in 59.0%; disturbances of gait and myoclonic crises in 54.5%; bradikinesias in 59.0%. Other symptoms were verified in a mirror scale: paresias

  4. Usefulness of real time PCR to quantify parasite load in serum samples from chronic Chagas disease patients

    OpenAIRE

    Melo, Myllena F; Moreira, Otacilio C.; Tenório, Priscila; Lorena, Virginia; Lorena-Rezende, Izaura; Júnior, Wilson Oliveira; Gomes, Yara; Britto, Constança

    2015-01-01

    Background Inconclusive results of serological diagnosis in Chagas disease have an important impact on blood banks worldwide, reflecting in the high number of discarded bags or in an increased transmission by blood transfusion. Molecular techniques such as qPCR have been used for diagnosis and to monitor Trypanosoma cruzi load in peripheral blood samples. A promising perspective refers to the possibility of parasite DNA detection in serum, taking advantage in using the same samples collected ...

  5. Síncope em pacientes com extra-sístoles de via de saída de ventrículo direito e sem cardiopatia estrutural aparente Syncope in patients with right ventricle outflow tract premature beats and no apparent structural cardiopathy

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    Ana Cristina Ludovice

    2006-11-01

    ventricular premature beats, with right ventricle outflow tract morphology (RVOT and no apparent structural cardiopathy. METHODS: Ninety patients (66 women, mean age 40.2±16.95 years of age with monomorphic premature beats originated at RVOT were evaluated prospectively. Fifty-four patients reported syncopes or near-syncopes associated to palpitations or not; twenty-seven presented palpitations with no pre-syncope or syncope, and nine were asymptomatic. All patients were submitted to echocardiogram, high resolution ECG and cardiac MRI to rule out structural cardiopathy, to exertion test to rule out adrenergic dependent ventricular tachycardia, and ECG prolonged outpatient monitoring (Holter and symptomatic events monitor to correlate symptoms and ventricular arrhythmias. Investigation on the susceptibility to neurocardiogenic syncope was evaluated by Tilt Table Test (TTT. Groups were compared regarding gender, age, premature beats frequency and complexity, at exertion or not, TTT results and clinical course. RESULTS: In the syncope and pre-syncope groups, TTT was positive for 38% of cases, and in groups with palpitations and assymptomatics, it was positive for 11% (p = 0.0257. After recommendations and treatment of neurocardiogenic syncope, 85% of syncope and pre-syncope patients and positive TTT was asymptomatic along the 40-month follow-up. Two patients with syncope and negative TTT presented spontaneous, sustained ventricular tachycardia during clinic course. CONCLUSION: The prevalence of neurocardiogenic syncope in patients with idiopathic RVOT premature beats is high. Patients with recurrent, unexplained syncope and idiopathic VE must be kept under investigation.

  6. Efeitos da mudança de modo de estimulação ventricular para atrioventricular sobre a qualidade de vida em pacientes com cardiopatia chagásica e bloqueio atrioventricular na troca eletiva do gerador de pulsos Health-related quality of life in patients with Chagas' cardiomiopathy and complete atrioventricular block at elective pulse generator replacement: effects of pacing mode upgraded from VVI to DDD

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    Luiz Antonio Castilho Teno

    2005-03-01

    ção da Faculdade de Medicina da Universidade de São Paulo and Hospital de Beneficência Portuguesa de Ribeirão Preto, a total of 27 patients with chronic Chagas' cardiopathy, complete atrioventricular block and implanted ventricular pacemaker were upgraded to a dual-chamber pacing mode. At the beginning of the study and after 90-days periods under each pacing modes, the patients' quality of life was evaluated. Statistical analysis was made at basal, VVI and DDD conditions using the analysis of repetitive measures. RESULTS: No significant differences in the health-related quality of life, across the three studied variables (physical function, vitality and general health, were detected after the change of pacing mode from VVI to DDD. There were three cases of complications related to pacing mode upgrade: two cases of atrial tachycardia triggered to ventricles through DDD pacemaker and one atrial lead displacement. CONCLUSIONS: No benefits no quality of life were detected after the change of pacing mode VVI to DDD during elective replacement of pulse generator, in patients with Chagas' cardiomyopathy and complete AV block

  7. Serodiagnosis of chronic Chagas infection by using EIE-Recombinant-Chagas-Biomanguinhos kit

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    Gomes Yara M

    2001-01-01

    Full Text Available A kit based on an enzyme immunoassay, EIE-Recombinant-Chagas-Biomanguinhos, developed by the Oswaldo Cruz Foundation, was evaluated for the serodiagnosis of chronic Chagas disease. Evaluation was performed with 368 serum samples collected from individuals living in an endemic area for Chagas disease: 131 patients in the chronic phase with confirmed clinical, epidemiological, and serological diagnosis (indirect immunofluorescence, indirect hemagglutination or enzyme-linked immunosorbent assay and 237 nonchagasic seronegative individuals were considered negative control. The EIE-Recombinant-Chagas-Biomanguinhos kit showed high sensitivity, 100% (CI 95%: 96.4-100% and high specificity, 100% (CI 95%: 98-100%. The data obtained were in full agreement with clinical and conventional serology data. In addition, no cross-reaction was observed with sera from patients with cutaneous (n=14 and visceral (n=3 leishmaniasis. However, when these sera were tested by conventional serological assays for Chagas disease, cross-reactions were detected in 14.3% and 33.3% of the patients with cutaneous and visceral leishmaniasis, respectively. No cross-reactions were observed when sera from nonchagasic seronegative patients bearing other infectious disease (syphilis, n=8; HTLV, n=8; HCV, n=7 and HBV, n=12 were tested. In addition, sera of patients with inconclusive results for Chagas disease by conventional serology showed results in agreement with clinical evaluation, when tested by the kit. These results are relevant and indicate that the refered kit provides a safe immunodiagnosis of Chagas disease and could be used in blood bank screening.

  8. Analytical Validation of Quantitative Real-Time PCR Methods for Quantification of Trypanosoma cruzi DNA in Blood Samples from Chagas Disease Patients.

    Science.gov (United States)

    Ramírez, Juan Carlos; Cura, Carolina Inés; da Cruz Moreira, Otacilio; Lages-Silva, Eliane; Juiz, Natalia; Velázquez, Elsa; Ramírez, Juan David; Alberti, Anahí; Pavia, Paula; Flores-Chávez, María Delmans; Muñoz-Calderón, Arturo; Pérez-Morales, Deyanira; Santalla, José; Marcos da Matta Guedes, Paulo; Peneau, Julie; Marcet, Paula; Padilla, Carlos; Cruz-Robles, David; Valencia, Edward; Crisante, Gladys Elena; Greif, Gonzalo; Zulantay, Inés; Costales, Jaime Alfredo; Alvarez-Martínez, Miriam; Martínez, Norma Edith; Villarroel, Rodrigo; Villarroel, Sandro; Sánchez, Zunilda; Bisio, Margarita; Parrado, Rudy; Maria da Cunha Galvão, Lúcia; Jácome da Câmara, Antonia Cláudia; Espinoza, Bertha; Alarcón de Noya, Belkisyole; Puerta, Concepción; Riarte, Adelina; Diosque, Patricio; Sosa-Estani, Sergio; Guhl, Felipe; Ribeiro, Isabela; Aznar, Christine; Britto, Constança; Yadón, Zaida Estela; Schijman, Alejandro G

    2015-09-01

    An international study was performed by 26 experienced PCR laboratories from 14 countries to assess the performance of duplex quantitative real-time PCR (qPCR) strategies on the basis of TaqMan probes for detection and quantification of parasitic loads in peripheral blood samples from Chagas disease patients. Two methods were studied: Satellite DNA (SatDNA) qPCR and kinetoplastid DNA (kDNA) qPCR. Both methods included an internal amplification control. Reportable range, analytical sensitivity, limits of detection and quantification, and precision were estimated according to international guidelines. In addition, inclusivity and exclusivity were estimated with DNA from stocks representing the different Trypanosoma cruzi discrete typing units and Trypanosoma rangeli and Leishmania spp. Both methods were challenged against 156 blood samples provided by the participant laboratories, including samples from acute and chronic patients with varied clinical findings, infected by oral route or vectorial transmission. kDNA qPCR showed better analytical sensitivity than SatDNA qPCR with limits of detection of 0.23 and 0.70 parasite equivalents/mL, respectively. Analyses of clinical samples revealed a high concordance in terms of sensitivity and parasitic loads determined by both SatDNA and kDNA qPCRs. This effort is a major step toward international validation of qPCR methods for the quantification of T. cruzi DNA in human blood samples, aiming to provide an accurate surrogate biomarker for diagnosis and treatment monitoring for patients with Chagas disease. PMID:26320872

  9. Analytical Validation of Quantitative Real-Time PCR Methods for Quantification of Trypanosoma cruzi DNA in Blood Samples from Chagas Disease Patients

    Science.gov (United States)

    Ramírez, Juan Carlos; Cura, Carolina Inés; Moreira, Otacilio da Cruz; Lages-Silva, Eliane; Juiz, Natalia; Velázquez, Elsa; Ramírez, Juan David; Alberti, Anahí; Pavia, Paula; Flores-Chávez, María Delmans; Muñoz-Calderón, Arturo; Pérez-Morales, Deyanira; Santalla, José; Guedes, Paulo Marcos da Matta; Peneau, Julie; Marcet, Paula; Padilla, Carlos; Cruz-Robles, David; Valencia, Edward; Crisante, Gladys Elena; Greif, Gonzalo; Zulantay, Inés; Costales, Jaime Alfredo; Alvarez-Martínez, Miriam; Martínez, Norma Edith; Villarroel, Rodrigo; Villarroel, Sandro; Sánchez, Zunilda; Bisio, Margarita; Parrado, Rudy; Galvão, Lúcia Maria da Cunha; da Câmara, Antonia Cláudia Jácome; Espinoza, Bertha; de Noya, Belkisyole Alarcón; Puerta, Concepción; Riarte, Adelina; Diosque, Patricio; Sosa-Estani, Sergio; Guhl, Felipe; Ribeiro, Isabela; Aznar, Christine; Britto, Constança; Yadón, Zaida Estela; Schijman, Alejandro G.

    2015-01-01

    An international study was performed by 26 experienced PCR laboratories from 14 countries to assess the performance of duplex quantitative real-time PCR (qPCR) strategies on the basis of TaqMan probes for detection and quantification of parasitic loads in peripheral blood samples from Chagas disease patients. Two methods were studied: Satellite DNA (SatDNA) qPCR and kinetoplastid DNA (kDNA) qPCR. Both methods included an internal amplification control. Reportable range, analytical sensitivity, limits of detection and quantification, and precision were estimated according to international guidelines. In addition, inclusivity and exclusivity were estimated with DNA from stocks representing the different Trypanosoma cruzi discrete typing units and Trypanosoma rangeli and Leishmania spp. Both methods were challenged against 156 blood samples provided by the participant laboratories, including samples from acute and chronic patients with varied clinical findings, infected by oral route or vectorial transmission. kDNA qPCR showed better analytical sensitivity than SatDNA qPCR with limits of detection of 0.23 and 0.70 parasite equivalents/mL, respectively. Analyses of clinical samples revealed a high concordance in terms of sensitivity and parasitic loads determined by both SatDNA and kDNA qPCRs. This effort is a major step toward international validation of qPCR methods for the quantification of T. cruzi DNA in human blood samples, aiming to provide an accurate surrogate biomarker for diagnosis and treatment monitoring for patients with Chagas disease. PMID:26320872

  10. International study to evaluate PCR methods for detection of Trypanosoma cruzi DNA in blood samples from Chagas disease patients.

    Directory of Open Access Journals (Sweden)

    Alejandro G Schijman

    Full Text Available BACKGROUND: A century after its discovery, Chagas disease still represents a major neglected tropical threat. Accurate diagnostics tools as well as surrogate markers of parasitological response to treatment are research priorities in the field. The purpose of this study was to evaluate the performance of PCR methods in detection of Trypanosoma cruzi DNA by an external quality evaluation. METHODOLOGY/FINDINGS: An international collaborative study was launched by expert PCR laboratories from 16 countries. Currently used strategies were challenged against serial dilutions of purified DNA from stocks representing T. cruzi discrete typing units (DTU I, IV and VI (set A, human blood spiked with parasite cells (set B and Guanidine Hidrochloride-EDTA blood samples from 32 seropositive and 10 seronegative patients from Southern Cone countries (set C. Forty eight PCR tests were reported for set A and 44 for sets B and C; 28 targeted minicircle DNA (kDNA, 13 satellite DNA (Sat-DNA and the remainder low copy number sequences. In set A, commercial master mixes and Sat-DNA Real Time PCR showed better specificity, but kDNA-PCR was more sensitive to detect DTU I DNA. In set B, commercial DNA extraction kits presented better specificity than solvent extraction protocols. Sat-DNA PCR tests had higher specificity, with sensitivities of 0.05-0.5 parasites/mL whereas specific kDNA tests detected 5.10(-3 par/mL. Sixteen specific and coherent methods had a Good Performance in both sets A and B (10 fg/µl of DNA from all stocks, 5 par/mL spiked blood. The median values of sensitivities, specificities and accuracies obtained in testing the Set C samples with the 16 tests determined to be good performing by analyzing Sets A and B samples varied considerably. Out of them, four methods depicted the best performing parameters in all three sets of samples, detecting at least 10 fg/µl for each DNA stock, 0.5 par/mL and a sensitivity between 83.3-94.4%, specificity of 85

  11. International Study to Evaluate PCR Methods for Detection of Trypanosoma cruzi DNA in Blood Samples from Chagas Disease Patients

    Science.gov (United States)

    Schijman, Alejandro G.; Bisio, Margarita; Orellana, Liliana; Sued, Mariela; Duffy, Tomás; Mejia Jaramillo, Ana M.; Cura, Carolina; Auter, Frederic; Veron, Vincent; Qvarnstrom, Yvonne; Deborggraeve, Stijn; Hijar, Gisely; Zulantay, Inés; Lucero, Raúl Horacio; Velazquez, Elsa; Tellez, Tatiana; Sanchez Leon, Zunilda; Galvão, Lucia; Nolder, Debbie; Monje Rumi, María; Levi, José E.; Ramirez, Juan D.; Zorrilla, Pilar; Flores, María; Jercic, Maria I.; Crisante, Gladys; Añez, Néstor; De Castro, Ana M.; Gonzalez, Clara I.; Acosta Viana, Karla; Yachelini, Pedro; Torrico, Faustino; Robello, Carlos; Diosque, Patricio; Triana Chavez, Omar; Aznar, Christine; Russomando, Graciela; Büscher, Philippe; Assal, Azzedine; Guhl, Felipe; Sosa Estani, Sergio; DaSilva, Alexandre; Britto, Constança; Luquetti, Alejandro; Ladzins, Janis

    2011-01-01

    Background A century after its discovery, Chagas disease still represents a major neglected tropical threat. Accurate diagnostics tools as well as surrogate markers of parasitological response to treatment are research priorities in the field. The purpose of this study was to evaluate the performance of PCR methods in detection of Trypanosoma cruzi DNA by an external quality evaluation. Methodology/Findings An international collaborative study was launched by expert PCR laboratories from 16 countries. Currently used strategies were challenged against serial dilutions of purified DNA from stocks representing T. cruzi discrete typing units (DTU) I, IV and VI (set A), human blood spiked with parasite cells (set B) and Guanidine Hidrochloride-EDTA blood samples from 32 seropositive and 10 seronegative patients from Southern Cone countries (set C). Forty eight PCR tests were reported for set A and 44 for sets B and C; 28 targeted minicircle DNA (kDNA), 13 satellite DNA (Sat-DNA) and the remainder low copy number sequences. In set A, commercial master mixes and Sat-DNA Real Time PCR showed better specificity, but kDNA-PCR was more sensitive to detect DTU I DNA. In set B, commercial DNA extraction kits presented better specificity than solvent extraction protocols. Sat-DNA PCR tests had higher specificity, with sensitivities of 0.05–0.5 parasites/mL whereas specific kDNA tests detected 5.10−3 par/mL. Sixteen specific and coherent methods had a Good Performance in both sets A and B (10 fg/µl of DNA from all stocks, 5 par/mL spiked blood). The median values of sensitivities, specificities and accuracies obtained in testing the Set C samples with the 16 tests determined to be good performing by analyzing Sets A and B samples varied considerably. Out of them, four methods depicted the best performing parameters in all three sets of samples, detecting at least 10 fg/µl for each DNA stock, 0.5 par/mL and a sensitivity between 83.3–94.4%, specificity of 85–95

  12. Carlos Chagas: biographical sketch.

    Science.gov (United States)

    Moncayo, Alvaro

    2010-01-01

    Carlos Chagas was born on 9 July 1878 in the farm "Bon Retiro" located close to the City of Oliveira in the interior of the State of Minas Gerais, Brazil. He started his medical studies in 1897 at the School of Medicine of Rio de Janeiro. In the late XIX century, the works by Louis Pasteur and Robert Koch induced a change in the medical paradigm with emphasis in experimental demonstrations of the causal link between microbes and disease. During the same years in Germany appeared the pathological concept of disease, linking organic lesions with symptoms. All these innovations were adopted by the reforms of the medical schools in Brazil and influenced the scientific formation of Chagas. Chagas completed his medical studies between 1897 and 1903 and his examinations during these years were always ranked with high grades. Oswaldo Cruz accepted Chagas as a doctoral candidate and directed his thesis on "Hematological studies of Malaria" which was received with honors by the examiners. In 1903 the director appointed Chagas as research assistant at the Institute. In those years, the Institute of Manguinhos, under the direction of Oswaldo Cruz, initiated a process of institutional growth and gathered a distinguished group of Brazilian and foreign scientists. In 1907, he was requested to investigate and control a malaria outbreak in Lassance, Minas Gerais. In this moment Chagas could not have imagined that this field research was the beginning of one of the most notable medical discoveries. Chagas was, at the age of 28, a Research Assistant at the Institute of Manguinhos and was studying a new flagellate parasite isolated from triatomine insects captured in the State of Minas Gerais. Chagas made his discoveries in this order: first the causal agent, then the vector and finally the human cases. These notable discoveries were carried out by Chagas in twenty months. At the age of 33 Chagas had completed his discoveries and published the scientific articles that gave him world

  13. Designing and exploring active N'-[(5-nitrofuran-2-yl) methylene] substituted hydrazides against three Trypanosoma cruzi strains more prevalent in Chagas disease patients.

    Science.gov (United States)

    Palace-Berl, Fanny; Pasqualoto, Kerly Fernanda Mesquita; Jorge, Salomão Dória; Zingales, Bianca; Zorzi, Rodrigo Rocha; Silva, Marcelo Nunes; Ferreira, Adilson Kleber; de Azevedo, Ricardo Alexandre; Teixeira, Sarah Fernandes; Tavares, Leoberto Costa

    2015-01-01

    Chagas disease affects around 8 million people worldwide and its treatment depends on only two nitroheterocyclic drugs, benznidazole (BZD) and nifurtimox (NFX). Both drugs have limited curative power in chronic phase of disease. Nifuroxazide (NF), a nitroheterocyclic drug, was used as lead to design a set of twenty one compounds in order to improve the anti-Trypanosoma cruzi activity. Lipinski's rules were considered in order to support drug-likeness designing. The set of N'-[(5-nitrofuran-2-yl) methylene] substituted hydrazides was assayed against three T. cruzi strains, which represent the discrete typing units more prevalent in human patients: Y (TcII), Silvio X10 cl1 (TcI), and Bug 2149 cl10 (TcV). All the derivatives, except one, showed enhanced trypanocidal activity against the three strains as compared to BZD. In the Y strain 62% of the compounds were more active than NFX. The most active compound was N'-((5-nitrofuran-2-yl) methylene)biphenyl-4-carbohydrazide (C20), which showed IC50 values of 1.17 ± 0.12 μM; 3.17 ± 0.32 μM; and 1.81 ± 0.18 μM for Y, Silvio X10 cl1, and Bug 2149 cl10 strains, respectively. Cytotoxicity assays with human fibroblast cells have demonstrated high selectivity indices for several compounds. Exploratory data analysis indicated that primarily topological, steric/geometric, and electronic properties have contributed to the discrimination of the set of investigated compounds. The findings can be helpful to drive the designing, and subsequently, the synthesis of additional promising drugs against Chagas disease. PMID:25899337

  14. Estudo da infecção e morbidade da doença de Chagas no município de João Costa: Parque Nacional Serra da Capivara, Piauí, Brasil Study of the infection and morbidity of Chagas' disease in municipality of João Costa: National Park Serra da Capivara, Piauí, Brazil

    Directory of Open Access Journals (Sweden)

    José Borges-Pereira

    2002-08-01

    Full Text Available Com o objetivo de investigar aspectos da infecção e morbidade da doença de Chagas no município de João Costa, Piauí, Brasil, realizamos pesquisa sorológica para detectar Ig G anti-T. cruzi em 2.080 moradores através dos testes de imunofluorescência indireta, hemaglutinação indireta e ELISA. Em seguida, 189 pacientes soropositivos e 141 soronegativos foram avaliados pelo exame clínico e eletrocardiograma (ECG, enquanto a parasitemia foi pesquisada em 106 chagásicos pelo xenodiagnóstico indireto e teste da reação polimerásica em cadeia (PCR. A soropositividade total para Ig G anti-T.cruzi foi de 9,8%, com variação de 0,5% em menores de 10 anos a 39,4% em maiores de 59 anos, independentemente do sexo. O percentual de ECG alterados foi de 41,3% entre os chagásicos e de 15,6% entre os não-chagásicos (p In order to investigate aspects of the infection and morbidity of Chagas' disease in the municipality of João Costa, Piauí State, Brazil, we carried out a serological survey to detect anti-Trypanosoma cruzi antibodies in 2,080 individuals, by indirect immunofluorescence, indirect hemagglutination and ELISA. A total of 189 seropositive and 141 seronegative patients were evaluated by anamnesis, physical exam and electrocardiogram (EKG. The parasitaemia of 106 chagasic patients was evaluated by indirect xenodiagnosis and PCR (polymerase chain reaction. The total seropositivity was 9.8%, with intervals of 0.5% in patients younger than 10 years old, and 39.4% among patients older than 59 years old, independently of the sex. The PCR and xenodiagnosis were positive, respectively in 74.5% and 15.1% of the seropositive patients (p < 0.05. The rate of abnormal EKG was 41.3% in chagasic and 15.6% in non-chagasic patients (p < 0.05. In spite of the high prevalence of infection in the investigated population, the low rate of seropositivity among children is indicative of a possible decrease of the active transmission mediated by triatomines

  15. Chagas disease. A new pathophysiological assessment

    International Nuclear Information System (INIS)

    Background: There is scarce information on myocardial perfusion abnormalities and on the coronary vasomotor condition in Chagas disease patients. Aims: To assess regional perfusion abnormalities and the coronary vasomotor response of patients in the chronic phase of Chagas disease. Methods: With the use of 99mTc-sestamibi SPECT imaging and cold pressor test and intracoronary acetylcoline (ACH) perfusion, we studied 9 patients aged 42,6±12 years, 4 males, in the chronic stage of Chagas disease (5 with the indeterminate form and 4 with heart lesion) with normal coronary arteries. Vasomotor responses to intracoronary increasing doses of ACH and to a single dose of nitroglycerine (NTG) were assessed with digital quantitative angiography. Regional myocardial perfusion was evaluated at rest and after cold pressor test by a semi quantitative score analysis in an 18-segment model with 99mTc-sestamibi SPECT images. Results were expressed as mean ± 2SD. Differences between continuous variables were measured by two tails Student's t test for paired variables and the significance level was set at 5 %. Results: All patients had regional perfusion defects and abnormal vasomotor response. The diameter of the left anterior descending artery decreased 34% from a basal diameter of 3.66∫0.95 mm down to 2.42±0.74 mm after maximal response to ACH (p<0.002). NTG infusion augmented its diameter to 3.86±0.77 mm (p<0.0002) that is a 60% increase from post ACH diameter. Myocardial perfusion score was 1∫2.66 at rest and 6.22±3.6 after cold pressor test (p<0.0001). Conclusions: This group of patients in the chronic phase of Chagas disease showed an abnormal vasoconstrictive response to intracoronary ACH and cold-induced perfusion defects suggesting that endothelial dysfunction plays a role in the pathophysiology of chronic Chagas heart disease

  16. Cardiopathies congénitales: aspects épidémiologiques et échocardiographies à propos de 109 cas au centre hospitalier universitaire pédiatrique Charles de Gaulle (CHUP-CDG) de Ouagadougou, Burkina Faso

    Science.gov (United States)

    Kinda, Georges; Millogo, Georges Rosario Christian; Koueta, Fla; Dao, Lassina; Talbousouma, Sollimy; Cissé, Hassane; Djiguimdé, Aristide; Yé, Diarra; Sorgho, Claudine Lougue

    2015-01-01

    Notre travail avait pour objectif d’étudier les aspects épidémiologiques et écho-cardiographiques des cardiopathies congénitales au CHUP-CDG afin d'y faire l’état des lieux. Pour se faire, nous avons mené sur une période de 27 mois d'aout 2009 à mai 2010 et d'octobre 2011 à décembre 2011, une étude rétrospective des comptes rendus d’échocardiographies Doppler des patients admis dans le service d'imagerie médicale. Nous avons utilisé une sonde cardiaque de 5MHz sur appareil Aloka Prosound 4000 Plus. Durant la période d’étude, 380 examens écho-cardiographiques ont été réalisés et ont permis de mettre en évidence 109 cas de cardiopathies congénitales avec 138 entités nosologiques différentes. Les cardiopathies congénitales représentaient 0,98% des 11169 entrées. Les souffles étaient au premier rang des motifs de demande de l’échographie Doppler cardiaque (121 cas sur 380) soit 39,53%. Les CIV étaient au premier plan des cardiopathies congénitales (28,26%), suivies des CIA (23,19%), des sténoses pulmonaires (19,57%), des Tétralogie de Fallot (9,42%). Dans leur forme isolée, les CIA étaient les plus fréquentes avec 21,95% des cas, suivies des CIV avec 20,73%. Sur 138 cas de cardiopathies congénitales (chez 109 enfants), 53 cas ont été observés chez des enfants de sexe féminin et 56 cas chez des enfants de sexe masculin soit un sexe ration de 1,1. La tranche d’âge présentant une fréquence élevée de cardiopathie congénitale est celle de 1mois- 30 mois avec 55% des cas. Les cardiopathies congénitales de l'enfant sont une réalité en Afrique, leurs fréquences dans toutes les séries rapportées sont certainement sous estimées en raison de l'inaccessibilité de l’échocardiographie doppler. PMID:26090039

  17. Serological based monitoring of a cohort of patients with chronic Chagas disease treated with benznidazole in a highly endemic area of northern Argentina

    Science.gov (United States)

    Niborski, Leticia L; Grippo, Vanina; Lafón, Sonia O; Levitus, Gabriela; García-Bournissen, Facundo; Ramirez, Juan C; Burgos, Juan M; Bisio, Margarita; Juiz, Natalia A; Ayala, Vilma; Coppede, María; Herrera, Verónica; López, Crescencia; Contreras, Ana; Gómez, Karina A; Elean, Juan C; Mujica, Hugo D; Schijman, Alejandro G; Levin, Mariano J; Longhi, Silvia A

    2016-01-01

    This study aimed to evaluate well-documented diagnostic antigens, named B13, 1F8 and JL7 recombinant proteins, as potential markers of seroconversion in treated chagasic patients. Prospective study, involving 203 patients treated with benznidazole, was conducted from endemic areas of northern Argentina. Follow-up was possible in 107 out of them and blood samples were taken for serology and PCR assays before and 2, 3, 6, 12, 24 and 36 months after treatment initiation. Reactivity against Trypanosoma cruzi lysate and recombinant antigens was measured by ELISA. The rate of decrease of antibody titers showed nonlinear kinetics with an abrupt drop within the first three months after initiation of treatment for all studied antigens, followed by a plateau displaying a low decay until the end of follow-up. At this point, anti-B13, anti-1F8 and anti-JL7 titers were relatively close to the cut-off line, while anti-T. cruzi antibodies still remained positive. At baseline, 60.8% (45/74) of analysed patients tested positive for parasite DNA by PCR and during the follow-up period in 34 out of 45 positive samples (75.5%) could not be detected T. cruzi DNA. Our results suggest that these antigens might be useful as early markers for monitoring antiparasitic treatment in chronic Chagas disease. PMID:27223650

  18. Chagas Disease, France

    OpenAIRE

    Lescure, François-Xavier; Canestri, Ana; Melliez, Hugues; Jauréguiberry, Stéphane; Develoux, Michel; Dorent, Richard; Guiard-Schmid, Jean-Baptiste; Bonnard, Philippe; Ajana, Faïza; Rolla, Valeria; Carlier, Yves; Gay, Frederick; Elghouzzi, Marie-Hélène; Danis, Martin; Pialoux, Gilles

    2008-01-01

    Chagas disease (CD) is endemic to Latin America; its prevalence is highest in Bolivia. CD is sometimes seen in the United States and Canada among migrants from Latin America, whereas it is rare in Europe. We report 9 cases of imported CD in France from 2004 to 2006.

  19. Involvement of the autonomic nervous system in Chagas heart disease

    Directory of Open Access Journals (Sweden)

    Edison Reis Lopes

    1983-12-01

    Full Text Available The autonomic nervous system and especially the intracardiac autonomic nervous system is involved in Chagas' disease. Ganglionitis and periganglionitis were noted in three groups ofpatients dying with Chagas'disease: 1 Those in heart failure; 2 Those dying a sudden, non violent death and; 3 Those dying as a consequence ofaccidents or homicide. Hearts in the threegroups also revealed myocarditis and scattered involvement of intramyocardial ganglion cells as well as lesions of myelinic and unmyelinic fibers ascribable to Chagas'disease. In mice with experimentally induced Chagas' disease weobserved more intensive neuronal lesions of the cardiac ganglia in the acute phase of infection. Perhaps neuronal loss has a role in the pathogenesis of Chagas cardiomyopathy. However based on our own experience and on other data from the literature we conclude that the loss of neurones is not the main factor responsible for the manifestations exhibited by chronic chagasic patients. On the other hand the neuronal lesions may have played a role in the sudden death ofone group of patients with Chagas'disease but is difficult to explain the group of patients who did not die sudderly but instead progressed to cardiac failure.

  20. Chagas' disease and AIDS

    OpenAIRE

    Vaidian, Anil K; Louis M Weiss; Tanowitz, Herbert B.

    2004-01-01

    Chagas' disease caused by Trypanosoma cruzi is an opportunistic infection in the setting of HIV/AIDS. Some individuals with HIV and chronic T. cruzi infection may experience a reactivation, which is most commonly manifested by meningoencephalitis. A reactivation myocarditis is the second most common manifestation. These presentations may be difficult to distinguish from toxoplasmosis in individuals with HIV/AIDS. The overlap of HIV and Trypanosoma cruzi infection occurs not only in endemic ar...

  1. Towards the establishment of a consensus real-time qPCR to monitor Trypanosoma cruzi parasitemia in patients with chronic Chagas disease cardiomyopathy: a substudy from the BENEFIT trial.

    Science.gov (United States)

    Moreira, Otacilio C; Ramírez, Juan David; Velázquez, Elsa; Melo, Myllena F A Dias; Lima-Ferreira, Carolina; Guhl, Felipe; Sosa-Estani, Sergio; Marin-Neto, Jose Antonio; Morillo, Carlos A; Britto, Constança

    2013-01-01

    Quantitative real-time PCR (qPCR) is an accurate method to quantify Trypanosoma cruzi DNA and can be used to follow-up parasitemia in Chagas disease (CD) patients undergoing chemotherapy. The Benznidazole Evaluation for Interrupting Trypanosomiasis (BENEFIT) study is an international, multicenter, randomized, double-blinded and placebo-controlled clinical trial to evaluate the efficacy of benznidazole (BZ) treatment in patients with chronic Chagas cardiomyopathy (CCC). One important question to be addressed concerns the effectiveness of BZ in reducing overall parasite load in CCC patients, even in the absence of parasitological cure. This report describes the evaluation of multiple procedures for DNA extraction and qPCR-based protocols aiming to establish a standardized methodology for the absolute quantification of T. cruzi DNA in Guanidine-EDTA blood (GEB) samples. A panel of five primer sets directed to the T. cruzi nuclear satellite DNA repeats (Sat-DNA) and to the minicircle DNA conserved regions (kDNA) was compared in either SYBR Green or TaqMan systems. Standard curve parameters such as, amplification efficiency, coefficient of determination and intercept were evaluated, as well as different procedures to generate standard samples containing pre-established T. cruzi DNA concentration. Initially, each primer set was assayed in a SYBR Green qPCR to estimate parasite load in GEB samples from chronic Chagas disease patients. The results achieved from Bayesian transmutability analysis elected the primer sets Cruzi1/Cruzi2 (p=0.0031) and Diaz7/Diaz8 (p=0.0023) coupled to the QIAamp DNA Kit extraction protocol (silica gel column), as the most suitable for monitoring parasitemia in these patients. Comparison between the parasite burden of 150 GEB samples of BENEFIT patients from Argentina, Brazil and Colombia, prior to drug/placebo administration, was performed using Cruzi1/Cruzi2 primers in a SYBR Green approach. The median parasitemia found in patients from

  2. Cell Therapy in Chagas Disease

    Directory of Open Access Journals (Sweden)

    Antonio C. Campos de Carvalho

    2009-01-01

    Full Text Available Chagas disease which is caused by the parasite Trypanosoma cruzi is an important cause of cardiomyopathy in Latin America. In later stages chagasic cardiomyopathy is associated with congestive heart failure which is often refractory to medical therapy. In these individuals heart transplantation has been attempted. However, this procedure is fraught with many problems attributable to the surgery and the postsurgical administration of immunosuppressive drugs. Studies in mice suggest that the transplantation of bone-marrow-derived cells ameliorates the inflammation and fibrosis in the heart associated with this infection. Cardiac magnetic resonance imaging reveals that bone marrow transplantation ameliorates the infection induced right ventricular enlargement. On the basis of these animal studies the safety of autologous bone marrow transplantation has been assessed in patients with chagasic end-stage heart disease. The initial results are encouraging and more studies need to be performed.

  3. Avaliação do metabolismo dos fosfatos de alta energia em pacientes com doença de Chagas Evaluation of the metabolism of high energy phosphates in patients with Chagas' disease

    OpenAIRE

    Ana Maria Betim Paes Leme; Vera Maria Cury Salemi; José Rodrigues Parga; Bárbara Maria Ianni; Charles Mady; Weiss, Robert G; Roberto Kalil-Filho

    2010-01-01

    FUNDAMENTO: Anormalidades do metabolismo miocárdico têm sido observadas em pacientes com insuficiência cardíaca de diferentes etiologias. A espectroscopia por ressonância magnética (ERM) com fósforo 31 é uma técnica não invasiva que permite a detecção de alterações metabólicas miocárdicas. OBJETIVO: Determinar o metabolismo de repouso dos fosfatos de alta energia em pacientes portadores de doença de Chagas (DC) pela ERM com fósforo 31. MÉTODOS: Foram estudados 39 pacientes com DC, sendo 23 co...

  4. Chronic Chagas disease: from basics to laboratory medicine.

    Science.gov (United States)

    Haberland, Annekathrin; Saravia, Silvia Gilka Munoz; Wallukat, Gerd; Ziebig, Reinhard; Schimke, Ingolf

    2013-02-01

    Chagas disease, caused by Trypanosoma cruzi infection, is ranked as the most serious parasitic disease in Latin America and has huge potential to become a worldwide problem, due to increasing migration, and international tourism, as well as infectant transfer by blood contact and transfusion, intrauterine transfer, and organ transplantation. Nearly 30% of chronically-infected patients become symptomatic, often with a latency of 10-30 years, developing life-threatening complications. Of those, nearly 90% develop Chagas heart disease, while the others manifest gastrointestinal disease and neuronal disorders. Besides interrupting the infection cycle and chemo therapeutic infectant elimination, starting therapy early in symptomatic patients is important for counteracting the disease. This would be essentially supported by optimized patient management, involving risk assessment, early diagnosis and monitoring of the disease and its treatment. From economic and logistic viewpoints, the tools of laboratory medicine should be especially able to guarantee this. After summarizing the basics of chronic Chagas disease, such as the epidemiological data, the pathogenetic mechanisms thought to drive symptomatic Chagas disease and also treatment options, we present tools of laboratory medicine that address patient diagnosis, risk assessment for becoming symptomatic and guidance, focusing on autoantibody estimation for risk assessment and heart marker measurement for patient guidance. In addition, increases in levels of inflammation and oxidative stress markers in chronic Chagas disease are discussed. PMID:23045386

  5. Chagas' disease and social security: a case-control study in an urban area, Goiás, Brazil Doença de Chagas e previdência social: estudo caso-controle em uma área urbana, Goiás, Brasil

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    Fábio Zicker

    1988-08-01

    Full Text Available One hundred and twenty subjects with Chagas' cardiopathy and 120 non-infected subjects were randomly selected from first time claimants of sickness benefits in the National Institute of Social Security (INPS in Goiás. Cases of Chagas' cardiopathy were defined based on serological test, history of residence in an endemic area and, clinical and/or electrocardiogram (ECG alterations suggestive of Chagas' cardiomyopathy. Controls were defined as subjects with at least two negative serological tests. Case and controls were compared in the analysis for age, sex, place of birth, migration history, socio-economic level, occupation, physical exertion at work, age at affiliation and years of contribution to the social security scheme, clinical course of their disease and ECG abnormalities. Chagas' disease patients were younger than other subjects and predominantly of rural origin. Non-infected subjects presented a better socio-economic level, were performing more skilled activities and had less changes of job than cases. No important difference was observed in relation to age at affiliation to INPS. About 60% of cases have claimed for benefits within the first four years of contribution while among controls this proportion was 38.5%. Cases were involved, proportionally more than controls, in "heavy" activities. A risk of 2.3 (95%CL 1.5 - 4.6 and 1.8 (95%CL 1.2- 3.5 was obtained comparing respectively "heavy" and "moderate" physical activity against "light". A relative risk of 8.5 (95%CL 4.9 - 14.8 associated with the presence of cardiopathy was estimated comparing the initial sample of seropositive subjects and controls. A high relative risk was observed in relation to right bundle branch block (RR = 37.1 95%CL = 8.8 - 155.6 and left anterior hemiblock (RR = 4.4, 95%CL = 2.1 - 9.1.São descritas as características sociais e ocupacionais de um grupo de pacientes chagásicos em área urbana no intuito de se estudar a importância médico-social da doen

  6. Prevailing of ischemia cardiopathy, demonstrated by gammagraphy in less than 40 years old persons and its association with risk factors

    International Nuclear Information System (INIS)

    The Coronary Arterial Illness (EAC) is the first cause of death of those Mexicans. Among their numerous risk factors it highlights the age with more bias starting from the 45 years. The objective of this investigation was to determine the prevailing of ischemic cardiopathy (Cl) and heart attack to the myocardium (IAM) in fellows smaller than 40 years and to identify risk factors. The study of myocardial perfusion (EPM) it is a non invasive study and of great sensibility and specificity that it allows to detect obstructive coronary lesions. The used method was retrospective-traverse Study in 125 patients smaller than 40 years. Files of patients to who EPM had been practiced with Technetium 99m-SESTAMlBI, protocol of one day, were revised, where its were analyzed the short and long axis (vertical and horizontal). General data, somatometry, emotional profile analysis, lipids and glucose profiles were gathered. Results. The population conformed it 53% women and 47% men with average of 31.9 year-old age of corporal mass index (IMC) 25.1 kg/cm2. 46% of abnormal studies was obtained, of which 35% was compatible with ischemic cardiopathy (Cl) and 11% with heart attack to the myocardium (IAM). The characteristics of these were: age 31.6±6 Vs 32.6±5.9 years; IMC 25.4±7.0 Vs 24.4±3.34 kg/cm2; stature 161.6±9.8 Vs 165.5±9.7cm; TAS 139.1±29.2 Vs. 115±13.4 mm Hg, TAD 84.5±17.4 Vs. 75±9.4 mm Hg; civil state married 65.5% (p=0.005) Vs single 57%; bigger depression 32% Vs anxiety 28%, in the group of patients with Cl and IAM, respectively. In the IAM population it was found an additional IRC 21% (p=0.030), HAS 21% (p=0.025) and drug addiction 21% (p=0.002). The rest of the results didn't show significant differences. Conclusion: Only 6.5% of the patients that went to EPM-99mTc-SESTAMIBl in a 6 year-old lapse, were smaller than 40 years. 71% of them was referred by prechordal pain in who almost the half it was evidenced Cl or IAM. In this investigation besides the well

  7. Morbidade da doença de Chagas: I - Estudo de casos procedentes de vários estados do Brasil, observados no Rio de Janeiro Morbidity of Chagas' disease: I - Study of cases originating from various states of Brazil, observed in Rio de Janeiro

    Directory of Open Access Journals (Sweden)

    J. Rodrigues Coura

    1983-09-01

    Estados não permitiu qualquer inferência de proporção entre as formas...A study of morbidity was made among 510 patients with positive serology for Chagas' disease, originating from various states in Brazil. The study began in 1960 when the patients were submitted, in Rio de Janeiro, to clinical, electrocardiographic and radiological examinations as well as to serological, xenodiagnostic and other serial laboratory tests. The patients were classified according to their clinical state as: asymptomatic (indeterminate form, cardiac, and carriers of "megas" or associated clinical forms. The prevalence of cardiopathy was 52.1% and of "megas" was 14,3%. An association of cardiopathy and "megas" was observed in 10.7% of the patients whereas the association of megacolon and megaesophagus appeard in 10.9% of the cases. The indeterminate form (asymptomatic was observed in 39% of the patients. The proportion of cardiopathic cases increased progressively between the first and the fifth decade of life, whereas the proportion of "megas" increased until the 7th decade. However, the highest number of cases in both forms appeard during the 4th decade of life. No significant differences were observed among the clinical forms by sex, in spite of a discrete predominance of cardiopathy in the male and of "megas" in the female. In relation to the patient's race (whites, blacks and of mixed race, it was not possible to observe a significant correlation with the different clinical forms since constitution of the cohort's origin was unknown. Even if the smal number of cases cannot be considered as representative of the clinical form prevalent in the area of origin, using te data of the four states with the larger number of cases, we observed that the proportion of cardiopathy/"megas" was respectively 65.7% and 20.1% in Bahia, 55.7% and 14.7% in Minas Gerais, 50.9% and 15% in Pernambuco and 23,.% and 0% in Paraíba. The small number of cases from the other states didi not permit any estimation

  8. Control of Chagas disease vectors

    OpenAIRE

    JM Ramsey; CJ Schofield

    2003-01-01

    Most Latin American countries are making dramatic progress in controlling Chagas disease, through a series of national and international initiatives focusing on elimination of domestic populations of Triatominae, improved screening of blood donors, and clinical support and treatment of persons infected with Trypanosoma cruzi. Some countries, particularly Uruguay, Chile and Brazil, are sufficiently advanced in their programmes to initiate detailed planning of the subsequent phases of Chagas di...

  9. Acute Chagas Disease in a Returning Traveler

    OpenAIRE

    Carter, Yvonne L.; Juliano, Jonathan J; Montgomery, Susan P.; Qvarnstrom, Yvonne

    2012-01-01

    Acute Chagas disease is rarely recognized, and the risk for acquiring the disease is undefined in travelers to Central America. We describe a case of acute Chagas disease in a traveler to Costa Rica and highlight the need for increased awareness of this infection in travelers to Chagas-endemic areas.

  10. VDR activation and uremic cardiopathy: myths and paradoxes

    Directory of Open Access Journals (Sweden)

    Diego Brancaccio

    2015-04-01

    Full Text Available The role of vitamin D receptor (VDR activators for the control of secondary hyperparathyroidism has been clarified during the last few decades; however, their possible activity in conditioning cardiovascular comorbidity and mortality has become of interest more recently. On the basis of experimental studies showing that VDR activating therapy is associated with a reduction of cardiac hypertrophy, the PRIMO Study (an international randomized controlled trial [RCT] was carried out a few years ago, but the results were disappointing, as the group of uremic patients on dialysis treated for 48 weeks with paricalcitol showed no differences in comparison with controls in terms of regression of heart hypertrophy. The aim of this editorial is to analyze the possible reasons for such results, and to help understand the actual role of VDR activators in dialysis patients in controlling cardiovascular morbidity and mortality.

  11. Associação entre função endotelial e a modulação autonômica em pacientes com doença de chagas Association between endothelial function and autonomic modulation in patients with chagas disease

    Directory of Open Access Journals (Sweden)

    Adriana Barni Truccolo

    2013-02-01

    Full Text Available FUNDAMENTO: Em condição homeostática, o Sistema Nervoso Autônomo (SNA, pela liberação de neurotransmissores vasoconstritores, e o endotélio, pela liberação de substâncias vasodilatadoras, atuam em sintonia para manter o tônus vascular. Todavia, a associação entre esses dois sistemas em portadores da doença de Chagas na forma indeterminada (DChI ainda não foi estudada. OBJETIVO: Verificar a associação entre parâmetros referentes à modulação autonômica e à função endotelial em portadores da DChI. MÉTODOS: Treze pacientes com DChI (59,2 ± 11,23 anos sem fatores de risco para doença cardiovascular foram avaliados para modulação autonômica pelo método oscilométrico da pressão arterial (Finapress e a análise dos registros mediante a técnica da Variabilidade da Frequência Cardíaca (VFC no domínio da frequência. A função endotelial foi avaliada pelo método de dilatação mediada pelo fluxo da artéria braquial (DMF, usando imagens de ultrassom de alta resolução. RESULTADOS: Na posição em decúbito dorsal foi observada correlação entre os componentes espectrais de alta (HF (r = 0,78 p = 0,007 e baixa (LF frequências normalizadas (r = 0,68 p = 0,01, bem como com o balanço simpatovagal (LF/HF (r= -0,78 p = 0,004 com a DMF. CONCLUSÃO: Nosso estudo aponta a existência de uma relação entre as alterações na modulação autonômica e na função endotelial em pacientes com Doença de Chagas na forma indeterminada.BACKGROUND: Under homeostatic condition, the autonomic nervous system (ANS, through the release of vasoconstrictor neurotransmitters, and the endothelium, through the release of vasodilating substances, interact to maintain blood vessel tone. However, the association between those two systems in patients with Chagas disease in its indeterminate phase (IChD has not been studied. OBJECTIVE: To assess the association between autonomic modulation parameters and endothelial function in patients with

  12. Cognitive impairment in human chronic Chagas' disease

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    C.A. Mangone

    1994-06-01

    Full Text Available We proposed to investigate subclinical cognitive impairment secondary to chronic Chagas' disease (CCD. No similar study was previously done. The neuropsychological performance of 45 chronic Chagasic patients and 26 matched controls (age, education place and years of residency in endemic area was compared using the Mini Mental State Exam (MMSE, Weschler Memory Scale (WMS and the Weschler Adult Intelligent Scale (WAIS. Non-parametric tests and Chi2 were used to compare group means and multivariate statistics in two way frequency tables for measures of independence and association of categorical variables with the disease. Results: Chagasic patients showed lower MMSE scores (p<004, poor orientation (p<.004, and attention (p<.007. Lower WMS MQ were associated with CCD (Chi2 5.9; p<.01; Fisher test p<.02. Lower WAIS IQ were associated with CCD (Chi2 6.3, p<.01; Fisher test p<.01 being the digit symbol (p<.03, picture completion (p<.03, picture arrangement (p<.01 and object assembly (p<.03 subtests the most affected. The impairment in non-verbal reasoning, speed of information processing, problem solving, learning and sequencing observed in chronic Chagas disease patients resembles the cognitive dysfunction associated with white matter disease.

  13. Control of Chagas disease.

    Science.gov (United States)

    Yamagata, Yoichi; Nakagawa, Jun

    2006-01-01

    The Southern Cone Initiative (Iniciativa de Salud del Cono Sur, INCOSUR) to control domestic transmission of Trypanosoma cruzi is a substantial achievement based on the enthusiasm of the scientific community, effective strategies, leadership, and cost-effectiveness. INCOSUR triggered the launch of other regional initiatives in Central America and in the Andean and Amazon regions, which have all made progress. The Central American Initiative targeted the elimination of an imported triatomine bug (Rhodnius prolixus) and the control of a widespread native species (Triatoma dimidiata), and faced constraints such as a small scientific community, the difficulty in controlling a native species, and a vector control programme that had fragmented under a decentralized health system. International organizations such as the Japan International Cooperation Agency (JICA) have played an important role in bridging the gaps between fragmented organizational resources. Guatemala achieved virtual elimination of R. prolixus and ;reduction of Tri. Dimidiata and El Salvador and Honduras revitalized their national programmes. The programme also revealed new challenges. Tri. dimidiata control needs to cover a large geographic area efficiently with stratification, quality control, community mobilization, and information management. Stakeholders such as the National Chagas Program, the local health system and their communities, as well as local government must share responsibilities to continue comprehensive vector control. PMID:16735164

  14. Chagas cardiomyopathy in the context of the chronic disease transition.

    Directory of Open Access Journals (Sweden)

    Alicia I Hidron

    Full Text Available BACKGROUND: Patients with Chagas disease have migrated to cities, where obesity, hypertension and other cardiac risk factors are common. METHODOLOGY/PRINCIPAL FINDINGS: The study included adult patients evaluated by the cardiology service in a public hospital in Santa Cruz, Bolivia. Data included risk factors for T. cruzi infection, medical history, physical examination, electrocardiogram, echocardiogram, and contact 9 months after initial data collection to ascertain mortality. Serology and PCR for Trypanosoma cruzi were performed. Of 394 participants, 251 (64% had confirmed T. cruzi infection by serology. Among seropositive participants, 109 (43% had positive results by conventional PCR; of these, 89 (82% also had positive results by real time PCR. There was a high prevalence of hypertension (64% and overweight (body mass index [BMI] >25; 67%, with no difference by T. cruzi infection status. Nearly 60% of symptomatic congestive heart failure was attributed to Chagas cardiomyopathy; mortality was also higher for seropositive than seronegative patients (p = 0.05. In multivariable models, longer residence in an endemic province, residence in a rural area and poor housing conditions were associated with T. cruzi infection. Male sex, increasing age and poor housing were independent predictors of Chagas cardiomyopathy severity. Males and participants with BMI Chagas cardiomyopathy remains an important cause of congestive heart failure in this hospital population, and should be evaluated in the context of the epidemiological transition that has increased risk of obesity, hypertension and chronic cardiovascular disease.

  15. High Interleukin 17 Expression Is Correlated With Better Cardiac Function in Human Chagas Disease

    OpenAIRE

    Magalhães, Luisa M. D.; Villani, Fernanda N. A.; Nunes, Maria do Carmo P.; Gollob, Kenneth J.; Rocha, Manoel O. C.; Dutra, Walderez O.

    2012-01-01

    This study was designed to investigate whether the expression of interleukin 17 (IL-17) is associated with the indeterminate or cardiac clinical forms of Chagas disease and whether IL-17 expression can be correlated with patients' cardiac function. Our results demonstrated that cardiac Chagas patients have a lower intensity of expression of IL-17 by total lymphocytes and lower frequency of circulating T helper 17 cells. Correlative analysis showed that high IL-17 expression was associated wit...

  16. Control of Chagas disease vectors

    Directory of Open Access Journals (Sweden)

    Ramsey JM

    2003-01-01

    Full Text Available Most Latin American countries are making dramatic progress in controlling Chagas disease, through a series of national and international initiatives focusing on elimination of domestic populations of Triatominae, improved screening of blood donors, and clinical support and treatment of persons infected with Trypanosoma cruzi. Some countries, particularly Uruguay, Chile and Brazil, are sufficiently advanced in their programmes to initiate detailed planning of the subsequent phases of Chagas disease control, while others such as Peru, Ecuador, and Mexico, are currently applying only the initial phases of the control campaigns. In this review, we seek to provide a brief history of the campaigns as a basis for discussion of future interventions. Our aim is to relate operational needs to the underlying biological aspects that have made Chagas disease so serious in Latin America but have also revealed the epidemiological vulnerability of this disease.

  17. Nanotechnological approaches against Chagas disease.

    Science.gov (United States)

    Romero, Eder Lilia; Morilla, Maria Jose

    2010-03-18

    Over several thousand years, the flagellated Trypanosome cruzi-causative agent of Chagas disease-developed a complex life cycle between the reduviidae vectors and its human hosts. Due to their silent and hidden location, the intracellular amastigotes are mainly responsible for the nearly 50,000 annual deaths caused by the chronic chagasic cardiomyopathy. Chagas disease is the most important parasitic disease in the Americas, though treatments have not evolved towards a more efficient pharmacotherapy that (i) eradicates the scarce amastigotes present at the indeterminate/chronic form and (ii) employs less toxic drugs than benznidazole or nifurtimox. Nano-drug delivery systems (nanoDDS) represent useful means to selectively deliver the drug to intracellular targets. However, preclinical research in Chagas must be extended in order to improve the chances of a clinical implementation. The stages involved in this process are (i) selection of the appropriate drug for a specific parasite, (ii) development of a drug-loaded nanoDDS structure that displays the adequate pharmacokinetics, biodistribution and intracellular transit and (iii) selection of the right parasite form to target and the right stage of the disease for the treatment to be started. In this review we will critically overview the few research works published in the last 20years in the context of nanotechnology and Chagas diseases and highlight the gaps in knowledge towards the design of more efficient medicines to address this endemic. PMID:19941920

  18. Update on Chagas' disease in Mexico

    Directory of Open Access Journals (Sweden)

    Dumonteil Eric

    1999-01-01

    Full Text Available Chagas' disease, caused by the protozoan parasite Trypanosoma cruzi, represents a major public health problem in most of the American continent. As transmission of the parasite is being interrupted in most of South America, the disease remains endemic in various areas of Mexico. We review here some of the information gathered in recent years. Seroprevalence of T. cruzi infection in humans remains relatively high in some areas, and there has been a general increase in the number of chronic cases reported to health authorities in recent years. In fact, chronic chagasic cardiomyopathy appears to be affecting a large number of patients with heart disease, but many cases may be misreported because of the unspecific nature of the clinical symptoms. Epidemiological monitoring of vector and reservoir populations, as well as of human cases is helping focus on endemic areas, but a better coordination and development of these efforts is still needed. Recent studies of parasite biology are in agreement with previous work showing the great diversity of parasite characteristics, and support the need for a regional approach to this zoonosis. Strong and continuing support from health and academic authorities is thus still needed to further improve our understanding of Chagas' disease in Mexico and implement efficient control programs.

  19. Current drug therapy and pharmaceutical challenges for Chagas disease.

    Science.gov (United States)

    Bermudez, José; Davies, Carolina; Simonazzi, Analía; Real, Juan Pablo; Palma, Santiago

    2016-04-01

    One of the most significant health problems in the American continent in terms of human health, and socioeconomic impact is Chagas disease, caused by the protozoan parasite Trypanosoma cruzi. Infection was originally transmitted by reduviid insects, congenitally from mother to fetus, and by oral ingestion in sylvatic/rural environments, but blood transfusions, organ transplants, laboratory accidents, and sharing of contaminated syringes also contribute to modern day transmission. Likewise, Chagas disease used to be endemic from Northern Mexico to Argentina, but migrations have earned it global. The parasite has a complex life cycle, infecting different species, and invading a variety of cells - including muscle and nerve cells of the heart and gastrointestinal tract - in the mammalian host. Human infection outcome is a potentially fatal cardiomyopathy, and gastrointestinal tract lesions. In absence of a vaccine, vector control and treatment of patients are the only tools to control the disease. Unfortunately, the only drugs now available for Chagas' disease, Nifurtimox and Benznidazole, are relatively toxic for adult patients, and require prolonged administration. Benznidazole is the first choice for Chagas disease treatment due to its lower side effects than Nifurtimox. However, different strategies are being sought to overcome Benznidazole's toxicity including shorter or intermittent administration schedules-either alone or in combination with other drugs. In addition, a long list of compounds has shown trypanocidal activity, ranging from natural products to specially designed molecules, re-purposing drugs commercialized to treat other maladies, and homeopathy. In the present review, we will briefly summarize the upturns of current treatment of Chagas disease, discuss the increment on research and scientific publications about this topic, and give an overview of the state-of-the-art research aiming to produce an alternative medication to treat T. cruzi infection

  20. Atrial Cardiopathy: A Broadened Concept of Left Atrial Thromboembolism Beyond Atrial Fibrillation

    Science.gov (United States)

    Kamel, Hooman; Okin, Peter M.; Longstreth, W. T.; Elkind, Mitchell S.V.; Soliman, Elsayed Z.

    2016-01-01

    Atrial fibrillation (AF) has long been associated with a heightened risk of ischemic stroke and systemic thromboembolism, but recent data require a re-evaluation of our understanding of the nature of this relationship. New findings about the temporal connection between AF and stroke, alongside evidence linking markers of left atrial abnormalities with stroke in the absence of apparent AF, suggest that left atrial thromboembolism may occur even without AF. These observations undermine the hypothesis that the dysrhythmia that defines AF is necessary and sufficient to cause thromboembolism. In this commentary, we instead suggest that the substrate for thromboembolism may often be the anatomic and physiological atrial derangements associated with AF. Therefore, our understanding of cardioembolic stroke may be more complete if we shift our representation of its origin from AF to the concept of atrial cardiopathy. PMID:26021638

  1. Transplante de Células-tronco marcadas para o miocárdio de paciente com doença de chagas Labeled stem cells transplantation to the myocardium of a patient with chagas' disease

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    José Luiz Balthazar Jacob

    2007-08-01

    Full Text Available O transplante de células-tronco é uma nova terapia com objetivo de produzir regeneração cardíaca pela diferenciação ou aumento dos miócitos cardíacos ou proliferação neovascular em pacientes no estágio final de insuficiência cardíaca congestiva secundária a cardiomiopatia dilatada¹, mas os resultados são desconhecidos2,3.Stem cell transplantation is a new therapy applied to produce cardiac regeneration through differentiation or increase of heart myocytes or neovascular proliferation in patients in the end stage of congestive heart failure secondary to dilated cardiomyopathy¹, but the results are still unknown2,3.

  2. Epidemiologia da doença de Chagas em quatro localidades rurais de Jaguaruana, Estado do Ceará: soroprevalência da infecção, parasitemia e aspectos clínicos Epidemiology of Chagas disease in four rural localities in Jaguaruana, State of Ceará: seroprevalence of infection, parasitemia and clinical characteristics

    Directory of Open Access Journals (Sweden)

    José Borges-Pereira

    2008-08-01

    Full Text Available Um estudo transversal sobre a doença de Chagas realizado com o exame da população de quatro localidades (nº= 541 habitantes do município de Jaguaruana, estado do Ceará, mostrou: a soroprevalência da infecção chagásica em 3,1%, avaliada pelos testes de imunofluorescência indireta, hemaglutinação indireta e ELISA, maior entre as pessoas com mais de 50 anos e sem diferença em relação ao sexo; a parasitemia positiva em 11,8% (2/17 soropositivos, determinada pelo xenodiagnóstico indireto e em 75% (9/12 pela reação em cadeia da polimerase (pA cross-sectional study on Chagas disease that examined the populations of four localities (nº = 541 inhabitants in the municipality of Jaguaruana, State of Ceará, showed seroprevalence of Chagas infection of 3.1%, as assessed by indirect immunofluorescence, indirect hemagglutination and ELISA tests. The rate was higher among adults over 50 years old, without any difference in relation to sex. Positive parasitemia was found in 11.8% (2/17 of the seropositive individuals by means of indirect xenodiagnosis and in 75% (9/12 by means of the polymerase chain reaction (p < 0.05. Cardiopathy was found by means of anamnesis, physical examination and resting electrocardiogram in 41% (7/17 of the seropositive individuals and in 11.8% (2/17 of the seronegative controls (p < 0.05. Analysis of these results showed that the prevalences of positive parasitemia and chronic Chagas cardiopathy were similar to those in the Caatinga area of Piauí and greater than in the Sertão area of Paraíba, although all these areas historically presented Triatoma brasiliensis and Triatoma pseudomaculata as the primary vectors responsible for Chagas infection transmission.

  3. Enfermedad de Chagas en Nicaragua

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    Carlos N. Talavera - López

    2008-04-01

    Full Text Available LA ENFERMEDAD DE CHAGAS ES UN PROBLEMA DE SALUD pública en toda Latinoamérica; alrededor de 20 millones de personas están infectadas y 200 millones están en riesgo de contraer la enfermedad. En 2006, la prevalencia en Centroamérica era del 7%. Actualmente no existe vacuna contra el protozoo y el tratamiento disponible resulta, aparte de poco efectivo, muy tóxico para el paciente. Los programas de control de vectores han ayudado a reducir los índices de infestación en Latinoamérica, pero aún falta mucho por hacer. En Nicaragua, la enfermedad de Chagas está subvalorada y los trabajos publicados son muy pocos. Es necesario investigar sobre esta enfermedad en nuestro país con otro enfoque, uno que no subvalore la enfermedad y ayude a desarrollar métodos diagnósticos y posibles tratamientos. Este artículo recopila información sobre los trabajos realizados porlos grupos más importantes de investigación en Chagas de Nicaragua en cuanto a epidemiología, control vectorial, diagnóstico y caracterización molecular.

  4. Mode of death on Chagas heart disease: comparison with other etiologies. a subanalysis of the REMADHE prospective trial.

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    Silvia M Ayub-Ferreira

    Full Text Available Sudden death has been considered the main cause of death in patients with Chagas heart disease. Nevertheless, this information comes from a period before the introduction of drugs that changed the natural history of heart failure. We sought to study the mode of death of patients with heart failure caused by Chagas heart disease, comparing with non-Chagas cardiomyopathy.We examined the REMADHE trial and grouped patients according to etiology (Chagas vs non-Chagas and mode of death. The primary end-point was all-cause, heart failure and sudden death mortality; 342 patients were analyzed and 185 (54.1% died. Death occurred in 56.4% Chagas patients and 53.7% non-Chagas patients. The cumulative incidence of all-cause mortality and heart failure mortality was significantly higher in Chagas patients compared to non-Chagas. There was no difference in the cumulative incidence of sudden death mortality between the two groups. In the Cox regression model, Chagas etiology (HR 2.76; CI 1.34-5.69; p = 0.006, LVEDD (left ventricular end diastolic diameter (HR 1.07; CI 1.04-1.10; p<0.001, creatinine clearance (HR 0.98; CI 0.97-0.99; p = 0.006 and use of amiodarone (HR 3.05; CI 1.47-6.34; p = 0.003 were independently associated with heart failure mortality. LVEDD (HR 1.04; CI 1.01-1.07; p = 0.005 and use of beta-blocker (HR 0.52; CI 0.34-0.94; p = 0.014 were independently associated with sudden death mortality.In severe Chagas heart disease, progressive heart failure is the most important mode of death. These data challenge the current understanding of Chagas heart disease and may have implications in the selection of treatment choices, considering the mode of death.ClinicalTrials.gov NCT00505050 (REMADHE.

  5. Chagas disease risk in Texas.

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    Sahotra Sarkar

    Full Text Available BACKGROUND: Chagas disease, caused by Trypanosoma cruzi, remains a serious public health concern in many areas of Latin America, including México. It is also endemic in Texas with an autochthonous canine cycle, abundant vectors (Triatoma species in many counties, and established domestic and peridomestic cycles which make competent reservoirs available throughout the state. Yet, Chagas disease is not reportable in Texas, blood donor screening is not mandatory, and the serological profiles of human and canine populations remain unknown. The purpose of this analysis was to provide a formal risk assessment, including risk maps, which recommends the removal of these lacunae. METHODS AND FINDINGS: The spatial relative risk of the establishment of autochthonous Chagas disease cycles in Texas was assessed using a five-stage analysis. 1. Ecological risk for Chagas disease was established at a fine spatial resolution using a maximum entropy algorithm that takes as input occurrence points of vectors and environmental layers. The analysis was restricted to triatomine vector species for which new data were generated through field collection and through collation of post-1960 museum records in both México and the United States with sufficiently low georeferenced error to be admissible given the spatial resolution of the analysis (1 arc-minute. The new data extended the distribution of vector species to 10 new Texas counties. The models predicted that Triatoma gerstaeckeri has a large region of contiguous suitable habitat in the southern United States and México, T. lecticularia has a diffuse suitable habitat distribution along both coasts of the same region, and T. sanguisuga has a disjoint suitable habitat distribution along the coasts of the United States. The ecological risk is highest in south Texas. 2. Incidence-based relative risk was computed at the county level using the Bayesian Besag-York-Mollié model and post-1960 T. cruzi incidence data. This

  6. Chagas disease and transfusion medicine: a perspective from non-endemic countries.

    Science.gov (United States)

    Angheben, Andrea; Boix, Lucia; Buonfrate, Dora; Gobbi, Federico; Bisoffi, Zeno; Pupella, Simonetta; Gandini, Giorgio; Aprili, Giuseppe

    2015-10-01

    In the last decades, increasing international migration and travel from Latin America to Europe have favoured the emergence of tropical diseases outside their "historical" boundaries. Chagas disease, a zoonosis endemic in rural areas of Central and South America represents a clear example of this phenomenon. In the absence of the vector, one of the potential modes of transmission of Chagas disease in non-endemic regions is through blood and blood products. As most patients with Chagas disease are asymptomatic and unaware of their condition, in case of blood donation they can inadvertently represent a serious threat to the safety of the blood supply in non-endemic areas. Since the first cases of transfusion-transmitted Chagas disease were described in the last years, non-endemic countries began to develop ad hoc strategies to prevent and control the spread of the infection. United States, Spain, United Kingdom and France first recognised the need for Trypanosoma cruzi screening in at-risk blood donors. In this review, we trace an up-to-date perspective on Chagas disease, describing its peculiar features, from epidemiological, pathological, clinical and diagnostic points of view. Moreover, we describe the possible transmission of Chagas disease through blood or blood products and the current strategies for its control, focusing on non-endemic areas. PMID:26513769

  7. Opportunity cost for early treatment of Chagas disease in Mexico.

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    Janine M Ramsey

    2014-04-01

    Full Text Available BACKGROUND: Given current neglect for Chagas disease in public health programs in Mexico, future healthcare and economic development policies will need a more robust model to analyze costs and impacts of timely clinical attention of infected populations. METHODOLOGY/PRINCIPAL FINDINGS: A Markov decision model was constructed to simulate the natural history of a Chagas disease cohort in Mexico and to project the associated short and long-term clinical outcomes and corresponding costs. The lifetime cost for a timely diagnosed and treated Chagas disease patient is US$ 10,160, while the cost for an undiagnosed individual is US$ 11,877. The cost of a diagnosed and treated case increases 24-fold from early acute to indeterminate stage. The major cost component for lifetime cost was working days lost, between 44% and 75%, depending on the program scenario for timely diagnosis and treatment. CONCLUSIONS/SIGNIFICANCE: In the long term, it is cheaper to diagnose and treat chagasic patients early, instead of doing nothing. This finding by itself argues for the need to shift current policy, in order to prioritize and attend this neglected disease for the benefit of social and economic development, which implies including treatment drugs in the national formularies. Present results are even more relevant, if one considers that timely diagnosis and treatment can arrest clinical progression and enhance a chronic patient's quality of life.

  8. Discrepancies and consequences of indirect hemagglutination, indirect immunofluorescence and Elisa tests for the diagnosis of Chagas disease

    OpenAIRE

    Regina Maia de Souza; Vicente Amato Neto

    2012-01-01

    Using the indirect hemagglutination (IH), indirect immunofluorescence (IIF) and enzyme linked immunosorbent assay (ELISA) tests for the diagnosis of Chagas disease, 4000 serum samples were examined. This study was conducted with different purposes: clinical interest, research support and parasitological monitoring of those patients with Chagas disease who were treated with heart transplantations. The tests occurred without patient selection and in accordance with the medical requests. The res...

  9. Estado actual en el tratamiento de la enfermedad de Chagas

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    WERNER APT B

    2011-02-01

    Full Text Available Efficient drugs against Chagas' disease must have an effect on the amastigote forms or intracellular reproduction elements of Trypanosoma cruzi (T. cruzi. Trypomastigote and epimastigote forms derive from the former and their response to medications is less marked. The only drugs used in humans are nifurtimox (NF and benznidazole (BNZ. Other useful medications are allopurinol and itraconazole. NF acts producing free radicals and BNZ inhibits the synthesis of macromolecules. There is consensus that Chagas' disease must be treated in all its periods, since T.cruzi DNA is detected by polymerase chain reaction in chronic cases, even when microscopy is negative. The pharmacological treatment modifies the natural evolution of the disease. It also helps to solve a public health problem, considering that there is a high number of subjects with Chagas' disease. Subjects with chronic chagasic cardiomyopathy with terminal heart failure are the only cases without indication for treatment. Due to the digestive and skin secondary effects of the drugs, treated patients must be controlled clinically and with complete blood counts and hepatic proiles before, during and after the therapy. Approximately 30% of patients will experience secondary effects. Children have a better tolerance to the drugs. Congenital or acquired acute, intermediate and chronic cases should be treated.

  10. Scintigraphy for the detection of myocardial damage in the indeterminate form of Chagas disease

    Energy Technology Data Exchange (ETDEWEB)

    Pedroso, Enio Roberto Pietra; Rezende, Nilton Alves de, E-mail: narezende@terra.com.b [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Faculdade de Medicina; Abuhid, Ivana Moura [Instituto de Medicina Nuclear e Diagnostico Molecular, Belo Horizonte, MG (Brazil)

    2010-07-15

    Background: non-invasive cardiological methods have been used for the identification of myocardial damage in Chagas disease. Objective: to verify whether the rest/stress myocardial perfusion scintigraphy is able to identify early myocardial damage in the indeterminate form of Chagas disease. Methods: eighteen patients with the indeterminate form of Chagas Disease and the same number of normal controls, paired by sex and age, underwent rest/stress myocardial scintigraphy using sestamibi-99mTc, aiming at detecting early cardiac damage. Results: the results did not show perfusion or ventricular function defects in patients at the indeterminate phase of Chagas disease and in the normal controls, except for a patient who presented signs of ventricular dysfunction in the myocardial perfusion scintigraphy with electrocardiographic gating. Conclusion: the results of this study, considering the small sample size, showed that the rest/stress myocardial scintigraphy using sestamibi-99mTc is not an effective method to detect early myocardial alterations in the indeterminate form of Chagas disease (author)

  11. Chagas heart disease: pathophysiologic mechanisms, prognostic factors and risk stratification

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    Anis Rassi Jr

    2009-07-01

    Full Text Available Chagas heart disease (CHD results from infection with the protozoan parasite Trypanosoma cruzi and is the leading cause of infectious myocarditis worldwide. It poses a substantial public health burden due to high morbidity and mortality. CHD is also the most serious and frequent manifestation of chronic Chagas disease and appears in 20-40% of infected individuals between 10-30 years after the original acute infection. In recent decades, numerous clinical and experimental investigations have shown that a low-grade but incessant parasitism, along with an accompanying immunological response [either parasite-driven (most likely or autoimmune-mediated], plays an important role in producing myocardial damage in CHD. At the same time, primary neuronal damage and microvascular dysfunction have been described as ancillary pathogenic mechanisms. Conduction system disturbances, atrial and ventricular arrhythmias, congestive heart failure, systemic and pulmonary thromboembolism and sudden cardiac death are the most common clinical manifestations of chronic Chagas cardiomyopathy. Management of CHD aims to relieve symptoms, identify markers of unfavourable prognosis and treat those individuals at increased risk of disease progression or death. This article reviews the pathophysiology of myocardial damage, discusses the value of current risk stratification models and proposes an algorithm to guide mortality risk assessment and therapeutic decision-making in patients with CHD.

  12. Scrutinizing the Biomarkers for the Neglected Chagas Disease: How Remarkable!

    Science.gov (United States)

    Pinho, Rosa T.; Waghabi, Mariana C.; Cardillo, Fabíola; Mengel, José; Antas, Paulo R. Z.

    2016-01-01

    Biomarkers or biosignature profiles have become accessible over time in population-based studies for Chagas disease. Thus, the identification of consistent and reliable indicators of the diagnosis and prognosis of patients with heart failure might facilitate the prioritization of therapeutic management to those with the highest chance of contracting this disease. The purpose of this paper is to review the recent state and the upcoming trends in biomarkers for human Chagas disease. As an emerging concept, we propose a classification of biomarkers based on plasmatic-, phenotype-, antigenic-, genetic-, and management-related candidates. The available data revisited here reveal the lessons learned thus far and the existing challenges that still lie ahead to enable biomarkers to be employed consistently in risk evaluation for this disease. There is a strong need for biomarker validation, particularly for biomarkers that are specific to the clinical forms of Chagas disease. The current failure to achieve the eradication of the transmission of this disease has produced determination to solve this validation issue. Finally, it would be strategic to develop a wide variety of biomarkers and to test them in both preclinical and clinical trials. PMID:27563302

  13. Pre-and postoperative nutritional evaluation in patients with chagasic megaesophagus Evaluación nutricional pre y postoperatoriade los pacientes con megaesófago por enfermedad de Chagas

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    F. A. S. Penhavel

    2004-03-01

    Full Text Available Chagasic megaesophagus is a chronic disease that courses with progressive dysphagia, regurgitation and protein-calorie malnutrition. Advanced or recurrent megaesophagus can be treated with Serra Dória’s operation (cardioplasty, partial gastrectomy and gastrojejunal Roux-en-Y anastomosis. A nutritional evaluation was performed on 27 patients (mean age 58 ± 10 years with chagasic megaesophagus at admission and after postoperative day 90. The nutritional state was assessed through global subjective nutritional evaluation (GSNE, anthropometry and laboratorial exams, besides the analysis of alimentary intake. In the preoperative period, GSNE pointed to malnutrition in 2/3 patients, while the anthropometric and laboratorial evaluation revealed that over 60% of the patients had protein-calorie malnutrition of the marasmic type. The preoperative nutritional state as evaluated by GSNE did not correlate with complications or postoperative mortality. The postoperative evaluation showed an increase in the intake of proteins, recovery in the body mass index and a reduction in the hemoglobin levels of the peripheral blood.El megaesófago debido a la enfermedad de Chagas es una enfermedad crónica que cursa con disfagia progresiva, regurgitación y malnutrición proteínico-calórica. El megaesófago en fase avanzada recidivante se puede tratar con la operación de Serra Doria (cardioplastia, gastrectomía parcial y anastomosis gastroyeyunal Souxen- Y. Se efectuó una evaluación nutricional de 27 pacientes (promedio de edad de 58 ± 10 años con megaesófago por enfermedad de Chagas durante el ingreso así como a los 90 días del postoperatorio. El estado nutricional se examinó a través de la evaluación nutricional subjetiva general (GSNE, la antropometría y los datos de laboratorio, aparte del análisis del aporte alimentario. Durante el preoperatorio, la GSNE delató una malnutrición de 2/3 de los pacientes, mientras que la evaluación antropom

  14. [Investigation of vectors and reservoirs in an acute Chagas outbreak due to possible oral transmission in Aguachica, Cesar, Colombia].

    Science.gov (United States)

    Soto, Hugo; Tibaduiza, Tania; Montilla, Marleny; Triana, Omar; Suárez, Diana Carolina; Torres Torres, Mariela; Arias, María Teresa; Lugo, Ligia

    2014-04-01

    Colombia recorded 11 cases of acute Chagas disease and 80 cases of oral contamination with Trypanosoma cruzi. The current study analyzes the entomological and parasitological characteristics of the outbreak in Aguachica, Cesar Department, in 2010. An interdisciplinary group of health professionals and regional university personnel conducted the laboratory tests in the patients and the investigation of the transmission focus. Eleven cases of acute Chagas diseases were detected in a single family in a dwelling with domiciliated triatomines and Rhodnius pallescens, Pantrongylus geniculatus, Eratyrus cuspidatus, and two Didelphis marsupialis opossums infected with T. cruzi in Attalea butyracea and Elaeis oleifera palm trees in the urban area of Aguachica. The study analyzes the role of R. pallescens and palm trees in the wild cycle of T. cruzi and in oral transmission of Chagas disease. Sporadic incursions by wild R. pallescens, P. geniculatus, and E. cuspidatus from the nearby palm trees into human dwellings may cause increasingly frequent outbreaks of oral Chagas disease. PMID:24896050

  15. Perspectivas da evolução clínica de pacientes com cardiomiopatia chagásica listados em prioridade para o transplante cardíaco Clinical perspectives of patients with Chagas cardiomyopathy listed as high priority for heart transplantation

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    Luiz Felipe P. Moreira

    2005-09-01

    Full Text Available INTRODUÇÃO: O choque cardiogênico é responsável por elevados índices de mortalidade na fila de espera para o transplante cardíaco. Na cardiomiopatia chagásica, a alta incidência de disfunção biventricular pode contribuir com a gravidade desta complicação. MÉTODO: Foram estudados 141 pacientes indicados em caráter de prioridade para o transplante. Destes pacientes, 46 eram portadores de cardiomiopatia chagásica e 95 de outras cardiomiopatias. O choque cardiogênico foi tratado farmacologicamente e com o implante ocasional do balão intra-aórtico. Em cinco pacientes chagásicos, foi realizado o implante de dispositivo paracorpóreo de assistência ventricular esquerda. RESULTADOS: Num período médio de 2,8 meses, 58 (41,1% dos 141 pacientes foram transplantados, 73 (51,7% faleceram e 10 foram retirados da fila. A mortalidade entre os pacientes chagásicos e não chagásicos foi de 45,6% e 54,7%, respectivamente. No entanto, a expectativa média de vida, sem a realização do transplante cardíaco, dos pacientes chagásicos foi de apenas 1,5 meses, sendo observado risco relativo de mortalidade de 1,6 para estes pacientes em relação aos não chagásicos (pINTRODUCTION: Heart failure is responsible for high mortality rates of patients on heart transplantation waiting lists. In Chagas cardiomyopathy, the presence of biventricular dysfunction increases the severity of this situation. METHOD: One hundred and forty-one patients suffering from cardiogenic shock, listed as high priority for heart transplantation, were studied. Forty-six patients presented with Chagas cardiomyopathy and 95 with other cardiomyopathies. Heart failure was treated using intravenous inotropic drugs and intra-aortic balloon pump implantation. Five patients with Chagas disease underwent paracorporeal left ventricular assist device implantation. RESULTS: During a mean follow-up of 2.8 months, 58 (41.1% of the 141 patients were transplanted, while 73 (53.7% died

  16. Implications of genetic variability of Trypanosoma cruzi for the pathogenesis of Chagas disease Implicações da variabilidade genética do Trypanosoma cruzi na patogênese da doença de Chagas

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    Fernanda da Silva Manoel-Caetano

    2007-10-01

    Full Text Available Trypanosoma cruzi, the etiological agent of Chagas disease, presents a high degree of intraspecific genetic variability, with possible implications for the clinical forms of the disease, like the development of cardiopathy, megaesophagus, and megacolon, alone or in combination. This tissue tropism involved in the pathogenesis of Chagas disease has still not been totally elucidated. Thus, the current review approaches key aspects of T. cruzi genetic diversity, the clinical forms of Chagas disease, and the infection of the host cell by the parasite and the immune response. Other aspects discussed here include the release of immunosuppressive factors by the parasite, acting in the host's immune response pathways; host cell apoptosis inhibition; the pathogenesis of chagasic megaesophagus, which can be related to host-parasite interaction; and finally the association between megaesophagus and increased risk for the development of squamous-cell esophageal carcinoma. However, despite great advances in the understanding of this disease, it is still not possible to establish the true relationship between the parasite's genetic variability and the clinical form of Chagas disease.O Trypanosoma cruzi, agente etiológico da doença de Chagas, apresenta elevado grau de variabilidade genética intra-específica, com possíveis implicações na forma clínica da doença, como o desenvolvimento de cardiopatia, do megaesôfago e do megacólon de forma isolada ou em associação. Este tropismo tecidual envolvido na patogênese da doença não está totalmente esclarecido. Assim, nesta revisão são abordados alguns aspectos referentes à diversidade genética dos parasitas isolados, às formas clínicas da doença de Chagas, ao processo de infecção do parasita na célula hospedeira e resposta imune. Outros aspectos também são enfocados, como os fatores imunossupressivos liberados pelo parasita que atuam na regulação das respostas imunes, a inibição da

  17. Doença de Chagas no Brasil Chagas disease in Brazil

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    Márcio C. Vinhaes

    2000-01-01

    Full Text Available Sumariam-se os dados da Fundação Nacional de Saúde (FNS sobre o estado atual dos vetores da doença de Chagas no Brasil, verificando-se que após vinte anos de controle químico continuado houve franca redução dos índices triatomínico-tripanosômicos, particularmente para esp��cies como Triatoma infestans e Panstrongylus megistus. Em paralelo, dados de sorologia escolar, de internações e de mortalidade pela doença indicam descenso nas taxas de incidência e impacto médico social da protozoose, restando áreas mais preocupantes, como o Nordeste e resíduos de T. infestans. Impõe-se urgente uma vigilância epidemiológica efetiva, a ser realizada por estados e municípios ante o processo de descentralização da FNS.This article presents the current situation for Chagas disease vectors in Brazil, based on data from the Brazilian National Health Foundation (FNS. Over the course of the last 20 years, continuous chemical control has resulted in a clear reduction of triatomine densities and Trypanosoma cruzi in Brazilian dwellings. Results have been particularly promising in relation to Triatoma infestans and Panstrongylus megistus, considered the most important species in the past. In parallel, data from school serological surveys, hospitalized patients, and mortality records show an important decrease in the disease. Nevertheless, some areas of the Brazilian Northeast and some residual foci of Triatoma infestans and Panstrongylus megistus remain as major challenges for public health authorities, requiring effective epidemiological surveillance. States and municipalities are required to assume this task at present, as the traditional Brazilian National Health Foundation is undergoing decentralization.

  18. Morphometric study of the fibrosis and mast cell count in the circular colon musculature of chronic Chagas patients with and without megacolon Estudo morfométrico da fibrose e do número de mastócitos na muscular circular do cólon de chagásicos crônicos com e sem megacólon

    Directory of Open Access Journals (Sweden)

    Simone Wanderley Pinheiro

    2003-07-01

    Full Text Available A morphometric study of the circular colon musculature was performed, in which the mast cell count was determined and the connective fibrous tissue in this layer was measured. The objective was to gain better understanding of Chagas megacolon morphology and contribute towards the knowledge of fibrosis pathogenesis in Chagas megas. An evaluation was made of 15 distal sigmoid rings from Chagas patients with megacolon (MCC, 15 without megacolon (CSMC and 15 non-Chagas patients (NC. The rings were fixed in formol, embedded in paraffin, and 7mm thick sections were cut and stained using Azan-Heidenhain and Giemsa. The mast cell count and fibrosis were greater in the MCC group than in the CSMC and NC groups (p Com os objetivos de conhecer melhor a morfologia do megacólon chagásico e contribuir para o conhecimento da patogênese da fibrose dos megas, realizou-se estudo morfométrico na muscular circular do cólon, contando-se o número de mastócitos e medindo o conjuntivo fibroso nessa camada. Foram avaliados anéis do sigmóide distal de 15 chagásicos com megacólon (MCC, 15 sem megacólon (CSMC e 15 não chagásicos (NC. Os anéis foram fixados em formol, incluídos em parafina, cortados com 7mm de espessura e corados por Azan-Heidenhain e Giemsa. O número de mastócitos e a fibrose foram maiores no grupo com MCC em relação ao CSMC e NC (p < 0,05; teste de Kruskal-Wallis; não houve diferença significante entre os dois últimos grupos. Diante destes achados, é possível, que haja relação entre mastocitose e fibrose no megacólon chagásico, como já se demonstrou em outras doenças.

  19. Enfermedad de Chagas congenita en la Ciudad de Salta, Argentina Congenital Chagas' disease in Salta, Argentina

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    Mario Zaidenberg

    1993-02-01

    ' disease in patients attending the hospital de Maternidad e Infancia from Salta appeared mostly oligosymptomatic. In agreeement with previous reports, micro-hematocrites appeared to be the method of choice for the rapid detection of T. cruzi infection in NB. Two concordant serologic reactions showed to be a satisfactory criterion for the follow up of infected NB. Due to scarce clinical manifestations of congenital Chagas' disease in NB, our results strongly suggest the surveillance of all offsprings to either confirm or discard the presence of infection.

  20. Peptic disease and Helicobacter pylori are highly prevalent in patients with the indeterminate form of chagas? disease: report of 21 cases

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    OLIVEIRA Luiz Carlos Marques de

    1997-01-01

    Full Text Available Given that chagasic patients in the indeterminate form of this disease, can have abnormal motility of the digestive tract and immunologic abnormalities, we decided to assess the frequency of peptic disease and Helicobacter pylori (Hp infection in these individuals. Twenty-one individuals, 13 males and 8 females, mean age 37.6 ± 11.1 years, were examined. Biopsies of the duodenum, antrum, lesser and greater gastric curvature and esophagus were performed. The endoscopic findings were of chronic gastritis in 20 (95.2% patients, duodenal ulcer in 3 (14.3%, gastric and duodenal ulcer in 3 (14.3%, gastric ulcer alone in 1 (4.8%, esophagitis in 5 (23.8%, and duodenitis in 5 (23.8%. The diagnosis of infection by the Hp was done by the urease test and histologic examination. Hp infection was found in 20 (95.2% individuals: in 20 out of them in the antrum, in 17 in the lesser curvature, and in 17 in the greater curvature. Hp was not found in the esophagus and duodenum. The only individual with no evidence of infection by Hp was also the only one with normal endoscopic and histologic examinations. The histologic examinations confirmed the diagnoses of gastric ulcer as peptic, chronic gastritis in 20 patients, duodenitis in 14, and esophagitis in 9. In this series the patients had a high frequency of peptic disease, which was closely associated with Hp infection

  1. ADENOSINE DEAMINASE ACTIVITY AND SERUM C-REACTIVE PROTEIN AS PROGNOSTIC MARKERS OF CHAGAS DISEASE SEVERITY

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    Iván Darío BRAVO-TOBAR

    2015-10-01

    Full Text Available SUMMARY Chagas disease is a public health problem worldwide. The availability of diagnostic tools to predict the development of chronic Chagas cardiomyopathy is crucial to reduce morbidity and mortality. Here we analyze the prognostic value of adenosine deaminase serum activity (ADA and C-reactive protein serum levels (CRP in chagasic individuals. One hundred and ten individuals, 28 healthy and 82 chagasic patients were divided according to disease severity in phase I (n = 35, II (n = 29, and III (n = 18. A complete medical history, 12-lead electrocardiogram, chest X-ray, and M-mode echocardiogram were performed on each individual. Diagnosis of Chagas disease was confirmed by ELISA and MABA using recombinant antigens; ADA was determined spectrophotometrically and CRP by ELISA. The results have shown that CRP and ADA increased linearly in relation to disease phase, CRP being significantly higher in phase III and ADA at all phases. Also, CRP and ADA were positively correlated with echocardiographic parameters of cardiac remodeling and with electrocardiographic abnormalities, and negatively with ejection fraction. CRP and ADA were higher in patients with cardiothoracic index ≥ 50%, while ADA was higher in patients with ventricular repolarization disturbances. Finally, CRP was positively correlated with ADA. In conclusion, ADA and CRP are prognostic markers of cardiac dysfunction and remodeling in Chagas disease.

  2. Tratamiento de la enfermedad de Chagas TREATMENT OF CHAGAS DISEASES

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    Werner Apt

    1999-07-01

    Full Text Available En la actualidad se acepta que la enfermedad de Chagas humana debe ser tratada en cualquier período de su evolución con la única excepción del período crónico terminal. En el período agudo clínico, infección de menos de 2 meses así como en el biológico: pesquisa de parásitos al fresco, frotis, gota gruesa y con serología convencional positiva e IgM(+. El ideal de tratamiento es con nifurtimox (NF 8-10 mg/kg día en adultos y 15 mg/kg día en niños por 60-90 días. La dosis se reparte en tres tomas. La curación clínica y serológica es de un 60%. En Brasil donde no se utiliza este fármaco se trata con benznidazol (BNZ 5 mg/kg día (adultos y 5-10mg/kg día en niños por 60 días. En las infecciones congénitas la terapia debe ser precoz en cuanto se realice el diagnóstico por clínica y pesquisa del parásito al fresco, frotis, microstraut etc. Muchas veces el diagnóstico se efectúa por persistencia de la serología por más de 6 meses y el recién nacido ya esta en etapa crónica de la infección. Es necesario efectuar seguimiento clínico serológico y parasitológico de los casos. Las infecciones accidentales deben ser tratadas por 10 días. En los trasplantes de órganos en que el receptor o dador es chagásico se debe indicar terapia con NF o BNZ a igual dosis y tiempo que la señalada anteriormente. Las reactivaciones en los casos crónicos ejem: que adquieren un SIDA o que presentan depresiones del sistema de inmunidad celular como leucemias, Hodgkin, etc se deben tratar como cuadros agudos con NF ó BNZ por periodos prolongados de 5 ó más meses. En estos casos obviamente la prevención es lo ideal: hacer serología para Chagas a los pacientes con SIDA, etc. En el período crónico hay consenso en el tratamiento debido a que tanto en la forma indeterminada como en el período crónico inicial la terapia tiene rendimiento ya que siempre hay parásitos tisulares demostrados por PCR aunque el microscopio óptico no los

  3. Cerebral evoked potentials in human chronic Chagas' disease

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    O. M. Genovese

    1989-09-01

    Full Text Available Seventy five patients with the diagnosis of chronic Chagas' disease were studied by employing EPs techniques. Two of them had delayed arrival of the signal to the Erb's point and one to the spinal cord when looking at SEPs. TWo patients had increment of the time interval between waves 1st and IIIrd, when studying PEATs. These findings were interpreted as due to peripheral nerve fibers damage, a feature described in previous papers. The, most striking finding was the prolonged time interval between waves N13 and N20 (SEPs found in two patients and between waves IIIrd and Vth (PEAT seen in 7 affected subjects. These observations suggested the development of some sort of CNS involvement, perhaps related to myelin damage, in patients who reached the chronic state of the infection.

  4. Emmanuel Dias: o principal artífice do combate à doença de Chagas nas Américas Emmanuel Dias: the principal architect of the fight against Chagas disease in the Americas

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    João Carlos Pinto Dias

    2008-10-01

    Full Text Available Comemora-se em 2008 o centenário de nascimento do Dr. Emmanuel Dias, cuja vida foi intensamente dedicada ao estudo, reconhecimento e controle da doença de Chagas. Esta súmula se incorpora às diversas homenagens feitas no Brasil e no Exterior, resgatando alguns elementos históricos na trajetória do cientista e o enorme impacto social resultante direta e indiretamente de seu trabalho. Afilhado e assistente de Carlos Chagas, Emmanuel foi considerado por Chagas Filho como o mais profícuo dos seguidores de seu pai. Em trinta anos de atividades, Dias iniciou-se como brilhante protozoologista depois passando ao enfrentamento da doença humana. Trabalhou intensivamente em diagnóstico, epidemiologia, clinica e controle. Idealizou estratégias de prospecção, mapeou a doença nas Américas, participou diretamente da sistematização da cardiopatia crônica e descreveu o primeiro inseticida eficaz contra os triatomíneos, também formatando a estratégia de seu controle. Mais ainda, estendeu suas atividades para toda a área endêmica, divulgando a doença e seu controle, de um lado, e impulsionando autoridades sanitárias e centros de decisão com vistas a implantação de ações, de outro. De seu trabalho resultaram programas nacionais e regionais que reduziram significativamente a transmissão da doença humana em todo o Continente. Foi recentemente considerado como o cientista que teve o maior impacto no enfrentamento desta tripanossomíase, em todos os tempos.In 2008, the centenary of the birth of Emmanuel Dias, whose life was intensely dedicated to the study, recognition and control of Chagas disease, is being celebrated. This summary of his life joins with the various homages paid in Brazil and abroad, to recall some of the key historical points in this scientist's career and the enormous social impact that resulted directly and indirectly from his work. Dias, who was Carlos Chagas' protégée and assistant, was considered by Chagas Filho

  5. Associação entre função endotelial e a modulação autonômica em pacientes com doença de chagas Association between endothelial function and autonomic modulation in patients with chagas disease

    OpenAIRE

    Adriana Barni Truccolo; Thiago Dipp; Bruna Eibel; Rodrigo Antonini Ribeiro; Karina Rabello Casali; Maria Claudia Irigoyen; Iseu Gus; Lucia Campos Pellanda; Rodrigo Della Meã Plentz

    2013-01-01

    FUNDAMENTO: Em condição homeostática, o Sistema Nervoso Autônomo (SNA), pela liberação de neurotransmissores vasoconstritores, e o endotélio, pela liberação de substâncias vasodilatadoras, atuam em sintonia para manter o tônus vascular. Todavia, a associação entre esses dois sistemas em portadores da doença de Chagas na forma indeterminada (DChI) ainda não foi estudada. OBJETIVO: Verificar a associação entre parâmetros referentes à modulação autonômica e à função endotelial em portadores da D...

  6. Leptin levels in different forms of Chagas' disease

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    F. Fernandes

    2007-12-01

    Full Text Available Leptin is produced primarily by adipocytes. Although originally associated with the central regulation of satiety and energy metabolism, increasing evidence indicates that leptin may be an important mediator in cardiovascular pathophysiology. The aim of the present study was to investigate plasma leptin levels in patient with Chagas' heart disease and their relation to different forms of the disease. We studied 52 chagasic patients and 30 controls matched for age and body mass index. All subjects underwent anthropometric, leptin and N-terminal pro-brain natriuretic peptide (NT-proBNP measurements and were evaluated by echocardiography, 12-lead electrocardiogram (ECG, and chest X-ray. All patients had fasting blood samples taken between 8:00 and 9:00 am. Chagasic patients were divided into 3 groups: group I (indeterminate form, IF group consisted of 24 subjects with 2 positive serologic reactions for Chagas' disease and no cardiac involvement as evaluated by chest X-rays, ECG and two-dimensional echocardiography; group II (showing ECG abnormalities and normal left ventricular systolic function, ECG group consisted of 14 patients; group III consisted of 14 patients with congestive heart failure (CHF group and left ventricular dysfunction. Serum leptin levels were significantly lower (P < 0.001 in the CHF group (1.4 ± 0.8 ng/mL when compared to the IF group (5.3 ± 5.3 ng/mL, ECG group (9.7 ± 10.7 ng/mL, and control group (8.1 ± 7.8 ng/mL. NT-proBNP levels were significantly higher (P < 0.001 in the CHF group (831.8 ± 800.1 pg/mL when compared to the IF group (53.2 ± 33.3 pg/mL, ECG group (83.3 ± 57.4 pg/mL, and control group (32 ± 22.7 pg/mL. Patients with Chagas' disease and an advanced stage of CHF have high levels of NT-ProBNP andlow plasma levels of leptin. One or more leptin-suppressing mechanisms may operate in chagasic patients.

  7. Chagas' Disease and HIV Co-infection: Genotypic Characterization of the Trypanosoma cruzi Strain

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    Pacheco Raquel S

    1998-01-01

    Full Text Available In the past few years, new aspects of the immunopathology of Chagas' disease have been described in immunosuppressed patients, such as fatal central nervous system lesions related to the reactivation of the parasite. This article is the first description of the genotypic characterization, at the strain level, of Trypanosoma cruzi isolated from a patient with Chagas` disease/AIDS co-infection. The presence of four hypodense lesions was observed in the cranial compute tomographic scan. The diagnosis of AIDS was assessed by the detection of anti-HIV antibodies using enzyme-linked immunosorbent assay (ELISA and Western blot techniques. The CD4+ lymphocyte counts were maintained under 200 cells/mm3 during one year demonstrating the severity of the state of immunosuppression. Chagas' disease was confirmed by serological and parasitological methods. Trypomastigote forms were visualized in a thick blood smear. The parasite isolated is genotypically similar to the CL strain. The paper reinforces that cerebral Chagas' disease can be considered as another potential opportunistic infection in AIDS resulting from the reactivation of a dormant T. cruzi infection acquired years earlier.

  8. Chronic phase of Chagas disease: why should it be treated? A comprehensive review

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    José Rodrigues Coura

    2011-09-01

    Full Text Available The pathogenesis and evolutive pattern of Chagas disease suggests that the chronic phase should be more widely treated in order to (i eliminate Trypanosoma cruzi and prevent new inflammatory foci and the extension of tissue lesions, (ii promote tissue regeneration to prevent fibrosis, (iii reverse existing fibrosis, (iv prevent cardiomyopathy, megaoesophagus and megacolon and (v reduce or eliminate cardiac block and arrhythmia. All cases of the indeterminate chronic form of Chagas disease without contraindications due to other concomitant diseases or pregnancy should be treated and not only cases involving children or recently infected cases. Patients with chronic Chagas cardiomyopathy grade II of the New York Heart Association classification should be treated with specific chemotherapy and grade III can be treated according to medical-patient decisions. We are proposing the following new strategies for chemotherapeutic treatment of the chronic phase of Chagas disease: (i repeated short-term treatments for 30 consecutive days and interval of 30-60 days for six months to one year and (ii combinations of drugs with different mechanisms of action, such as benznidazole + nifurtimox, benznidazole or nifurtimox + allopurinol or triazole antifungal agents, inhibition of sterol synthesis.

  9. Melatonin in Chagas´ disease: Possible therapeutic value

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    Daniel P. Cardinali

    2011-10-01

    Full Text Available Chagas' disease is a severe health problem in Latin America, causing approximately 50 000 deaths a year, with approximately 18 million infected people. About 25-30% of the patients infected with Trypanosoma cruzi develop the chronic form of the disease. The protective response against T. cruzi depends on both innate and acquired immunity involving macrophages, natural killer cells, T and B lymphocytes, and the production of proinflammatory Th-1 cytokines. In addition, an increased nitric oxide (NO production in macrophages leading to effective microbicidal action is needed to control parasitemia. Melatonin is detectable in T. cruzi and may play a role in promoting infection whereas, when administered in high doses during the acute phase of T. cruzi infection, it can decrease parasitemia while reducing NO production. During chronic disease progression, the sustained oxidative stress concomitant to myocardial damage could be reduced by administering melatonin. It is hypothesized that the coordinated administration of a melatonin agonist like the MT1/MT2 agonist ramelteon, that lacks antioxidant activity and may not affect NO production during the acute phase, and of melatonin in doses high enough to decrease oxidative damage, to preserve mitochondrial and to prevent cardiomyopathy during the chronic phase, could be a novel add-on treatment of Chagas´ disease.

  10. Chagas disease in the Amazon Region

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    Hugo Marcelo Aguilar

    2007-10-01

    Full Text Available The risk that Chagas disease becomes established as a major endemic threat in Amazonia (the world's largest tropical biome, today inhabited by over 30 million people relates to a complex set of interacting biological and social determinants. These include intense immigration from endemic areas (possibly introducing parasites and vectors, extensive landscape transformation with uncontrolled deforestation, and the great diversity of wild Trypanosoma cruzi reservoir hosts and vectors (25 species in nine genera, which maintain intense sylvatic transmission cycles. Invasion of houses by adventitious vectors (with infection rates > 60% is common, and focal adaptation of native triatomines to artificial structures has been reported. Both acute (~ 500 and chronic cases of autochthonous human Chagas disease have been documented beyond doubt in the region. Continuous, low-intensity transmission seems to occur throughout the Amazon, and generates a hypoendemic pattern with seropositivity rates of ~ 1-3%. Discrete foci also exist in which transmission is more intense (e.g., in localized outbreaks probably linked to oral transmission and prevalence rates higher. Early detection-treatment of acute cases is crucial for avoiding further dispersion of endemic transmission of Chagas disease in Amazonia, and will require the involvement of malaria control and primary health care systems. Comprehensive eco-epidemiological research, including prevalence surveys or the characterization of transmission dynamics in different ecological settings, is still needed. The International Initiative for Chagas Disesae Surveillance and Prevention in the Amazon provides the framework for building up the political and scientific cooperation networks required to confront the challenge of preventing Chagas disease in Amazonia.

  11. Advanced megaesophagus (Group III secondary to vector-borne Chagas disease in a 20-month-old infant

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    Anis Rassi

    2012-04-01

    Full Text Available The authors report the case of a female infant with Group III (or Grade III megaesophagus secondary to vector-borne Chagas disease, resulting in severe malnutrition that reversed after surgery (Heller technique. The infant was then treated with the antiparasitic drug benznidazole, and the infection was cured, as demonstrated serologically and parasitologically. After follow-up of several years without evidence of disease, with satisfactory weight and height development, the patient had her first child at age 23, in whom serological tests for Chagas disease yielded negative results. Thirty years after the initial examination, the patient's electrocardiogram, echocardiogram, and chest radiography remained normal.

  12. Chronic Chagas' heart disease: a disease on its way to becoming a worldwide health problem: epidemiology, etiopathology, treatment, pathogenesis and laboratory medicine.

    Science.gov (United States)

    Muñoz-Saravia, Silvia Gilka; Haberland, Annekathrin; Wallukat, Gerd; Schimke, Ingolf

    2012-01-01

    Chagas' disease, caused by Trypanosoma cruzi infection, is ranked as the most serious parasitic disease in Latin America. Nearly 30% of infected patients develop life-threatening complications, and with a latency of 10-30 years, mostly Chagas' heart disease which is currently the major cause of morbidity and mortality in Latin America, enormously burdening economic resources and dramatically affecting patients' social and labor situations. Because of increasing migration, international tourism and parasite transfer by blood contact, intrauterine transfer and organ transplantation, Chagas' heart disease could potentially become a worldwide problem. To raise awareness of this problem, we reflect on the epidemiology and etiopathology of Chagas' disease, particularly Chagas' heart disease. To counteract Chagas' heart disease, in addition to the general interruption of the infection cycle and chemotherapeutic elimination of the infection agent, early and effective causal or symptomatic therapies would be indispensable. Prerequisites for this are improved knowledge of the pathogenesis and optimized patient management. From economic and logistics viewpoints, this last prerequisite should be performed using laboratory medicine tools. Consequently, we first summarize the mechanisms that have been suggested as driving Chagas' heart disease, mainly those associated with the presence of autoantibodies against G-protein-coupled receptors; secondly, we indicate new treatment strategies involving autoantibody apheresis and in vivo autoantibody neutralization; thirdly, we present laboratory medicine tools such as autoantibody estimation and heart marker measurement, proposed for diagnosis, risk assessment and patient guidance and lastly, we critically reflect upon the increase in inflammation and oxidative stress markers in Chagas' heart disease. PMID:21165698

  13. Protective human leucocyte antigen haplotype, HLA-DRB1*01-B*14, against chronic Chagas disease in Bolivia.

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    Florencia del Puerto

    Full Text Available BACKGROUND: Chagas disease, caused by the flagellate parasite Trypanosoma cruzi affects 8-10 million people in Latin America. The mechanisms that underlie the development of complications of chronic Chagas disease, characterized primarily by pathology of the heart and digestive system, are not currently understood. To identify possible host genetic factors that may influence the clinical course of Chagas disease, Human Leucocyte Antigen (HLA regional gene polymorphism was analyzed in patients presenting with differing clinical symptoms. METHODOLOGY: Two hundred and twenty nine chronic Chagas disease patients in Santa Cruz, Bolivia, were examined by serological tests, electrocardiogram (ECG, and Barium enema colon X-ray. 31.4% of the examinees showed ECG alterations, 15.7% megacolon and 58.1% showed neither of them. A further 62 seropositive megacolon patients who had undergone colonectomy due to acute abdomen were recruited. We analyzed their HLA genetic polymorphisms (HLA-A, HLA-B, MICA, MICB, DRB1 and TNF-alpha promoter region mainly through Sequence based and LABType SSO typing test using LUMINEX Technology. PRINCIPAL FINDINGS: The frequencies of HLA-DRB1*01 and HLA-B*14:02 were significantly lower in patients suffering from megacolon as well as in those with ECG alteration and/or megacolon compared with a group of patients with indeterminate symptoms. The DRB1*0102, B*1402 and MICA*011 alleles were in strong Linkage Disequilibrium (LD, and the HLA-DRB1*01-B*14-MICA*011 haplotype was associated with resistance against chronic Chagas disease. CONCLUSIONS: This is the first report of HLA haplotype association with resistance to chronic Chagas disease.

  14. Prevailing of ischemia cardiopathy, demonstrated by gammagraphy in less than 40 years old persons and its association with risk factors; Prevalencia de cardiopatia isquemica, demostrada por gammagrafia en menores de 40 anos y su asociacion con factores de riesgo

    Energy Technology Data Exchange (ETDEWEB)

    Cano G, M.A.; Castillo M, L.; Orea T, A. [Departamento de Medicina Nuclear, Departamento de Cardioiogia del Insitituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran. Mexico Distrito Federal (Mexico)

    2005-07-01

    The Coronary Arterial Illness (EAC) is the first cause of death of those Mexicans. Among their numerous risk factors it highlights the age with more bias starting from the 45 years. The objective of this investigation was to determine the prevailing of ischemic cardiopathy (Cl) and heart attack to the myocardium (IAM) in fellows smaller than 40 years and to identify risk factors. The study of myocardial perfusion (EPM) it is a non invasive study and of great sensibility and specificity that it allows to detect obstructive coronary lesions. The used method was retrospective-traverse Study in 125 patients smaller than 40 years. Files of patients to who EPM had been practiced with Technetium 99m-SESTAMlBI, protocol of one day, were revised, where its were analyzed the short and long axis (vertical and horizontal). General data, somatometry, emotional profile analysis, lipids and glucose profiles were gathered. Results. The population conformed it 53% women and 47% men with average of 31.9 year-old age of corporal mass index (IMC) 25.1 kg/cm{sup 2}. 46% of abnormal studies was obtained, of which 35% was compatible with ischemic cardiopathy (Cl) and 11% with heart attack to the myocardium (IAM). The characteristics of these were: age 31.6{+-}6 Vs 32.6{+-}5.9 years; IMC 25.4{+-}7.0 Vs 24.4{+-}3.34 kg/cm{sup 2}; stature 161.6{+-}9.8 Vs 165.5{+-}9.7cm; TAS 139.1{+-}29.2 Vs. 115{+-}13.4 mm Hg, TAD 84.5{+-}17.4 Vs. 75{+-}9.4 mm Hg; civil state married 65.5% (p=0.005) Vs single 57%; bigger depression 32% Vs anxiety 28%, in the group of patients with Cl and IAM, respectively. In the IAM population it was found an additional IRC 21% (p=0.030), HAS 21% (p=0.025) and drug addiction 21% (p=0.002). The rest of the results didn't show significant differences. Conclusion: Only 6.5% of the patients that went to EPM-{sup 99m}Tc-SESTAMIBl in a 6 year-old lapse, were smaller than 40 years. 71% of them was referred by prechordal pain in who almost the half it was evidenced Cl or IAM

  15. A Paratransgenic Strategy for the Control of Chagas Disease

    OpenAIRE

    Ivy Hurwitz; Annabeth Fieck; Nichole Klein; Christo Jose; Angray Kang; Ravi Durvasula

    2012-01-01

    Chagas disease results from infection with the parasite Trypanosoma cruzi. This disease remains a significant cause of morbidity and mortality in central and south America. Chagas disease now exists and is detected worldwide because of human migration. Control of Chagas disease has relied mainly on vector eradication however, the development of insect resistance to pesticides, coupled with cost and adverse health effects of insecticide treatments, has prompted our group to investigate novel m...

  16. Frequência de anticorpos aos agentes etiológicos da síndrome da imunodeficiência adquirida, sífilis, hepatites virais B e C e doença de Chagas em pacientes reumatológicos em tratamento com antifator de necrose tumoral (Tumor Necrosis Factor - TNF Frequency of antibodies against the etiologic agents of acquired imunodeficiency syndrome, syphilis, hepatitis B and C, and Chagas' disease in patients with rheumatic diseases treated with anti-tumor necrosis factor

    Directory of Open Access Journals (Sweden)

    Bárbara Santos Pires da Silva

    2009-10-01

    foram positivos e estavam estáveis. CONCLUSÃO: A frequência de soropositividade para certas doenças infecciosas em pacientes em terapia com anti-TNF é baixa. Os indivíduos que merecem maior atenção são aqueles com sorologia positiva para o HCV.INTRODUCTION: Patients with rheumatic diseases treated with anti-tumor necrosis factor (anti-TNF are considered to be immunosuppressed. Therefore, investigation for infectious diseases is mandatory in this population due to the high morbidity and, occasionally, mortality associated with this condition. OBJECTIVES: The objective of the present study was to evaluate the frequency of seropositivity for the following infectious agents: syphilis, Chagas' disease, acquired human immunodeficiency virus (HIV, and hepatitis B and C in patients under anti-TNF therapy. PATIENTS AND METHODS: This observational study evaluated 143 rheumatology patients with rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and others, under anti-TNF therapy (adalimumab, etanercept, and infliximab from September 2007 to November 2008. Clinical and demographic data, as well as presence of antibodies against HIV, hepatitis B and C, syphilis, and Chagas' disease, were evaluated. RESULTS: The study population had a mean age of 45.78 ± 12.7 years; 60.1% were females and 76.9% Caucasian. Thirteen (9% patients had at least one positive serology. None of the patients had antibodies to Chagas' disease and HIV. Only two (1.4% individuals were positive for syphilis (positive ELISA and negative VDRL. The frequency of total anti-HBc was 5% (7/140, and those patients were also positive for anti-HBs. All patients were negative for AgHBs. Four patients were HCV positive: and two of them had negative virus PCR and the other two were positive, but they were stable. CONCLUSION: The frequency of seropositivity for different infectious diseases in patients under anti-TNF therapy is low. Individuals with positive serology for hepatitis C deserve close

  17. Chronic Chagas Disease Diagnosis: A Comparative Performance of Commercial Enzyme Immunoassay Tests.

    Science.gov (United States)

    Santos, Fred Luciano Neves; de Souza, Wayner Vieira; Barros, Michelle da Silva; Nakazawa, Mineo; Krieger, Marco Aurélio; Gomes, Yara de Miranda

    2016-05-01

    There is a significant heterogeneity in reported performance of serological assays for Chagas disease diagnosis. The conventional serology testing in laboratory diagnosis and in blood banks is unsatisfactory because of a high number of inconclusive and misclassified results. We aimed to assess the quality of four commercially available enzyme-linked immunosorbent assay tests for their ability to detect Trypanosoma cruzi antibodies in 685 sera samples. Cross-reactivity was assessed by using 748 sera from patients with unrelated diseases. Initially, we found that the reactivity index against T. cruzi antigen was statistically higher in sera from Chagas disease patients compared with those from non-chagasic patients, supporting the notion that all evaluated tests have a good discriminatory ability toward the diagnosis of T. cruzi infection in patients in the chronic phase of the disease. Although all tests were similarly sensitive for diagnosing T. cruzi infection, there were significant variations in terms of specificity and cross-reactivity among them. Indeed, we obtained divergent results when testing sera from patient with unrelated diseases, particularly leishmaniasis, with the levels of cross-reactivity being higher in tests using whole T. cruzi extracts compared with those using recombinant proteins. Our data suggest that all four tests may be used for the laboratory diagnosis and routine blood screening diagnose for Chagas disease. We also emphasize that, despite their general good performance, caution is needed when analyzing the results when these tests are performed in areas where other diseases, particularly leishmaniasis, are endemic. PMID:26976886

  18. Analysis of the relationship cost-effectiveness of the myocardial gammagraphy studies and the impact to the total expenditure by diagnostic of ischemic cardiopathy

    International Nuclear Information System (INIS)

    Recent advances in pharmacology, diagnostic and invasive procedures provide a series of modalities that diminish the morbidity and increase the long term survival in the patients that have suffered a heart attack to myocardium. The stratification by risk is an essential element for the handling of the survivors of heart attack to myocardium. In their attention it is looked for to optimize the therapeutic benefit, to diminish the unnecessary diagnostic and therapeutic procedures and to improve the efficiency. For example, a coronariography in sick with heart attack to myocardium it is not cost-effective if not is clinically suitable. Of there that from the institutional point of view, this is, of the Mexican Institute of the Public Health, they are required of appropriate reference approaches and counter reference to grant to the sick person, the best service that is the one in this case the diagnostic and the handling of the ischemic cardiopathy with the smallest waste of resources. The estimation of the annual survival is the base of the stratification, it constitutes the angular stone of the early handling of the heart attack to myocardium. The goal for the clinical would be to identify patients with intermediate risk, since, this risk makes them candidates to therapy interventionist. As long as those with low risk won't require intervention. This would allow the decrease of rates by revenues of heart attack to myocardium, and therefore to diminish the hospital staying rates. The Nuclear Cardiology (myocardial gammagraphy) it is not the only invasive method available to evaluate the myocardial perfusion in sick in who coronary illness is suspected. When the myocardial gammagraphy is carried out in appropriate population, the cost it diminishes because it restricts the necessity of additional invasive evaluations. This because the nuclear cardiology has predictive value so much for the mortality like to detect myocardial viability. Based on these probabilities

  19. The ecology of Chagas disease in Chile.

    Science.gov (United States)

    Schofield, C J; Apt, W; Miles, M A

    1982-01-01

    Chagas disease probably affects over half a million people in Chile, principally in rural communities in the fertile valleys of the arid 'norte chico' region, north of Santiago. The main domestic vector is Triatoma infestans, but Triatoma spinolai, although mainly in rocky sylvatic and peridomestic ecotopes, also invades houses. Since the Spanish invasion in the sixteenth century, and particularly during the last 100 years, the endemic region has suffered an ecological breakdown, largely due to excessive timbering and over-grazing, which has led to a denuded landscape with severe loss of agricultural productivity. This breakdown, combined with uneconomically sized farms and poor marketing, exacerbates the poverty of the rural communities. As in other similar areas of Latin America, the combination of poverty and poor education discourages improvements in housing which would reduce the risk of vector-transmitted Chagas disease. This paper reviews the historical and ecological background of the endemic region of Chile, both as a basis for further work, and as a point of comparison with other endemic areas. The review attempts to show how the current status of Chagas disease is likely to be maintained through its association with poor quality housing, poverty and ecological degradation, drawing parallels with other endemic++ areas and suggesting ways by which the ecological damage might be reversed. PMID:6821391

  20. Uruguay declared free of Chagas disease transmission.

    Science.gov (United States)

    1998-06-01

    According to 1997 entomological and sero-epidemiological data, the transmission of Chagas disease has been interrupted in Uruguay; this has been certified by an independent commission appointed by the Pan American Health Organization/World Health Organization (PAHO/WHO). Transmission of Chagas disease, which is endemic in Uruguay, is via the vector Triatoma infestans or through transfusion with infected blood. In 1983, T. infestans lived in dwellings in 80% of Uruguay; in 1996, in all departments except Tacuarembo, house infestation rates decreased to below 0.1% (a reduction equivalent to 95%). The vector is found around the home, rather than in it, in Tacuarembo; therefore, its presence does not have any significance for transmission. The number of infected blood donors is now negligible, and there is 100% coverage via compulsory blood screening. Uruguay is the first Southern Cone country to have achieved the goals established by the Ministries of Health of Argentina, Bolivia, Brazil, Chile, Paraguay, and Uruguay to eliminate the transmission of Chagas disease. PMID:12321803

  1. [Association of encephalic vascular accidents and Chagas disease].

    Science.gov (United States)

    Lopes, E R; Marquez, J O; da Costa Neto, B; Menezes, A A; Chapadeiro, M E

    1991-01-01

    The frequency of strokes was studied in chronic chagasic and years of age, non-chagasic patients, older than 15 coming to necropsy in Uberaba, from 1979 than 1988. The study consisted of paired sex and age matched controls. Two hundred and eight pairs were analysed. Either ischemic or hemorrhagic strokes were found in 41 (19.7%) of the chagasics and in 55 (26.4%) of the non-chagasic, a difference not significant at the level of 5%. Twelve (75%) of the former had infarcts and 4 (25%) had brain hemorrhage; five (31.3%) of the non-chagasics had ischemic strokes and 11 (68.7%) had hemorrhagic strokes. The differences were significant to the level of 5%. The results indicate a high frequency of ischemic strokes in human Chagas' disease and demonstrate a lesser frequency of hemorrhagic stroke in chagasics when compared with non-chagasics. PMID:1841424

  2. Prevalence, clinical staging and risk for blood-borne transmission of Chagas disease among Latin American migrants in Geneva, Switzerland.

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    Yves Jackson

    Full Text Available BACKGROUND: Migration of Latin Americans to the USA, Canada and Europe has modified Chagas disease distribution, but data on imported cases and on risks of local transmission remain scarce. We assessed the prevalence and risk factors for Chagas disease, staged the disease and evaluated attitudes towards blood transfusion and organ transplant among Latin American migrants in Geneva, Switzerland. METHODOLOGY/PRINCIPAL FINDINGS: This cross-sectional study included all consecutive Latin American migrants seeking medical care at a primary care facility or attending two Latino churches. After completing a questionnaire, they were screened for Chagas disease with two serological tests (Biomérieux ELISA cruzi; Biokit Bioelisa Chagas. Infected subjects underwent a complete medical work-up. Predictive factors for infection were assessed by univariate and multivariate logistic regression analysis.1012 persons (females: 83%; mean age: 37.2 [SD 11.3] years, Bolivians: 48% [n = 485] were recruited. 96% had no residency permit. Chagas disease was diagnosed with two positive serological tests in 130 patients (12.8%; 95%CI 10.8%-14.9%, including 127 Bolivians (26.2%; 95%CI 22.3%-30.1%. All patients were in the chronic phase, including 11.3% with cardiac and 0.8% with digestive complications. Predictive factors for infection were Bolivian origin (OR 33.2; 95%CI 7.5-147.5, reported maternal infection with T. cruzi (OR 6.9; 95%CI 1.9-24.3, and age older than 35 years (OR 6.7; 95%CI 2.4-18.8. While 22 (16.9% infected subjects had already donated blood, 24 (18.5% and 34 (26.2% considered donating blood and organs outside Latin America, respectively. CONCLUSIONS: Chagas disease is highly prevalent among Bolivian migrants in Switzerland. Chronic cardiac and digestive complications were substantial. Screening of individuals at risk should be implemented in nonendemic countries and must include undocumented migrants.

  3. Chagas cardiomyopathy: the potential of diastolic dysfunction and brain natriuretic peptide in the early identification of cardiac damage.

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    Ana Garcia-Alvarez

    Full Text Available INTRODUCTION: Chagas disease remains a major cause of mortality in several countries of Latin America and has become a potential public health problem in non-endemic countries as a result of migration flows. Cardiac involvement represents the main cause of mortality, but its diagnosis is still based on nonspecific criteria with poor sensitivity. Early identification of patients with cardiac involvement is desirable, since early treatment may improve prognosis. This study aimed to assess the role of diastolic dysfunction, abnormal myocardial strain and elevated brain natriuretic peptide (BNP in the early identification of cardiac involvement in Chagas disease. METHODOLOGY/PRINCIPAL FINDINGS: Fifty-four patients divided into 3 groups--group 1 (undetermined form: positive serology without ECG or 2D-echocardiographic abnormalities; N = 32, group 2 (typical ECG abnormalities of Chagas disease but normal 2D-echocardiography; N = 14, and group 3 (regional wall motion abnormalities, left ventricular [LV] end-diastolic diameter >55 mm or LV ejection fraction 37 pg/ml were noted in 0%, 13%, 29% and 63% in controls and groups 1 to 3, respectively. Half of patients in the undetermined form had impaired relaxation patterns, whereas half of patients with ECG abnormalities suggestive of Chagas cardiomyopathy had normal diastolic function. In group 1, BNP levels were statistically higher in patients with diastolic dysfunction as compared to those with normal diastolic function (27 ± 26 vs. 11 ± 8 pg/ml, p = 0.03. CONCLUSION/SIGNIFICANCE: In conclusion, the combination of diastolic function and BNP measurement adds important information that could help to better stratify patients with Chagas disease.

  4. Recommandations Europeennes pour la prise en charge des cardiopathies congenitales de l'adulte.

    OpenAIRE

    Miltner, B.; Seghaye, Marie-Christine; Lancellotti, Patrizio

    2013-01-01

    Improved survival of patients with congenital heart disease has increased the number of these patients at adulthood. In 2010, the European Society of Cardiology has published new guidelines for the management of grown-up congenital heart disease. They provide more detailed information on specific defects in adults. This article summarizes the guidelines for the management of the most common adult congenital heart diseases.

  5. Nanomedicines against Chagas disease: an update on therapeutics, prophylaxis and diagnosis.

    Science.gov (United States)

    Morilla, Maria Jose; Romero, Eder Lilia

    2015-02-01

    Chagas disease is a neglected parasitic infection caused by the protozoan Trypanosoma cruzi. After a mostly clinically silent acute phase, the disease becomes a lifelong chronic condition that can lead to chronic heart failure and thromboembolic phenomena followed by sudden death. Antichagasic treatment is only effective in the acute phase but fails to eradicate the intracellular form of parasites and causes severe toxicity in adults. Although conventional oral benznidazol is not a safe and efficient drug to cure chronic adult patients, current preclinical data is insufficient to envisage if conventional antichagasic treatment could be realistically improved by a nanomedical approach. This review will discuss how nanomedicines could help to improve the performance of therapeutics, vaccines and diagnosis of Chagas disease. PMID:25707979

  6. Interferon-γ and other inflammatory mediators in cardiomyocyte signaling during Chagas disease cardiomyopathy

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    Ludmila; Rodrigues; Pinto; Ferreira; Amanda; Farage; Frade; Monique; Andrade; Baron; Isabela; Cunha; Navarro; Jorge; Kalil; Christophe; Chevillard; Edecio; Cunha-Neto

    2014-01-01

    Chagas disease cardiomyopathy(CCC), the main consequence of Trypanosoma cruzi(T.cruzi) infection, is an inflammatory cardiomyopathy that develops in up to 30% of infected individuals. The heart inflammation in CCC patients is characterized by a Th1 T cell-rich myocarditis with increased production of interferon(IFN)-γ, produced by the CCC myocardial infiltrate and detected at high levels in the periphery. IFN-γ has a central role in the cardiomyocyte signaling during both acute and chronic phases of T.cruzi infection. In this review, we have chosen to focus in its pleiotropic mode of action during CCC, which may ultimately be the strongest driver towards pathological remodeling and heart failure. We describe here the antiparasitic protective and pathogenic dual role of IFN-γ in Chagas disease.

  7. Interferon-γ and other inflammatory mediators in cardiomyocyte signaling during Chagas disease cardiomyopathy.

    Science.gov (United States)

    Ferreira, Ludmila Rodrigues Pinto; Frade, Amanda Farage; Baron, Monique Andrade; Navarro, Isabela Cunha; Kalil, Jorge; Chevillard, Christophe; Cunha-Neto, Edecio

    2014-08-26

    Chagas disease cardiomyopathy (CCC), the main consequence of Trypanosoma cruzi (T.cruzi) infection, is an inflammatory cardiomyopathy that develops in up to 30% of infected individuals. The heart inflammation in CCC patients is characterized by a Th1 T cell-rich myocarditis with increased production of interferon (IFN)-γ, produced by the CCC myocardial infiltrate and detected at high levels in the periphery. IFN-γ has a central role in the cardiomyocyte signaling during both acute and chronic phases of T.cruzi infection. In this review, we have chosen to focus in its pleiotropic mode of action during CCC, which may ultimately be the strongest driver towards pathological remodeling and heart failure. We describe here the antiparasitic protective and pathogenic dual role of IFN-γ in Chagas disease. PMID:25228957

  8. Outbreak of acute Chagas disease associated with oral transmission in the Rio Negro region, Brazilian Amazon

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    Rita de Cássia de Souza-Lima

    2013-10-01

    Full Text Available Introduction Chagas disease is considered as emerging in the Brazilian Amazon, usually occurring in acute outbreaks. Methods We describe 17 cases of acute Chagas disease in Rio Negro, Amazonas. Results There were 15 males (average age, 31.3 years, all positive for Trypanosoma cruzi in fresh blood smear examination, and 14 positive by xenodiagnosis and PCR. The top clinical manifestations were fever, asthenia, abdominal pain, and palpitations. Electrocardiograms featured low-voltage QRS, anterosuperior divisional block, and right bundle branch block associated with anterosuperior divisional block. Conclusions All patients had consumed açaí products from Monte Alegre in the rural area around Santa Izabel do Rio Negro, Brazil.

  9. Outbreak of acute Chagas disease associated with oral transmission in the Rio Negro region, Brazilian Amazon

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    Rita de Cassia de Souza-Lima

    2013-07-01

    Full Text Available Introduction Chagas disease is considered as emerging in the Brazilian Amazon, usually occurring in acute outbreaks. Methods We describe 17 cases of acute Chagas disease in Rio Negro, Amazonas. Results There were 15 males (average age, 31.3 years, all positive for Trypanosoma cruzi in fresh blood smear examination, and 14 positive by xenodiagnosis and PCR. The top clinical manifestations were fever, asthenia, abdominal pain, and palpitations. Electrocardiograms featured low-voltage QRS, anterosuperior divisional block, and right bundle branch block associated with anterosuperior divisional block. Conclusions All patients had consumed açaí products from Monte Alegre in the rural area around Santa Izabel do Rio Negro, Brazil.

  10. A global systematic review of Chagas disease prevalence among migrants.

    Science.gov (United States)

    Conners, Erin E; Vinetz, Joseph M; Weeks, John R; Brouwer, Kimberly C

    2016-04-01

    Human migration has been identified as a potential factor for increased Chagas disease risk and has transformed the disease from a Latin American problem to a global one. We conducted a systematic review of the scientific literature between 2004-2014 in order to: summarize recent seroprevalence estimates of Chagas disease among Latin American migrants, in both endemic and non-endemic settings; compare seroprevalence estimates in migrants to countrywide prevalence estimates; and identify risk factors for Chagas disease among migrants. A total of 320 studies were screened and 23 studies were included. We found evidence that the prevalence of Chagas disease is higher than expected in some migrant groups and that reliance on blood donor screening prevalence estimates underestimates the burden of disease. Overall there is a dearth of high quality epidemiologic studies on the prevalence of Chagas disease in migrants, especially among intra-regional migrants within Latin America. Given that this zoonotic disease cannot likely be eradicated, improved surveillance and reporting is vital to continuing control efforts. More accurate health surveillance of both Latin American migrants and the Chagas disease burden will help countries appropriately scale up their response to this chronic disease. Overall, improved estimates of Chagas disease among migrants would likely serve to highlight the real need for better screening, diagnostics, and treatment of individuals living with the disease. PMID:26777312

  11. Update on Chagas' disease in Mexico Actualización sobre la enfermedad de Chagas en México

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    Eric Dumonteil

    1999-07-01

    Full Text Available Chagas' disease, caused by the protozoan parasite Trypanosoma cruzi, represents a major public health problem in most of the American continent. As transmission of the parasite is being interrupted in most of South America, the disease remains endemic in various areas of Mexico. We review here some of the information gathered in recent years. Seroprevalence of T. cruzi infection in humans remains relatively high in some areas, and there has been a general increase in the number of chronic cases reported to health authorities in recent years. In fact, chronic chagasic cardiomyopathy appears to be affecting a large number of patients with heart disease, but many cases may be misreported because of the unspecific nature of the clinical symptoms. Epidemiological monitoring of vector and reservoir populations, as well as of human cases is helping focus on endemic areas, but a better coordination and development of these efforts is still needed. Recent studies of parasite biology are in agreement with previous work showing the great diversity of parasite characteristics, and support the need for a regional approach to this zoonosis. Strong and continuing support from health and academic authorities is thus still needed to further improve our understanding of Chagas' disease in Mexico and implement efficient control programs.La enfermedad de Chagas, causada por el parásito protozoario Trypanosoma cruzi, constituye un importante problema de salud pública en el continente americano. La transmisión del parásito se ha ido interrumpiendo en la mayor parte de América del Sur, pero la enfermedad sigue siendo endémica en varias regiones de México. En este artículo se revisa la información más reciente sobre dicha enfermedad. La seroprevalencia de la infección por T. cruzi se ha mantenido a niveles relativamente altos en algunas regiones, y se observa un aumento general en el número de casos reportados a las autoridades de salud en los últimos a

  12. Integrate Study of a Bolivian Population Infected by Trypanosoma cruzi, the Agent of Chagas Disease

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    Simone Frédérique Brenière

    2002-04-01

    Full Text Available A cross section of a human population (501 individuals selected at random, and living in a Bolivian community, highly endemic for Chagas disease, was investigated combining together clinical, parasitological and molecular approaches. Conventional serology and polymerase chain reaction (PCR indicated an active transmission of the infection, a high seroprevalence (43.3% ranging from around 12% in 45 years, and a high sensitivity (83.8% and specificity of PCR. Abnormal ECG tracing was predominant in chagasic patients and was already present among individuals younger than 13 years. SAPA (shed acute phase antigen recombinant protein and the synthetic peptide R-13 were used as antigens in ELISA tests. The reactivity of SAPA was strongly associated to Trypanosoma cruzi infection and independent of the age of the patients but was not suitable neither for universal serodiagnosis nor for discrimination of specific phases of Chagas infection. Anti-R-13 response was observed in 27.5% only in chagasic patients. Moreover, anti-R13 reactivity was associated with early infection and not to cardiac pathology. This result questioned previous studies, which considered the anti-R-13 response as a marker of chronic Chagas heart disease. The major clonets 20 and 39 (belonging to Trypanosoma cruzi I and T. cruzi II respectively which circulate in equal proportions in vectors of the studied area, were identified in patients' blood by PCR. Clonet 39 was selected over clonet 20 in the circulation whatever the age of the patient. The only factor related to strain detected in patients' blood, was the anti-R-13 reactivity: 37% of the patients infected by clonet 39 (94 cases had anti-R13 antibodies contrasting with only 6% of the patients without clonet 39 (16 cases.

  13. Anatomia patológica de corações de chagásicos assintomáticos falecidos de modo violento Anatomo-pathology of heart of asymptomatic chagas' patients who had a violent death

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    Edison Reis Lopes

    1981-06-01

    Full Text Available Com finalidade de melhor conhecimento da forma indeterminada da doença de Chagas os autores realizaram estudo anatomopatólogico sistematizado de trinta corações de chagásicos assintomáticos falecidos de modo violento. Demonstram que nos portadores da forma em questão da tripanossomiase cruzi o coração e acometido por lesões da mesma natureza, porém de intensidade muito menor do que as observadas em chagásicos crônicos que falecem subitamente ou após periodo variável de insuficiência cardíaca. Baseados em seus achados e em outros dados da literatura, concluem que a infecção chagásica, sem inflamação do coração, se ocorre, é rara. Tecem ainda considerações a respeito do significado das lesões observadas no sistema nervoso autônomo intracardíaco no sistema de condução e sobre a gênese formal da cardite chagásica crônica humana.With the purpose of better knowledge of the indeterminate form of Chagas's disease the authors carried out a systematized anatomopathological study of thirty hearts from symptomatic chagasics who had a violent death. In this specific form of the trypanosomiasis cruzi the hearts show lesions of the same nature but much less intense as those observed in chronic chagasics who had a sudden death or died after cardiac failure. Based on theses findings and on data from literature, we conclude that chagasic infection without a cardiac inflammatory process, if it occurs, is very rarely only. Also some comments are made upon the meaning of the lesions observed in the intra-cardiac autonomic nervous system, in the conduction system and on the formal origin of the human chronic chagasic carditis.

  14. Aspectos neurológicos da doença de chagas: sistema nervoso central Neurological aspects of Chagas' disease: central nervous system

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    Sylvio de Vergueiro Forjaz

    1967-09-01

    Full Text Available The lesions of the nervous system in the Trypanosomiasis Cruzi are quite frequent and are not only limited to the encephalo-spinal-axis. Actually, they are much more common in the peripheral representations of the autonomic nervous system, resulting in the so-called enteromegalies (mega-esophagus, megacolon, etc. so frequent in Brazil. However, only the clinical manifestations due to the encephalic and spinal lesions have been included in the neurological aspects of Chagas' disease (as formerly contended for by Carlos Chagas. In the acute phase of the central nervous system infestation, the Trypanosoma cruzi,as leishmanias, is found in cellular elements of the neuroglia (microglia, astroglia and may be isolated from the peripheral blood and cerebrospinal fluid (inoculation in sensitive animals. The corresponding clinical manifestations are the severe difuse meningo-encephalo-myelitis with a high degree of lethality and also signs of infection, hepatomegaly and splenomegaly. The infants from endemic areas are much more compromised. The clinical-pathologic as well as experimental confirmations on that acute phase of the disease are numerous and irrefutable. In the chronic phase of the disease, the neurological manifestations are not very clear. Early in 1909, Chagas, impressed with the great number of cases of infantile encephalopathy found in infested regions, imputed to the T. cruzithe etiology of such cases of encephalopathy and considered them as pertaining to a chronic phase of the disease. This has not been confirmed by other investigations, and even if the etiologic agent were the T. cruzithe clinical manifestations have no evolutive character and seem more sequelae than symptoms of a real chronic nervous phase. Even experimentally it has not been possible to demonstrate the presence of parasites in the nervous system of infested animals after clearing of the signs of the acute phase. In patients with chronic Chagas' disease with lesions in

  15. Chagas disease and globalization of the Amazon.

    Science.gov (United States)

    Briceño-León, Roberto

    2007-01-01

    The increasing number of autochthonous cases of Chagas disease in the Amazon since the 1970s has led to fear that the disease may become a new public health problem in the region. This transformation in the disease's epidemiological pattern in the Amazon can be explained by environmental and social changes in the last 30 years. The current article draws on the sociological theory of perverse effects to explain these changes as the unwanted result of the shift from the "inward" development model prevailing until the 1970s to the "outward" model that we know as globalization, oriented by industrial forces and international trade. The current article highlights the implementation of five new patterns in agriculture, cattle-raising, mining, lumbering, and urban occupation that have generated changes in the environment and the traditional indigenous habitat and have led to migratory flows, deforestation, sedentary living, the presence of domestic animals, and changes in the habitat that facilitate colonization of human dwellings by vectors and the domestic and work-related transmission of the disease. The expansion of Chagas disease is thus a perverse effect of the globalization process in the Amazon. PMID:17308715

  16. Gas exchange during exercise in different evolutional stages of chronic Chagas' heart disease

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    Fátima Palha de Oliveira

    2000-12-01

    Full Text Available OBJECTIVE: To compare gas exchange at rest and during exercise in patients with chronic Chagas' heart disease grouped according to the Los Andes clinical/hemodynamic classification. METHODS: We studied 15 healthy volunteers and 52 patients grouped according to the Los Andes clinical/hemodynamic classification as follows: 17 patients in group IA (normal electrocardiogram/echocardiogram, 9 patients in group IB (normal electrocardiogram and abnormal echocardiogram, 14 patients in group II (abnormal electrocardiogram/echocardiogram, without congestive heart failure, and 12 patients in group III (abnormal electrocardiogram/echocardiogram with congestive heart failure. The following variables were analyzed: oxygen consumption (V O2, carbon dioxide production (V CO2, gas exchange rate (R, inspiratory current volume (V IC, expiratory current volume (V EC, respiratory frequency, minute volume (V E, heart rate (HR, maximum load, O2 pulse, and ventilatory anaerobic threshold (AT. RESULTS: When compared with the healthy group, patients in groups II and III showed significant changes in the following variables: V O2peak, V CO2peak, V ICpeak, V ECpeak, E, HR, and maximum load. Group IA showed significantly better results for these same variables as compared with group III. CONCLUSION: The functional capacity of patients in the initial phase of chronic Chagas' heart disease is higher than that of patients in an advanced phase and shows a decrease that follows the loss in cardiac-hemodynamic performance.

  17. Multi-epitope proteins for improved serological detection of Trypanosoma cruzi infection and Chagas Disease.

    Science.gov (United States)

    Duthie, Malcolm S; Guderian, Jeffery A; Vallur, Aarthy C; Misquith, Ayesha; Liang, Hong; Mohamath, Raodoh; Luquetti, Alejandro O; Carter, Darrick; Tavares, Suelene N B; Reed, Steven G

    2016-03-01

    We previously reported that tandem repeat (TR) proteins from Trypanosoma cruzi could serve as targets of the antibody response and be useful as diagnostic indicators. To optimize reagents for detecting T. cruzi infection we evaluated individual TR proteins and identified several that were recognized by the majority of Chagas patient's sera collected from individuals form Brazil. We then produced novel, recombinant fusion proteins to combine the reactive TR proteins into a single diagnostic product. Direct comparison of the antibody response of serum samples that were readily detected by the established fusion antigen used in commercial detection of Chagas disease, TcF, revealed strong responses to TcF43 and TcF26 proteins. While the TcF43 and TcF26 antigens enhanced detection and strength of signal, they did not compromise the specificity of detection compared to that obtained with TcF. Finally, it was apparent by testing against a panel of 84 serum samples assembled on the basis of moderate or weak reactivity against TcF (mostly signal:noise TcF43 and TcF26 could more strongly detected by many of the sera that had low TcF antibody levels. Taken together, these data indicate that TcF43 and TcF26 could be used to enhance the detection of T. cruzi infection as well as supporting a diagnosis of Chagas disease. PMID:26658314

  18. Relationship between Fibrosis and Ventricular Arrhythmias in Chagas Heart Disease Without Ventricular Dysfunction

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    Tassi, Eduardo Marinho, E-mail: etassi@ibest.com.br [Instituto de Cardiologia Edson Saad - Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil); Continentino, Marcelo Abramoff [Hospital Frei Galvão, Guaratinguetá, SP (Brazil); Nascimento, Emília Matos do; Pereira, Basílio de Bragança [Instituto de Cardiologia Edson Saad - Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil); Coppe - Instituto Alberto Luiz Coimbra de Pós-Graduação e Pesquisa de Engenharia - UFRJ, Rio de Janeiro, RJ (Brazil); Pedrosa, Roberto Coury [Instituto de Cardiologia Edson Saad - Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil)

    2014-05-15

    Patients with Chagas disease and segmental wall motion abnormality (SWMA) have worse prognosis independent of left ventricular ejection fraction (LVEF). Cardiac magnetic resonance (CMR) is currently the best method to detect SWMA and to assess fibrosis. To quantify fibrosis by using late gadolinium enhancement CMR in patients with Chagas disease and preserved or minimally impaired ventricular function (> 45%), and to detect patterns of dependence between fibrosis, SWMA and LVEF in the presence of ventricular arrhythmia. Electrocardiogram, treadmill exercise test, Holter and CMR were carried out in 61 patients, who were divided into three groups as follows: (1) normal electrocardiogram and CMR without SWMA; (2) abnormal electrocardiogram and CMR without SWMA; (3) CMR with SWMA independently of electrocardiogram. The number of patients with ventricular arrhythmia in relation to the total of patients, the percentage of fibrosis, and the LVEF were, respectively: Group 1, 4/26, 0.74% and 74.34%; Group 2, 4/16, 3.96% and 68.5%; and Group 3, 11/19, 14.07% and 55.59%. Ventricular arrhythmia was found in 31.1% of the patients. Those with and without ventricular arrhythmia had mean LVEF of 59.87% and 70.18%, respectively, and fibrosis percentage of 11.03% and 3.01%, respectively. Of the variables SWMA, groups, age, LVEF and fibrosis, only the latter was significant for the presence of ventricular arrhythmia, with a cutoff point of 11.78% for fibrosis mass (p < 0.001). Even in patients with Chagas disease and preserved or minimally impaired ventricular function, electrical instability can be present. Regarding the presence of ventricular arrhythmia, fibrosis is the most important variable, its amount being proportional to the complexity of the groups.

  19. Relationship between Fibrosis and Ventricular Arrhythmias in Chagas Heart Disease Without Ventricular Dysfunction

    International Nuclear Information System (INIS)

    Patients with Chagas disease and segmental wall motion abnormality (SWMA) have worse prognosis independent of left ventricular ejection fraction (LVEF). Cardiac magnetic resonance (CMR) is currently the best method to detect SWMA and to assess fibrosis. To quantify fibrosis by using late gadolinium enhancement CMR in patients with Chagas disease and preserved or minimally impaired ventricular function (> 45%), and to detect patterns of dependence between fibrosis, SWMA and LVEF in the presence of ventricular arrhythmia. Electrocardiogram, treadmill exercise test, Holter and CMR were carried out in 61 patients, who were divided into three groups as follows: (1) normal electrocardiogram and CMR without SWMA; (2) abnormal electrocardiogram and CMR without SWMA; (3) CMR with SWMA independently of electrocardiogram. The number of patients with ventricular arrhythmia in relation to the total of patients, the percentage of fibrosis, and the LVEF were, respectively: Group 1, 4/26, 0.74% and 74.34%; Group 2, 4/16, 3.96% and 68.5%; and Group 3, 11/19, 14.07% and 55.59%. Ventricular arrhythmia was found in 31.1% of the patients. Those with and without ventricular arrhythmia had mean LVEF of 59.87% and 70.18%, respectively, and fibrosis percentage of 11.03% and 3.01%, respectively. Of the variables SWMA, groups, age, LVEF and fibrosis, only the latter was significant for the presence of ventricular arrhythmia, with a cutoff point of 11.78% for fibrosis mass (p < 0.001). Even in patients with Chagas disease and preserved or minimally impaired ventricular function, electrical instability can be present. Regarding the presence of ventricular arrhythmia, fibrosis is the most important variable, its amount being proportional to the complexity of the groups

  20. Polymorphic sites at the immunoregulatory CTLA-4 gene are associated with chronic chagas disease and its clinical manifestations.

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    Fabrício C Dias

    Full Text Available BACKGROUND: Chagas disease affects approximately 10 million people mainly in Latin America. The immune regulation by the host seems to be an essential factor for disease evolution, and immune system inhibitory molecules such as CTLA-4 and PD-1 favor the maintenance of peripheral tolerance. Considering that polymorphisms at the immunoregulatory CTLA-4 and PDCD1 genes may alter their inhibitory function, we investigated the association of alleles, genotypes and haplotypes of polymorphic sites observed at the CTLA-4 and PDCD1 genes with different clinical manifestations of chronic Chagas disease (indeterminate, cardiac, digestive and mixed. METHODS: The polymorphisms at the CTLA-4 (-1722T/C, -318C/T and +49A/G and PDCD1 (PD-1.3G/A genes were typed using TaqMan methodology in 277 chronic Chagas disease patients classified into four groups, according to clinical characteristics, and 326 non-infected controls. RESULTS: Our results showed that CTLA-4 -1722CC genotype (22%, -1722C allele (27% and CTLA-4 TCG (8.6%, TCA (26% and CCA (15% haplotypes were strongly associated with the indeterminate form, while the CTLA-4-318CT genotype (82% and CTLA-4-318T allele (47% were found mainly in patients with the mixed form of the disease. The CTLA-4 TCG haplotype (10.2% was associated with the digestive form. On the other hand, the PD-1.3G/A polymorphism was not associated with chronic Chagas disease and its clinical manifestations. CONCLUSIONS: Here, we showed that alleles, genotypes and haplotypes reported to increase the expression of the regulatory molecule CTLA-4 were associated with the indeterminate form of the disease. Taken together, our data support the idea that polymorphic sites at immunoregulatory genes may influence the development of Chagas disease variants.

  1. The noble enigma: Chagas' nominations for the Nobel Prize

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    Coutinho Marilia

    1999-01-01

    Full Text Available Carlos Chagas, a Brazilian physician, discovered the American trypanosomiasis in 1909. Like other remarkable discoveries of those days, his work helped to articulate the insect-vector theory and other theoretical guidelines in tropical medicine. Unlike all other discoveries, all the stages of this work were accomplished in a few months and by a single man. Chagas' discovery was widely recognized at home and abroad. He was twice nominated for the Nobel Prize - in 1913 and in 1921-, but never received the award. Evidence suggests that the reasons for this failure are related to the violent opposition that Chagas faced in Brazil. The contentions towards Chagas were related to a rejection of the meritocratic procedures that gave him prominence, as well as to local petty politics.

  2. American Trypanosomiasis (Also Known as Chagas Disease) Detailed FAQs

    Science.gov (United States)

    ... mainly, in rural areas of Latin America where poverty is widespread). Chagas disease ( T. cruzi infection) is ... Prevention 1600 Clifton Rd. Atlanta, GA 30329-4027, USA 800-CDC-INFO (800-232-4636) TTY: (888) ...

  3. Long term evaluation of etiological treatment of Chagas disease with benznidazole

    OpenAIRE

    Cançado J Romeu

    2002-01-01

    The aim of this article is to present an investigation of cure rate, after long follow up, of specific chemotherapy with benznidazole in patients with both acute and chronic Chagas disease, applying quantitative conventional serological tests as the base of the criterion of cure. Twenty one patients with the acute form and 113 with one or other of the various chronic clinical forms of the disease were evaluated, after a follow up period of 13 to 21 years, for the acute, and 6 to 18 years, for...

  4. The noble enigma: Chagas' nominations for the Nobel Prize

    OpenAIRE

    Marilia Coutinho; Olival Freire Jr.; João Carlos Pinto Dias

    1999-01-01

    Carlos Chagas, a Brazilian physician, discovered the American trypanosomiasis in 1909. Like other remarkable discoveries of those days, his work helped to articulate the insect-vector theory and other theoretical guidelines in tropical medicine. Unlike all other discoveries, all the stages of this work were accomplished in a few months and by a single man. Chagas' discovery was widely recognized at home and abroad. He was twice nominated for the Nobel Prize - in 1913 and in 1921-, but never r...

  5. Prophylactic and therapeutic DNA vaccines against Chagas disease

    OpenAIRE

    Arce-Fonseca, Minerva; Rios-Castro, Martha; Carrillo-Sánchez, Silvia del Carmen; Martínez-Cruz, Mariana; Rodríguez-Morales, Olivia

    2015-01-01

    Chagas disease is a zoonosis caused by Trypanosoma cruzi in which the most affected organ is the heart. Conventional chemotherapy has a very low effectiveness; despite recent efforts, there is currently no better or more effective treatment available. DNA vaccines provide a new alternative for both prevention and treatment of a variety of infectious disorders, including Chagas disease. Recombinant DNA technology has allowed some vaccines to be developed using recombinant proteins or virus-lik...

  6. Biologic and Genetics Aspects of Chagas Disease at Endemic Areas

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    Marilanda Ferreira Bellini; Rosana Silistino-Souza; Marileila Varella-Garcia; Maria Tercília Vilela Azeredo-Oliveira; Ana Elizabete Silva

    2012-01-01

    The etiologic agent of Chagas Disease is the Trypanosoma cruzi, transmitted through blood-sucking insect vectors of the Triatominae subfamily, representing one of the most serious public health concerns in Latin America. There are geographic variations in the prevalence of clinical forms and morbidity of Chagas disease, likely due to genetic variation of the T. cruzi and the host genetic and environmental features. Increasing evidence has supported that inflammatory cytokines and chemokines a...

  7. A Multi-disciplinary Overview of Chagas in Periurban Peru

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    Sarah McCune

    2010-04-01

    Full Text Available There are between 8 and 11 million cases of America Human Trypanosomiasis, commonly known as Chagas disease, in Latin America. Chagas is endemic in southern Peru, especially the Arequipa region, where it has expanded from poor, rural areas to periurban communities. This paper summarizes the findings of four studies in periurban Arequipa: on determinants of disease-vector infestation; on prevalence, spatial patterns, and risk factors of Chagas; on links between migration, settlement patterns, and disease-vector infestation; and on the relationship between discordant test results and spatially clustered transmission hotspots. These studies identified two risk factors associated with the disease: population dynamics and the urbanization of poverty. Understanding the disease within this new urban context will allow for improved public health prevention efforts and policy initiatives. Discovered in 1909 by Brazilian physician Carlos Chagas, American Human Trypanosomiasis is a chronic and potentially life-threatening illness found throughout Latin America (Moncayo, 2003. Indeed, it is estimated that there are between 8 and 11 million cases in Mexico and Central and South America (Centers for Disease Control [CDC], 2009. Chagas disease, as it is most commonly known, is endemic in southern Peru, especially in the region of Arequipa. Once thought to be limited to poor, rural areas, the disease is now appearing in the periurban communities that surround Arequipa City, the capital of the region (Cornejo del Carpio, 2003. Understanding the urbanization of Chagas disease will allow public health and medical professionals to better combat the further transmission of the disease. After providing an overview of Chagas and introducing the scope of the disease in Latin America, this paper will summarize the findings of four recent studies conducted in periurban districts in Arequipa. Ultimately, this paper seeks to identify the risk factors associated with Chagas

  8. Altered Cardiomyocyte Function and Trypanosoma cruzi Persistence in Chagas Disease.

    Science.gov (United States)

    Cruz, Jader Santos; Santos-Miranda, Artur; Sales-Junior, Policarpo Ademar; Monti-Rocha, Renata; Campos, Paula Peixoto; Machado, Fabiana Simão; Roman-Campos, Danilo

    2016-05-01

    Chagas disease, caused by the triatominae Trypanosoma cruzi, is one of the leading causes of heart malfunctioning in Latin America. The cardiac phenotype is observed in 20-30% of infected people 10-40 years after their primary infection. The cardiac complications during Chagas disease range from cardiac arrhythmias to heart failure, with important involvement of the right ventricle. Interestingly, no studies have evaluated the electrical properties of right ventricle myocytes during Chagas disease and correlated them to parasite persistence. Taking advantage of a murine model of Chagas disease, we studied the histological and electrical properties of right ventricle in acute (30 days postinfection [dpi]) and chronic phases (90 dpi) of infected mice with the Colombian strain of T. cruzi and their correlation to parasite persistence. We observed an increase in collagen deposition and inflammatory infiltrate at both 30 and 90 dpi. Furthermore, using reverse transcriptase polymerase chain reaction, we detected parasites at 90 dpi in right and left ventricles. In addition, we observed action potential prolongation and reduced transient outward K(+) current and L-type Ca(2+) current at 30 and 90 dpi. Taking together, our results demonstrate that T. cruzi infection leads to important modifications in electrical properties associated with inflammatory infiltrate and parasite persistence in mice right ventricle, suggesting a causal role between inflammation, parasite persistence, and altered cardiomyocyte function in Chagas disease. Thus, arrhythmias observed in Chagas disease may be partially related to altered electrical function in right ventricle. PMID:26976879

  9. Suicide risk and alcohol and drug abuse in outpatients with HIV infection and Chagas disease

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    Patrícia M. Guimarães

    2014-05-01

    Full Text Available Objective: To evaluate psychiatric comorbidities in outpatients receiving care for HIV and Chagas disease at Instituto de Pesquisa Clínica Evandro Chagas (IPEC, Fundação Oswaldo Cruz (Fiocruz, Rio de Janeiro, Brazil. Methods: Cross-sectional study with a consecutive sample of 125 patients referred to an outpatient psychiatric clinic from February to December 2010. The Mini International Neuropsychiatric Interview (MINI was used. Factors associated with more frequent mental disorders were estimated by odds ratios (OR with 95% confidence intervals (95%CI by multiple logistic regression. Results: Seventy-six (60.8% patients with HIV, 40 (32% patients with Chagas disease, and nine (7.2% patients with human T-lymphotropic virus were interviewed. The majority were women (64%, with up to 8 years of formal education (56%, and unemployed (81.6%. The median age was 49 years. Suicide risk (n=71 (56%, agoraphobia (n=65 (52%, major depressive episode (n=56 (44.8%, and alcohol/drug abuse (n=43 (34.4% predominated, the latter being directly associated with lower family income (OR = 2.64; 95%CI 1.03-6.75 and HIV infection (OR = 5.24; 95%CI 1.56-17.61. Suicide risk was associated with non-white skin color (OR = 2.21; 95%CI 1.03-4.75, unemployment (OR = 2.72; 95%CI 1.01-7.34, and diagnosis of major depression (OR = 3.34; 95%CI 1.54-7.44. Conclusion: Measures targeting adverse socioeconomic conditions and psychiatric and psychological monitoring and care should be encouraged in this population, considering the association with abuse of alcohol/other psychoactive drugs and suicide risk.

  10. Chagas disease among the Latin American adult population attending in a primary care center in Barcelona, Spain.

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    Carme Roca

    Full Text Available BACKGROUND/AIMS: The epidemiology of Chagas disease, until recently confined to areas of continental Latin America, has undergone considerable changes in recent decades due to migration to other parts of the world, including Spain. We studied the prevalence of Chagas disease in Latin American patients treated at a health center in Barcelona and evaluated its clinical phase. We make some recommendations for screening for the disease. METHODOLOGY/PRINCIPAL FINDINGS: We performed an observational, cross-sectional prevalence study by means of an immunochromatographic test screening of all continental Latin American patients over the age of 14 years visiting the health centre from October 2007 to October 2009. The diagnosis was confirmed by serological methods: conventional in-house ELISA (cELISA, a commercial kit (rELISA and ELISA using T cruzi lysate (Ortho-Clinical Diagnostics (oELISA. Of 766 patients studied, 22 were diagnosed with T. cruzi infection, showing a prevalence of 2.87% (95% CI, 1.6-4.12%. Of the infected patients, 45.45% men and 54.55% women, 21 were from Bolivia, showing a prevalence in the Bolivian subgroup (n=127 of 16.53% (95% CI, 9.6-23.39%. ALL THE INFECTED PATIENTS WERE IN A CHRONIC PHASE OF CHAGAS DISEASE: 81% with the indeterminate form, 9.5% with the cardiac form and 9.5% with the cardiodigestive form. All patients infected with T. cruzi had heard of Chagas disease in their country of origin, 82% knew someone affected, and 77% had a significant history of living in adobe houses in rural areas. CONCLUSIONS: We found a high prevalence of T. cruzi infection in immigrants from Bolivia. Detection of T. cruzi-infected persons by screening programs in non-endemic countries would control non-vectorial transmission and would benefit the persons affected, public health and national health systems.

  11. Carvedilol Enhances the Antioxidant Effect of Vitamins E and C in Chronic Chagas Heart Disease

    Energy Technology Data Exchange (ETDEWEB)

    Budni, Patrícia, E-mail: budnip@gmail.com [Universidade Federal de Santa Catarina, Florianópolis, SC (Brazil); Pedrosa, Roberto Coury [Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ (Brazil); Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, RJ (Brazil); Dalmarco, Eduardo Monguilhott; Dalmarco, Juliana Bastos; Frode, Tânia Sílvia; Wilhelm, Danilo Filho [Universidade Federal de Santa Catarina, Florianópolis, SC (Brazil)

    2013-10-15

    Chagas disease is still an important endemic disease in Brazil, and the cardiac involvement is its more severe manifestation. To verify whether the concomitant use of carvedilol will enhance the antioxidant effect of vitamins E and C in reducing the systemic oxidative stress in chronic Chagas heart disease. A total of 42 patients with Chagas heart disease were studied. They were divided into four groups according to the modified Los Andes classification: 10 patients in group IA (normal electrocardiogram and echocardiogram; no cardiac involvement); 20 patients in group IB (normal electrocardiogram and abnormal echocardiogram; mild cardiac involvement); eight patients in group II (abnormal electrocardiogram and echocardiogram; no heart failure; moderate cardiac involvement); and four patients in group III (abnormal electrocardiogram and echocardiogram with heart failure; severe cardiac involvement). Blood levels of markers of oxidative stress were determined before and after a six-month period of treatment with carvedilol, and six months after combined therapy of carvedilol with vitamins E and C. The markers analyzed were as follows: activities of superoxide dismutase, catalase, glutathione peroxidase, glutathione S-transferase and reductase, myeloperoxidade and adenosine deaminase; and the levels of reduced glutathione, thiobarbituric-acid reactive substances, protein carbonyls, vitamin E, and nitric oxide. After treatment with carvedilol, all groups showed significant decrease in protein carbonyls and reduced glutathione levels, whereas nitric oxide levels and adenosine activity increased significantly only in the less severely affected group (IA). In addition, the activity of most of the antioxidant enzymes was decreased in the less severely affected groups (IA and IB). By combining the vitamins with carvedilol, a reduction in protein damage, in glutathione levels, and in the activity of most of the antioxidant enzymes were observed. The decrease in oxidative

  12. Carvedilol Enhances the Antioxidant Effect of Vitamins E and C in Chronic Chagas Heart Disease

    International Nuclear Information System (INIS)

    Chagas disease is still an important endemic disease in Brazil, and the cardiac involvement is its more severe manifestation. To verify whether the concomitant use of carvedilol will enhance the antioxidant effect of vitamins E and C in reducing the systemic oxidative stress in chronic Chagas heart disease. A total of 42 patients with Chagas heart disease were studied. They were divided into four groups according to the modified Los Andes classification: 10 patients in group IA (normal electrocardiogram and echocardiogram; no cardiac involvement); 20 patients in group IB (normal electrocardiogram and abnormal echocardiogram; mild cardiac involvement); eight patients in group II (abnormal electrocardiogram and echocardiogram; no heart failure; moderate cardiac involvement); and four patients in group III (abnormal electrocardiogram and echocardiogram with heart failure; severe cardiac involvement). Blood levels of markers of oxidative stress were determined before and after a six-month period of treatment with carvedilol, and six months after combined therapy of carvedilol with vitamins E and C. The markers analyzed were as follows: activities of superoxide dismutase, catalase, glutathione peroxidase, glutathione S-transferase and reductase, myeloperoxidade and adenosine deaminase; and the levels of reduced glutathione, thiobarbituric-acid reactive substances, protein carbonyls, vitamin E, and nitric oxide. After treatment with carvedilol, all groups showed significant decrease in protein carbonyls and reduced glutathione levels, whereas nitric oxide levels and adenosine activity increased significantly only in the less severely affected group (IA). In addition, the activity of most of the antioxidant enzymes was decreased in the less severely affected groups (IA and IB). By combining the vitamins with carvedilol, a reduction in protein damage, in glutathione levels, and in the activity of most of the antioxidant enzymes were observed. The decrease in oxidative

  13. Cintilografia para detecção de comprometimento miocárdico na forma indeterminada da doença de Chagas Gammagrafía para detección de compromiso miocárdico en la forma indeterminada de la enfermedad de Chagas Scintigraphy for the detection of myocardial damage in the indeterminate form of Chagas disease

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    Ivana Moura Abuhid

    2010-07-01

    ón ventricular en los pacientes en la fase indeterminada de la Enfermedad de Chagas y en los controles normales, excepto en un paciente que presentó signos de disfunción ventricular en el análisis funcional en la gammagrafía miocárdica de perfusión sincronizada con el electrocardiograma (ECG. CONCLUSIÓN: Los resultados de este estudio, en el cual, pese al pequeño número de pacientes, mostraron que la gammagrafía miocárdica de reposo y esfuerzo con sestamibi-99mTc no es un método eficaz para detectar precozmente alteraciones miocárdicas en la forma indeterminada del Mal de Chagas.BACKGROUND: Non-invasive cardiological methods have been used for the identification of myocardial damage in Chagas disease. OBJECTIVE: To verify whether the rest/stress myocardial perfusion scintigraphy is able to identify early myocardial damage in the indeterminate form of Chagas disease. METHODS: Eighteen patients with the indeterminate form of Chagas Disease and the same number of normal controls, paired by sex and age, underwent rest/stress myocardial scintigraphy using sestamibi-99mTc, aiming at detecting early cardiac damage. RESULTS: The results did not show perfusion or ventricular function defects in patients at the indeterminate phase of Chagas disease and in the normal controls, except for a patient who presented signs of ventricular dysfunction in the myocardial perfusion scintigraphy with electrocardiographic gating. CONCLUSION: The results of this study, considering the small sample size, showed that the rest/stress myocardial scintigraphy using sestamibi-99mTc is not an effective method to detect early myocardial alterations in the indeterminate form of Chagas disease.

  14. Aspectos neurológicos da doença de chagas: sistema nervoso central

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    Sylvio de Vergueiro Forjaz

    1967-09-01

    Full Text Available The lesions of the nervous system in the Trypanosomiasis Cruzi are quite frequent and are not only limited to the encephalo-spinal-axis. Actually, they are much more common in the peripheral representations of the autonomic nervous system, resulting in the so-called enteromegalies (mega-esophagus, megacolon, etc. so frequent in Brazil. However, only the clinical manifestations due to the encephalic and spinal lesions have been included in the neurological aspects of Chagas' disease (as formerly contended for by Carlos Chagas. In the acute phase of the central nervous system infestation, the Trypanosoma cruzi,as leishmanias, is found in cellular elements of the neuroglia (microglia, astroglia and may be isolated from the peripheral blood and cerebrospinal fluid (inoculation in sensitive animals. The corresponding clinical manifestations are the severe difuse meningo-encephalo-myelitis with a high degree of lethality and also signs of infection, hepatomegaly and splenomegaly. The infants from endemic areas are much more compromised. The clinical-pathologic as well as experimental confirmations on that acute phase of the disease are numerous and irrefutable. In the chronic phase of the disease, the neurological manifestations are not very clear. Early in 1909, Chagas, impressed with the great number of cases of infantile encephalopathy found in infested regions, imputed to the T. cruzithe etiology of such cases of encephalopathy and considered them as pertaining to a chronic phase of the disease. This has not been confirmed by other investigations, and even if the etiologic agent were the T. cruzithe clinical manifestations have no evolutive character and seem more sequelae than symptoms of a real chronic nervous phase. Even experimentally it has not been possible to demonstrate the presence of parasites in the nervous system of infested animals after clearing of the signs of the acute phase. In patients with chronic Chagas' disease with lesions in

  15. Deficient regulatory T cell activity and low frequency of IL-17-producing T cells correlate with the extent of cardiomyopathy in human Chagas' disease.

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    Paulo Marcos Matta Guedes

    Full Text Available BACKGROUND: Myocardium damage during Chagas' disease results from the immunological imbalance between pro- and production of anti-inflammatory cytokines and has been explained based on the Th1-Th2 dichotomy and regulatory T cell activity. Recently, we demonstrated that IL-17 produced during experimental T. cruzi infection regulates Th1 cells differentiation and parasite induced myocarditis. Here, we investigated the role of IL-17 and regulatory T cell during human Chagas' disease. METHODOLOGY/PRINCIPAL FINDINGS: First, we observed CD4(+IL-17(+ T cells in culture of peripheral blood mononuclear cells (PBMC from Chagas' disease patients and we evaluated Th1, Th2, Th17 cytokine profile production in the PBMC cells from Chagas' disease patients (cardiomyopathy-free, and with mild, moderate or severe cardiomyopathy cultured with T. cruzi antigen. Cultures of PBMC from patients with moderate and severe cardiomyopathy produced high levels of TNF-α, IFN-γ and low levels of IL-10, when compared to mild cardiomyopathy or cardiomyopathy-free patients. Flow cytometry analysis showed higher CD4(+IL-17(+ cells in PBMC cultured from patients without or with mild cardiomyopathy, in comparison to patients with moderate or severe cardiomyopathy. We then analyzed the presence and function of regulatory T cells in all patients. All groups of Chagas' disease patients presented the same frequency of CD4(+CD25(+ regulatory T cells. However, CD4(+CD25(+ T cells from patients with mild cardiomyopathy or cardiomyopathy-free showed higher suppressive activity than those with moderate and severe cardiomyopathy. IFN-γ levels during chronic Chagas' disease are inversely correlated to the LVEF (P = 0.007, r = -0.614, while regulatory T cell activity is directly correlated with LVEF (P = 0.022, r = 0.500. CONCLUSION/SIGNIFICANCE: These results indicate that reduced production of the cytokines IL-10 and IL-17 in association with high levels of IFN-γ and TNF

  16. ESTUDIO SEROLOGICO POR INMUNOFLUORESCENCIA DE LA ENFERMEDAD DE CHAGAS EN COSTA RICA

    OpenAIRE

    LILIANA REYES; Bonilla, A.; T. MOYA; MISAEL CHINCHILLA

    1998-01-01

    RESUMEN Se estudiaron 1.043 sueros de pacientes provenientes de todo el territorio nacional por anticuerpos anti-Trypanosoma cruzi utilizando la técnica de inmunofluorescencia. Se demostró un porcentaje de positividad general de 2,14%. La mayor positividad se encontró en la provincia de San José (2,4%) y la menor en Heredia (0,8%).SEROLOGICAL STUDY OF CHAGAS DISEASE IN COSTA RICA BY IMMUNOFLUORESCENCE One thousand and fourty three patients were studied for anti-Trypanosoma cruzi antibodies by...

  17. Resultados iniciais do transplante de células de medula óssea para o miocárdio de pacientes com insuficiência cardíaca de etiologia chagásica Early results of bone marrow cell transplantation to the myocardium of patients with heart failure due to chagas disease

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    Fábio Vilas-Boas

    2006-08-01

    Full Text Available OBJETIVO: Avaliar efeitos precoces do transplante de células de medula óssea para o miocárdio de pacientes com insuficiência cardíaca (IC de etiologia chagásica. MÉTODOS: A amostra consistiu de 28 pacientes, idade média 52,2±9,9 anos, 24 masculinos, 25 em classe NYHA III e 3 em NYHA IV, apesar de tratamento otimizado. O procedimento consistiu na aspiração de 50ml de medula óssea, separação da fração mononuclear e injeção intracoronariana. Foram avaliados os efeitos sobre a fração de ejeção ventricular esquerda (FEVE, distância no teste de 6 minutos, qualidade de vida, classe NYHA, efeitos arritmogênicos e bioquímicos. RESULTADOS: Não houve complicações relacionadas diretamente ao procedimento. A fração de ejeção ventricular esquerda em repouso antes do transplante era 20,1±6,8% e, após 60 dias, aumentou para 23,0±9,0%, p = 0,02. Houve melhora da classe NYHA (3,1±0,3 para 1,8±0,5; pOBJECTIVE: To evaluate early effects of bone marrow cell transplantation to the myocardium of patients with heart failure (CHF due to Chagas disease. METHODS: We studied 28 patients (mean age 52.2 ± 9.9, of whom 24 were male. Despite optimized treatment, 25 patients were in NYHA class III and three patients, in NYHA class IV. The procedure consisted of aspiration of 50 mL of bone marrow, separation of the mononuclear fraction, and intracoronary injection. Effects on left ventricle ejection fraction (LVEF, distance walked in the six-minute walking test, quality-of-life, NYHA class, arrhythmogenic and biochemical parameters, were all evaluated. RESULTS: There were no complications directly related to the procedure. Baseline left ventricular ejection fraction was 20.1 ± 6.8%, and 60 days after transplantation it increased to 23.0 ± 9.0%, p = 0.02. Significant improvements were observed in the NYHA class (3.1 ± 0.3 to 1.8 ± 0.5; p < 0.0001; quality-of-life (50.9 ± 11.7 to 21.8 ± 13.4; p < 0.0001; and distance walked in six

  18. Chagas Cardiomiopathy: The Potential of Diastolic Dysfunction and Brain Natriuretic Peptide in the Early Identification of Cardiac Damage

    OpenAIRE

    Ana Garcia-Alvarez; Marta Sitges; María-Jesús Pinazo; Ander Regueiro-Cueva; Elizabeth Posada; Silvia Poyatos; José Tomás Ortiz-Pérez; Magda Heras; Manel Azqueta; Joaquim Gascon; Ginés Sanz

    2010-01-01

    INTRODUCTION: Chagas disease remains a major cause of mortality in several countries of Latin America and has become a potential public health problem in non-endemic countries as a result of migration flows. Cardiac involvement represents the main cause of mortality, but its diagnosis is still based on nonspecific criteria with poor sensitivity. Early identification of patients with cardiac involvement is desirable, since early treatment may improve prognosis. This study aimed to assess the r...

  19. Advanced megaesophagus (Group III) secondary to vector-borne Chagas disease in a 20-month-old infant

    OpenAIRE

    Anis Rassi; Joffre Marcondes de Rezende; Anis Rassi Junior

    2012-01-01

    The authors report the case of a female infant with Group III (or Grade III) megaesophagus secondary to vector-borne Chagas disease, resulting in severe malnutrition that reversed after surgery (Heller technique). The infant was then treated with the antiparasitic drug benznidazole, and the infection was cured, as demonstrated serologically and parasitologically. After follow-up of several years without evidence of disease, with satisfactory weight and height development, the patient had her ...

  20. Evaluación de la función diastólica en la enfermedad de chagas mediante doppler tisular pulsado

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    R. A. Migliore

    2003-12-01

    Full Text Available En la etapa indeterminada de la enfermedad de Chagas las alteraciones de la función diastólica preceden a las de la función sistólica. El Doppler tisular pulsado es una nueva técnica no invasiva que permite analizar la función diastólica mediante el registro de la velocidad de estiramiento miocárdico en el eje longitudinal. Con el objetivo de evaluar la función diastólica en la enfermedad de Chagas mediante Doppler tisular pulsado fueron estudiados con ecocardiograma y Doppler 51 pacientes con serología positiva para enfermedad de Chagas (48 ± 12 años y 24 individuos normales (47 ± 15 años como grupo control. De acuerdo al patrón del flujo mitral y de vena pulmonar los pacientes con enfermedad de Chagas fueron divididos en 2 grupos: restrictivo (17 pacientes y no restrictivo (34 pacientes. La velocidad pico de la onda E del anillo lateral mitral estuvo disminuida en los pacientes con patrón no restrictivo y restrictivo (0.13 ± 0.04 m/seg, 0.11 ± 0.05 m/seg respectivamente con respecto al grupo control (0.18 ± 0.07 m/seg, pDiastolic function is early involved during the undetermined form of Chagas disease. Pulsed Doppler tissue imaging is a new technique to evaluate diastolic function by mean of the record of myocardial velocities in the longitudinal axis. With the purpose to evaluate diastolic function by pulsed Doppler tissue imaging in patients with Chagas disease, we studied with Doppler echocardiography 51 patients (age average 48 ± 12 years and 24 normal subjects (age average 47 ± 15 years as a control group. Patients were divided in two groups according to the pattern of mitral and pulmonary vein flow: restrictive (17 patients and no restrictive (35 patients. Peak velocity of E wave of the lateral mitral annulus was diminished in no restrictive and restrictive patients (0.13 ± 0.04 m/s, 0.11 ± 0.05 m/s respectively in regard to control group (0.18 ± 0.07 m/s, p<0.01. Pulsed Doppler tissue imaging was useful in the

  1. Morbidade da doença de Chagas: III. Estudo longitudinal, de seis anos, em Virgem da Lapa, MG, Brasil Morbidity of Chagas disease: III. Six-year longitudinal study, at Virgem da Lapa, MG, Brazil

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    José Borges Pereira

    1985-03-01

    , composed of pairs of non chagasic persons with the same age and sex, was shown to be 27.4% higher than among patients with positive serology. This factor represents the excess risk or exclusively chagasic component in the development of the disease. No differences were observed by sex related to the development of the disease. It was more premature and seven times more frequent however when related to the cardiopathy than to the megaesophagus. Both conditions occurring mainly in slight or moderate degree. In 192 chagasic patients and 188 non chagasic persons observed in that area in the same period, the mortality was 3.6 times higher among the chagasic patients with a letality due to cardiopathy of 8.9% without difference between sexes but more premature among the males. Sudden death was more frequent than that one caused by cardiac insufficiency. The prognostic was good for the patients with indeterminate and digestive forms and reserved for patients with the highest degree of cardiopathy.

  2. Chagas disease: Central American initiative launched.

    Science.gov (United States)

    1998-02-01

    An initiative to interrupt the transmission of Chagas disease in Central America was launched at a meeting held October 22-24, 1997, in Tegucigalpa, Honduras. Sponsored by the UNDP/World Bank/WHO Special Program for Research and Training in Tropical Diseases (TDR), the meeting was attended by government delegates from Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, and Panama. The initiative was launched within the framework of Resolution 13 of the Meeting of Ministers of Health of the Central American Countries, held in Belize in September 1997. Detailed plans of activities were prepared for each country for the period 1998-2001, for approval by the various ministries of health, while operational, epidemiological, and entomological research priorities were also agreed upon. Research projects to help improve disease control will be sponsored by TDR. The first meeting of the Technical Intergovernment Commission established to meet annually to assess progress in control activities will occur in October 1998 in Guatemala. Vector and infection rate data are briefly presented on each country represented at the meeting. PMID:12348564

  3. Behavioural biology of Chagas disease vectors

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    Claudio Ricardo Lazzari

    2013-01-01

    Full Text Available Many arthropod species have adopted vertebrate blood as their main food source. Blood is rich in nutrients and, except for the presence of parasites, sterile. However, this food source is not freely available, nor is obtaining it devoid of risk. It circulates inside vessels hidden underneath the skin of mobile hosts that are able to defend themselves and even predate the insects that try to feed on them. Thus, the haematophagous lifestyle is associated with major morphological, physiological and behavioural adaptations that have accumulated throughout the evolutionary history of the various lineages of blood-sucking arthropods. These adaptations have significant consequences for the evolution of parasites as well as for the epidemiology of vector-transmitted diseases. In this review article, we analyse various aspects of the behaviour of triatomine bugs to illustrate how each behavioural trait represents a particular adaptation to their close association with their hosts, which may easily turn into predators. Our aim is to offer to the reader an up-to-date integrative perspective on the behaviour of Chagas disease vectors and to propose new research avenues to encourage both young and experienced colleagues to explore this aspect of triatomine biology.

  4. A new era for chagas disease drug discovery?

    Science.gov (United States)

    Keenan, Martine; Chaplin, Jason H

    2015-01-01

    Recent clinical trials investigating treatment of chronic indeterminate Chagas disease with two re-purposed azole anti-fungal drugs, posaconazole and ravuconazole, revealed their inferiority to the current standard-of-care benznidazole and highlighted the inadequacy of the existing pre-clinical testing paradigm for this disease. A very limited number of controlled clinical trials for Chagas disease have been conducted to date. The selection of these compounds for clinical evaluation relied heavily on pre-clinical data obtained from in vitro screens and animal studies. This chapter reviews the evolution of CYP51 as a target for Trypanosoma cruzi growth inhibition and also explores the impact of clinical trial data on contemporary Chagas disease drug discovery. Advances in pre-clinical profiling assays, the current compound landscape and progress towards the identification of new drug targets to re-invigorate research are reviewed. PMID:25727705

  5. [Consensus document for the detection and management of Chagas disease in primary health care in a non-endemic areas].

    Science.gov (United States)

    Roca Saumell, Carme; Soriano-Arandes, Antoni; Solsona Díaz, Lluís; Gascón Brustenga, Joaquim

    2015-05-01

    Chagas disease is caused by the protozoan Trypanosoma cruzi. Although it is commonly transmitted by an insect vector in continental Latin-America, in recent decades, due migration, has been diagnosed in other countries such Spain, the European country with a largest immigrant population of Latin American. For a long time, the patient remains asymptomatic, but some years after this stage, the symptoms can be serious (dilated cardiomyopathy, megacolon, megaesophagus). In addition, detection in pregnant women has a high priority because of the route of vertical transmission. Several specific guidelines about Chagas disease has been developed on the Banks of blood, maternal hospitals, HIV co-infection, organ transplant. But due to the detection of lack of information to primary care professionals, we consider to will be useful this document written and agreed to by family phisicians, pediatricians and specialists in International Health. PMID:25704793

  6. Treatment with Benznidazole during the Chronic Phase of Experimental Chagas' Disease Decreases Cardiac Alterations

    Science.gov (United States)

    Garcia, Simone; Ramos, Carolina O.; Senra, Juliana F. V.; Vilas-Boas, Fabio; Rodrigues, Maurício M.; Campos-de-Carvalho, Antonio C.; Ribeiro-dos-Santos, Ricardo; Soares, Milena B. P.

    2005-01-01

    Chagas' disease, caused by Trypanosoma cruzi infection, is one of the main causes of death due to heart failure in Latin American countries. Benznidazole, the chemotherapeutic agent most often used for the treatment of chagasic patients, is highly toxic and has limited efficacy, especially in the chronic phase of the disease. In the present study we used a mouse model of chronic Chagas' disease to investigate the effects of benznidazole treatment during the chronic phase on disease progression. The hearts of benznidazole-treated mice had decreased parasitism and myocarditis compared to the hearts of untreated chagasic mice. Both groups of Trypanosoma cruzi-infected mice had significant alterations in their electrocardiograms compared to those of the healthy mice. However, untreated mice had significantly higher cardiac conduction disturbances than benznidazole-treated mice, including intraventricular conduction disturbances, atrioventricular blocks, and extrasystoles. The levels of antibodies against T. cruzi antigens (epimastigote extract, P2β, and trans-sialidase) as well as antibodies against peptides of the second extracellular loops of β1-adrenergic and M2-muscarinic cardiac receptors were also lower in the sera from benznidazole-treated mice than in the sera from untreated mice. These results demonstrate that treatment with benznidazole in the chronic phase of infection prevents the development of severe chronic cardiomyopathy, despite the lack of complete parasite eradication. In addition, our data highlight the role of parasite persistence in the development of chronic Chagas' disease and reinforce the importance of T. cruzi elimination in order to decrease or prevent the development of severe chagasic cardiomyopathy. PMID:15793134

  7. Antitrypanosomal Treatment with Benznidazole Is Superior to Posaconazole Regimens in Mouse Models of Chagas Disease.

    Science.gov (United States)

    Khare, Shilpi; Liu, Xianzhong; Stinson, Monique; Rivera, Ianne; Groessl, Todd; Tuntland, Tove; Yeh, Vince; Wen, Ben; Molteni, Valentina; Glynne, Richard; Supek, Frantisek

    2015-10-01

    Two CYP51 inhibitors, posaconazole and the ravuconazole prodrug E1224, were recently tested in clinical trials for efficacy in indeterminate Chagas disease. The results from these studies show that both drugs cleared parasites from the blood of infected patients at the end of the treatment but that parasitemia rebounded over the following months. In the current study, we sought to identify a dosing regimen of posaconazole that could permanently clear Trypanosoma cruzi from mice with experimental Chagas disease. Infected mice were treated with posaconazole or benznidazole, an established Chagas disease drug, and parasitological cure was defined as an absence of parasitemia recrudescence after immunosuppression. Twenty-day therapy with benznidazole (10 to 100 mg/kg of body weight/day) resulted in a dose-dependent increase in antiparasitic activity, and the 100-mg/kg regimen effected parasitological cure in all treated mice. In contrast, all mice remained infected after a 25-day treatment with posaconazole at all tested doses (10 to 100 mg/kg/day). Further extension of posaconazole therapy to 40 days resulted in only a marginal improvement of treatment outcome. We also observed similar differences in antiparasitic activity between benznidazole and posaconazole in acute T. cruzi heart infections. While benznidazole induced rapid, dose-dependent reductions in heart parasite burdens, the antiparasitic activity of posaconazole plateaued at low doses (3 to 10 mg/kg/day) despite increasing drug exposure in plasma. These observations are in good agreement with the outcomes of recent phase 2 trials with posaconazole and suggest that the efficacy models combined with the pharmacokinetic analysis employed here will be useful in predicting clinical outcomes of new drug candidates. PMID:26239982

  8. Melatonin in Chagas´ disease: Possible therapeutic value La melatonina en la enfermedad de Chagas: Su posible valor terapéutico

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    Daniel P. Cardinali

    2011-10-01

    Full Text Available Chagas' disease is a severe health problem in Latin America, causing approximately 50 000 deaths a year, with approximately 18 million infected people. About 25-30% of the patients infected with Trypanosoma cruzi develop the chronic form of the disease. The protective response against T. cruzi depends on both innate and acquired immunity involving macrophages, natural killer cells, T and B lymphocytes, and the production of proinflammatory Th-1 cytokines. In addition, an increased nitric oxide (NO production in macrophages leading to effective microbicidal action is needed to control parasitemia. Melatonin is detectable in T. cruzi and may play a role in promoting infection whereas, when administered in high doses during the acute phase of T. cruzi infection, it can decrease parasitemia while reducing NO production. During chronic disease progression, the sustained oxidative stress concomitant to myocardial damage could be reduced by administering melatonin. It is hypothesized that the coordinated administration of a melatonin agonist like the MT1/MT2 agonist ramelteon, that lacks antioxidant activity and may not affect NO production during the acute phase, and of melatonin in doses high enough to decrease oxidative damage, to preserve mitochondrial and to prevent cardiomyopathy during the chronic phase, could be a novel add-on treatment of Chagas´ disease.La enfermedad de Chagas es un problema grave de salud en América Latina, causando cerca de 50 000 muertes al año y unos 18 millones de infectados. Alrededor del 25-30% de los pacientes infectados con Trypanosoma cruzi desarrollan la forma crónica de la enfermedad. La respuesta de defensa ante el T. cruzi depende de la inmunidad innata y adquirida con la participación de macrófagos, células “natural killer”, linfocitos T y B, y la producción de citoquinas proinflamatorias de tipo Th-1. Además, el aumento en la producción de óxido nítrico (NO en los macrófagos lleva a una acci

  9. Uso de pericardio bovino para la corrección de cardiopatías congénitas Use of bovine pericardium for correcting congenital cardiopathies

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    Juan C Rendón

    2007-08-01

    una herramienta útil para la corrección de cardiopatías congénitas. Las características del tejido ofrecen al cirujano ventajas como el fácil moldeamiento, lo que permite implantarlo en diferentes zonas anatómicas.Bovine pericardial patch has been utilized as an alternative for different surgical pathologies, including congenital heart malformations. Nevertheless, there are only few articles that report the experience with this kind of patch. The objective of this study is to evaluate the experience with the use of bovine pericardium for the reconstruction of cardiopathies in the Santa Maria Cardiovascular Clinic Medellín since 1994. Materials and methods: 520 patients underwent a corrective or palliative surgical procedure of a congenital heart disease in which the bovine pericardial patch was utilized. 163 of these patients had at least two years follow-up. The localization of the patch, as well as the kind of procedures, the survival, calcifications, aneurysms and leaks, were evaluated. The functional class was evaluated as well and the patients’ survival was compared according to the localization and the kind of patch. Results: 520 procedures were realized using the bovine pericardial patch. Prevalent malformations were septal defects (58% followed by the tetralogy of Fallot (16%.The patch was also used in total or partial anomalous venous connections, and pulmonary atresia among others. 50.9% was localized in a systemic way and 49.7% in the pulmonary circulation. According to the localization, 50.3% were intracardiac and 49.7% extracardiac. Two leaks, two bleedings and three re-interventions were reported during the implantation. During the follow-up only three leaks were reported. Global survival was 95%. There were no significant differences in survival with intra or extracardiac patches or in those that supported pulmonary or systemic circulation. No calcifications were reported. 95% of patients were in functional class I or II, and the rest in III

  10. Aspectos neurológicos da moléstia de chagas Neurological aspects of Chagas disease

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    Fritz Köberle

    1967-09-01

    Full Text Available Carlos Chagas related in more than two 200 cases, what he called "nervous forms" of trypanosomiasis, that is neurological manifestations from central origin (idiotism, infantilism, pseudo-bulbar paralysis, aphasia, cerebellar ataxia, atetosis, espostic or paralytic diplegia, disbasia. At that time Chagas expressed his concepts as follows: "In relation to the frequency of trypanosomiasis nervous forms we have performed many observations which allow us to state that this disease is the one which causes the largest number of organic affections of the central nervous system, in human pathology". We are plenty convinced by Chagas's statement. By experiments on animals of laboratory we have very often noticed a rather varied neurological symptomatology, being worth point out identical syndromes to those observed by Chagas. Our autopsy material non-rarely include chronic Chagas cases presenting a most varied symtomatology. Among them we have named only three cases of discerebral nanism, a rather rare affection in other parts of the world and relatively frequent in our material. The fact which we have demonstrated, i.e., a relatively great decreasing of number of nervous cells in the peripheral system could happen in the central nervous system as well. Provided that there are only two quantitative works on neuron number diminishing in the central nervous system in mice and rats we decline to go into further details about central neuropathies in man. We emphasized the necessity to perform researches on this field by means of intimate collaboration between clinicians and pathologists, as the only way to confirm on scientific basis all that was observed by the panoramic and genial vision of Carlos Chagas.

  11. Long term evaluation of etiological treatment of chagas disease with benznidazole.

    Science.gov (United States)

    Cancado, J Romeu

    2002-01-01

    The aim of this article is to present an investigation of cure rate, after long follow up, of specific chemotherapy with benznidazole in patients with both acute and chronic Chagas disease, applying quantitative conventional serological tests as the base of the criterion of cure. Twenty one patients with the acute form and 113 with one or other of the various chronic clinical forms of the disease were evaluated, after a follow up period of 13 to 21 years, for the acute, and 6 to 18 years, for the chronic patients. The duration of the acute as well as the chronic disease, a condition which influences the results of the treatment, was determined. The therapeutic schedule was presented, with emphasis on the correlation between adverse reactions and the total dose of 18 grams, approximately, as well as taking into consideration precautions to assure the safety of the treatment. Quantitative serological reactions consisting of complement fixation, indirect immunofluorescence, indirect hemagglutination, and, occasionally, ELISA, were used. Cure was found in 76 per cent of the acute patients but only in 8 per cent of those with chronic forms of the disease. In the light of such contrasting results, fundamentals of the etiological therapy of Chagas disease were discussed, like the criterion of cure, the pathogenesis and the role of immunosuppression showing tissue parasitism in long standing chronic disease, in support of the concept that post-therapeutic consistently positive serological reactions mean the presence of the parasite in the patient's tissues. In relation to the life-cycle of T. cruzi in vertebrate host, there are still some obscure and controversial points, though there is no proof of the existence of resistant or latent forms. However, the finding over the last 15 years, that immunosuppression brings about the reappearance of acute disease in long stand chronic patients justifies a revision of the matter. Facts were quoted in favor of the treatment of

  12. Long term evaluation of etiological treatment of Chagas disease with benznidazole

    Directory of Open Access Journals (Sweden)

    CANÇADO J. Romeu

    2002-01-01

    Full Text Available The aim of this article is to present an investigation of cure rate, after long follow up, of specific chemotherapy with benznidazole in patients with both acute and chronic Chagas disease, applying quantitative conventional serological tests as the base of the criterion of cure. Twenty one patients with the acute form and 113 with one or other of the various chronic clinical forms of the disease were evaluated, after a follow up period of 13 to 21 years, for the acute, and 6 to 18 years, for the chronic patients. The duration of the acute as well as the chronic disease, a condition which influences the results of the treatment, was determined. The therapeutic schedule was presented, with emphasis on the correlation between adverse reactions and the total dose of 18 grams, approximately, as well as taking into consideration precautions to assure the safety of the treatment. Quantitative serological reactions consisting of complement fixation, indirect immunofluorescence, indirect hemagglutination, and, occasionally, ELISA, were used. Cure was found in 76 per cent of the acute patients but only in 8 per cent of those with chronic forms of the disease. In the light of such contrasting results, fundamentals of the etiological therapy of Chagas disease were discussed, like the criterion of cure, the pathogenesis and the role of immunosuppression showing tissue parasitism in long standing chronic disease, in support of the concept that post-therapeutic consistently positive serological reactions mean the presence of the parasite in the patient's tissues. In relation to the life-cycle of T. cruzi in vertebrate host, there are still some obscure and controversial points, though there is no proof of the existence of resistant or latent forms. However, the finding over the last 15 years, that immunosuppression brings about the reappearance of acute disease in long stand chronic patients justifies a revision of the matter. Facts were quoted in favor of

  13. Perinatal Screening for Chagas Disease in Southern Texas.

    Science.gov (United States)

    Edwards, Morven S; Rench, Marcia A; Todd, Charles W; Czaicki, Nancy; Steurer, Francis J; Bern, Caryn; Montgomery, Susan P

    2015-03-01

    Perinatal screening for Trypanosoma cruzi in a cohort of 4000 predominantly Hispanic women in southern Texas revealed that Chagas disease occurs with sufficient frequency (0.25%) that targeted perinatal screening should be considered to identify infected mothers and infants at risk for congenital infection. PMID:26407360

  14. Ruthenium Complex with Benznidazole and Nitric Oxide as a New Candidate for the Treatment of Chagas Disease

    Science.gov (United States)

    Sesti-Costa, Renata; Carneiro, Zumira A.; Silva, Maria C.; Santos, Maíta; Silva, Grace K.; Milanezi, Cristiane; da Silva, Roberto S.; Silva, João S.

    2014-01-01

    Background Chagas disease remains a serious medical and social problem in Latin America and is an emerging concern in nonendemic countries as a result of population movement, transfusion of infected blood or organs and congenital transmission. The current treatment of infected patients is unsatisfactory due to strain-specific drug resistance and the side effects of the current medications. For this reason, the discovery of safer and more effective chemotherapy is mandatory for the successful treatment and future eradication of Chagas disease. Methods and Findings We investigated the effect of a ruthenium complex with benznidazole and nitric oxide (RuBzNO2) against Trypanosoma cruzi both in vitro and in vivo. Our results demonstrated that RuBzNO2 was more effective than the same concentrations of benznidazole (Bz) in eliminating both the extracellular trypomastigote and the intracellular amastigote forms of the parasite, with no cytotoxic effect in mouse cells. In vivo treatment with the compound improved the survival of infected mice, inhibiting heart damage more efficiently than Bz alone. Accordingly, tissue inflammation and parasitism was significantly diminished after treatment with RuBzNO2 in a more effective manner than that with the same concentrations of Bz. Conclusions The complexation of Bz with ruthenium and nitric oxide (RuBzNO2) increases its effectiveness against T. cruzi and enables treatment with lower concentrations of the compound, which may reduce the side effects of Bz. Our findings provide a new potential candidate for the treatment of Chagas disease. PMID:25275456

  15. Ruthenium complex with benznidazole and nitric oxide as a new candidate for the treatment of chagas disease.

    Directory of Open Access Journals (Sweden)

    Renata Sesti-Costa

    2014-10-01

    Full Text Available Chagas disease remains a serious medical and social problem in Latin America and is an emerging concern in nonendemic countries as a result of population movement, transfusion of infected blood or organs and congenital transmission. The current treatment of infected patients is unsatisfactory due to strain-specific drug resistance and the side effects of the current medications. For this reason, the discovery of safer and more effective chemotherapy is mandatory for the successful treatment and future eradication of Chagas disease.We investigated the effect of a ruthenium complex with benznidazole and nitric oxide (RuBzNO2 against Trypanosoma cruzi both in vitro and in vivo. Our results demonstrated that RuBzNO2 was more effective than the same concentrations of benznidazole (Bz in eliminating both the extracellular trypomastigote and the intracellular amastigote forms of the parasite, with no cytotoxic effect in mouse cells. In vivo treatment with the compound improved the survival of infected mice, inhibiting heart damage more efficiently than Bz alone. Accordingly, tissue inflammation and parasitism was significantly diminished after treatment with RuBzNO2 in a more effective manner than that with the same concentrations of Bz.The complexation of Bz with ruthenium and nitric oxide (RuBzNO2 increases its effectiveness against T. cruzi and enables treatment with lower concentrations of the compound, which may reduce the side effects of Bz. Our findings provide a new potential candidate for the treatment of Chagas disease.

  16. Chagas disease: control, elimination and eradication. Is it possible?

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    Jose Rodrigues Coura

    2013-12-01

    Full Text Available From an epidemiological point of view, Chagas disease and its reservoirs and vectors can present the following characteristics: (i enzooty, maintained by wild animals and vectors, with broad occurrence from southern United States of America (USA to southern Argentina and Chile (42ºN 49ºS, (ii anthropozoonosis, when man invades the wild ecotope and becomes infected with Trypanosoma cruzi from wild animals or vectors or when the vectors and wild animals, especially marsupials, invade the human domicile and infect man, (iii zoonosis-amphixenosis and exchanged infection between animals and humans by domestic vectors in endemic areas and (iv zooanthroponosis, infection that is transmitted from man to animals, by means of domestic vectors, which is the rarest situation in areas endemic for Chagas disease. The characteristics of Chagas disease as an enzooty of wild animals and as an anthropozoonosis are seen most frequently in the Brazilian Amazon and in the Pan-Amazon region as a whole, where there are 33 species of six genera of wild animals: Marsupialia, Chiroptera, Rodentia, Edentata (Xenarthra, Carnivora and Primata and 27 species of triatomines, most of which infected with T. cruzi . These conditions place the resident populations of this area or its visitors - tourists, hunters, fishermen and especially the people whose livelihood involves plant extraction - at risk of being affected by Chagas disease. On the other hand, there has been an exponential increase in the acute cases of Chagas disease in that region through oral transmission of T. cruzi , causing outbreaks of the disease. In four seroepidemiological surveys that were carried out in areas of the microregion of the Negro River, state of Amazonas, in 1991, 1993, 1997 and 2010, we found large numbers of people who were serologically positive for T. cruzi infection. The majority of them and/or their relatives worked in piassava extraction and had come into contact with and were stung by

  17. Echocardiographic Parameters and Survival in Chagas Heart Disease with Severe Systolic Dysfunction

    Energy Technology Data Exchange (ETDEWEB)

    Rassi, Daniela do Carmo, E-mail: dani.rassi@hotmail.com [Faculdade de Medicina e Hospital das Clínicas da Universidade Federal de Goiás (UFG), Goiânia, GO (Brazil); Vieira, Marcelo Luiz Campos [Instituto do Coração da Faculdade de Medicina da Universidade de São Paulo (USP), São Paulo, SP (Brazil); Arruda, Ana Lúcia Martins [Instituto de Radiologia da Faculdade de Medicina da Universidade de São Paulo (USP), São Paulo, SP (Brazil); Hotta, Viviane Tiemi [Instituto do Coração da Faculdade de Medicina da Universidade de São Paulo (USP), São Paulo, SP (Brazil); Furtado, Rogério Gomes; Rassi, Danilo Teixeira; Rassi, Salvador [Faculdade de Medicina e Hospital das Clínicas da Universidade Federal de Goiás (UFG), Goiânia, GO (Brazil)

    2014-03-15

    Echocardiography provides important information on the cardiac evaluation of patients with heart failure. The identification of echocardiographic parameters in severe Chagas heart disease would help implement treatment and assess prognosis. To correlate echocardiographic parameters with the endpoint cardiovascular mortality in patients with ejection fraction < 35%. Study with retrospective analysis of pre-specified echocardiographic parameters prospectively collected from 60 patients included in the Multicenter Randomized Trial of Cell Therapy in Patients with Heart Diseases (Estudo Multicêntrico Randomizado de Terapia Celular em Cardiopatias) - Chagas heart disease arm. The following parameters were collected: left ventricular systolic and diastolic diameters and volumes; ejection fraction; left atrial diameter; left atrial volume; indexed left atrial volume; systolic pulmonary artery pressure; integral of the aortic flow velocity; myocardial performance index; rate of increase of left ventricular pressure; isovolumic relaxation time; E, A, Em, Am and Sm wave velocities; E wave deceleration time; E/A and E/Em ratios; and mitral regurgitation. In the mean 24.18-month follow-up, 27 patients died. The mean ejection fraction was 26.6 ± 5.34%. In the multivariate analysis, the parameters ejection fraction (HR = 1.114; p = 0.3704), indexed left atrial volume (HR = 1.033; p < 0.0001) and E/Em ratio (HR = 0.95; p = 0.1261) were excluded. The indexed left atrial volume was an independent predictor in relation to the endpoint, and values > 70.71 mL/m{sup 2} were associated with a significant increase in mortality (log rank p < 0.0001). The indexed left atrial volume was the only independent predictor of mortality in this population of Chagasic patients with severe systolic dysfunction.

  18. Chagas Cardiomyopathy: Usefulness of EKG and Echocardiogram in a Non-Endemic Country.

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    Adrián Sánchez-Montalvá

    Full Text Available Chagas disease (CD is a major cause of cardiomyopathy in Latin America, and migration movements have now spread the disease worldwide. However, data regarding Chagas cardiomyopathy (CC and the usefulness of echocardiography in non endemic countries are still scarce.We selected 485 patients in the chronic phase of CD from two Spanish settings. Data from physical examination, electrocardiogram (EKG, x-ray, and two dimensional transthoracic echocardiogram were recorded. Trypanosoma cruzi DNA was assessed by PCR in peripheral blood. Patients were stratified according to the Kuschnir classification and a combination of echocardiogram and electrocardiogram findings. Patients mainly came from Bolivia (459; 94.6%. One hundred and forty three patients (31.5% had at least one electrocardiogram abnormality. Twenty seven patients (5.3% had an abnormal echocardiography. Patients with abnormal echocardiography were older (47 (IQR 38-57 years vs 41 (IQR 38-57 years; p = 0.019 and there was a greater proportion of males (66.7% vs 29.7%; p<0.001. Among echocardiographic variables, diastolic dysfunction was associated with poor cardiac status. In the multivariate analysis, abnormal EKG and gender were associated with abnormal echocardiography. Echocardiography may be spared for males under 30 and females under 45 years old with normal EKG as the likelihood of having an abnormal echocardiography is minimal. Association between T. cruzi DNA in the peripheral blood and cardiac involvement was not observed.CC rates in the studied population are low. Age and sex are important determinants for the development of CC, and with the EKG should guide echocardiogram performance.

  19. Um aspecto electrocardiográfico da doença de Chagas

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    Bernardo Figueiredo Magalhães

    1945-10-01

    Full Text Available Os A.A. mostram electrocardiogramas de um portador de fórma cardíaca crônica da doença de Chagas. O ecg variava, de tempos a tempos, evidenciando, ora um bloqueio auriculo-ventricular total, ora um bloqueio auriculo-ventricular do tipo 2 : 1, ora rítmo normal, etc. Além disso foram registradas variaçãoes em um mesmo ecg. Foram levantadas duas hipóteses para interpretação dêstes achados: uma, em que as toxinas seriam responsáveis; outra, em que houvesse aumetno do período refratário ventricular.The A. A. show electrocardiagrams of a patient of the chronic cardiac form of the Chagas disease. The ecg varied from time to time, showing at one time a totla ventricula auricle stoppage, at another a ventricular auricle stoppage of the type 2 : 1, at another normal rhythm etc. Besides this, variatios were registered in one single ecg. Two hypothesis were offered to explain these facts: one, in which the toxins would be responisble; another, that there had been an increase in the ventricular refratory period.

  20. Chagas disease in a Texan horse with neurologic deficits.

    Science.gov (United States)

    Bryan, Laura K; Hamer, Sarah A; Shaw, Sarah; Curtis-Robles, Rachel; Auckland, Lisa D; Hodo, Carolyn L; Chaffin, Keith; Rech, Raquel R

    2016-01-30

    A 10-year-old Quarter Horse gelding presented to the Texas A&M University Veterinary Teaching Hospital with a six month-history of ataxia and lameness in the hind limbs. The horse was treated presumptively for equine protozoal myeloencephalitis (EPM) based on clinical signs but was ultimately euthanized after its condition worsened. Gross lesions were limited to a small area of reddening in the gray matter of the thoracic spinal cord. Histologically, trypanosome amastigotes morphologically similar to Trypanosoma cruzi, the agent of Chagas disease in humans and dogs, were sporadically detected within segments of the thoracic spinal cord surrounded by mild lymphoplasmacytic inflammation. Ancillary testing for Sarcocystis neurona, Neospora spp., Toxoplasma gondii and Leishmania spp. was negative. Conventional and real time polymerase chain reaction (PCR) of affected paraffin embedded spinal cord were positive for T. cruzi, and sequencing of the amplified T. cruzi satellite DNA PCR fragment from the horse was homologous with various clones of T. cruzi in GenBank. While canine Chagas disease cases have been widely reported in southern Texas, this is the first report of clinical T. cruzi infection in an equid with demonstrable amastigotes in the spinal cord. In contrast to previous instances of Chagas disease in the central nervous system (CNS) of dogs and humans, no inflammation or T. cruzi amastigotes were detected in the heart of the horse. Based on clinical signs, there is a potential for misdiagnosis of Chagas disease with other infectious diseases that affect the equine CNS. T. cruzi should be considered as a differential diagnosis in horses with neurologic clinical signs and histologic evidence of meningomyelitis that originate in areas where Chagas disease is present. The prevalence of T. cruzi in horses and the role of equids in the parasite life cycle require further study. PMID:26801589

  1. Prevalence of Cardiac Arrhythmias During and After Pregnancy in Women with Chagas' Disease without Apparent Heart Disease

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    Achá Renato Enrique Sologuren

    2002-01-01

    Full Text Available OBJECTIVE: To evaluate cardiac arrhythmias during and after pregnancy in women with Chagas' disease without apparent heart disease using dynamic electrocardiography. METHODS: Twenty pregnant women with Chagas' disease without apparent heart disease aged 19 to 42 years (26.96 ± 3.6 and a control group of 20 non-chagasic pregnant patients aged 16 to 34 years (22.5 ± 4.8. The patients were submitted to passive hemagglutination and indirect immunofluorescence for the detection of Trypanosoma cruzi evaluation, and electrocardiography, echocardiography and 24-h dynamic electrocardiography. RESULTS: Supraventricular premature depolarizations were observed in 18 (90% patients and ventricular premature depolarization in 11 (55% patients of both groups during pregnancy. After delivery, supraventricular premature depolarizations were present in 13 (60% chagasic patients and in 16 (89.4% control patients (P<=0.05. Ventricular premature depolarization were observed in 9 (45% chagasic patients and 11 (57.8% control patients. CONCLUSION: The prevalence of ventricular premature depolarization was similar for the chagasic and control groups during and after pregnancy. The incidence of supraventricular premature depolarizations was similar in the two groups during pregnancy, while after delivery a predominance was observed in the control group compared to the chagasic group.

  2. Long term evaluation of etiological treatment of Chagas disease with benznidazole Avaliação a longo prazo do tratamento etiológico da doença de Chagas com benznidazol

    OpenAIRE

    J. Romeu CANÇADO

    2002-01-01

    The aim of this article is to present an investigation of cure rate, after long follow up, of specific chemotherapy with benznidazole in patients with both acute and chronic Chagas disease, applying quantitative conventional serological tests as the base of the criterion of cure. Twenty one patients with the acute form and 113 with one or other of the various chronic clinical forms of the disease were evaluated, after a follow up period of 13 to 21 years, for the acute, and 6 to 18 years, for...

  3. Evaluation of Parasiticide Treatment with Benznidazol in the Electrocardiographic, Clinical, and Serological Evolution of Chagas Disease.

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    Abilio Augusto Fragata-Filho

    2016-03-01

    Full Text Available Chagas disease is one of the most important endemic parasitic diseases in Latin America. In its chronic phase, progression to cardiomyopathy has high morbidity and mortality. The persistence of a normal electrocardiogram (ECG provides a similar prognosis to that of a non-diseased population. Benznidazole (BNZ is the only drug with trypanocidal action available in Brazil.A group of 310 patients with chronic Chagas disease who had normal ECGs at the first medical visit performed before 2002 were included. There were 263 patients treated with BNZ and 47 untreated. The follow-up period was 19.59 years. Univariate analyses showed that those treated were younger and predominantly male. As many as 79.08% of those treated and 46.81% of those untreated continued with normal electrocardiograms (p <0.0001. The occurrence of electrocardiographic abnormalities and relevant clinical events (heart failure, stroke, total mortality, and cardiovascular death was less prevalent in treated patients (p <0.001, p: 0.022, p: 0.047 respectively. In multivariate analyses, the parasiticide treatment was an independent variable for persistence of a normal ECG pattern, which was an independent variable in the prevention of significant clinical events. The immunofluorescence titers decreased with the parasitological treatment. However, the small number of tests in untreated patients did not allow the correlation of the decrease of these titers with electrocardiographic alterations.These data suggest that treatment with benznidazole prevents the occurrence of electrocardiographic alterations. On the other hand, patients who develop ECG abnormalities present with more significant clinical events.

  4. O gênero Schizotrypanum Chagas, 1909

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    Emmanuel Dias

    1939-01-01

    Full Text Available No presente trabalho, em que foram analisados os caractéres de Schizotrypanum e consideradas suas relações com os de outros flagelados digenéticos, acreditamos ter ficado bem demonstrado que este gênero encontra sólidos fundamentos em que se baseie. Schizotrypanum possue caractéres morfológicos peculiares, que o aproximam de Leishmania no periodo de multiplicação e de Trypanosoma na fase sanguinea. Os flagelados pertencentes a esse gênero caracterisam-se não só pela morfologia da fórma de tripanosoma, como pela evolução no organismo do vertebrado. No S. cruzi, como no S. vespertilionis, a multiplicação se processa nos tecidos, constando da divisão binaria das formas intracelulares de leishmania; os tripanosomas sanguicolas não se multiplicam. Nenhum Trypanosoma apresenta no mamífero uma evolução morfológicamente e ecológicamente identica á de Schizotrypanum. S. cruzi aproxima-se dos tripanosomas patogenicos pela morfologia da fórma sanguicola e pela virulencia ás vezes mortal para o homem e diversos animais; deles se afasta entretanto pela evolução no inséto, modo de transmissão e facil cultivabilidade, caractéres biológicos estes que são comuns aos tripanosomas não patogenicos. Em nenhum dos grupos de tripanosomas póde o S. cruzi ser rigorosamente incluido, deles se distinguindo facilmente seja por sua morfologia, seja por sua biologia. O conjunto de caractéres próprios fundamenta perfeitamente a manutenção do gênero de Chagas, indicando-lhe como situação mais adequada, na classificação dos tripanosomídeos de mamíferos, o logar intermediario entre Leishmania e Trypanosoma. A separação do gênero Schizotrypanum é o melhor caso, quiça o unico justificado, dentre as numerosas tentativas para o desmembramento de Trypanosoma. Ela se impõe como medida compreensiva e util para a coordenação dos membros da complexa familia dos tripanosomideos e se justifica á luz dos mais exigentes crit

  5. Avaliação de pacientes assintomáticos com forma crônica da doença de Chagas através da análise do eletrocardiograma dinâmico, ecocardiograma e do peptídeo natriurético tipo B Evaluation of asymptomatic patients with chronic Chagas’ disease through ambulatory electrocardiogram, echocardiogram and B-Type natriuretic peptide analyses

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    Divina Seila de Oliveira Marques

    2006-09-01

    Full Text Available OBJETIVO: Avaliar pacientes assintomáticos com forma crônica da doença de Chagas em relação a prevalência de arritmias ventriculares, disfunção ventricular esquerda e níveis plasmáticos do peptídeo natriurético tipo B (BNP. MÉTODOS: Avaliação clínica, eletrocardiograma (ECG, índice cardiotorácico (ICT, eletrocardiograma dinâmico, ecocardiograma e dosagem BNP foram realizados em 106 pacientes do Ambulatório de Doença de Chagas, distribuídos em três grupos: GI (50-ECG normal, GIIA (31-ECG com alterações características de doença de Chagas e GIIB (25-ECG com outras alterações. RESULTADOS: Alterações eletrocardiográficas mais prevalentes no GIIA: bloqueio completo do ramo direito, bloqueio divisional ântero-superior esquerdo (35% cada e áreas inativas (32%, GIIB: alteração da repolarização inferolateral (28% e sobrecarga ventricular esquerda (24%. Os valores médios do ICT foram semelhantes (p = 0,383. A prevalência de arritmia ventricular foi maior nos grupos GIIA (77% e GIIB (75% do que no GI (46% (p = 0,002. A disfunção ventricular foi mais prevalente no GIIA (52% e GIIB (32% do que no GI (14% (p = 0,001. A disfunção sistólica foi mais prevalente no GIIA (29% do que no GIIB (20% e GI (2% (p OBJECTIVE: To evaluate asymptomatic patients with chronic Chagas’ disease to determine prevalence of ventricular arrhythmias, left ventricular dysfunction, and B-type natriuretic peptide (BNP plasma levels. METHODS: One hundred and six patients from the Chagas’ disease outpatient clinic underwent clinical evaluation, electrocardiogram (ECG, cardiothoracic index (CTI, ambulatory electrocardiogram (Holter monitoring, echocardiogram, and BNP measurement and then were distributed into three groups: GI, with normal ECG (n = 50; GIIA, with ECG changes characteristic of Chagas’ disease (n = 31; and GIIB, with other ECG changes (n = 25. RESULTS: The most common electrocardiographic changes were the following. GIIA

  6. Chagas disease, migration and community settlement patterns in Arequipa, Peru.

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    Angela M Bayer

    Full Text Available BACKGROUND: Chagas disease is one of the most important neglected tropical diseases in the Americas. Vectorborne transmission of Chagas disease has been historically rare in urban settings. However, in marginal communities near the city of Arequipa, Peru, urban transmission cycles have become established. We examined the history of migration and settlement patterns in these communities, and their connections to Chagas disease transmission. METHODOLOGY/PRINCIPAL FINDINGS: This was a qualitative study that employed focus group discussions and in-depth interviews. Five focus groups and 50 in-depth interviews were carried out with 94 community members from three shantytowns and two traditional towns near Arequipa, Peru. Focus groups utilized participatory methodologies to explore the community's mobility patterns and the historical and current presence of triatomine vectors. In-depth interviews based on event history calendars explored participants' migration patterns and experience with Chagas disease and vectors. Focus group data were analyzed using participatory analysis methodologies, and interview data were coded and analyzed using a grounded theory approach. Entomologic data were provided by an ongoing vector control campaign. We found that migrants to shantytowns in Arequipa were unlikely to have brought triatomines to the city upon arrival. Frequent seasonal moves, however, took shantytown residents to valleys surrounding Arequipa where vectors are prevalent. In addition, the pattern of settlement of shantytowns and the practice of raising domestic animals by residents creates a favorable environment for vector proliferation and dispersal. Finally, we uncovered a phenomenon of population loss and replacement by low-income migrants in one traditional town, which created the human settlement pattern of a new shantytown within this traditional community. CONCLUSIONS/SIGNIFICANCE: The pattern of human migration is therefore an important

  7. Clínica e terapêutica da doença de Chagas

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    Francisco S. Laranja

    1948-06-01

    evidences are reported to support the viewpoint that chronic Chagas' heart disease is a well defined clinical entity. 4 - The manifestations of acute infecion are studied in the light of authors' experience with 103 acute cases found in Bambui. Two kinds of edema may occur in patients with acute Chagas' disease: the local edema or edema of portal of entry of the parasite in the organism, and the generalized edema, the so-called "mixedema". The pathogenesis of the last mentioned is reviewed and it is suggested it may be related to hypoproteinemia. The local edema seems to be of inflamatory nature. The manifestations of acute Chagas' heart disease are described. Gallop Rhythm, increase in cardiac shadow (in some cases due to pericardial effusion, prolongation of P-R interval, primary T wave changes and ventricular premature contractions are the more important diagnostic signs of acute Chagas' heart diasease. Right bundle branch block occurred in three fatal cases of acute Chagas' heart disease; in one of them a pronounced ST displacement ("injury pattern" was also present. Death during the acute period of Chagas' disease is usually preceded by convulsions. The manifestations of the acute infection subside spontaneously and gradually in most cases; the disease then goes into the chronic stage and the patients become apparently cured, although still infected. 5 - Patients with chronic infection and without evidences of heart involvement are considered as potencial heart patients and classified in the chronic indeterminate form of the disease. Infection remains in the organism, as a rule under an active form, and signs of heart involvement may devellop later. 6 - Chronic Chagas' heart disease is usually a late manifestation of the infection. About 50% of chonically infected patients present signs of heart involvement. The manifestations of chronic Chagas' heart disease depend upon the severity of myocardial changes. Palpitations, dyspnea, convulsive-syncopal crisis (advanced A

  8. Dissecting slander and crying for justice: Carlos Chagas and the Nobel Prize of 1921.

    Science.gov (United States)

    Bestetti, Reinaldo B; Cardinalli-Neto, Augusto

    2013-10-01

    Chagas disease was discovered by Carlos Chagas in 1909. Chagas worked at Oswaldo Cruz Institute, where the bases of experimental medicine were settled in Brazil, and that had no connection with the Faculty of Medicine of Rio de Janeiro. Chagas had several enemies at Oswaldo Cruz Institute mainly because of his election to Head of Service in 1910, and for the position of Oswaldo Cruz Directorship in 1917. Furthermore, Chagas gained enemies at Faculty of Medicine of Rio de Janeiro, which did not like to see the economical political autonomy of Oswaldo Cruz Institute. This allowed the Institute not only to perform top experimental research, but also to take the leadership of research in the country. Chagas was nominated to the Nobel Prize of 1921 in December, 1920. None was awarded the Nobel Prize in that year. He seems to have been evaluated by the Noble Committee of Karolinska Institute from March to May of 1921. At that time, his enemies were denying his discovery of Trypanosoma cruzi, a key point in Chagas' nomination by Karolinska Institute, and giving no epidemiological importance for the disease. By the same way, the obligation of small pox vaccination was tarnishing his public image. Having taken into account the epidemiologic importance of Chagas disease, the strong historical mistake in the process of Chagas evaluation, and the inequity behind all these facts, we insist on a posthumous Nobel Prize for the man who made the most complete medical-scientist discovery of all time. PMID:23410487

  9. Regulatory T Cells Phenotype in Different Clinical Forms of Chagas' Disease

    Science.gov (United States)

    Teixeira-Carvalho, Andréa; Renato Zuquim Antas, Paulo; Assis Silva Gomes, Juliana; Sathler-Avelar, Renato; Otávio Costa Rocha, Manoel; Elói-Santos, Silvana Maria; Pinho, Rosa Teixeira; Correa-Oliveira, Rodrigo; Martins-Filho, Olindo Assis

    2011-01-01

    CD25High CD4+ regulatory T cells (Treg cells) have been described as key players in immune regulation, preventing infection-induced immune pathology and limiting collateral tissue damage caused by vigorous anti-parasite immune response. In this review, we summarize data obtained by the investigation of Treg cells in different clinical forms of Chagas' disease. Ex vivo immunophenotyping of whole blood, as well as after stimulation with Trypanosoma cruzi antigens, demonstrated that individuals in the indeterminate (IND) clinical form of the disease have a higher frequency of Treg cells, suggesting that an expansion of those cells could be beneficial, possibly by limiting strong cytotoxic activity and tissue damage. Additional analysis demonstrated an activated status of Treg cells based on low expression of CD62L and high expression of CD40L, CD69, and CD54 by cells from all chagasic patients after T. cruzi antigenic stimulation. Moreover, there was an increase in the frequency of the population of Foxp3+ CD25HighCD4+ cells that was also IL-10+ in the IND group, whereas in the cardiac (CARD) group, there was an increase in the percentage of Foxp3+ CD25High CD4+ cells that expressed CTLA-4. These data suggest that IL-10 produced by Treg cells is effective in controlling disease development in IND patients. However, in CARD patients, the same regulatory mechanism, mediated by IL-10 and CTLA-4 expression is unlikely to be sufficient to control the progression of the disease. These data suggest that Treg cells may play an important role in controlling the immune response in Chagas' disease and the balance between regulatory and effector T cells may be important for the progression and development of the disease. Additional detailed analysis of the mechanisms on how these cells are activated and exert their function will certainly give insights for the rational design of procedure to achieve the appropriate balance between protection and pathology during parasite

  10. Interactive Media on Chagas Disease: Development and Content

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    Claudinei Caetano de Souza

    2013-10-01

    Full Text Available An interactive media on Chagas disease was developed as an educational tool, on the context of the scientific research and dissemination actions of the National Institute of Structural Biotechnology and Medicinal Chemistry in Infectious Diseases (INBEQMeDI. Different computational resources were used either in terms of hardware and software. The media contains 13 videos that range from 30 seconds to 4 minutes, all with information about Chagas disease, showing the social and economic aspects; the research made by the INBEQMeDI group; different aspects of the disease illustrated by slides arranged in a mobile carousel, and radio programs, with funny skits. The target audience for use of this feature is students aged 10 to 17 years. Teachers of areas of science and biology, through a partnership with the Agency of Education of the State of São Paulo, will be invited to plan a strategy for media use with their students.

  11. Distribution and characterization of canine Chagas disease in Texas.

    Science.gov (United States)

    Kjos, S A; Snowden, K F; Craig, T M; Lewis, B; Ronald, N; Olson, J K

    2008-04-15

    Although acute and chronic cases of canine Chagas disease have been reported from multiple areas in the southern region of the United States, little data are available on current disease occurrence patterns in endemic areas. Therefore, a study to assess frequency, geographic distribution, signalment, and clinical spectrum of Chagas disease in domestic dogs from Texas was conducted. Serology, histopathology, and clinical case records from multiple institutions for the time period 1993-2007 were analyzed. A total of 537 serologically and/or histopathologically confirmed cases were documented. Cases were reported from 48 of 254 counties within Texas, covering all major geographic regions. Forty-eight dog breeds were represented among the cases, primarily in the sporting and working groups. In histopathologically confirmed cases, acute death occurred in 42%, approximately half of which were ecoregions of Texas, affecting a broad range of dog breeds and age groups. PMID:18255233

  12. Estresse ortostático ativo e arritmia sinusal respiratória em chagásicos com função sistólica global do ventrículo esquerdo preservada Active orthostatic stress and respiratory sinus arrhythmia in patients with Chagas' disease with preserved left ventricular global systolic function

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    Antonio Luiz P. Ribeiro

    2004-07-01

    Full Text Available OBJETIVO: Avaliar a utilização do teste de estresse ostostático ativo na detecção de disfunção vagal em chagásicos com função sistólica global preservada, comparando-o ao teste da arritmia sinusal respiratória. MÉTODO: Foram selecionados 61 chagásicos (Ch e 38 não-chagásicos (NCh sem evidências significativas de cardiopatia ou doenças sistêmicas, submetidos ao ecodopplercardiograma e às provas autonômicas. O teste da arritmia sinusal respiratória foi realizado através do registro eletrocardiográfico enquanto o paciente respirava profundamente, a 6 irpm, calculando-se a razão E:I (média das razões entre os maiores intervalos RR expiratórios e os menores RR inspiratórios a cada ciclo. O eletrocardiograma foi registrado enquanto o paciente se levantava e nos 30s seguintes (teste do estresse ortostático ativo, calculando-se a razão RR máx./RR min (maior e menor intervalo RR logo após a mudança postural. Os índices foram ajustados para covariáveis significativas. RESULTADOS: A razão RR max:min (NCh: 1,52 [1,44-1,74] x Ch: 1,43 [1,33-1,51], p OBJECTIVE: To assess the use of the active orthostatic stress test for detecting vagal dysfunction in patients with Chagas' disease with preserved overall systolic function, and to compare it with the respiratory sinus arrhythmia test. METHODS: Sixty-one chagasic patients (Ch and 38 nonchagasic (NCh patients with no significant evidence of heart disease or systemic diseases underwent Doppler echocardiography and autonomic function tests. The respiratory sinus arrhythmia test was performed through electrocardiographic recording during deep breathing, at 6 ripm, calculating the E:I ratio (mean ratio between the longest expiratory RR interval and the shortest inspiratory RR interval at each cycle. The electrocardiogram was recorded during the act of standing and during the following 30 seconds (active orthostatic stress test, and the max RR/min RR ratio (the longest and shortest

  13. Epidemiologia de um caso de doença de Chagas na Ilha do Mosqueiro - Pará

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    Adelson A.A. de Souza

    1988-12-01

    Full Text Available Os autores apresentam os resultados do estudo epidemiológico de um caso autóctone da fase aguda da doença de Chagas na ilha do Mosqueiro, Estado do Pará, aproximadamente 75km da capital, Belém. 0 caso já havia sido objeto de uma publicação anterior. Agora são apresentadas informações epidemiológicas. Nas proximidades da casa do paciente foram capturados em duas palmeiras de Inajá ('Maximilian regi ay e em uma de Mucajá (Acrocomia sclerocarpia 114 triatomíneos: Rhodnius pictipes, R. robustus, Panstrongylus lignarius, P. geniculatus e Microtriatoma trinidadensis, com tripanossomas em 31 deles. Na casa do paciente foram encontrados exemplares de Rhodnius pictipes, infectados com formas metacíclicas do Trypanosoma cruzi. Em 14 marsupiais, capturados na localidade, haviam 3 infectados com organismos semelhantes ao T. cruzi. A eletroforese dos isoenzimas nos tripanossomas isolados do paciente, de R. pictipes e de Didelphis marsupialis os classificou como zimodema 1. Os autores concluem que a doença de Chagas do paciente teve origem silvestre.The authors present the results of an epidemiological study relating to a case of acute Chagas' disease acquired in the island of Mosqueiro, State of Para, approximately 75 km from the capital Belem. The patient has been the object of a previous publication but now epidemiological information is reported. Near the house of the patient in two Inaja palm trees (Maximilian regia and one Mucaja palm (Acrocomia sclerocarpia 114 triatomine bugs were captured of the following species: Rhodnius pictipes, R. robustus, Panstrongylus lignarius, P. geniculatus and Microtriatoma trinidadensis. Trypanosomes were found in 31 bugs. In the house of the patient specimens of R. pictipes were captured infected with metacyclic forms óf Trypanosoma cruzi. In 14 marsupials captured in the locality three had infections with cruzi like trypanosomes. Enzyme electrophoresis of the trypanosomes isolated from the patient, R

  14. Chagas Heart Disease Pathogenesis: One Mechanism or Many?

    OpenAIRE

    Bonney, Kevin M.; David M. Engman

    2008-01-01

    Chagas heart disease (CHD), caused by the protozoan parasite Trypanosoma cruzi, is the leading cause of infectious myocarditis in the world. The etiology of CHD is unclear and multiple mechanisms have been proposed to explain the pathogenesis of the disease. This review describes the proposed mechanisms of CHD pathogenesis and evaluates the historical significance and evidence supporting each. Although the majority of CHD-related pathologies are currently attributed to parasite persistence in...

  15. A cost-benefit analisys of chagas disease control

    OpenAIRE

    C.J. Schofield; J.C.P. Dias

    1991-01-01

    Chagas disease transmission can be effetively interrupted by insecticidal control of its triatomine bug vectors. We present here a simple model comparing the costs and benefits of such a programme, designed to eliminate domestic populations of Triatoma infestans throughout its known area of distribution over the seven southernmost countries of Latin America. The model has been simplified to require only four financial estimates relating to the unit cost of housing spraying and benefits due to...

  16. Acute Chagas Disease Induces Cerebral Microvasculopathy in Mice

    OpenAIRE

    Nisimura, Lindice Mitie; Estato, Vanessa; de Souza, Elen Mello; Reis, Patricia A.; Lessa, Marcos Adriano; de Castro-Faria-Neto, Hugo Caire; Pereira, Mirian Claudia de Souza; Tibiriçá, Eduardo; Garzoni, Luciana Ribeiro

    2014-01-01

    Cardiomyopathy is the main clinical form of Chagas disease (CD); however, cerebral manifestations, such as meningoencephalitis, ischemic stroke and cognitive impairment, can also occur. The aim of the present study was to investigate functional microvascular alterations and oxidative stress in the brain of mice in acute CD. Acute CD was induced in Swiss Webster mice (SWM) with the Y strain of Trypanosoma cruzi (T. cruzi). Cerebral functional capillary density (the number of spontaneously perf...

  17. Elimination of vector-borne transmission of Chagas disease

    OpenAIRE

    AC Silveira; MC Vinhaes

    1999-01-01

    The control of the vector-borne transmission of Chagas disease in Brazil was organized as a national program in 1975, when two large entomological and sero-epidemiological surveys were conducted in the country in order to identify areas at highest risk of transmission and to guide inerventions regarding the chemical treatment of domestic vectors of the disease. The authors present the baseline data gathered through these studies and compare them with more recent data. The evaluation performed...

  18. Epicuticular lipids induce aggregation in Chagas disease vectors

    OpenAIRE

    Juárez M Patricia; Mijailovsky Sergio J; Girotti Juan R; Figueiras Alicia

    2009-01-01

    Abstract Background The triatomine bugs are vectors of the protozoan parasite Trypanosoma cruzi, the causative agent of Chagas disease. Aggregation behavior plays an important role in their survival by facilitating the location of refuges and cohesion of aggregates, helping to keep them safely assembled into shelters during daylight time, when they are vulnerable to predators. There are evidences that aggregation is mediated by thigmotaxis, by volatile cues from their faeces, and by hexane-ex...

  19. O plexo pampiniforme na fase crônica da doença de Chagas humana: avaliação histológica The pampiniform plexus of chronic chagasic patients: a histologic evaluation

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    Ademir Rocha

    2000-10-01

    Full Text Available Pesquisou-se a ocorrência, na parede das veias do plexo pampiniforme de chagásicos crônicos, de acúmulos intracelulares de Trypanosoma cruzi e sinais inflamatórios (flebite. Para tal fim, colheram-se, à necropsia, 23 pares de funículos espermáticos, epidídimos e testículos, sendo 17 de chagásicos crônicos e 6 de controles (não chagásicos. Em cada caso, foram feitos múltiplos cortes das gônadas e dos vasos; fez-se pesquisa de T. cruzi por imuno-histoquímica nos funículos espermáticos de todos os casos. Não se observaram parasitos nas paredes vasculares. Notou-se flebite crônica inespecífica, focal e discreta, em cinco chagásicos (bilateral em três pacientes e dois controles; havia infiltração mononuclear discreta do interstício funicular em treze chagásicos e cinco controles. A análise estatística dos resultados (chi2 não revelou diferenças significativas. Conclui-se que o ambiente hormonal devido à testosterona não parece favorecer a infecção da parede dos vasos gonadais por Trypanosoma cruzi, embora, segundo a literatura, o referido hormônio pareça ter ações imunodepressoras.The occurrence of Trypanosoma cruzi intracellular clusters and phlebitis was searched for on pampiniform plexus vein walls of chronic chagasic patients. For this purpose, 23 pairs of spermatic cords, epididymides and testes (17 from chagasic patients and 6 from non-chagasic controls were obtained, at autopsy. Trypanosoma cruzi was investigated by immuno-histochemistry on slides obtained from several sections of the gonads and vessels of each case. Only discrete and focal undetermined chronic phlebitis was observed, with no parasites, in 5 chagasics (bilateral in 3 and 2 controls (chi2: p < 0.10, and discrete mononuclear interstitial infiltration in the funiculi of 13 chagasics and 5 controls (chi2: p < 0.75. In conclusion, on the contrary to that published regarding the supra-renal central veins, it seems that the hormonal environment

  20. A Paratransgenic Strategy for the Control of Chagas Disease

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    Ivy Hurwitz

    2012-01-01

    Full Text Available Chagas disease results from infection with the parasite Trypanosoma cruzi. This disease remains a significant cause of morbidity and mortality in central and south America. Chagas disease now exists and is detected worldwide because of human migration. Control of Chagas disease has relied mainly on vector eradication however, the development of insect resistance to pesticides, coupled with cost and adverse health effects of insecticide treatments, has prompted our group to investigate novel methods of transmission control. Our laboratory has been instrumental in the development of the paratransgenic strategy to control vectorial transmission of T. cruzi. In this paper, we discuss various components of the paratransgenic approach. Specifically, we describe classes of molecules that can serve as effectors, including antimicrobial peptides, endoglucanases, and highly specific single chain antibodies that target surface glycoprotein tags on the surface of T. cruzi. Furthermore, we address evolving concepts related to field dispersal of engineered bacteria as part of the paratransgenic control strategy and attendant risk assessment evaluation.

  1. Electrocardiographic study in subjects with positive and negative serology for Trypanosoma Cruzi - asymptomatic patients coming from the Chicamocha study (cardiovascular health investigation from Colombia to assess the markers and outcomes of Chagas Disease)

    International Nuclear Information System (INIS)

    An electrocardiographic study made in 2.130 blood donors in the city of Bucaramanga, Colombia between 1999 and 2004 is presented. The findings between 486 seropositive T (+) patients in relation with 1.644 seronegative T (-) for trypanosome Cruzi are compared. Differences in percentages that were statistically significant were found in the T (+) population respect to the T (-) regarding the following parameters: right bundle branch block (6, 1/2,6 p<0,001), anterosuperior left hemi- block (5, 7/2,3 p<0,001), atrioventricular block (2,7/1 p=0,006), ventricular extrasystoles (2,5/0,9 .p=0,009 flattening or inversion of T wave (16,4/10,8 p=0,001) and bordering pr (6,9/4,1 p=0,009). likewise, significant differences favoring T (-) group with regard to right bundle branch block (9,9/5,9 p=0,007) and non specific conduction disorders (42,5/34,1 i p=0,001), were found. on the subject of supraventricular extra systole or the presence of pathological T waves no statistically significant differences were found. also, if conduction disorders and rhythm disorders are associated, to have at least one of them is more frequent in T (+) group (16,8/11,3 p<0,001) and this is even more significant if two or more associated disorders are present (3,0/0,9 p<0,001)

  2. In vivo studies of 5-arylethenylbenzofuroxans in acute murine models of Chagas' disease.

    Science.gov (United States)

    Boiani, Lucía; Davies, Carolina; Arredondo, Carolina; Porcal, Williams; Merlino, Alicia; Gerpe, Alejandra; Boiani, Mariana; Pacheco, José Pedro; Basombrío, Miguel Angel; Cerecetto, Hugo; González, Mercedes

    2008-10-01

    5-arylethenylbenzofuroxan derivatives with high in vitro anti-Trypanosoma cruzi activity were studied in vivo using acute murine models of Chagas' disease. The selected compounds, as pure isomeric forms, 1, 2, 3 and 4, or as equimolecular mixture of geometric isomers, 1:2, 3:4, 5:6 were studied against different T. cruzi strains. Consequently, Tulahuen 2 strain, Colombiana strain (resistant to Nifurtimox and Benznidazole), and two different wild strains, one isolated from the wild reservoir Didelphis marsupialis and another one from Uruguayan patients, were selected. No relevant signs of in vivo toxicity were observed with the benzofuroxans orally administered. Compound 1 and the mixture of isomers 1:2 were the best for treating infection against the four studied strains. PMID:18255195

  3. FIRST REPORT OF ACUTE CHAGAS DISEASE BY VECTOR TRANSMISSION IN RIO DE JANEIRO STATE, BRAZIL

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    Luiz Henrique Conde SANGENIS

    2015-08-01

    Full Text Available SUMMARY Chagas disease (CD is an endemic anthropozoonosis from Latin America of which the main means of transmission is the contact of skin lesions or mucosa with the feces of triatomine bugs infected by Trypanosoma cruzi. In this article, we describe the first acute CD case acquired by vector transmission in the Rio de Janeiro State and confirmed by parasitological, serological and PCR tests. The patient presented acute cardiomyopathy and pericardial effusion without cardiac tamponade. Together with fever and malaise, a 3 cm wide erythematous, non-pruritic, papule compatible with a "chagoma" was found on his left wrist. This case report draws attention to the possible transmission of CD by non-domiciled native vectors in non-endemic areas. Therefore, acute CD should be included in the diagnostic workout of febrile diseases and acute myopericarditis in Rio de Janeiro.

  4. Chagas disease and globalization of the Amazon La enfermedad de Chagas y la globalización de la Amazonia

    OpenAIRE

    Roberto Briceño-León

    2007-01-01

    The increasing number of autochthonous cases of Chagas disease in the Amazon since the 1970s has led to fear that the disease may become a new public health problem in the region. This transformation in the disease's epidemiological pattern in the Amazon can be explained by environmental and social changes in the last 30 years. The current article draws on the sociological theory of perverse effects to explain these changes as the unwanted result of the shift from the "inward" development mod...

  5. I Latin American Guidelines for the diagnosis and treatment of Chagas' heart disease: executive summary.

    Science.gov (United States)

    Andrade, Jadelson Pinheiro de; Marin Neto, Jose Antonio; Paola, Angelo Amato Vincenzo de; Vilas-Boas, Fábio; Oliveira, Glaucia Maria Moraes; Bacal, Fernando; Bocchi, Edimar Alcides; Almeida, Dirceu Rodrigues; Fragata Filho, Abilio Augusto; Moreira, Maria da Consolação Vieira; Xavier, Sergio Salles; Oliveira Junior, Wilson Alves de; Dias, João Carlos Pinto

    2011-06-01

    Much has been achieved in one century after Carlos Chagas' discovery. However, there is surely much to be done in the next decades. At present, we are witnessing many remarkable efforts to monitor the epidemiology of the disease, to better understand the biology of the T. cruzi and its interaction with human beings as well as the pathogenesis and pathophysiology of the complications in the chronic phase, and deal more appropriately and effectively with late cardiac and digestive manifestations. Although the vector and transfusion-derived transmission of the disease has been controlled in many countries, there remains a pressing need for sustained surveillance of the measures that led to this achievement. It is also necessary to adopt initiatives that enable appropriate management of social and medical conditions resulting from the migration of infected individuals to countries where the disease formerly did not exist. It's also necessary to standardize the most reliable methods of detection of infection with T. cruzi, not only for diagnosis purposes, but more crucially, as a cure criterion. The etiological treatment of millions of patients in the chronic stage of the disease is also to be unraveled. A renewed interest in this area is observed, including prospects of studies focusing on the association of drugs with benznidazole. We also wait for full evidence of the actual effectiveness of the etiological treatment to impact favorably on the natural history of the disease in its chronic phase. Eventually, cardiologists are primarily responsible for improving the clinical management of their patients with Chagas' disease, judiciously prescribing drugs and interventions that respect, as much as possible, the peculiar pathophysiology of the disease, wasting no plausible therapeutic opportunities. PMID:21789345

  6. Ventriculectomia parcial: um novo conceito no tratamento cirúrgico de cardiopatias em fase final Partial ventriculectomy: a new concept for surgical treatment of end stage cardiopathies

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    Randas J. V Batista

    1996-03-01

    cardiac problems and end stage congestive heart failure (NYHA IV with dilated cardiomyopathy underwent "Partial Ventriculectomy". The operation was based on Laplace's law (T-P.II.D and consisted of removal of a large wedge of muscle from the lateral wall of the left ventricle beginning at the apex and extending between the papillary muscles, ending proximal to the mitral annulus. The operation was performed under normothermic cardiopulmonary bypass and no cardioplegia was used. Pre-operative left ventriculography and echocardiography showed global hypocontractility of the hearts with ejection fraction lower than 20% in all patients who were considered candidates for cardiac transplantation. Males were predominant (n=73 and the age varied from 19 to 74 years. The pathologies were: viral miocarditis (n=12; post miocardioplasty (n=1; Chagas' disease (n=15; valvular disease (n=38; ischemic disease (n=16; idiopathic (n=21. Hospital mortality (30 days post operative (n=13: pulmonary embolus (n=4; renal failure (n=5; bleeding (n=4. Late deaths (after 30 days post-operative (n=10: arhythmia (n=6; "cardiac failure" (n=2; unknown (n=2; 8 patients required reoperation for bleeding. There were no infection and none required IAPB. All patients had nipride and 19 needed inotropics. Post-op ventriculographies and echocardiographies showed improvement of EF (from 100% to 300%. In conclusion, this new technique "Partial Ventriculectomy", with it's purpose of reducing the ventricular diameter, may benefit patients with end stage heart failure. And this new concept may, in our experience, give the patient improvement in his clinical status and increase life span.

  7. Cardiopatia chagásica crônica na Amazônia: uma etiologia a ser lembrada Cardiopatía chagásica crónica en la Amazonía: una etiología que recordar Chronic chagasic cardiopathy in Amazon region: an etiology to remember

    Directory of Open Access Journals (Sweden)

    João Marcos Bemfica Barbosa Ferreira

    2009-12-01

    Full Text Available Este estudo avaliou a frequência de cardiopatia chagásica crônica (CCC em 37 pacientes autóctones da Amazônia com disfunção sistólica ventricular esquerda sem etiologia definida. Foram diagnosticados três casos com frequência de 8,1% no grupo estudado.Este estudio evaluó la frecuencia de cardiopatía chagásica crónica (CCC en 37 pacientes autóctonos de la Amazonía con disfunción sistólica ventricular izquierda sin etiología definida. Se diagnosticaron tres casos con frecuencia del 8,1% en el grupo estudiado.This study assessed the frequency of chronic chagasic cardiopathy (CCC in 37 autochthonus patients from Amazon region with left ventricular systolic dysfunction of undefined etiology. Three cases were diagnosed in the studied sample, with an 8.1% frequency.

  8. Antigenicity and diagnostic potential of vaccine candidates in human Chagas disease.

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    Shivali Gupta

    Full Text Available BACKGROUND: Chagas disease, caused by Trypanosoma cruzi, is endemic in Latin America and an emerging infectious disease in the US and Europe. We have shown TcG1, TcG2, and TcG4 antigens elicit protective immunity to T. cruzi in mice and dogs. Herein, we investigated antigenicity of the recombinant proteins in humans to determine their potential utility for the development of next generation diagnostics for screening of T. cruzi infection and Chagas disease. METHODS AND RESULTS: Sera samples from inhabitants of the endemic areas of Argentina-Bolivia and Mexico-Guatemala were analyzed in 1(st-phase for anti-T. cruzi antibody response by traditional serology tests; and in 2(nd-phase for antibody response to the recombinant antigens (individually or mixed by an ELISA. We noted similar antibody response to candidate antigens in sera samples from inhabitants of Argentina and Mexico (n=175. The IgG antibodies to TcG1, TcG2, and TcG4 (individually and TcG(mix were present in 62-71%, 65-78% and 72-82%, and 89-93% of the subjects, respectively, identified to be seropositive by traditional serology. Recombinant TcG1- (93.6%, TcG2- (96%, TcG4- (94.6% and TcG(mix- (98% based ELISA exhibited significantly higher specificity compared to that noted for T. cruzi trypomastigote-based ELISA (77.8% in diagnosing T. cruzi-infection and avoiding cross-reactivity to Leishmania spp. No significant correlation was noted in the sera levels of antibody response and clinical severity of Chagas disease in seropositive subjects. CONCLUSIONS: Three candidate antigens were recognized by antibody response in chagasic patients from two distinct study sites and expressed in diverse strains of the circulating parasites. A multiplex ELISA detecting antibody response to three antigens was highly sensitive and specific in diagnosing T. cruzi infection in humans, suggesting that a diagnostic kit based on TcG1, TcG2 and TcG4 recombinant proteins will be useful in diverse situations.

  9. Comparison of esophageal motility impairment caused by Chagas' disease in two age groups Comparação em duas faixas etárias das alterações motoras do esôfago conseqüentes à doença de Chagas

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    Roberto Oliveira Dantas

    2006-09-01

    Full Text Available BACKGROUND: Chagas' disease and the aging process cause loss of neurons of the esophageal myenteric plexus. AIM: To evaluate the esophageal motility impairment caused by Chagas' disease in two age groups. Our hypothesis was that the aging process may cause further esophageal motility impairment in patients with Chagas' disease. METHODS: We studied the esophageal motility of 30 patients with Chagas' disease and dysphagia, with esophageal retention of barium sulfate and an esophageal diameter within the normal range. Fifteen were 34 to 59 years old (younger group, median 51 years and 15 were 61 to 77 years old (older group, median 66 years. As a control group we studied 15 subjects aged 33 to 58 years (median 42 years and 7 subjects aged 61 to 73 years (median 66 years. The esophageal contractions were measured by the manometric method with continuous perfusion after five swallows of a 5 mL bolus of water at 2, 7, 12 and 17 cm below the upper esophageal sphincter. RESULTS: Patients with Chagas' disease had lower amplitude of contractions and fewer peristaltic, more simultaneous, and more non-conducted contractions than controls. Older patients with Chagas' disease had lower amplitude of contractions in the distal esophagus (mean ± SE: 30.8 ± 4.3 mm Hg than younger patients (51.9 ± 8.6 mm Hg. From 12 to 17 cm, older patients had more non-conducted (41% and fewer peristaltic (8% contractions than younger patients (non-conducted: 16%, peristaltic: 21%. CONCLUSION: Older patients with Chagas' disease with clinical and radiological examinations similar to those of younger patients had motility alterations suggesting that the aging process may cause further deterioration of esophageal motility.RACIONAL: Doença de Chagas e o processo do envelhecimento causam perda de neurônios do plexo mientérico do esôfago. OBJETIVO: Avaliar em duas faixas etárias as possíveis alterações da motilidade do esôfago em pacientes com doença de Chagas. A hip

  10. Cognitive-behavioral Intervention to Reduce Stress in Patients with Ischemic Heart Disease

    OpenAIRE

    Leonor Canales Reyes

    2011-01-01

    The aim of this paper was to evaluate the effectiveness of a cognitive-behavioral treatment to reduce the perceived stress level in patients with isquemic cardiopathy. This was a study with intervention without control group. Nine people with isquemic cardiophaty participated, their age were between 40 and 60 years old; all of them were patients of a public hospital in north of Mexico. Stress inoculation training was used in eight sessions’ intervention; each session was about two hours. To m...

  11. Rastreamento de cardiopatias congênitas associadas ao diabetes mellitus por meio da concentração plasmática materna de frutosamina Congenital cardiopathies screening associated with diabetes mellitus using maternal fructosamine plasma concentration

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    Zilma Silveira Nogueira Reis

    2010-02-01

    Full Text Available OBJETIVO: avaliar a importância da concentração plasmática materna de frutosamina como indicador de cardiopatias congênitas fetais, em gestações complicadas pelo diabetes mellitus. MÉTODOS: o estudo retrospectivo incluiu 91 gestantes portadoras de diabetes mellitus, as quais foram submetidas à ecocardiografia fetal de rotina em centro universitário de referência em Medicina Fetal. Foram selecionadas 65 pacientes que apresentavam diabete pré-gestacional e registro em prontuário médico de frutosamina plasmática anterior ao exame ultrassonográfico. A primeira dosagem registrada foi confrontada com o resultado da ecocardiografia fetal de rotina, realizada por médico especialista do serviço. A presença ou ausência de achados ecográficos de cardiopatia congênita (AECC foi relacionada aos níveis plasmáticos de frutosamina, por meio de teste de médias, e sua acuidade para AECC verificada por curva ROC. Foram discutidos como pontos de corte os valores da concentração plasmática materna de frutosamina de 2,68, 2,9 e 2,23 mmol/L, que são, respectivamente, o valor de referência local do laboratório, o do kit de dosagem empregado e o de maior acurácia global. RESULTADOS: o AECC foi encontrado em 52,3% dos fetos. A primeira dosagem de frutosamina durante o pré-natal aconteceu em média com 20,4±8,0 semanas de gestação. A capacidade da concentração materna de frutosamina em identificar fetos com AECC foi significante (pPURPOSE: to evaluate the importance of maternal plasma concentration of fructosamine as an indicator of fetal congenital cardiopathies in pregnancies complicated by diabetes mellitus. METHODS: this was a retrospective study conducted on 91 pregnant women with diabetes mellitus who underwent routine fetal echocardiography at a university reference center in fetal medicine. Sixty-five patientes who presented pre-gestational diabetes mellitus and plasma fructosamine level were registered in the medical records

  12. Avaliação da qualidade de vida de pacientes com doença de Chagas submetidos a transplante de coração

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    Myrian Sabbaga Amato

    1997-04-01

    Full Text Available Analisamos a qualidade de vida de 11 pacientes com doença de Chagas, 26 a 126 meses após terem sido submetidos a transplante de coração. Essa condição, influenciável por diversos fatores e que não corresponde só ao prolongamento da existência, revelou sensível aprimoramento, passando os entrevistados a contar com objetivos e a poder concretizar realizações, antes inacessíveis.Quality of life was evaluated in 11 patients with Chagas' disease 26 to 126 months after submission to heart transplantation. There was an objetive improvement in their quality of life, after the transplant.

  13. Pneumonia lipoídica associada à forma digestiva da doença de Chagas Digestive Chagas disease with concomitant lipoid pneumonia

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    Marcelo Fernando Ranzani

    2004-10-01

    Full Text Available Mulher de 50 anos com megaesôfago e megacólon chagásico apresentou quadro clínico de tosse seca, dor torácica e dispnéia leves. O raio X de tórax mostrou opacidade do tipo alveolar bilateral sugestivo de pneumonia. Após biópsia a céu aberto chegou-se ao diagnóstico de pneumonia lipoídica. A doença foi causada pelo uso crônico de laxantes à base de óleo mineral, utilizados nos últimos três anos. Os autores discutem a associação da forma digestiva da doença de Chagas com pneumonia lipoídica, e apresentam recomendações sobre o uso de produtos que contenham óleo mineral.A 50-year-old woman with chagasic esophageal achalasia and megacolon presented with nonproductive cough, chest pain and dyspnea. A chest X-ray showed bilateral opacity suggestive of lobar pneumonia. Open lung biopsy revealed lipoid pneumonia resulting from aspiration of mineral oil from a mineral oil-based laxative that the patient had been taking regularly for the last three years. The authors discuss concomitance of chagasic megacolon and esophageal achalasia with lipoid pneumonia and make recommendations regarding the use of mineral oil-based products by these patients.

  14. 超声心动图诊断甲减性机能减退性心脏病的价值研究%Study on the Value of Echocardiography in Diagnosis of Hypothyroid Cardiopathy

    Institute of Scientific and Technical Information of China (English)

    熊颖

    2012-01-01

    目的 总结和探讨超声心动图在诊断甲减性机能减退性心脏病中的临床价值.方法 对确诊为甲减性机能减退性心脏病的46例患者与32例正常人行超声心动图检查,并进行对照分析.结果 48例甲减性机能减退性心脏病除一般临床表现外,二维超声心动图均表现为心肌壁增厚,心肌内不规则点状回声,室壁运动普遍减低,合并心包积液30例(占62.5%).M超表现为室壁增厚率(ΔT%),左室短轴缩短率(ΔD%)和射血分数(EF)降低,与对照组相比有显著差异性(P <0.05).多普勒超声心动图上表现为各瓣口血流加速度降低,峰值流速降低,心动周期时相上射血时间(ET)无明显改变,射血前期时间(PEP)延长,PEP/ET比值明显增加,与对照组相比有显著差异性(P <0.01),提示收缩与舒张功能不良.结论 甲减性机能减退性心脏病起病隐匿,临床表现复杂,超声心动图对其的诊断与鉴别诊断有重要意义.%Objective To summarize and study the clinical significance of echocardiography in diagnosing hypothyroid cardiopathy. Methods 48 patients with hypothyroidism and 40 healthy people were evaluated by standard echocardiography. Results Including general clinical manifestations, 48 patients with hypothyroidism heart disease showed myocardial wall thickening, irregular point-like echoes in the myocardium, generally reduction of wall motion and pericardial effusion(30 cases, 62.5%)evaluated by two dimensional ultrasonic. Compared to healthy people, patients with hypothyroidism heart disease had lower wall thickness ratio(AT%)(P<0.05), left ventricular minor axis decurtaion rate(AD%)(P<0.05)and ejection fraction(EF)(P<0.05%). The blood flow acceleration and peak velocity of transvalvular flow decreased, and the ejection time had no significant change during cardiac cycle. Pre-ejection phase prolonged, and PEP/ET ratio had a significant increase , evaluated by M-mode ultrasound, there is significant difference

  15. Baroreflex Sensitivity and its Association with Arrhythmic Events in Chagas Disease

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    Astrid Meireles Santos

    2014-07-01

    Full Text Available Background: Sudden death is the leading cause of death in Chagas disease (CD, even in patients with preserved ejection fraction (EF, suggesting that destabilizing factors of the arrhythmogenic substrate (autonomic modulation contribute to its occurrence. Objective: To determine baroreflex sensitivity (BRS in patients with undetermined CD (GI, arrhythmogenic CD with nonsustained ventricular tachycardia (NSVT (GII and CD with spontaneous sustained ventricular tachycardia (STV (GIII, to evaluate its association with the occurrence and complexity of arrhythmias. Method: Forty-two patients with CD underwent ECG and continuous and noninvasive BP monitoring (TASK force monitor. The following were determined: BRS (phenylephrine method; heart rate variability (HRV on 24-h Holter; and EF (echocardiogram. Results: GIII had lower BRS (6.09 ms/mm Hg as compared to GII (11.84 and GI (15.23. The difference was significant between GI and GIII (p = 0.01. Correlating BRS with the density of ventricular extrasystoles (VE, low VE density ( 10/h had preserved BRS (p = 0.003. Patients with depressed BRS had higher VE density (p = 0.01, regardless of the EF. The BRS was the only variable related to the occurrence of SVT (p = 0.028. Conclusion: The BRS is preserved in undetermined CD. The BRS impairment increases as disease progresses, being more severe in patients with more complex ventricular arrhythmias. The degree of autonomic dysfunction did not correlate with EF, but with the density and complexity of ventricular arrhythmias.

  16. Genetically Determined MBL Deficiency Is Associated with Protection against Chronic Cardiomyopathy in Chagas Disease.

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    Paola Rosa Luz

    2016-01-01

    Full Text Available Chagas disease (CD is caused by Trypanosoma cruzi, whose sugar moieties are recognized by mannan binding lectin (MBL, a soluble pattern-recognition molecule that activates the lectin pathway of complement. MBL levels and protein activity are affected by polymorphisms in the MBL2 gene. We sequenced the MBL2 promoter and exon 1 in 196 chronic CD patients and 202 controls. The MBL2*C allele, which causes MBL deficiency, was associated with protection against CD (P = 0.007, OR = 0.32. Compared with controls, genotypes with this allele were completely absent in patients with the cardiac form of the disease (P = 0.003. Furthermore, cardiac patients with genotypes causing MBL deficiency presented less heart damage (P = 0.003, OR = 0.23, compared with cardiac patients having the XA haplotype causing low MBL levels, but fully capable of activating complement (P = 0.005, OR = 7.07. Among the patients, those with alleles causing MBL deficiency presented lower levels of cytokines and chemokines possibly implicated in symptom development (IL9, p = 0.013; PDGFB, p = 0.036 and RANTES, p = 0.031. These findings suggest a protective effect of genetically determined MBL deficiency against the development and progression of chronic CD cardiomyopathy.

  17. Enfermedad de Chagas-Mazza congenita en Salta

    OpenAIRE

    Contreras Silvia; Fernandez María Rosa; Agüero Fernando; Desse Desse Javier; Orduna Tomás; Martino Olindo

    1999-01-01

    Se estudió la infección por T. cruzi en mujeres embarazadas en la localidad de General Güemes, provincia de Salta. La misma fue del 12,3 %. El 8,8% de los recién nacidos estudiados tuvieron diagnóstico de Enfermedad de Chagas utilizando la técnica directa (microhematocrito). Todos fueron tratados con benznidazol a razón de 5mg/kg/día durante 30 dias. Todos presentaron anemia, que fue interpretada como reacción adversa medicamentosa. Se estima que la técnica directa representa la mejor opción ...

  18. Risks of endemicity, morbidity and perspectives regarding the control of Chagas disease in the Amazon Region

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    José Rodrigues Coura

    2012-03-01

    Full Text Available Chagas disease, in the Amazon Region as elsewhere, can be considered an enzootic disease of wild animals or an anthropozoonosis, an accidental disease of humans that is acquired when humans penetrate a wild ecosystem or when wild triatomines invade human dwellings attracted by light or searching for human blood. The risk of endemic Chagas disease in the Amazon Region is associated with the following phenomena: (i extensive deforestation associated with the displacement of wild mammals, which are the normal sources of blood for triatomines, (ii adaptation of wild triatomines to human dwellings due to the need for a new source of blood for feeding and (iii uncontrolled migration of human populations and domestic animals that are already infected with Trypanosoma cruzi from areas endemic for Chagas disease to the Amazon Region. Several outbreaks of severe acute cases of Chagas disease, as well as chronic cases, have been described in the Amazon Region. Control measures targeted to avoiding endemic Chagas disease in the Amazon Region should be the following: improving health education in communities, training public health officials and communities for vector and Chagas disease surveillance and training local physicians to recognise and treat acute and chronic cases of Chagas diseases as soon as possible.

  19. Urban transmission of Chagas disease in Cochabamba, Bolivia

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    N Medrano-Mercado

    2008-08-01

    Full Text Available Chagas disease is a major public health problem in Bolivia. In the city of Cochabamba, 58% of the population lives in peripheral urban districts ("popular zones" where the infection prevalence is extremely high. From 1995 to 1999, we studied the demographics of Chagas infections in children from five to 13 years old (n = 2218 from the South zone (SZ and North zone (NZ districts, which differ in social, environmental, and agricultural conditions. Information gathered from these districts demonstrates qualitative and quantitative evidence for the active transmission of Trypanosoma cruzi in urban Cochabamba. Seropositivity was high in both zones (25% in SZ and 19% in NZ. We observed a high risk of infection in children from five to nine years old in SZ, but in NZ, a higher risk occurred in children aged 10-13, with odds ratio for infection three times higher in NZ than in SZ. This difference was not due to triatomine density, since more than 1,000 Triatoma infestans were captured in both zones, but was possibly secondary to the vector infection rate (79% in SZ and 37% in NZ. Electrocardiogram abnormalities were found to be prevalent in children and pre-adolescents (SZ = 40%, NZ = 17%, indicating that under continuous exposure to infection and re-infection, a severe form of the disease may develop early in life. This work demonstrates that T. cruzi infection should also be considered an urban health problem and is not restricted to the rural areas and small villages of Bolivia.

  20. Research priorities for Chagas disease, human African trypanosomiasis and leishmaniasis.

    Science.gov (United States)

    2012-01-01

    This report provides a review and analysis of the research landscape for three diseases - Chagas disease, human African trypanosomiasis and leishmaniasis - that disproportionately afflict poor and remote populations with limited access to health services. It represents the work of the disease reference group on Chagas Disease, Human African Trypanosomiasis and Leishmaniasis (DRG3) which was established to identify key research priorities through review of research evidence and input from stakeholders' consultations. The diseases, which are caused by related protozoan parasites, are described in terms of their epidemiology and diseases burden, clinical forms and pathogenesis, HIV coinfection, diagnosis, drugs and drug resistance, vaccines, vector control, and health-care interventions. Priority areas for research are identified based on criteria such as public health relevance, benefit and impact on poor populations and equity, and feasibility. The priorities are found in the areas of diagnostics, drugs, vector control, asymptomatic infection, economic analysis of treatment and vector control methods, and in some specific issues such as surveillance methods or transmission-blocking vaccines for particular diseases. This report will be useful to researchers, policy and decision-makers, funding bodies, implementation organizations, and civil society. This is one of ten disease and thematic reference group reports that have come out of the TDR Think Tank, all of which have contributed to the development of the Global Report for Research on Infectious Diseases of Poverty, available at: www.who.int/tdr/stewardship/global_report/en/index.html. PMID:23484340

  1. Chagas y SIDA, la importancia del diagnóstico precoz

    OpenAIRE

    Sergio R. Auger; Rubén Storino; Miguel De Rosa; Oscar Caravello; González, María I.; Edgardo Botaro; Liliana Bonelli; Oscar Rossini

    2005-01-01

    Objetivos: Evaluar las vías de contagio, la reactivación y la evolución de la enfermedad de Chagas en pacientes con HIV. Material y métodos Se incorporaron pacientes internados con SIDA y Chagas reactivo. Se evaluaron la epidemiología, la adicción a drogas, la reactivación de la enfermedad de Chagas y el órgano blanco más afectado, la demora del inicio de tratamiento antiparasitario y la evolución posterior. Se realizaron serologías, estudios parasitológicos en sangre y líquido cefalorraq...

  2. A therapeutic nanoparticle vaccine against Trypanosoma cruzi in a BALB/c mouse model of Chagas disease.

    Science.gov (United States)

    Barry, Meagan A; Wang, Qian; Jones, Kathryn M; Heffernan, Michael J; Buhaya, Munir H; Beaumier, Coreen M; Keegan, Brian P; Zhan, Bin; Dumonteil, Eric; Bottazzi, Maria Elena; Hotez, Peter J

    2016-04-01

    Chagas disease, caused by Trypanosoma cruzi, results in an acute febrile illness that progresses to chronic chagasic cardiomyopathy in 30% of patients. Current treatments have significant side effects and poor efficacy during the chronic phase; therefore, there is an urgent need for new treatment modalities. A robust TH1-mediated immune response correlates with favorable clinical outcomes. A therapeutic vaccine administered to infected individuals could bolster the immune response, thereby slowing or stopping the progression of chagasic cardiomyopathy. Prior work in mice has identified an efficacious T. cruzi DNA vaccine encoding Tc24. To elicit a similar protective cell-mediated immune response to a Tc24 recombinant protein, we utilized a poly(lactic-co-glycolic acid) nanoparticle delivery system in conjunction with CpG motif-containing oligodeoxynucleotides as an immunomodulatory adjuvant. In a BALB/c mouse model, the vaccine produced a TH1-biased immune response, as demonstrated by a significant increase in antigen-specific IFNγ-producing splenocytes, IgG2a titers, and proliferative capacity of CD8(+) T cells. When tested for therapeutic efficacy, significantly reduced systemic parasitemia was seen during peak parasitemia. Additionally, there was a significant reduction in cardiac parasite burden and inflammatory cell infiltrate. This is the first study demonstrating immunogenicity and efficacy of a therapeutic Chagas vaccine using a nanoparticle delivery system. PMID:26890466

  3. The indeterminate form of human chronic Chagas' disease: a clinical epidemological review

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    João Carlos Pinto Dias

    1989-09-01

    Full Text Available Data on the epidemiology and the natural history of the indeterminate form of human chronic Chagas' disease (IFCCD are discussed, revealing its great importance in endemic areas of Brazil. The work shows that IFCCD presents a gradual and very slow course, causing a benign picture in the studied patients. Evolution patterns, prognostic and anatomopathological features are also discussed. For practical purposes, the classical concept of IFCCD proved to be simple, operational and consistent, It is defined by the absence of symptoms and clinical findings in chronic infected patients with positive serology and/or parasitological examinations for Trypanosoma cruzi coupled with normal electrocardiographic and radiological exams (heart, oesophagus and colon X-Rays. If a patient is submitted to more rigorous and sophisticated tests, these can reveal some alterations, generally small ones and unable to interfere with the prognosis of the infection. It is suggested that research lines specially related to the evolution ary factors and immunological involvement during this phase be adopted.

  4. The potential influence of atherogenic dyslipidemia on the severity of chronic Chagas heart disease

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    Luz Peverengo

    2016-02-01

    Full Text Available SUMMARY Introduction: chronic Chagas heart disease (CCHD is the most common manifestation of American Trypanosomiasis, causing about 50,000 deaths annually. Several factors bear correlation with the severity of CCHD. However, to our knowledge, the assessment on the contribution of major cardiovascular risk factors (CRF, such as hypertension and atherogenic dyslipidemia (AD to CCHD severity is scarce, despite their well-established role in coronary artery disease, heart failure and stroke. Objective: to explore the potential relationship of blood pressure and AD with the clinical profile of patients with CCHD. Methods: we performed a cross-sectional study in T. cruziseropositive patients categorized according to a standard CCHD classification. All individuals were subjected to complete clinical examination. Autoantibodies induced by T. cruzi were assessed by ELISA. Results: we observed that Atherogenic index (AI levels rose significantly in relation to the severity of the CCHD stage, with CCHD III cases showing the highest values of AI. Furthermore, those patients with globally dilated cardiomyopathy with reduced ejection fraction showed higher levels of AI. In regard to autoantibodies, anti-B13 also showed relation with the severity of the disease. Conclusion: we observed that AI correlated with CCHD stages and contributed, in association with anti-B13 antibodies and age, to the prediction of systolic heart failure.

  5. Total Artificial Heart as Bridge to Heart Transplantation in Chagas Cardiomyopathy: Case Report.

    Science.gov (United States)

    Ruzza, A; Czer, L S C; De Robertis, M; Luthringer, D; Moriguchi, J; Kobashigawa, J; Trento, A; Arabia, F

    2016-01-01

    Chagas disease (CD) is becoming an increasingly recognized cause of dilated cardiomyopathy outside of Latin America, where it is endemic, due to population shifts and migration. Heart transplantation (HTx) is a therapeutic option for end-stage cardiomyopathy due to CD, but may be considered a relative contraindication due to potential reactivation of the causative organism with immunosuppression therapy. The total artificial heart (TAH) can provide mechanical circulatory support in decompensated patients with severe biventricular dysfunction until the time of HTx, while avoiding immunosuppressive therapy and removing the organ most affected by the causative organism. We report herein a patient with CD and severe biventricular dysfunction, who had mechanical circulatory support with a TAH for more than 6 months, followed by successful orthotopic HTx and treatment with benznidazole for 3 months. The patient had no evidence of recurrent disease in the transplanted heart based on endomyocardial biopsy up to 1 year post-transplantation, and remains alive more than 30 months after insertion of a TAH and 24 months after HTx. PMID:26915885

  6. Avaliação clínica da deglutição na doença de Chagas Clinical evaluation of swallowing in Chagas disease

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    Carla Manfredi dos Santos

    2011-06-01

    Full Text Available OBJETIVO: Avaliar clinicamente a deglutição orofaríngea de pacientes portadores da doença de Chagas com disfagia e comparar os achados da anamnese entre os doentes chagásicos de acordo com o grau do megaesôfago. MÉTODOS: Utilizando protocolo de avaliação, estudamos a deglutição de 21 pacientes com doença de Chagas e comprometimento do esôfago diagnosticado por sorologia e exame radiológico do esôfago, e de 18 sujeitos sadios assintomáticos pareados por idade e gênero. Nos dois grupos foi realizada anamnese contendo questões relacionadas à queixa de disfagia. Após este procedimento, foi realizada avaliação clínica da deglutição, sem introdução de dieta via oral e com dieta via oral nas consistências líquida e pastosa, abrangendo aspectos estruturais e funcionais. Os resultados foram analisados estatisticamente. Este é um estudo experimental e transversal. RESULTADOS: Maior proporção de pacientes chagásicos apresentou deglutições múltiplas e elevação laríngea reduzida na deglutição das consistências líquida e pastosa, em relação aos sujeitos sadios. Os pacientes com aumento do diâmetro do esôfago referiram mais frequentemente queixa de perda de peso quando comparados aos pacientes sem aumento do diâmetro do esôfago. CONCLUSÃO: Os pacientes chagásicos podem apresentar alterações na deglutição orofaringeana e pacientes com maior comprometimento do esôfago apresentam maior perda de peso do que os pacientes com menor comprometimento.PURPOSE: To clinically evaluate oropharyngeal swallowing in dysphagic patients with Chagas disease, and to compare anamnesis data among chagasic subjects according to the degree of megaesophagus. METHODS: An evaluation protocol was used to assess the swallowing of 21 patients with Chagas disease and involvement of the esophagus, diagnosed through serology and radiologic evaluation of the esophagus, and 18 asymptomatic healthy subjects paired by age and gender. Both

  7. Resultados perinatológicos del servicio de Cardiopatía y Embarazo del Hospital Ginecobstétrico "Ramón González Coro" en el bienio 2000-2001, Habana Perinatologic results of Cardiopathy and Pregnancy's Service in 2000-2001, in "Ramón González Coro" Hospital, Havana

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    Roberto Viñas Oliva

    2003-03-01

    Full Text Available OBJETIVOS: establecer las bases para el tratamiento y atención de la mujer portadora de cardiopatía en edad fértil, caracterizando al grupo de gestantes atendidas en servicio. MÉTODOS: realizó un estudio descriptivo y las mujeres fueran clasificadas según cardiopatía y grado de afectación funcional en relación con los resultados, se decribiendo las complicaciones durante el embarazo, parto y puerperio y los resultados perinatales. Variables analizadas: tipo de cardiopatía y clasificación funcional de las mismas, complicaciones obstétricas y/o cardiovasculares, edad gestacional al parto, modo de nacimiento, peso y puntaje de Apgar en el recién nacido y mortalidad materna y del recién nacido. RESULTADOS: encontramos 129 valvulopatías adquiridas, 79 congénitas, 18 casos de trastornos del ritmo. Lesiones más frecuentes valvulopatías mitrales (92 y comunicaciones interauriculares (31. 21 pacientes presentaron empeoramiento funcional durante el embarazo. Aparecieron complicaciones cardiovasculares en 19 pacientes y obstétricas en 142. 14 requirieron ingreso en Servicios de Terapia Intensiva y tres fallecieron. CONCLUSIONES: Se confirmó la asociación entre clasificación funcional y complicaciones cardiovasculares durante el embarazo, parto y puerperio. Las complicaciones obstétricas se comportan igual que en las gestaciones de pacientes sanas y más de la mitad de los partos fueron eutócicos.OBJECTIVES: to establish the basis for treatment and care of cardiopath women in fertile age, following the criteria of evidence based Medicine, through the clinical and perinatal assessment of a group of pregnant women admitted in our service. METHODS: the women were classified according to their cardiopathy and degree of functional impairment related to the complications described during pregnancy, delivery and puerperal stage and perinatal results. The variables analysed were : type of cardiopathy and functional classification of the

  8. Inhibition of Autoimmune Chagas-Like Heart Disease by Bone Marrow Transplantation

    Czech Academy of Sciences Publication Activity Database

    Guimaro, M.C.; Alves, R. J. V.; Rose, E.; Sousa, A.O.; Rosa, A.D.; Hecht, M.M.; Sousa, M.V.; Andrade, R.R.; Vital, T.; Plachý, Jiří; Nitz, N.; Hejnar, Jiří; Gomes, C.C.; Teixeira, A.R.L.

    2014-01-01

    Roč. 8, č. 12 (2014). ISSN 1935-2735 Institutional support: RVO:68378050 Keywords : Chagas disease * inbred chicken * adoptive transfer of immunity Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 4.446, year: 2014

  9. IL18 Gene Variants Influence the Susceptibility to Chagas Disease

    Science.gov (United States)

    Leon Rodriguez, Daniel A; Carmona, F. David; Echeverría, Luis Eduardo; González, Clara Isabel; Martin, Javier

    2016-01-01

    Chagas disease is a parasitic disorder caused by the infection with the flagellated protozoan Trypanosoma cruzi. According to the World Health Organization, more than six million people are currently infected in endemic regions. Genetic factors have been proposed to influence predisposition to infection and development of severe clinical phenotypes like chronic Chagas cardiomyopathy (CCC). Interleukin 18 (IL18) encodes a proinflammatory cytokine that has been proposed to be involved in controlling T. cruzi infection. In this study, we analyzed the possible role of six IL18 gene variants (rs5744258, rs360722, rs2043055, rs187238, rs1946518 and rs360719), which cover most of the variation within the locus, in the susceptibility to infection by T. cruzi and/or CCC. In total, 1,171 individuals from a Colombian region endemic for Chagas disease, classified as seronegative (n = 595), seropositive asymptomatic (n = 175) and CCC (n = 401), were genotyped using TaqMan probes. Significant associations with T. cruzi infection were observed when comparing seronegative and seropositive individuals for rs187238 (P = 2.18E-03, OR = 0.77), rs360719 (P = 1.49E-03, OR = 0.76), rs2043055 (P = 2.52E-03, OR = 1.29), and rs1946518 (P = 0.0162, OR = 1.22). However, dependence analyses suggested that the association was mainly driven by the polymorphism rs360719. This variant is located within the promoter region of the IL18 gene, and it has been described that it creates a binding site for the transcription factor OCT-1 affecting IL-18 expression levels. In addition, no evidence of association was observed between any of the analyzed IL18 gene polymorphisms and the development of CCC. In summary, our data suggest that genetic variation within the promoter region of IL18 is directly involved in the susceptibility to infection by T. cruzi, which provides novel insight into disease pathophysiology and adds new perspectives to achieve a more effective disease control. PMID:27027876

  10. The potential for emergence of Chagas disease in the United States

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    Rebecca Click Lambert

    2008-05-01

    Full Text Available To determine the risk for Chagas disease (American trypanosomiasis in the United States, the characteristics that make the triatomine vector effective and the areas most at risk for transmission were delineated. In addition, the status of Chagas disease awareness among physicians in areas with a potential risk for the disease was determined. A geographical information system (GIS was used to analyze three triatomine species within the United States known to harbor Trypanosoma cruzi and that exhibit qualities of domesticity. An analysis of the minimum temperature threshold for increased triatomine activity delineates the current population at increased risk, and by incorporating temperature predictions for 2030, the population at risk under a future climate scenario was also delineated. Considering both environmental and social factors, a vignette-based physician survey, based on the results of the GIS analysis, was used to gauge the level of awareness of Chagas disease within the delineated higher risk range. The current area at increased risk for Chagas disease includes much of the southern United States, and the higher risk range is expected to expand into the central United States based upon the 1°C (1.8°F increase in temperature predicted by the Intergovernmental Panel on Climate Change (IPCC by the year 2030. Survey results indicate a limited consideration of Chagas disease during differential diagnosis, illustrating that the low number of Chagas disease cases discovered in the United States may be attributable to a lack of disease awareness as opposed to a lack of disease threat. This study combines GIS and survey analyses to evaluate the role that temperature variability and disease awareness among physicians play in the potential emergence of Chagas disease in the United States. This approach indicates that there is a potential for Chagas disease to emerge in the United States.

  11. Ecological aspects of the vectorial control of Chagas' disease in Brazil

    OpenAIRE

    João Carlos P. Dias

    1994-01-01

    The feasibility and most important ecological aspects of vectorial Chagas' disease control are discussed. The spread and maintenance of this disease involve multiple ecological and sociopolitical factors that must be taken into account when control programs are planned, executed and evaluated. In spite of its complexity, Chagas disease can be controlled using methods that target specific mechanisms of transmission, the most important being vectorial and transfusional. Major ecological problem...

  12. Mapping of Chagas disease research: analysis of publications in the period between 1940 and 2009

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    José Manuel Ramos

    2011-12-01

    Full Text Available INTRODUCTION: Publications are often used as a measure of success in research work. Chagas disease occurs in Central and Southern America. However, during the past years, the disease has been occurring outside Latin America due to migration from endemic zones. This article describes a bibliometric review of the literature on Chagas disease research indexed in PubMed during a 70-year period. METHODS: Medline was used via the PubMed online service of the U.S. National Library of Medicine from 1940 to 2009. The search strategy was: Chagas disease [MeSH] OR Trypanosoma cruzi [MeSH]. RESULTS: A total of 13,989 references were retrieved. The number of publications increased steadily over time from 1,361 (1940-1969 to 5,430 (2000-2009 (coefficient of determination for linear fit, R²=0.910. Eight journals contained 25% of the Chagas disease literature. Of the publications, 64.2% came from endemic countries. Brazil was the predominant country (37%, followed by the United States (17.6% and Argentina (14%. The ranking in production changed when the number of publications was normalized by estimated cases of Chagas disease (Panama and Uruguay, population (Argentina and Uruguay, and gross domestic product (Bolivia and Brazil. CONCLUSIONS: Several Latin American countries, where the prevalence of T. cruzi infection was not very high, were the main producers of the Chagas disease literature, after adjusting for economic and population indexes. The countries with more estimated cases of Chagas disease produced less research on Chagas disease than some developed countries.

  13. Estudo de fatores pró-trombóticos e pró-inflamatórios na cardiomiopatia chagásica Study of pro-thrombotic and pro-inflammatory factors in chagas cardiomyopathy

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    Leila Maria Magalhães Pessoa de Melo

    2010-10-01

    Full Text Available FUNDAMENTO: A relação entre atividade inflamatória e pró-trombótica na cardiomiopatia chagásica e em outras etiologias é obscura. OBJETIVO: Estudar o perfil de marcadores pró-trombóticos e pró-inflamatórios em pacientes com insuficiência cardíaca chagásica e compará-los com os de etiologia não chagásica. MÉTODOS: Coorte transversal. Critérios de inclusão: fração de ejeção do VE (FEVE um mês. Os pacientes foram divididos em dois grupos: grupo 1 (G1 - sorologias positivas para Chagas - e grupo 2 (G2 - sorologias negativas para Chagas. Fator pró-inflamatório: PCR ultrassensível. Fatores pró-trombóticos: fator trombina-antitrombina, fibrinogênio, antígeno do fator de von Willebrand, P-selectina plasmática e tromboelastograma. Amostra calculada para poder de 80%, assumindo-se diferença de 1/3 de desvio-padrão; p significativo se BACKGROUND: The relationship between inflammatory and prothrombotic activity in chagas cardiomyopathy and in other etiologies is unclear. OBJECTIVE: To study the profile of pro-thrombotic and pro-inflammatory markers in patients with Chagas' heart failure and compare them with patients of non-chagas etiology. METHODS: Cross-sectional cohort. Inclusion criteria: left ventricle ejection fraction (LVEF one month. The patients were divided into two groups: group 1 (G1 - seropositive for Chagas - and group 2 (G2 - seronegative for Chagas. Pro-inflammatory factor: Ultra-sensitive CRP. Pro-thrombotic factors: thrombin-antithrombin factor, fibrinogen, von Willebrand factor antigen, plasma P-selectin and thromboelastography. Sample calculated for 80% power, assuming a standard deviation difference of 1/3; significant p if it is < 0.05. Statistical analysis: Fisher's exact test for categorical variables; unpaired Student's t-test for parametric continuous variables and Mann-Whitney test for nonparametric continuous variables. RESULTS: Between January and June 2008, 150 patients were included, 80 in G1

  14. Severe digestive pathology associated with chronic Chaga's disease in Ecuador: report of two cases

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    Angel G. Guevara

    1997-10-01

    Full Text Available DNA extracted from peripheral blood of two Ecuadorian patients showing severe digestive pathology was amplified by the polymerase chain reaction using a Trypanosoma cruzi specific oligonucleotide primers derived from the primary sequence of a cDNA encoding for a 24 kDa excretory/secretory protein. The positive PCR results together with the clinical findings confirmed that both patients had a digestive pathology due to Chagas' disease. This pathology could be more frequent than previously described in the chagasic endemic regions of Andean countries.DNA obtido do sangue periférico de dois pacientes equatorianos, que apresentavam severa patologia digestiva, foi amplificado pela "polymerase chain reaction" (PCR utilizando os oligonucleotídoes específicos do Trypanosoma cruzi, derivados de uma seqüência primária de cDNA codificado de 24 kDa proteína excretória/secretória. Os resultados positivos da PCR junto com os achados clínicos confirmam que os dois pacientes tinham uma patologia digestiva de origem chagásica. Esta patologia poderia ser mais freqüente que a descrita previamente nas regiões endêmicas chagásicas das cidades dos Andes.

  15. Chagas disease: What is known and what should be improved: a systemic review

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    José Rodrigues Coura

    2012-06-01

    Full Text Available This study consists of a broad review on what is known and what should be improved regarding knowledge of Chagas disease, not only through analysis on the main studies published on the topics discussed, but to a large extent based on experience of this subject, acquired over the past 50 years (1961-2011. Among the subjects covered, we highlight the pathogenesis and evolution of infection by Trypanosoma cruzi, drugs in use and new strategies for treating Chagas disease; the serological tests for the diagnosis and the controls of cure the infection; the regional variations in prevalence, morbidity and response to treatment of the disease; the importance of metacyclogenesis of T. cruzi in different species of triatomines and its capacity to transmit Chagas infection; the risks of adaptation of wild triatomines to human dwellings; the morbidity and need for a surveillance and control program for Chagas disease in the Amazon region and the need to prioritize initiatives for controlling Chagas disease in Latin America and Mexico and in non-endemic countries, which is today a major international dilemma. Finally, we raise the need for to create a new initiative for controlling Chagas disease in the Gran Chaco, which involves parts of Argentina, Bolivia and Paraguay.

  16. Urban Chagas disease in children and women in primary care centres in Buenos Aires, Argentina

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    Guillermo Moscatelli

    2015-08-01

    Full Text Available The primary objective of this study was to estimate the prevalence of this disease in women of childbearing age and children treated at health centres in underserviced areas of the city of Buenos Aires. Demographic and Chagas disease status data were collected. Samples for Chagas disease serology were obtained on filter paper and the reactive results were confirmed with conventional samples. A total of 1,786 subjects were screened and 73 positive screening results were obtained: 17 were from children and 56 were from women. The Trypanosoma cruziinfection risk was greater in those individuals who had relatives with Chagas disease, who remember seeing kissing bugs, who were of Bolivian nationality or were born in the Argentine province of Santiago del Estero. The overall prevalence of Chagas disease was 4.08%. Due to migration, Chagas disease is currently predominantly urban. The observed prevalence requires health programme activities that are aimed at urban children and their mothers. Most children were infected congenitally, which reinforces the need for Chagas disease screening of all pregnant women and their babies in Argentina. The active search for new cases is important because the appropriate treatment in children has a high cure rate.

  17. A cost-benefit analisys of chagas disease control

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    C. J. Schofield

    1991-09-01

    Full Text Available Chagas disease transmission can be effetively interrupted by insecticidal control of its triatomine bug vectors. We present here a simple model comparing the costs and benefits of such a programme, designed to eliminate domestic populations of Triatoma infestans throughout its known area of distribution over the seven southernmost countries of Latin America. The model has been simplified to require only four financial estimates relating to the unit cost of housing spraying and benefits due to avoidance of premature death in the acute phase of the disease, avoidance of supportive treatment and care in the chronic phase of the disease, and avoidance of corrective digestive and cardiac surgery. Exceptfor these direct medical costs, al other potential benefits have been ignored. Nevertheless, the model shows that the direct financial benefits of such a programme would far outweigh the costs, and the project would support a remarkably high internal rate of return under the least optimistic estimates.

  18. Cost-effectiveness analysis in Chagas' disease vectors control interventions

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    A. M. Oliveira Filho

    1989-01-01

    Full Text Available After a large scale field trial performed in central Brazil envisaging the control of Chagas' disease vectors in an endemic area colonized by Triatoma infestans and T. sordida the cost-effectiveness analysis for each insecticide/formulation was performed. It considered the operational costs and the prices of insecticides and formulations, related to the activity and persistence of each one. The end point was considered to be less than 90% of domicilliary unitis (house + annexes free of infestation. The results showed good cost-effectiveness for a slow-release emulsifiable suspension (SRES based on PVA and containing malathion as active ingredient, as well as for the pyrethroids tested in this assay-cyfluthrin, cypermethrin, deltamethrin and permethrin.

  19. Chagas disease and globalization of the Amazon La enfermedad de Chagas y la globalización de la Amazonia

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    Roberto Briceño-León

    2007-01-01

    Full Text Available The increasing number of autochthonous cases of Chagas disease in the Amazon since the 1970s has led to fear that the disease may become a new public health problem in the region. This transformation in the disease's epidemiological pattern in the Amazon can be explained by environmental and social changes in the last 30 years. The current article draws on the sociological theory of perverse effects to explain these changes as the unwanted result of the shift from the "inward" development model prevailing until the 1970s to the "outward" model that we know as globalization, oriented by industrial forces and international trade. The current article highlights the implementation of five new patterns in agriculture, cattle-raising, mining, lumbering, and urban occupation that have generated changes in the environment and the traditional indigenous habitat and have led to migratory flows, deforestation, sedentary living, the presence of domestic animals, and changes in the habitat that facilitate colonization of human dwellings by vectors and the domestic and work-related transmission of the disease. The expansion of Chagas disease is thus a perverse effect of the globalization process in the Amazon.El incremento de casos autóctonos de la enfermedad de Chagas en la Amazonia a partir de los años setenta hace temer que pueda convertirse en un novedoso problema de salud pública en la región. Este cambio del patrón epidemiológico de la enfermedad en la región amazónica debe ser explicado por las transformaciones ambientales y sociales que han ocurrido en los pasados treinta años. Este artículo utiliza la teoría sociológica de los efectos perversos para explicar esos cambios como el resultado indeseado del cambio de modelo de desarrollo "hacia adentro", que había existido hasta los años setenta, por otro "hacia fuera" que está orientado por las fuerzas de la producción y el comercio internacional que conocemos como globalización. El art

  20. Biomarkers of therapeutic responses in chronic Chagas disease: state of the art and future perspectives

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    Maria-Jesus Pinazo

    2015-05-01

    Full Text Available The definition of a biomarker provided by the World Health Organization is any substance, structure, or process that can be measured in the body, or its products and influence, or predict the incidence or outcome of disease. Currently, the lack of prognosis and progression markers for chronic Chagas disease has posed limitations for testing new drugs to treat this neglected disease. Several molecules and techniques to detect biomarkers in Trypanosoma cruzi-infected patients have been proposed to assess whether specific treatment with benznidazole or nifurtimox is effective. Isolated proteins or protein groups from different T. cruzi stages and parasite-derived glycoproteins and synthetic neoglycoconjugates have been demonstrated to be useful for this purpose, as have nucleic acid amplification techniques. The amplification of T. cruzi DNA using the real-time polymerase chain reaction method is the leading test for assessing responses to treatment in a short period of time. Biochemical biomarkers have been tested early after specific treatment. Cytokines and surface markers represent promising molecules for the characterisation of host cellular responses, but need to be further assessed.

  1. Right Ventricular Doppler Echocardiographic Study of Indeterminate Form of Chagas Disease

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    Rogério Gomes Furtado

    2015-03-01

    Full Text Available Background: Patients with indeterminate form of Chagas disease/cardiac normality (ICD/CN exhibited normal electrocardiograms and chest X-rays; however, more sophisticated tests detected some degree of morphological and functional changes in the heart. Objective: To assess the prevalence of systolic and diastolic dysfunction of the right ventricle (RV in patients with ICD/CN. Methods: This was a case–control and prevalence study. Using Doppler two-dimensional echocardiography (2D, 92 patients were assessed and divided into two groups: group I (normal, n = 31 and group II (ICD/CN, n = 61. Results: The prevalence of RV systolic dysfunction in patients in groups I and II was as follows: fractional area change (0.0% versus 0.6%, mobility of the tricuspid annulus (0.0% versus 0.0%, and S-wave tissue Doppler (6.4% versus 26.0%, p = 0.016. The prevalence of global disorders such as the right myocardial performance index using tissue Doppler (16.1% versus 27.8%, p = 0.099 and pulsed Doppler (61.3% versus 68%, p = 0.141 and diastolic disorders such as abnormal relaxation (0.0% versus 6.0%, pseudonormal pattern (0.0% versus 0.0%, and restrictive pattern (0.0% versus 0.0% was not statistically different between groups. Conclusion: The prevalence of RV systolic dysfunction was estimated to be 26% (S wave velocity compared with other variables, suggesting incipient changes in RV systolic function in the ICD/CN group.

  2. Chagas' disease in the Amazon Basin: V. Periurban palms as habitats of Rhodnius robustus and Rhodnius pictipes - triatomine vectors of Chagas' disease

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    M. A. Miles

    1983-12-01

    Full Text Available Trypanosoma cruzi infected Rhodnius robustus and/or Rhodnius pictipes were commonly found, in large numbers, in the Brazilian Amazonian palms Maximiliana regia ("inajá", Acrocomia sclerocarpa ("mucajá" and Orbignya speciosa ("babaçu". The common opossum, Didelphis marsupialis, was the animal most frequently associated with triatomine infested palms. R. pictipes, frequently light-attracted into houses from palm trees, was the probable source of an acute case of Chagas' disease in the vicinity of Belém. It is considered that triatomine infested palms are likely to cause some cases of acute Chagas' disease in the States of Amazonas and Rondônia. Possible control methods are suggested.Rhodnius robustus e/ou Rhodnius pictipes, infectados com Trypanosoma cruzi foram comumente encontrados, em grande numero, nas palmeiras Maximiliana regia (inaja, Acrocomia sclerocarpa (mucaja e Orbignya speciosa (babacu na Amazonia brasileira. O marsupial Didelphis marsupialis foi o animal encontrado mais frequentemente nas palmeiras associadas a alta prevalencia de triatomineos. R. pictipes que e atraido pela luz nas residencias de palmeiras vizinhas, provavelmente e a fonte de um caso agudo de doenca de Chagas nas vizinhancas de Belem. Sugere-se que as palmeiras albergando triatomineos poderiam ser relacionadas com infeccoes humanas de doenca de Chagas nos Estados de Amazonas e Rondonia. Sugere-se, tambem, possiveis metodos de controle.

  3. Comparação entre o reagente Chagas-latex e a imunofluorescência no diagnóstico sorológico da doença de Chagas na zona sul do Rio Grande do Sul

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    Giovanni Baruffa

    1973-10-01

    Full Text Available Os Autores submeteram 142 amostras de soros de casos agudos e crônicos de Doença de Chagas, já examinados com o Reagente Chagas-Latex, ao exame de Imunofluorescência, obtendo correspondência de resultados em 139 (97,9%. O alto índice de fidelidade, provavelmente devido à ausência na zona de doenças que possam proporcionar resultados falsamente positivos, fez do Reagente Chagas-Latex um método simples e fácil para a triagem sorológica nos casos suspeitos em zona endêmica.142 serum samples from acute and ehronic Chagas Disease, diagnosed by Chagas-Latex Reagent, were examined by Imunofluorescence. Results of both Imunofiuorescence and Chagas-Latex were in concordance in 139 (97,9%. The high concordance rate between the two technics, praibably depending from the absence in the region of endemic diseases causing false positive results, leads to the conclusion that Chagas-Latex Reagent is a simple and easy test for sorological trials in endemic Chagas Disease area

  4. Here, There and Everywhere: The Ubiquitous Distribution of the Immunosignaling Molecule Lysophosphatidylcholine and its Role on Chagas Disease

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    Mario Alberto Cardoso Silva-Neto

    2016-02-01

    Full Text Available Chagas disease is a severe illness, which can lead to death if the patients are not promptly treated. The disease is caused by the protozoan parasite Trypanosoma cruzi, which is mostly transmitted by a triatomine insect vector. There are 8-10 million people infected with T. cruzi in the world, but the vector-borne transmission occurs only in the Americas, especially Latin America. About 30 % of chronically infected people develop cardiac diseases and up to 10 % develop digestive, neurological or mixed disorders. Lysophosphatydilcholine (LPC is the major phospholipid component of oxidized low-density lipoproteins associated with atherosclerosis-related tissue damage. Insect-derived LPC is a powerful chemoattractant for inflammatory cells at the site of the insect bite, enhances parasite invasion, and inhibits the production of nitric oxide (NO by T. cruzi-stimulated macrophages. The recognition of the ubiquitous presence of LPC on the vector saliva, its production by the parasite itself and its presence both on patient plasma as well as its role on diverse host x parasite interaction systems lead us to compare its distribution in nature with the title of the famous Beatles song Here, There and Everywhere recorded exactly 50 years ago in 1966. Here, we review the major findings pointing out the role of such molecule as an immunosignaling modulator of Chagas disease transmission. Also, we believe that future investigation of the connection of this ubiquity and the immune role of such molecule may lead in the future to novel methods to control parasite transmission, infection and pathogenesis.

  5. La enfermedad de Chagas en las Américas: una perspectiva de ecosalud Chagas disease in the Americas: an ecohealth perspective

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    Roberto Briceño-León

    2009-01-01

    Full Text Available El proceso de transmisión de la enfermedad de Chagas ha estado históricamente relacionado con los patrones de ocupación territorial de los asentamientos humanos. En las áreas rurales puede ocurrir más fácilmente el encuentro del vector, los agentes patógenos y los seres humanos, por las condiciones de la vivienda y la pobreza existente en estas zonas. Los procesos migratorios permanentes o estacionales han jugado un papel igualmente importante en el transporte de los vectores y en la infección de la población en las zonas urbanas. Las nuevas fronteras agrícolas del Amazonas se han establecido nuevas áreas de transmisión de la enfermedad. La atención dada a los bancos de sangre ha permitido disminuir la transmisión transfusional, pero la inmigración internacional ha cambiado la situación epidemiológica, pues en Estados Unidos y España viven miles de enfermos que habían sido infectados décadas antes y no encuentran adecuada atención. Los avances en el conocimiento y el control de la enfermedad son mostrados en el artículo, señalando las limitaciones existentes en cuanto al mejoramiento de las condiciones ambientales y de vivienda de los pobres.The historical processes involved in Chagas disease transmission relate to the patterns and conditions of human settlements, especially in rural areas, due to proximity to forest areas, where both vectors and Trypanosoma cruzi can occur, combined with precarious housing conditions and underlying poverty. However, seasonal and permanent rural-urban migration has played a major role in re-mobilizing vectors, T. cruzi, and Chagas-infected individuals. A new agricultural frontier in the Amazon has led to a new transmission pattern, especially with palm trees located close to houses. Improved blood bank surveillance has decreased transmission by blood transfusions. International migration also plays a role in Chagas disease epidemiology. The United States and Spain, where specific health

  6. Insights into the clinical and functional significance of cardiac autonomic dysfunction in Chagas disease

    Directory of Open Access Journals (Sweden)

    Luiz Fernando Junqueira Junior

    2012-04-01

    Full Text Available INTRODUCTION: Exclusive or associated lesions in various structures of the autonomic nervous system occur in the chronic forms of Chagas disease. In the indeterminate form, the lesions are absent or mild, whereas in the exclusive or combined heart and digestive disease forms, they are often more pronounced. Depending on their severity these lesions can result mainly in cardiac parasympathetic dysfunction but also in sympathetic dysfunction of variable degrees. Despite the key autonomic effect on cardiovascular functioning, the pathophysiological and clinical significance of the cardiac autonomic dysfunction in Chagas disease remains unknown. METHODS: Review of data on the cardiac autonomic dysfunction in Chagas disease and their potential consequences, and considerations supporting the possible relationship between this disturbance and general or cardiovascular clinical and functional adverse outcomes. RESULTS: We hypothesise that possible consequences that cardiac dysautonomia might variably occasion or predispose in Chagas disease include: transient or sustained arrhythmias, sudden cardiac death, adverse overall and cardiovascular prognosis with enhanced morbidity and mortality, an inability of the cardiovascular system to adjust to functional demands and/or respond to internal or external stimuli by adjusting heart rate and other hemodynamic variables, and immunomodulatory and cognitive disturbances. CONCLUSIONS: Impaired cardiac autonomic modulation in Chagas disease might not be a mere epiphenomenon without significance. Indirect evidences point for a likely important role of this alteration as a primary predisposing or triggering cause or mediator favouring the development of subtle or evident secondary cardiovascular functional disturbances and clinical consequences, and influencing adverse outcomes.

  7. Triatominae Biochemistry Goes to School: Evaluation of a Novel Tool for Teaching Basic Biochemical Concepts of Chagas Disease Vectors

    Science.gov (United States)

    Cunha, Leonardo Rodrigues; de Oliveria Cudischevitch, Cecília; Carneiro, Alan Brito; Macedo, Gustavo Bartholomeu; Lannes, Denise; da Silva-Neto, Mário Alberto Cardoso

    2014-01-01

    We evaluate a new approach to teaching the basic biochemistry mechanisms that regulate the biology of Triatominae, major vectors of "Trypanosoma cruzi," the causative agent of Chagas disease. We have designed and used a comic book, "Carlos Chagas: 100 years after a hero's discovery" containing scientific information…

  8. Chagas Disease Vector Control in Tupiza, Southern Bolivia

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    G Guillen

    1997-01-01

    Full Text Available Heavy domestic and peridomestic infestations of Triatoma infestans were controlled in two villages in southern Bolivia by the application of deltamethrin SC25 (2.5% suspension concentrate at a target dose of 25 mg a.i./m². Actual applied dose was monitored by HPLC analysis of filter papers placed at various heights on the house walls, and was shown to range from 0 to 59.6 about a mean of 28.5 mg a.i./m². Wall bioassays showed high mortality of T. infestans during the first month after the application of deltamethrin. Mortality declined to zero as summer temperatures increased, but reappeared with the onset of the following winter. In contrast, knockdown was apparent throughout the trial, showing no discernible temperature dependence. House infestation rates, measured by manual sampling and use of paper sheets to collect bug faeces, declined from 79% at the beginning of the trial to zero at the 6 month evaluation. All but one of the houses were still free of T. infestans at the final evaluation 12 months after spraying, although a small number of bugs were found at this time in 5 of 355 peridomestic dependencies. Comparative cost studies endorse the recommendation of large-scale application of deltamethrin, or pyrethroid of similar cost-effectiveness, as a means to eliminate domestic T. infestans populations in order to interrupt transmission of Chagas disease

  9. Urbanization, land tenure security and vector-borne Chagas disease

    Science.gov (United States)

    Levy, Michael Z.; Barbu, Corentin M.; Castillo-Neyra, Ricardo; Quispe-Machaca, Victor R.; Ancca-Juarez, Jenny; Escalante-Mejia, Patricia; Borrini-Mayori, Katty; Niemierko, Malwina; Mabud, Tarub S.; Behrman, Jere R.; Naquira-Velarde, Cesar

    2014-01-01

    Modern cities represent one of the fastest growing ecosystems on the planet. Urbanization occurs in stages; each stage characterized by a distinct habitat that may be more or less susceptible to the establishment of disease vector populations and the transmission of vector-borne pathogens. We performed longitudinal entomological and epidemiological surveys in households along a 1900 × 125 m transect of Arequipa, Peru, a major city of nearly one million inhabitants, in which the transmission of Trypanosoma cruzi, the aetiological agent of Chagas disease, by the insect vector Triatoma infestans, is an ongoing problem. The transect spans a cline of urban development from established communities to land invasions. We find that the vector is tracking the development of the city, and the parasite, in turn, is tracking the dispersal of the vector. New urbanizations are free of vector infestation for decades. T. cruzi transmission is very recent and concentrated in more established communities. The increase in land tenure security during the course of urbanization, if not accompanied by reasonable and enforceable zoning codes, initiates an influx of construction materials, people and animals that creates fertile conditions for epidemics of some vector-borne diseases. PMID:24990681

  10. Archaeosomes display immunoadjuvant potential for a vaccine against Chagas disease.

    Science.gov (United States)

    Higa, Leticia H; Corral, Ricardo S; Morilla, María José; Romero, Eder L; Petray, Patricia B

    2013-02-01

    Archaeosomes (ARC), vesicles made from lipids extracted from Archaea, display strong adjuvant properties. In this study, we evaluated the ability of the highly stable ARC formulated from total polar lipids of a new Halorubrum tebenquichense strain found in Argentinean Patagonia, to act as adjuvant for soluble parasite antigens in developing prophylactic vaccine against the intracellular protozoan T. cruzi, the etiologic agent of Chagas disease. We demonstrated for the first time that C3H/HeN mice subcutaneously immunized with trypanosomal antigens entrapped in these ARC (ARC-TcAg) rapidly developed higher levels of circulating T. cruzi antibodies than those measured in the sera from animals receiving the antigen alone. Enhanced humoral responses elicited by ARC-TcAg presented a dominant IgG2a antibody isotype, usually associated with Th1-type immunity and resistance against T. cruzi. More importantly, ARC-TcAg-vaccinated mice displayed reduced parasitemia during early infection and were protected against an otherwise lethal challenge with the virulent Tulahuén strain of the parasite. Our findings suggest that, as an adjuvant, H. tebenquichense-derived ARC may hold great potential to develop a safe and helpful vaccine against this relevant human pathogen. PMID:23291939

  11. Viability study of a multiplex diagnostic platform for Chagas disease

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    Leonardo Foti

    2009-07-01

    Full Text Available A new multiplex assay platform was evaluated to detect Trypanosoma cruzi infection using the recombinant antigens CRA, FRA, CRAFRA fusion and parasite lysate. The antigens presented different sensitivity and specificity in a singleplex test when compared to a serial dilution of two pools comprising 10 positive serum samples and one pool of 10 negative samples. The recombinant protein CRA presented lower sensitivity (55% in contrast to the 100% specificity and sensitivity of FRA, CRAFRA and T. cruzi lysate. These antigens also showed good results in a duplex test and the duplex test with CRAFRA/T. cruzi lysate showed better performance with 100% specificity and sensitivity, as well as a lower cut-off value in comparison to the other duplex test, FRA/T. cruzi lysate. Hence, when the antigens were used in duplex format, both tests showed decreased cut-off values and no interference between different bead sets, resulting in increasing sensitivity and specificity. The results of these multiplex tests show that they could be an alternative to singleplex detection for Chagas disease, and also indicate the necessity of using multiplex diagnostic tools to increase the sensitivity and specificity for diagnostic tests. Emerging data from the T. cruzi genome and from its ORFeome project will also allow the identification of new antigens for this disease detection application.

  12. Viability study of a multiplex diagnostic platform for Chagas disease.

    Science.gov (United States)

    Foti, Leonardo; Fonseca, Bruna de Paula Fonseca e; Nascimento, Lilian Dias; Marques, Christiane de Fatima Silva; da Silva, Edmilson Domingos; Duarte, Cesar Augusto Barros; Probst, Christian M; Goldenberg, Samuel; Pinto, Antônio Gomes; Krieger, Marco Aurélio

    2009-07-01

    A new multiplex assay platform was evaluated to detect Trypanosoma cruzi infection using the recombinant antigens CRA, FRA, CRAFRA fusion and parasite lysate. The antigens presented different sensitivity and specificity in a singleplex test when compared to a serial dilution of two pools comprising 10 positive serum samples and one pool of 10 negative samples. The recombinant protein CRA presented lower sensitivity (55%) in contrast to the 100% specificity and sensitivity of FRA, CRAFRA and T. cruzi lysate. These antigens also showed good results in a duplex test and the duplex test with CRAFRA/T. cruzi lysate showed better performance with 100% specificity and sensitivity, as well as a lower cut-off value in comparison to the other duplex test, FRA/T. cruzi lysate. Hence, when the antigens were used in duplex format, both tests showed decreased cut-off values and no interference between different bead sets, resulting in increasing sensitivity and specificity. The results of these multiplex tests show that they could be an alternative to singleplex detection for Chagas disease, and also indicate the necessity of using multiplex diagnostic tools to increase the sensitivity and specificity for diagnostic tests. Emerging data from the T. cruzi genome and from its ORFeome project will also allow the identification of new antigens for this disease detection application. PMID:19753468

  13. Congenital Chagas disease of second generation in Santiago, Chile. Report of two cases

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    SCHENONE Hugo

    2001-01-01

    Full Text Available Congenital Chagas disease (CChD has been reported in different countries, mostly in Latin America. In 1987 a fatal case of CChD of second generation (CChDSG was published. Within a period of six months - 1989-1990 - two cases of CChDSG were diagnosed and studied in the city of Santiago. Two premature newborns, sons of two sisters, with moderate liver and spleen enlargement, were found to have positive serology for Chagas disease and xenodiagnoses. The mothers, urban residents all their lives, without antecedents of triatomine bugs contact or blood transfusions, showed positive serology and xenodiagnoses. Their mother (grandmother of the infants, lived 20 years in a Northern rural Chagas disease endemic locality, in a triatomine infested house. Afterwards, she moved to Santiago, where she married and has resided up to now. Serology and xenodiagnoses were also positive. All the Trypanosoma cruzi infected individuals were successfully treated with nifurtimox.

  14. [José Lima Pedreira de Freitas and the redefinition and control of Chagas disease].

    Science.gov (United States)

    Rocha, Juan Stuardo Yazlle

    2016-08-01

    A brief overview of the evolution of knowledge about Chagas disease since its discovery by Carlos Chagas in 1909 until the mid-1940s is presented. The trajectory of physician Pedreira de Freitas and his growing involvement in research in the area led to his contributions to laboratory diagnosis - which lent consistency and security to epidemiological surveys of Chagas disease - and the redefinition of the scale of the disease in Brazil and the Americas with its terrible social and economic impact. His proposal for the disease prevention model - based on selective purging in the application of insecticide - was adopted nationally and internationally and made it possible to bring the disease under control in Brazil and other countries. He devoted himself with equal intensity to enhancing the teaching of medical practices in the community and was a pioneer in the implementation of preventive medicine in medical education in Brazil. PMID:27557035

  15. Proteins involved on TGF-β pathway are up-regulated during the acute phase of experimental Chagas disease.

    Science.gov (United States)

    Ferreira, Roberto Rodrigues; de Souza, Elen Mello; de Oliveira, Fabiane Loiola; Ferrão, Patrícia Mello; Gomes, Leonardo Henrique Ferreira; Mendonça-Lima, Leila; Meuser-Batista, Marcelo; Bailly, Sabine; Feige, Jean Jacques; de Araujo-Jorge, Tania Cremonini; Waghabi, Mariana Caldas

    2016-05-01

    Studies developed by our group in the last years have shown the involvement of TGF-β in acute and chronic Chagas heart disease, with elevated plasma levels and activated TGF-β cell signaling pathway as remarkable features of patients in the advanced stages of this disease, when high levels of cardiac fibrosis is present. Imbalance in synthesis and degradation of extracellular matrix components is the basis of pathological fibrosis and TGF-β is considered as one of the key regulators of this process. In the present study, we investigated the activity of the TGF-β signaling pathway, including receptors and signaling proteins activation in the heart of animals experimentally infected with Trypanosoma cruzi during the period that mimics the acute phase of Chagas disease. We observed that T. cruzi-infected animals presented increased expression of TGF-β receptors. Overexpression of receptors was followed by an increased phosphorylation of Smad2/3, p38 and ERK. Furthermore, we correlated these activities with cellular factors involved in the fibrotic process induced by TGF-β. We observed that the expression of collagen I, fibronectin and CTGF were increased in the heart of infected animals on day 15 post-infection. Correlated with the increased TGF-β activity in the heart, we found that serum levels of total TGF-β were significantly higher during acute infection. Taken together, our data suggest that the commitment of the heart associates with increased activity of TGF-β pathway and expression of its main components. Our results, confirm the importance of this cytokine in the development and maintenance of cardiac damage caused by T. cruzi infection. PMID:26852285

  16. Aspectos neurológicos da moléstia de chagas

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    Fritz Köberle

    1967-09-01

    Full Text Available Carlos Chagas related in more than two 200 cases, what he called "nervous forms" of trypanosomiasis, that is neurological manifestations from central origin (idiotism, infantilism, pseudo-bulbar paralysis, aphasia, cerebellar ataxia, atetosis, espostic or paralytic diplegia, disbasia. At that time Chagas expressed his concepts as follows: "In relation to the frequency of trypanosomiasis nervous forms we have performed many observations which allow us to state that this disease is the one which causes the largest number of organic affections of the central nervous system, in human pathology". We are plenty convinced by Chagas's statement. By experiments on animals of laboratory we have very often noticed a rather varied neurological symptomatology, being worth point out identical syndromes to those observed by Chagas. Our autopsy material non-rarely include chronic Chagas cases presenting a most varied symtomatology. Among them we have named only three cases of discerebral nanism, a rather rare affection in other parts of the world and relatively frequent in our material. The fact which we have demonstrated, i.e., a relatively great decreasing of number of nervous cells in the peripheral system could happen in the central nervous system as well. Provided that there are only two quantitative works on neuron number diminishing in the central nervous system in mice and rats we decline to go into further details about central neuropathies in man. We emphasized the necessity to perform researches on this field by means of intimate collaboration between clinicians and pathologists, as the only way to confirm on scientific basis all that was observed by the panoramic and genial vision of Carlos Chagas.

  17. Estado actual de nuestros conocimientos sobre la enfermedad de chagas en la Republica Mexicana

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    Jorge Tay

    1981-06-01

    Full Text Available Se presentan los datos obtenidos de la revisión minuciosa en relación a enfermedad de Chagas de la literatura médica de la República Mexicana y extranjera desde el afio de 1939 en que por primeira vez se reporta a Trypanosoma cruzi en México, hasta el ano de 1976. Mediante mapas, tablas y cuadros se senalan las localidades en donde se han encontrado casos humanos, reservorios no humanos y transmisores. Se hacen comentários acerca de los resultados obtenidos y se seffala la importancia de incrementar los estúdios sobre enfermedades de Chagas en nuestro país.É a apresentação dos dados obtidos a partir de uma minuciosa revisão feita na literatura médica mexicana e estrangeira com relação à doença de Chagas no México. O estudo refere-se ao período de 1939 quando, pela primeira vez, menciona-se Trypanosoma cruzi no México, até 1976. Através de mapas, tabelas e quadros são mostrados os lugares onde foram encontrados casos humanos, reservatórios e transmissores. São feitos comentários sobre os resultados obtidos e é ressaltada a necessidade de ampliação dos estudos sobre a doença de Chagas no México.A thorough review of the literature is made regarding Chagas disease in Mexico and else- where since 1939, when Trypanosoma cruzi was first reported in this country until 1976. The location where human cases, non human reservoirs and transmitters have been found is pointed out by means of maps, tables and charts comments are made regarding the results reported. The importance of increasing the studies of Chagas' disease in our country is stressed.

  18. Trypanosoma cruzi, causal agent of Chagas disease: The borderline between wild and domestic cycles in Venezuela.

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    Leidi eHerrera

    2014-11-01

    Full Text Available American trypanosomiasis or Chagas disease, caused by Trypanosoma cruzi, occurs between triatomine vectors and mammals, including man. T. cruzi has 150 Ma in America with almost 10 million of infected people today. The overlapping of its wild and domestic ecotopes is increasing. The host-parasite imbrications has been discerned by the study of infection patterns, transmissibility and transmission cycles in natural and laboratory models, through to parasitological and molecular tests. This article describes specific parasite niches, as plant biocenosis or biological corridors between domestic and wild ecotopes and helps distinguish Chagas disease risks and the borderline between wild and domestic transmission cycles, with emphasis on Venezuelan studies.

  19. Necroscopic study of a Chagas' disease chronic case with normal electrocardiograms

    International Nuclear Information System (INIS)

    The morphological changes in the postmortem study of a man probably with the indeterminate form of Chagas' disease are described. The heart exhibited lesions of the epicardium, myocardium and endocardium, as well as of the conduction system, primarily small inflammatory foci. There was mild fibrosis of the myocardium, atrioventricular node, and left bundle branch (at its origin). These alterations, although mild, were similar, in quality, to those described in the other chronic forms of Chagas' disease, and suggest active lesions, with a potential for further development. In the esophagus, among other features, a striking reduction of the number of neurons was observed. (author)

  20. Distantiae transmission of Trypanosoma cruzi: a new epidemiological feature of acute Chagas disease in Brazil.

    OpenAIRE

    Samanta Cristina das Chagas Xavier; André Luiz Rodrigues Roque; Daniele Bilac; Vitor Antônio Louzada de Araújo; Sócrates Fraga da Costa da Costa Neto; Elias Seixas Lorosa; Luiz Felipe Coutinho Ferreira da Silva; Ana Maria Jansen

    2014-01-01

    BACKGROUND: The new epidemiological scenario of orally transmitted Chagas disease that has emerged in Brazil, and mainly in the Amazon region, needs to be addressed with a new and systematic focus. Belém, the capital of Pará state, reports the highest number of acute Chagas disease (ACD) cases associated with the consumption of açaí juice. METHODOLOGY/PRINCIPAL FINDINGS: The wild and domestic enzootic transmission cycles of Trypanosoma cruzi were evaluated in the two locations (Jurunas and Va...

  1. Association of IL17A gene variants with chronic Chagas cardiomyopathy

    OpenAIRE

    Daniel Arturo León; Luis Eduardo Echeverría; Clara Isabel González

    2015-01-01

    Human host genetic factors have been suggested to be determinants of the prevalence and clinical forms of Chagas disease. In this regard, IL-17A is believed to control parasitemia and protect against heart disease. In this work, we assessed whether IL17A gene polymorphisms are related to infection and/or development of the cardiac form of Chagas disease by genotyping for five IL17A SNPs (rs4711998, rs8193036, rs3819024, rs2275913 and rs7747909) in 1171 individuals from a Colombian region ende...

  2. Antigenicity and Diagnostic Potential of Vaccine Candidates in Human Chagas Disease

    OpenAIRE

    Shivali Gupta; Xianxiu Wan; Zago, Maria P.; Martinez Sellers, Valena C.; Silva, Trevor S.; Dadjah Assiah; Monisha Dhiman; Sonia Nuñez; Petersen, John R; Vázquez-Chagoyán, Juan C.; Jose G Estrada-Franco; Nisha Jain Garg

    2013-01-01

    BACKGROUND: Chagas disease, caused by Trypanosoma cruzi, is endemic in Latin America and an emerging infectious disease in the US and Europe. We have shown TcG1, TcG2, and TcG4 antigens elicit protective immunity to T. cruzi in mice and dogs. Herein, we investigated antigenicity of the recombinant proteins in humans to determine their potential utility for the development of next generation diagnostics for screening of T. cruzi infection and Chagas disease. METHODS AND RESULTS: Sera samples f...

  3. Distantiae Transmission of Trypanosoma cruzi: A New Epidemiological Feature of Acute Chagas Disease in Brazil

    OpenAIRE

    Xavier, Samanta Cristina das Chagas; Roque, André Luiz Rodrigues; Bilac, Daniele; de Araújo, Vitor Antônio Louzada; Neto, Sócrates Fraga da Costa; Lorosa, Elias Seixas; da Silva, Luiz Felipe Coutinho Ferreira; Jansen, Ana Maria

    2014-01-01

    Background The new epidemiological scenario of orally transmitted Chagas disease that has emerged in Brazil, and mainly in the Amazon region, needs to be addressed with a new and systematic focus. Belém, the capital of Pará state, reports the highest number of acute Chagas disease (ACD) cases associated with the consumption of açaí juice. Methodology/Principal Findings The wild and domestic enzootic transmission cycles of Trypanosoma cruzi were evaluated in the two locations (Jurunas and Val-...

  4. Clinical manifestations of peripheral nervous system involvement in human chronic chagas disease Manifestaciones clinicas de compromiso del sistema nervioso periférico en el estádio crônico de la enfermedad de Chagas

    Directory of Open Access Journals (Sweden)

    Osvaldo Genovese

    1996-06-01

    Full Text Available We conducted a clinical and electromyographical study in patients with Chagas' disease in the indeterminate or chronic stages of the illness. Altogether 841 patients were examined. Only 511 were admitted within the protocol; the remainder patients were rejected because they showed other causes able to damage the nervous system. Fifty two (10.17% out of the 511 patients showed signs and symptoms of peripheral nervous system involvement in the form of sensory impairment and diminished tendon jerks suggesting the presence of neuropathy. Forty five of them were submitted to a conventional electromyographical examination. Fifteen of mem showed normal results, while the remainder 30 disclosed a reduced interference pattern, being most of the remaining motor unit potentials fragmented or poliphasic, reduced sensory and motor conduction velocities and diminished amplitude of the sensory action potential. The findings suggest that some chagasic patients in the indeterminate or chronic stages of the disease may develop a clinical mild sensory-motor peripheral neuropathy.El estúdio presente fue diseftado con ei objeto de pesquizar Ia existência de manifestaciones clinicas en pacientes afectados por enfermedad de Chagas, en estádio indeterminado o crônico, que tuviesen, ai menos, 2 reacciones serologicas positivas. En total fueron examinados 841 enfermos. De ellos solo 511 fueron admitidos en ei protocolo; los restantes fueron rechazados por mostrar Ia presencia de otras causas que hubiesen podido danar su sistema nervioso. Dentro de los 511 pacientes admitidos, 52 (10.17% evidenciaron alteraciones objetivas y subjetivas de Ia sensibilidad y disminucion de los reflejos osteotendinosos. Estos signos y sintomas, que sugieren la presencia de neuropatia, podian combinarse de diferente manera. Como complemento dei examen clinico, se efectuo estúdio electromiografico convencional en 45 de estos pacientes. En 15 los hallazgos fueron normales, en tanto que en

  5. Analysis of the relationship cost-effectiveness of the myocardial gammagraphy studies and the impact to the total expenditure by diagnostic of ischemic cardiopathy; Analisis de la relacion costo-efectividad de los estudios de gamagrafia miocardica e impacto al gasto total por diagnostico de cardiopatia isquemica

    Energy Technology Data Exchange (ETDEWEB)

    Valenzuela F, A.G.; Perez C, J.P. [Servicio de Cardiologia Nuclear, Hospital cardiologia CMN, IMSS, Mexico D.F. (Mexico); Arreola O, H. [Fundacion Mexicana para la Salud, Mexico D.F. (Mexico); Valenzuela F, A.A. [Unidad de Epidemiologia Hospitalaria, IMSS, Mexico D.F. (Mexico); Soto M, H. [UAEM, Toluca, Estado de Mexico (Mexico); Arguero S, R. [Director del Hospital de Cardiologia, IMSS, Mexico D.F. (Mexico)

    2005-07-01

    Recent advances in pharmacology, diagnostic and invasive procedures provide a series of modalities that diminish the morbidity and increase the long term survival in the patients that have suffered a heart attack to myocardium. The stratification by risk is an essential element for the handling of the survivors of heart attack to myocardium. In their attention it is looked for to optimize the therapeutic benefit, to diminish the unnecessary diagnostic and therapeutic procedures and to improve the efficiency. For example, a coronariography in sick with heart attack to myocardium it is not cost-effective if not is clinically suitable. Of there that from the institutional point of view, this is, of the Mexican Institute of the Public Health, they are required of appropriate reference approaches and counter reference to grant to the sick person, the best service that is the one in this case the diagnostic and the handling of the ischemic cardiopathy with the smallest waste of resources. The estimation of the annual survival is the base of the stratification, it constitutes the angular stone of the early handling of the heart attack to myocardium. The goal for the clinical would be to identify patients with intermediate risk, since, this risk makes them candidates to therapy interventionist. As long as those with low risk won't require intervention. This would allow the decrease of rates by revenues of heart attack to myocardium, and therefore to diminish the hospital staying rates. The Nuclear Cardiology (myocardial gammagraphy) it is not the only invasive method available to evaluate the myocardial perfusion in sick in who coronary illness is suspected. When the myocardial gammagraphy is carried out in appropriate population, the cost it diminishes because it restricts the necessity of additional invasive evaluations. This because the nuclear cardiology has predictive value so much for the mortality like to detect myocardial viability. Based on these

  6. Técnica do xenodiagnostico na molestia de Chagas

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    Emmanuel Dias

    1940-01-01

    Full Text Available O xenodiagnostico é um processo muito valioso para o diagnostico etiologico da moléstia de Chagas. Consiste em alimentar-se barbeiros normais em supótos portadores da infecção e determinar-se, depois, si eles adquirem ou não o parasitismo. Em cada região deve ser empregada, de preferência, o transmissor local mais importante. Três a seis ninfas famintas são geralmente empregadas em cada prova, devendo ficar em contacto com o doador até encherem-se completamente (15-30 minutos. Si o exame de fezes – espontaneamente eliminadas ou obtidas por punção anal – não revelar a presença de flagelados, os insetos devem ser dissecados 40 a 60 dias depois da sucção, para exame do conteúdo duodenal.Xenodiagnosis is a very valuable method for the etiological diagnosis of Chagas’s disease. It consists in allowing the clean insect transmitter to feed upon the suspected carrier, and in ascertaining whether the bugs become infected. The principal local vector is the most suitable species to be used in a given region. Three to six hungry nymphs are usually employed in each test and must feed until repletion (15-30 minutes. It flagellates are not detected in the faeces or in the rectal contents, obtained by anal puncture, insects are dissected 40-60 days after the and the duodenal contents is examined.

  7. Insecticide resistance in vector Chagas disease: evolution, mechanisms and management.

    Science.gov (United States)

    Mougabure-Cueto, Gastón; Picollo, María Inés

    2015-09-01

    Chagas disease is a chronic parasitic infection restricted to America. The disease is caused by the protozoa Trypanosoma cruzi, which is transmitted to human through the feces of infected triatomine insects. Because no treatment is available for the chronic forms of the disease, vector chemical control represents the best way to reduce the incidence of the disease. Chemical control has been based principally on spraying dwellings with insecticide formulations and led to the reduction of triatomine distribution and consequent interruption of disease transmission in several areas from endemic region. However, in the last decade it has been repeatedly reported the presence triatomnes, mainly Triatoma infestans, after spraying with pyrethroid insecticides, which was associated to evolution to insecticide resistance. In this paper the evolution of insecticide resistance in triatomines is reviewed. The insecticide resistance was detected in 1970s in Rhodnius prolixus and 1990s in R. prolixus and T. infestans, but not until the 2000s resistance to pyrthroids in T. infestans associated to control failures was described in Argentina and Bolivia. The main resistance mechanisms (i.e. enhanced metabolism, altered site of action and reduced penetration) were described in the T. infestans resistant to pyrethrods. Different resistant profiles were demonstrated suggesting independent origin of the different resistant foci of Argentina and Bolivia. The deltamethrin resistance in T. infestans was showed to be controlled by semi-dominant, autosomally inherited factors. Reproductive and developmental costs were also demonstrated for the resistant T. infestans. A discussion about resistance and tolerance concepts and the persistence of T. infestans in Gran Chaco region are presented. In addition, theoretical concepts related to toxicological, evolutionary and ecological aspects of insecticide resistance are discussed in order to understand the particular scenario of pyrethroid

  8. Barriers to treatment access for Chagas disease in Mexico.

    Directory of Open Access Journals (Sweden)

    Jennifer M Manne

    Full Text Available BACKGROUND: According to World Health Organization (WHO prevalence estimates, 1.1 million people in Mexico are infected with Trypanosoma cruzi, the etiologic agent of Chagas disease (CD. However, limited information is available about access to antitrypanosomal treatment. This study assesses the extent of access in Mexico, analyzes the barriers to access, and suggests strategies to overcome them. METHODS AND FINDINGS: Semi-structured in-depth interviews were conducted with 18 key informants and policymakers at the national level in Mexico. Data on CD cases, relevant policy documents and interview data were analyzed using the Flagship Framework for Pharmaceutical Policy Reform policy interventions: regulation, financing, payment, organization, and persuasion. Data showed that 3,013 cases were registered nationally from 2007-2011, representing 0.41% of total expected cases based on Mexico's national prevalence estimate. In four of five years, new registered cases were below national targets by 11-36%. Of 1,329 cases registered nationally in 2010-2011, 834 received treatment, 120 were pending treatment as of January 2012, and the treatment status of 375 was unknown. The analysis revealed that the national program mainly coordinated donation of nifurtimox and that important obstacles to access include the exclusion of antitrypanosomal medicines from the national formulary (regulation, historical exclusion of CD from the social insurance package (organization, absence of national clinical guidelines (organization, and limited provider awareness (persuasion. CONCLUSIONS: Efforts to treat CD in Mexico indicate an increased commitment to addressing this disease. Access to treatment could be advanced by improving the importation process for antitrypanosomal medicines and adding them to the national formulary, increasing education for healthcare providers, and strengthening clinical guidelines. These recommendations have important implications for other

  9. Molecular epidemiology of human oral Chagas disease outbreaks in Colombia.

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    Juan David Ramírez

    Full Text Available BACKGROUND: Trypanosoma cruzi, the causative agent of Chagas disease, displays significant genetic variability revealed by six Discrete Typing Units (TcI-TcVI. In this pathology, oral transmission represents an emerging epidemiological scenario where different outbreaks associated to food/beverages consumption have been reported in Argentina, Bolivia, Brazil, Ecuador and Venezuela. In Colombia, six human oral outbreaks have been reported corroborating the importance of this transmission route. Molecular epidemiology of oral outbreaks is barely known observing the incrimination of TcI, TcII, TcIV and TcV genotypes. METHODOLOGY AND PRINCIPAL FINDINGS: High-throughput molecular characterization was conducted performing MLMT (Multilocus Microsatellite Typing and mtMLST (mitochondrial Multilocus Sequence Typing strategies on 50 clones from ten isolates. Results allowed observing the occurrence of TcI, TcIV and mixed infection of distinct TcI genotypes. Thus, a majority of specific mitochondrial haplotypes and allelic multilocus genotypes associated to the sylvatic cycle of transmission were detected in the dataset with the foreseen presence of mitochondrial haplotypes and allelic multilocus genotypes associated to the domestic cycle of transmission. CONCLUSIONS: These findings suggest the incrimination of sylvatic genotypes in the oral outbreaks occurred in Colombia. We observed patterns of super-infection and/or co-infection with a tailored association with the severe forms of myocarditis in the acute phase of the disease. The transmission dynamics of this infection route based on molecular epidemiology evidence was unraveled and the clinical and biological implications are discussed.

  10. Chagas Disease: Challenges in Developing New Trypanocidal Lead Compounds [Doença de Chagas: Desafios no Desenvolvimento de Novas Substâncias Líderes Tripanomicidas

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    Fernando de C. da Silva

    2012-03-01

    Full Text Available Chagas disease cycle was fully elucidated by Carlos Chagas in 1909, when he reported his discovery to the scientific community in two seminal papers. Today remains innumerous factors that limit its therapeutic treatment. One of them is the lack of new drugs in the market since is well known that the existing drugs are poorly active with low efficacy and considerable side effects. Nowadays, many efforts have been done in combinatorial chemistry and synthesis of new compounds searching for new lead compounds. The present review intends to show that a wide variety of synthetic strategies are being used for the preparation of pharmaceutically active compounds against several strains of T. cruzi with a range of potential clinical applications.

  11. Bolivian migrants with Chagas disease in Barcelona, Spain: a qualitative study of dietary changes and digestive problems.

    Science.gov (United States)

    Posada, Elizabeth; Pell, Christopher; Angulo, Nataly; Pinazo, María Jesús; Gimeno, Faust; Elizalde, Ignasi; Gysels, Marjolein; Muñoz, Jose; Pool, Robert; Gascón, Joaquim

    2011-12-01

    Due to international migration, Chagas disease, endemic in Latin America, has become more common in non-endemic areas. Chronic Chagas disease can cause damage to the digestive system leading to constipation. However, a range of factors influences constipation and a better understanding of the role of non-Chagas related factors is required to improve management of Chagas-related digestive problems. This study explores perceptions of constipation and changes in food and exercise habits amongst Bolivians in Barcelona, Spain. Bolivian migrants attending the Tropical Medicine Unit (Hospital Clínic, Barcelona) were interviewed about their food habits in Spain and Bolivia, migratory experience, work and leisure activities. Chagas seropositive participants also received radiological examinations. Bolivian migrants experienced dietary changes, influenced by work-related factors, which included reductions in quantities of food and liquid consumed. Almost half the participants reported changes in digestive rhythm since arriving in Spain. Constipation, which was common, in some cases was only recounted during interviews. Bolivian migrants' constipation may be associated with chronic Chagas disease or migration-related dietary changes. Careful questioning using the Rome III criteria is however required to ensure its diagnosis. Radiological studies are also required to confirm the role of Chagas disease and identify potentially serious intestinal damage. PMID:24038501

  12. Comparação entre o reagente Chagas-latex e a imunofluorescência no diagnóstico sorológico da doença de Chagas na zona sul do Rio Grande do Sul

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    Giovanni Baruffa

    1973-10-01

    Full Text Available Os Autores submeteram 142 amostras de soros de casos agudos e crônicos de Doença de Chagas, já examinados com o Reagente Chagas-Latex, ao exame de Imunofluorescência, obtendo correspondência de resultados em 139 (97,9%. O alto índice de fidelidade, provavelmente devido à ausência na zona de doenças que possam proporcionar resultados falsamente positivos, fez do Reagente Chagas-Latex um método simples e fácil para a triagem sorológica nos casos suspeitos em zona endêmica.

  13. Chagas' disease in the Brazilian Amazon: I - a short review Doença de Chagas na Amazônia Brasileira: I. revisão

    OpenAIRE

    José Rodrigues Coura; Angela Cristina Verissimo Junqueira; Cristina Maria Giordano; Ilra Renata Komoda Funatsu

    1994-01-01

    At least eighteen species of triatominae have been found in the Brazilian Amazon, nine of them naturally infected with Trypanosoma cruzi or "cruzi-like" trypanosomes and associated with numerous wild reservoirs. Despite the small number of human cases of Chagas' disease described to date in the Brazilian Amazon the risk that the disease will become endemic in this area is increasing for the following reasons: a) uncontrolled deforestation and colonization altering the ecological balance betwe...

  14. FC-TRIPLEX Chagas/Leish IgG1: a multiplexed flow cytometry method for differential serological diagnosis of chagas disease and leishmaniasis.

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    Andréa Teixeira-Carvalho

    Full Text Available Differential serological diagnosis of Chagas disease and leishmaniasis is difficult owing to cross-reactivity resulting from the fact that the parasites that cause these pathologies share antigenic epitopes. Even with optimized serological assays that use parasite-specific recombinant antigens, inconclusive test results continue to be a problem. Therefore, new serological tests with high sensitivity and specificity are needed. In the present work, we developed and evaluated the performance of a new flow cytometric serological method, referred to as FC-TRIPLEX Chagas/Leish IgG1, for the all-in-one classification of inconclusive tests. The method uses antigens for the detection of visceral leishmaniasis, localized cutaneous leishmaniasis, and Chagas disease and is based on an inverted detuned algorithm for analysis of anti-Trypanosomatidae IgG1 reactivity. First, parasites were label with fluorescein isothiocyanate or Alexa Fluor 647 at various concentrations. Then serum samples were serially diluted, the dilutions were incubated with suspensions of mixed labeled parasites, and flow cytometric measurements were performed to determine percentages of positive fluorescent parasites. Using the new method, we obtained correct results for 76 of 80 analyzed serum samples (95% overall performance, underscoring the outstanding performance of the method. Moreover, we found that the fluorescently labeled parasite suspensions were stable during storage at room temperature, 4 °C, and -20 °C for 1 year. In addition, two different lots of parasite suspensions showed equivalent antigen recognition; that is, the two lots showed equivalent categorical segregation of anti-Trypanosomatidae IgG1 reactivity at selected serum dilutions. In conclusion, we have developed a sensitive and selective method for differential diagnosis of Chagas disease, visceral leishmaniasis, and localized cutaneous leishmaniasis.

  15. Changes in Proteome Profile of Peripheral Blood Mononuclear Cells in Chronic Chagas Disease.

    Science.gov (United States)

    Garg, Nisha Jain; Soman, Kizhake V; Zago, Maria P; Koo, Sue-Jie; Spratt, Heidi; Stafford, Susan; Blell, Zinzi N; Gupta, Shivali; Nuñez Burgos, Julio; Barrientos, Natalia; Brasier, Allan R; Wiktorowicz, John E

    2016-02-01

    Trypanosoma cruzi (Tc) infection causes chagasic cardiomyopathy; however, why 30-40% of the patients develop clinical disease is not known. To discover the pathomechanisms in disease progression, we obtained the proteome signature of peripheral blood mononuclear cells (PBMCs) of normal healthy controls (N/H, n = 30) and subjects that were seropositive for Tc-specific antibodies, but were clinically asymptomatic (C/A, n = 25) or clinically symptomatic (C/S, n = 28) with cardiac involvement and left ventricular dysfunction. Protein samples were labeled with BODIPY FL-maleimide (dynamic range: > 4 orders of magnitude, detection limit: 5 f-mol) and resolved by two-dimensional gel electrophoresis (2D-GE). After normalizing the gel images, protein spots that exhibited differential abundance in any of the two groups were analyzed by mass spectrometry, and searched against UniProt human database for protein identification. We found 213 and 199 protein spots (fold change: |≥ 1.5|, psurvival and free radical scavenging capacity in C/S (but not C/A) subjects. The MYC/SP1 transcription factors that regulate hypoxia and oxidative/inflammatory stress were predicted to be key targets in the context of control of Chagas disease severity. Further, MARS-modeling identified a panel of proteins that had >93% prediction success in classifying infected individuals with no disease and those with cardiac involvement and LV dysfunction. In conclusion, we have identified molecular pathways and a panel of proteins that could aid in detecting seropositive individuals at risk of developing cardiomyopathy. PMID:26919708

  16. Effects of Exercise Training on Heart Rate Variability in Chagas Heart Disease

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    Bruno Ramos Nascimento

    2014-09-01

    Full Text Available Background: Heart rate variability (HRV is a marker of autonomic dysfunction severity. The effects of physical training on HRV indexes in Chagas heart disease (CHD are not well established. Objective: To evaluate the changes in HRV indexes in response to physical training in CHD. Methods: Patients with CHD and left ventricular (LV dysfunction, physically inactive, were randomized either to the intervention (IG, N = 18 or control group (CG, N = 19. The IG participated in a 12-week exercise program consisting of 3 sessions/week. Results: Mean age was 49.5 ± 8 years, 59% males, mean LVEF was 36.3 ± 7.8%. Baseline HRV indexes were similar between groups. From baseline to follow-up, total power (TP: 1653 (IQ 625 - 3418 to 2794 (1617 - 4452 ms, p = 0.02 and very low frequency power: 586 (290 - 1565 to 815 (610 - 1425 ms, p = 0.047 increased in the IG, but not in the CG. The delta (post - pre HRV indexes were similar: SDNN 11.5 ± 30.0 vs. 3.7 ± 25.1 ms. p = 0.10; rMSSD 2 (6 - 17 vs. 1 (21 - 9 ms. p = 0.43; TP 943 (731 - 3130 vs. 1780 (921 - 2743 Hz. p = 0.46; low frequency power (LFP 1.0 (150 - 197 vs. 60 (111 - 146 Hz. p = 0.85; except for high frequency power, which tended to increase in the IG: 42 (133 - 92 vs. 79 (61 - 328 Hz. p = 0.08. Conclusion: In the studied population, the variation of HRV indexes was similar between the active and inactive groups. Clinical improvement with physical activity seems to be independent from autonomic dysfunction markers in CHD.

  17. Tratamento da Doença de Chagas pelo Nifurtimox (Bayer 2502

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    Aluizio Prata

    1975-12-01

    caixas positivas de 28,6 para 3,1. Não há vantagem em se prolongar o uso do nifurtimox por mais de dois meses. As percentagens de cura são bem inferiores as obtidas na Argentina, Chile e Rio Grande do Sul. A droga produz muitas reações, sendo a mais importante a polineuropatia periférica.Seventy seven patientes with Chagas disease were treated with nifurtimox. They were divided into 4 groups. Group I consisted of 30 patients in the acute phase of the disease. Twenty two patients took an insufficient dose. Only 8 patients used the drug for 120 days in an initial daity dose of 15 mg/kilogram body weight for up to 2 weeks and later in a daily dose of 10 mg/kilo body weight. In 4 patients (50% the xenodiagnosis became negativa after treatment and in 3 the Machado Guerreiro test became negative. One patient died with acute cardiac failure on the 5th day of treatment. Six patients developed evidence of sensory peripheral neuritis while on treatment. Group II consisted of 15 outpatients in the chronic phase. They also took the drug for 120 days in a variable dosage of 5-15 mg/kilo body weight. They had at least one xenodiagnosis performedafter treatment in four patients xenodiagnosis became negative. The treatment had no effect on the electrocardiogram, degree of cardiomegaly, or appearance on barium swallow. Treatment did not prevent one patient from developing an arrhythmia and another cardiac failure. Group III also contained 15 patients in the chronic phase with positive xenodiagnosis treated with 10 mg/kilo body weight for 120 days. Twelve serial monthly xenodiagnosis were done after treatment using 80 T. infestans (10 to a box for each examination. In only 28.5% of the patients were all these xenodiagnoses negative. The frequency of parasitemia was decreased in the other patients but not eradicated. The number of xenodiagnoses positive before treatment was 43% and afterwards 24.4%. The number of positive boxes diminished from 29.6% to 7%. Group IV consisted of 17

  18. Update on oral Chagas disease outbreaks in Venezuela: epidemiological, clinical and diagnostic approaches

    Science.gov (United States)

    de Noya, Belkisyolé Alarcón; Díaz-Bello, Zoraida; Colmenares, Cecilia; Ruiz-Guevara, Raiza; Mauriello, Luciano; Muñoz-Calderón, Arturo; Noya, Oscar

    2015-01-01

    Orally transmitted Chagas disease has become a matter of concern due to outbreaks reported in four Latin American countries. Although several mechanisms for orally transmitted Chagas disease transmission have been proposed, food and beverages contaminated with whole infected triatomines or their faeces, which contain metacyclic trypomastigotes of Trypanosoma cruzi, seems to be the primary vehicle. In 2007, the first recognised outbreak of orally transmitted Chagas disease occurred in Venezuela and largest recorded outbreak at that time. Since then, 10 outbreaks (four in Caracas) with 249 cases (73.5% children) and 4% mortality have occurred. The absence of contact with the vector and of traditional cutaneous and Romana’s signs, together with a florid spectrum of clinical manifestations during the acute phase, confuse the diagnosis of orally transmitted Chagas disease with other infectious diseases. The simultaneous detection of IgG and IgM by ELISA and the search for parasites in all individuals at risk have been valuable diagnostic tools for detecting acute cases. Follow-up studies regarding the microepidemics primarily affecting children has resulted in 70% infection persistence six years after anti-parasitic treatment. Panstrongylus geniculatus has been the incriminating vector in most cases. As a food-borne disease, this entity requires epidemiological, clinical, diagnostic and therapeutic approaches that differ from those approaches used for traditional direct or cutaneous vector transmission. PMID:25946155

  19. Dynamics of the antibody-T.cruzi competition during Chagas infection: Prognostic relevance of intracellular replication

    Science.gov (United States)

    Sibona, G. J.; Condat, C. A.; Isasi, S. Cossy

    2005-02-01

    A recently proposed model for the competitive parasite-antibody interactions in Chagas disease is extended by separately describing the parasitic intracellular and extracellular phases. The model solutions faithfully reproduce available population data and yield predictions for parasite-induced cardiac cell damage.

  20. [Serologic study of the diagnosis of Chagas disease in Nicaraguan students in the Juventud island].

    Science.gov (United States)

    Montes de Oca, N V; Cabrera Alonso, C; Martínez, R; Cantelar de Francisco, N; Pérez Insueta, O

    1989-01-01

    The results obtained during the serologic study for the diagnosis of Chagas' disease in 868 Nicaraguan students in the Isle of Youth are reported. Qualitative hemagglutination and indirect immunofluorescence were used. It was found that 8.5% of these students showed antibodies specific to Trypanosoma cruzi by means of this diagnostic test. PMID:2518003

  1. Update on oral Chagas disease outbreaks in Venezuela: epidemiological, clinical and diagnostic approaches

    Directory of Open Access Journals (Sweden)

    Belkisyolé Alarcón de Noya

    2015-05-01

    Full Text Available Orally transmitted Chagas disease has become a matter of concern due to outbreaks reported in four Latin American countries. Although several mechanisms for orally transmitted Chagas disease transmission have been proposed, food and beverages contaminated with whole infected triatomines or their faeces, which contain metacyclic trypomastigotes of Trypanosoma cruzi, seems to be the primary vehicle. In 2007, the first recognised outbreak of orally transmitted Chagas disease occurred in Venezuela and largest recorded outbreak at that time. Since then, 10 outbreaks (four in Caracas with 249 cases (73.5% children and 4% mortality have occurred. The absence of contact with the vector and of traditional cutaneous and Romana’s signs, together with a florid spectrum of clinical manifestations during the acute phase, confuse the diagnosis of orally transmitted Chagas disease with other infectious diseases. The simultaneous detection of IgG and IgM by ELISA and the search for parasites in all individuals at risk have been valuable diagnostic tools for detecting acute cases. Follow-up studies regarding the microepidemics primarily affecting children has resulted in 70% infection persistence six years after anti-parasitic treatment. Panstrongylus geniculatus has been the incriminating vector in most cases. As a food-borne disease, this entity requires epidemiological, clinical, diagnostic and therapeutic approaches that differ from those approaches used for traditional direct or cutaneous vector transmission.

  2. Oral Transmission of Chagas Disease by Consumption of Açaí Palm Fruit, Brazil

    OpenAIRE

    Nóbrega, Aglaêr A.; Garcia, Marcio H.; Tatto, Erica; Marcos T Obara; Costa, Elenild; Sobel, Jeremy; Araujo, Wildo N.

    2009-01-01

    In 2006, a total of 178 cases of acute Chagas disease were reported from the Amazonian state of Pará, Brazil. Eleven occurred in Barcarena and were confirmed by visualization of parasites on blood smears. Using cohort and case–control studies, we implicated oral transmission by consumption of açaí palm fruit.

  3. Trypanosoma cruzi in the chicken model: Chagas-like heart disease in the absence of parasitism

    Czech Academy of Sciences Publication Activity Database

    Teixeira, A.R.L.; Gomes, C.; Nitz, N.; Sousa, A.O.; Alvez, R.M.; Guimaro, M.C.; Cordeiro, C.; Bernal, F.M.; Rosa, A.C.; Hejnar, Jiří; Leonardecz, E.; Hecht, M.M.

    2011-01-01

    Roč. 5, č. 3 (2011), e1000. ISSN 1935-2735 Institutional research plan: CEZ:AV0Z50520514 Keywords : Chagas disease * Trypanosoma cruzi * kDNA minicircles * inbred chicken Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 4.716, year: 2011

  4. Cardiac-oxidized antigens are targets of immune recognition by antibodies and potential molecular determinants in chagas disease pathogenesis.

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    Monisha Dhiman

    Full Text Available Trypanosoma cruzi elicits reactive oxygen species (ROS of inflammatory and mitochondrial origin in infected hosts. In this study, we examined ROS-induced oxidative modifications in the heart and determined whether the resultant oxidized cardiac proteins are targets of immune response and of pathological significance in Chagas disease. Heart biopsies from chagasic mice, rats and human patients exhibited, when compared to those from normal controls, a substantial increase in protein 4-hydroxynonenal (4-HNE, malondialdehyde (MDA, carbonyl, and 3-nitrotyrosine (3-NT adducts. To evaluate whether oxidized proteins gain antigenic properties, heart homogenates or isolated cardiomyocytes were oxidized in vitro and one- or two-dimensional gel electrophoresis (2D-GE/Western blotting (WB was performed to investigate the proteomic oxidative changes and recognition of oxidized proteins by sera antibodies in chagasic rodents (mice, rats and human patients. Human cardiomyocytes exhibited LD(50 sensitivity to 30 µM 4-HNE and 100 µM H(2O(2 at 6 h and 12 h, respectively. In vitro oxidation with 4-HNE or H(2O(2 resulted in a substantial increase in 4-HNE- and carbonyl-modified proteins that correlated with increased recognition of cardiac (cardiomyocytes proteins by sera antibodies of chagasic rodents and human patients. 2D-GE/Western blotting followed by MALDI-TOF-MS/MS analysis to identify cardiac proteins that were oxidized and recognized by human chagasic sera yielded 82 unique proteins. We validated the 2D-GE results by enzyme-linked immunosorbent assay (ELISA and WB and demonstrated that oxidation of recombinant titin enhanced its immunogenicity and recognition by sera antibodies from chagasic hosts (rats and humans. Treatment of infected rats with phenyl-α-tert-butyl nitrone (PBN, antioxidant resulted in normalized immune detection of cardiac proteins associated with control of cardiac pathology and preservation of heart contractile function in chagasic

  5. Chagas' disease: the rural environment and vector control in the state of São Paulo, Brazil Doença de Chagas: meio rural e controle de vetores no Estado de São Paulo, Brasil

    OpenAIRE

    Dalva Marli V. Wanderley

    1993-01-01

    In the first half of this century - a period of expanding coffee cultivation - there was a close relationship between the growth of cleared spaces, the domestication of triatomines, and the establishment of Chagas' disease in the state of São Paulo. However, the initiation of control mesuares in 1950 coincided with a period characterized by a progressive reversal of the conditions that had facilitated the establishment of Chagas' disease in the first place. Alterations were taking place in th...

  6. Pregnancy follow-up in a patient with mechanical valve: possible in sub-Saharan Africa?

    OpenAIRE

    Butera Gianfranco; Ambassa JC; Tantchou Tchoumi JC

    2009-01-01

    Background In Africa in general and in Cameroon in particular, post rheumatic cardiopathies are a health care problem, one of the causes of infertility in the women population and a major cause of death among children and adults. Management of a pregnant woman with mechanical heart valve is a complex issue for all health care providers involved in the care of such patients. Patient and case report Miss A is 26-years old and consulted for cardiac assessment; referred from Bamenda (North-West p...

  7. Apresentação clínica da doença de Chagas crônica em indivíduos idosos Clinical presentation of chronic Chagas disease in elderly individuals

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    Eros Antonio de Almeida

    2007-06-01

    hypertension, in 26.2%; 18% had the indeterminate clinical form (p<0.05, 78.7% the cardiac form and 32.8% the digestive form; and abnormalities were frequently found on electrocardiogram: 24.6% presented AS-LBBB, 21.3% RBBB and 18% VEB. It was concluded that there were no clinical differences between elderly and non-elderly Chagas patients. The indeterminate clinical form predominated in patients less than 60 years old.

  8. Aspectos da padronização de testes sorológicos para a doença de Chagas: um teste imunoenzimático para a triagem de doadores de sangue Standardization of serological tests in Chagas' disease: immunoenzimatic test for screening of blood bank donnors

    Directory of Open Access Journals (Sweden)

    A. Walter Ferreira

    1991-04-01

    reagent (bioELISA cruzi, Biolab Diagnóstica S/A, Brasil, was tested in serum from 1648 patients 219 with Chagas disease and 104 with other diseases, plus a comparison with well standardized immunofluorescence and hemagglutination tests in 1325 sera. In the immunoenzimatic assays, the cut off was indicated by the absorbance value of a chagasic serum showing a minimal reactivity. ELISA sensibility was 0,9954 and specificity 0,9969, as conegativity. False positive results were absent with sera from sifilis, toxoplasmosis, mononucleosis and high titered sera for antistreptolysin 0 antibodies. However they were seen in 5 to 15 cases of tegu-mentar leishmaniosis, 1 of 12 Kala-azar 1 of 15 reumatoid arthritis and 1 of 12 sistemic lupus erythematosus. The high sensibility in chagasics and high specificity in the general population indicate the confiability of the imunoenzimatic assay for screening blood donors and even to confirm a clinical diagnosis of Chagas' disease.

  9. Interrupting Chagas disease transmission in Venezuela A interrupção da transmissão da doença de Chagas na Venezuela

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    Alberto ACHÉ

    2001-02-01

    Full Text Available The interruption of vectorial transmission of Chagas disease in Venezuela is attributed to the combined effects of ongoing entomoepidemiological surveillance, ongoing house spraying with residual insecticides and the concurrent building and modification of rural houses in endemic areas during almost five decades. The original endemic areas which totaled 750,000 km², have been reduced to 365,000 km². During 1958-1968, initial entomological evaluations carried out showed that the house infestation index ranged between 60-80%, the house infection index at 8-11% and a house density index of 30-50 triatomine bugs per house. By 1990-98, these indexes were further reduced to 1.6-4.0%, 0.01-0.6% and 3-4 bugs per house respectively. The overall rural population seroprevalence has declined from 44.5% (95% C.I.: 43.4-45.3% to 9.2% (95% C.I.: 9.0-9.4% for successive grouped periods from 1958 to 1998. The annual blood donor prevalence is firmly established below 1%. The population at risk of infection has been estimated to be less than four million. Given that prevalence rates are stable and appropriate for public health programmes, consideration has been given to potential biases that may distort results such as: a geographical differences in illness or longevity of patients; b variations in levels of ascertainment; c variations in diagnostic criteria; and d variations in population structure, mainly due to appreciable population migration. The endemic areas with continuous transmission are now mainly confined to piedmonts, as well as patchy foci in higher mountainous ranges, where the exclusive vector is Rhodnius prolixus. There is also an unstable area, of which landscapes are made up of grasslands with scattered broad-leaved evergreen trees and costal plains, where transmission is very low and occasional outbreaks are reported.A interrupção da transmissão da doença de Chagas é atribuida aos efeitos conjuntos da vigilância soroepidemiol

  10. Chagas' disease in the Brazilian Amazon: I - a short review Doença de Chagas na Amazônia Brasileira: I. revisão

    Directory of Open Access Journals (Sweden)

    José Rodrigues Coura

    1994-08-01

    Full Text Available At least eighteen species of triatominae have been found in the Brazilian Amazon, nine of them naturally infected with Trypanosoma cruzi or "cruzi-like" trypanosomes and associated with numerous wild reservoirs. Despite the small number of human cases of Chagas' disease described to date in the Brazilian Amazon the risk that the disease will become endemic in this area is increasing for the following reasons: a uncontrolled deforestation and colonization altering the ecological balance between reservoir hosts and wild vectors; b the adaptation of reservoir hosts of T.cruzi and wild vectors to peripheral and intradomiciliary areas, as the sole feeding alternative; c migration of infected human population from endemic areas, accompanied by domestic reservoir hosts (dogs and cats or accidentally carrying in their baggage vectors already adapted to the domestic habitat. In short, risks that Chagas' disease will become endemic to the Amazon appear to be linked to the transposition of the wild cycle to the domestic cycle in that area or to transfer of the domestic cycle from endemic areas to the Amazon.Pelo menos dezoito espécies de triatomíneos foram encontradas na Amazônia brasileira, nove das quais infectadas com Trypanosoma cruzi ou semelhante ("cruzi-like", associadas com numerosos reservatórios silvestres. A despeito do pequeno número de casos humanos da doença de Chagas descritos até agora na Amazônia brasileira, o risco que essa doença se torne endêmica é cada vez maior, pelas seguintes razões: a desmatamentos e colonização descontrolados, alterando o balanço entre reservatórios e vetores; b adaptação de reservatórios e vetores silvestres com T.cruzi ao peridomicílio, como única alternativa alimentar; c migração de populações humanas infectadas com T.cruzi acompanhadas de reservatórios domésticos (cães e gatos ou de vetores de suas regiões de origem na bagagem, já adaptados ao domicílio. Em resumo, o risco de que

  11. Diagnostic reliability of an immunochromatographic test for Chagas disease screening at a primary health care centre in a rural endemic area

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    Diego Mendicino

    2014-12-01

    Full Text Available Many patients with Chagas disease live in remote communities that lack both equipment and trained personnel to perform a diagnosis by conventional serology (CS. Thus, reliable tests suitable for use under difficult conditions are required. In this study, we evaluated the ability of personnel with and without laboratory skills to perform immunochromatographic (IC tests to detect Chagas disease at a primary health care centre (PHCC. We examined whole blood samples from 241 patients and serum samples from 238 patients. Then, we calculated the percentage of overall agreement (POA between the two groups of operators for the sensitivity (S, specificity (Sp and positive (PPV and negative (NPV predictive values of IC tests compared to CS tests. We also evaluated the level of agreement between ELISAs and indirect haemagglutination (IHA tests. The readings of the IC test results showed 100% agreement (POA = 1. The IC test on whole blood showed the following values: S = 87.3%; Sp = 98.8%; PPV = 96.9% and NPV = 95.9%. Additionally, the IC test on serum displayed the following results: S = 95.7%; Sp = 100%; PPV = 100% and NPV = 98.2%. Using whole blood, the agreement with ELISA was 96.3% and the agreement with IHA was 94.1%. Using serum, the agreement with ELISA was 97.8% and the agreement with IHA was 96.6%. The IC test performance with serum samples was excellent and demonstrated its usefulness in a PHCC with minimal equipment. If the IC test S value and NPV with whole blood are improved, then this test could also be used in areas lacking laboratories or specialised personnel.

  12. Diagnostic reliability of an immunochromatographic test for Chagas disease screening at a primary health care centre in a rural endemic area.

    Science.gov (United States)

    Mendicino, Diego; Stafuza, Mariana; Colussi, Carlina; Barco, Mónica del; Streiger, Mirtha; Moretti, Edgardo

    2014-12-01

    Many patients with Chagas disease live in remote communities that lack both equipment and trained personnel to perform a diagnosis by conventional serology (CS). Thus, reliable tests suitable for use under difficult conditions are required. In this study, we evaluated the ability of personnel with and without laboratory skills to perform immunochromatographic (IC) tests to detect Chagas disease at a primary health care centre (PHCC). We examined whole blood samples from 241 patients and serum samples from 238 patients. Then, we calculated the percentage of overall agreement (POA) between the two groups of operators for the sensitivity (S), specificity (Sp) and positive (PPV) and negative (NPV) predictive values of IC tests compared to CS tests. We also evaluated the level of agreement between ELISAs and indirect haemagglutination (IHA) tests. The readings of the IC test results showed 100% agreement (POA = 1). The IC test on whole blood showed the following values: S = 87.3%; Sp = 98.8%; PPV = 96.9% and NPV = 95.9%. Additionally, the IC test on serum displayed the following results: S = 95.7%; Sp = 100%; PPV = 100% and NPV = 98.2%. Using whole blood, the agreement with ELISA was 96.3% and the agreement with IHA was 94.1%. Using serum, the agreement with ELISA was 97.8% and the agreement with IHA was 96.6%. The IC test performance with serum samples was excellent and demonstrated its usefulness in a PHCC with minimal equipment. If the IC test S value and NPV with whole blood are improved, then this test could also be used in areas lacking laboratories or specialised personnel. PMID:25466624

  13. Chagas disease: from bush to huts and houses. Is it the case of the Brazilian amazon?

    Directory of Open Access Journals (Sweden)

    José Rodrigues Coura

    1999-09-01

    Full Text Available Two of the major problems facing the Amazon - human migration from the other areas and uncontrolled deforestation - constitute the greatest risk for the establishment of endemic Chagas disease in this part of Brazil. At least 18 species of triatomines had been found in the Brazilian Amazon, 10 of them infected with Trypanosoma cruzi, associated with numerous wild reservoirs. With wide-range deforestation, wild animals will perforce be driven into other areas, with tendency for triatomines to become adapted to alternative food sources in peri and intradomicilies. Serological surveys and cross-sectional studies for Chagas disease, carried out in rural areas of the Rio Negro, in the Brazilian Amazon, showed a high level of seropositivity for T. cruzi antibodies. A strong correlation of seroreactivity with the contact of gatherers of piaçava fibers with wild triatomines could be evidenced.

  14. Population differentiation of the Chagas disease vector Triatoma maculata (Erichson, 1848) from Colombia and Venezuela.

    Science.gov (United States)

    Monsalve, Yoman; Panzera, Francisco; Herrera, Leidi; Triana-Chávez, Omar; Gómez-Palacio, Andrés

    2016-06-01

    The emerging vector of Chagas disease, Triatoma maculata (Hemiptera, Reduviidae), is one of the most widely distributed Triatoma species in northern South America. Despite its increasing relevance as a vector, no consistent picture of the magnitude of genetic and phenetic diversity has yet been developed. Here, several populations of T. maculata from eleven Colombia and Venezuela localities were analyzed based on the morphometry of wings and the mitochondrial NADH dehydrogenase subunit 4 (ND4) gene sequences. Our results showed clear morphometric and genetic differences among Colombian and Venezuelan populations, indicating high intraspecific diversity. Inter-population divergence is suggested related to East Cordillera in Colombia. Analyses of other populations from Colombia, Venezuela, and Brazil from distinct eco-geographic regions are still needed to understand its systematics and phylogeography as well as its actual role as a vector of Chagas disease. PMID:27232127

  15. [Urbanization of chagas disease in Peru: experiences in prevention and control].

    Science.gov (United States)

    Náquira, César

    2014-04-01

    In Peru, Chagas disease has an epidemiological significance in three macro-regions, one of them is the southern macro-region formed by the departments of Arequipa, Moquegua and Tacna. In 1965 a successful control was performed by house spraying insecticides, however, the persistence of the vector made it necessary for a second control plan that was implemented in 2000 and followed the guidelines of CONAL Plan, based on the elimination of Triatoma infestans and screening in blood banks.This plan was successful in Tacna and Moquegua, therefore these departments were considered free of vectorial transmission by the Pan American Health Organization. A ssimilar situation has not been achieved in the department of Arequipa because of the presence, among other factors, of rural migration to the city, in this way the urbanization of Chagas disease is a new epidemiological scenario of which we need to know more. PMID:25123876

  16. Estado actual de nuestros conocimientos sobre la enfermedad de chagas en la Republica Mexicana

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    Jorge Tay

    1981-06-01

    Full Text Available Se presentan los datos obtenidos de la revisión minuciosa en relación a enfermedad de Chagas de la literatura médica de la República Mexicana y extranjera desde el afio de 1939 en que por primeira vez se reporta a Trypanosoma cruzi en México, hasta el ano de 1976. Mediante mapas, tablas y cuadros se senalan las localidades en donde se han encontrado casos humanos, reservorios no humanos y transmisores. Se hacen comentários acerca de los resultados obtenidos y se seffala la importancia de incrementar los estúdios sobre enfermedades de Chagas en nuestro país.

  17. A Case of Vertical Transmission of Chagas Disease Contracted via Blood Transfusion in Canada

    Directory of Open Access Journals (Sweden)

    Margaret A Fearon

    2013-01-01

    Full Text Available Chagas disease is caused by the protozoan parasite Trypanosoma cruzi and is endemic in many countries in Latin America, where infected bugs of the Triatominea subfamily carry the parasite in the gut and transmit it to humans through fecal contamination of a bite. However, vertical transmission and transmission through blood transfusion and organ transplantation is well documented. Increasing immigration from endemic countries to North America has prompted blood operators, including Canadian Blood Services and Hema Quebec, to initiate blood donor testing for Chagas antibody. In the present report, an unusual case of vertical transmission from a mother, most likely infected through blood transfusion, and detected as part of a concurrent seroprevalence study in blood donors is described.

  18. Dental treatment in patients with cardiovascular disease

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    Cleonice da Silveira TEIXEIRA

    2008-04-01

    Full Text Available Introduction: The correct evaluation of patients with cardiovasculardisease is based on a careful anamnesis and on the previous knowledgeof the main coronary diseases and its sequels. Objective: This articlerevised the concepts and characteristics of diverse heart illnesses asthe ischemic cardiopathy, chest angina, congestive cardiac insufficiency,arrhythmia and bradycardia. Literature review and conclusion:Complications like myocardium infarct and bacterial endocarditis were described focusing the dental clinical procedures. The handling of this information is important during the determination of the cardiac risk of each patient, classifying as high, moderate, or minimum risk. Dental professionals must plan the clinical appointments according to pre-established patient’s risk. Short duration appointments and the limitation of the stress and anxiety levels with the use of anti-anxiolytic medicines and complementary sedation can be important for a transoperative and postoperative without complications. The urgent procedures that occurred during the clinical trial in patients with coronary disease were also discussed.

  19. Exposure to Citral, Cinnamon and Ruda Disrupts the Life Cycle of a Vector of Chagas Disease

    OpenAIRE

    C. I. Abramson; E. Aldana; E. Sulbaran

    2007-01-01

    The main vector of Chagas disease in Venezuela was exposed to the odors of citral, cinnamon and ruda. Cinnamon was found to stop the life cycle of Rhodnius prolixus relative to untreated animals. Citral and ruda also influenced the life cycle but not to the extent of animals exposed to cinnamon. We suggest that future research be directed toward using cinnamon in field and toxicity tests.

  20. PREVALENCE OF CHAGAS DISEASE IN A RURAL AREA IN THE STATE OF CEARA, BRAZIL

    OpenAIRE

    Erlane Chaves FREITAS; Maria de Fátima OLIVEIRA; Mônica Coelho ANDRADE; VASCONCELOS, Arduina Sofia Ortet de Barros; José Damião da SILVA FILHO; CÂNDIDO, Darlan da Silva; PEREIRA, Laíse dos Santos; João Paulo Ramalho CORREIA; José Napoleão Monte da CRUZ; Cavalcanti, Luciano Pamplona de Góes

    2015-01-01

    SUMMARY Chagas disease is caused by Trypanosoma cruzi and affects about two to three million people in Brazil, still figuring as an important public health problem. A study was conducted in a rural area of the municipality of Limoeiro do Norte - CE, northeastern Brazil, aiming to determine the prevalence of T. cruzi infection. Of the inhabitants, 52% were examined, among whom 2.6% (4/154) were seropositive in at least two serological tests. All seropositive individuals were older than 50 year...

  1. Chagas Disease in a Non-endemic Country: A Multidisciplinary Research, Bologna, Italy.

    Science.gov (United States)

    Di Girolamo, Chiara; Martelli, Giulia; Ciannameo, Anna; Vocale, Caterina; Fini, Marco; Stefanini, Angelo; Landini, Maria Paola; Viale, Pierluigi; Verucchi, Gabriella

    2016-06-01

    Global processes have brought about a substantial change in the epidemiological landscape of Chagas disease, spreading it to non-endemic areas. Italy is the second country in Europe in terms of Latin American migrants and expected infection rate. Given that scenario, the Bologna University Teaching Hospital undertaken a study aimed at providing preliminary data on the prevalence and investigating the knowledge and the subjective perceptions of Chagas disease, migration pathways and other relevant ill-health experiences. A cross-sectional study was undertaken in association with an ethnographic research. Between November 2010 and May 2013 Chagas disease testing was offered to people who attended the hospital and data were collected to investigate the broader socio-demographic and cultural factors. 151 individuals were screened for anti T. cruzi antibodies; 12 of them, 10 Bolivians and 2 Argentinians, were seroreactive, resulting in an overall prevalence of 7.94 %. Both the quantitative and the qualitative analysis revealed a degree of heterogeneity in terms of knowledge and perceptions of the disease as well as of migration pathways. The results are comparable with those reported by previous studies with similar characteristics and highlight the relevance of such public health issue in a non-endemic context. Moreover, the interdisciplinary approach has greatly helped to unveil the complex social and cultural implications of Chagas disease, to explain the subjective ill-health experiences, and to understand the ways in which the broader socio-economic and cultural context affects an intervention and its potential for success or failure. PMID:25935443

  2. A Deep Insight Into the Sialotranscriptome of the Chagas Disease Vector, Panstrongylus megistus (Hemiptera: Heteroptera)

    Czech Academy of Sciences Publication Activity Database

    Ribeiro, J.M.C.; Schwarz, Alexandra; Francischetti, I.M.B.

    2015-01-01

    Roč. 52, č. 3 (2015), s. 351-358. ISSN 0022-2585 R&D Projects: GA MŠk LH12002; GA ČR GPP302/11/P798 Institutional support: RVO:60077344 Keywords : Chagas disease * vector biology * saliva ry gland * transcriptome * medical entomology Subject RIV: FN - Epidemiology, Contagious Diseases ; Clinical Immunology Impact factor: 1.953, year: 2014

  3. Evaluation of oral mucosal transudate for immunodiagnosis of Chagas´ disease

    Directory of Open Access Journals (Sweden)

    BARROS Maria das Neves D. S.

    1999-01-01

    Full Text Available Anticorpos anti-Trypanosoma cruzi (isotipo IgG foram detectados no transudato da mucosa oral (TMO através de um ensaio imunoenzimático. Foram estudados 21 indivíduos com doença de Chagas crônica comprovada através de diagnóstico clínico, eletrocardiográfico, epidemiológico e sorológico: 10 com forma cardíaca, 2 com forma digestiva, 6 com forma mista e 3 com forma assintomática. Sete indivíduos de área endêmica, com sorologia negativa, constituiram o grupo controle. O soro destes grupos foi armazenado a -20 oC. A coleta de TMO de ambos os grupos foi realizada com o dispositivo OraSureâ seguindo orientação do fabricante (OraSureâ , Epitope Inc., Beaverton, OR, USA. As amostras de TMO foram diluídas (1:2 e testadas em duplicata através de um ensaio imunoenzimático da Abbott Laboratories para detectar anticorpos IgG contra doença de Chagas. Vinte dos vinte e um pacientes chagásicos apresentaram densidade óptica acima do limiar de reatividade e foram considerados positivos para doença de Chagas. Nenhuma das amostras provenientes de indivíduos soronegativos foi positiva. A sensibilidade e especificidade foram de 95% e 100%, respectivamente. Estes resultados indicam que TMO poderá ser utilizado como um fluido biológico alternativo para o diagnóstico da doença de Chagas. Nós estamos aumentando o número de indivíduos para validar estes resultados incluindo a análise comparativa entre amostras de TMO e soro.

  4. Megabladder in experimental Chagas disease: pathological features of the bladder wall

    OpenAIRE

    Scremin Luciano Henrique Gazoni; Corbett Carlos Eduardo Pereira; Laurenti Márcia Dallastra; Nunes Elizabeth Visone; Gama-Rodrigues Joaquim José; Okumura Masayuki

    1999-01-01

    Mega-organs, primarily in the digestive tract, are well known to occur in chronic Chagas disease. Acute experimental infection with Trypanosoma cruzi results in parasitism of a wide range of cells, tissues, and organs, including the urinary bladder. Infection of BALB/c mice with 100,000 bloodstream forms of the Y strain of T. cruzi induced acute infection with intense parasitism of all layers of the urinary bladder. Parasites were found in the mucosa, lamina propria, muscular, adventitial con...

  5. Amazonian Triatomine Biodiversity and the Transmission of Chagas Disease in French Guiana: In Medio Stat Sanitas

    OpenAIRE

    Péneau, Julie; Nguyen, Anne; Flores-Ferrer, Alheli; Blanchet, Denis; Gourbière, Sébastien

    2016-01-01

    The effects of biodiversity on the transmission of infectious diseases now stand as a cornerstone of many public health policies. The upper Amazonia and Guyana shield are hot-spots of biodiversity that offer genuine opportunities to explore the relationship between the risk of transmission of Chagas disease and the diversity of its triatomine vectors. Over 730 triato-mines were light-trapped in four geomorphological landscapes shaping French-Guiana, and we determined their taxonomic status an...

  6. Development of a Novel Multiplex Immunoassay Multi-cruzi for the Serological Confirmation of Chagas Disease

    OpenAIRE

    Granjon, Elodie; Dichtel-Danjoy, Marie-Laure; Saba, Esber; Sabino, Ester; Campos de Oliveira, Lea; Zrein, Maan

    2016-01-01

    Background Chagas disease is due to the parasite Trypanosoma cruzi, a protist disseminated by a Triatome vector. This disease is endemic to Latin America and considered by WHO as one of the 17 world’s neglected diseases. In Europe and in North America, imported cases are also detected, due to migration of population outside of the endemic region. Diagnosis of T. cruzi infection is usually made indirectly by the detection of specific antibodies to T. cruzi antigens. Following initial diagnosti...

  7. Biology, diversity and strategies for the monitoring and control of triatomines - Chagas disease vectors

    OpenAIRE

    Jane Costa; Marcelo Lorenzo

    2009-01-01

    Despite the relevant achievements in the control of the main Chagas disease vectors Triatoma infestans and Rhodnius prolixus, several factors still promote the risk of infection. The disease is a real threat to the poor rural regions of several countries in Latin America. The current situation in Brazil requires renewed attention due to its high diversity of triatomine species and to the rapid and drastic environmental changes that are occurring. Using the biology, behaviour and diversity of ...

  8. The pathogenesis of Chagas' disease: when autoimmune and parasite-specific immune responses meet

    OpenAIRE

    Milena B. P. Soares; LAIN PONTES-DE-CARVALHO; RICARDO RIBEIRO-DOS-SANTOS

    2001-01-01

    Chagas' disease is a major health problem in Latin America, where it constitutes one of the leading causes of heart failure. About one fourth of Trypanosoma cruzi-infected individuals develop chronic chagasic cardiomyopathy (CChC), the most severe form of the disease. CChC is histologically characterized by the presence of multifocal inflammatory infiltrates in the heart, composed mainly by mononuclear cells, usually adhered to myocytes and leading to myocytolysis, and frequently by interstit...

  9. A scientometric evaluation of the Chagas disease implementation research programme of the PAHO and TDR.

    Directory of Open Access Journals (Sweden)

    Ana Laura Carbajal-de-la-Fuente

    2013-11-01

    Full Text Available The Special Programme for Research and Training in Tropical Diseases (TDR is an independent global programme of scientific collaboration cosponsored by the United Nations Children's Fund, the United Nations Development Program, the World Bank, and the World Health Organization. TDR's strategy is based on stewardship for research on infectious diseases of poverty, empowerment of endemic countries, research on neglected priority needs, and the promotion of scientific collaboration influencing global efforts to combat major tropical diseases. In 2001, in view of the achievements obtained in the reduction of transmission of Chagas disease through the Southern Cone Initiative and the improvement in Chagas disease control activities in some countries of the Andean and the Central American Initiatives, TDR transferred the Chagas Disease Implementation Research Programme (CIRP to the Communicable Diseases Unit of the Pan American Health Organization (CD/PAHO. This paper presents a scientometric evaluation of the 73 projects from 18 Latin American and European countries that were granted by CIRP/PAHO/TDR between 1997 and 2007. We analyzed all final reports of the funded projects and scientific publications, technical reports, and human resource training activities derived from them. Results about the number of projects funded, countries and institutions involved, gender analysis, number of published papers in indexed scientific journals, main topics funded, patents inscribed, and triatomine species studied are presented and discussed. The results indicate that CIRP/PAHO/TDR initiative has contributed significantly, over the 1997-2007 period, to Chagas disease knowledge as well as to the individual and institutional-building capacity.

  10. La enfermedad de Chagas ya no es tan exótica

    Centers for Disease Control (CDC) Podcasts

    2008-04-03

    Este podcast tiene el propósito de informar a los profesionales de la salud sobre la enfermedad de Chagas, su diagnóstico y tratamiento, así como orientar en la identificación de pacientes infectados.  Created: 4/3/2008 by National Center for Zoonotic, Vector-Borne, and Enteric Diseases (NCZVED).   Date Released: 4/9/2008.

  11. Positive deviance study to inform a Chagas disease control program in southern Ecuador.

    Science.gov (United States)

    Nieto-Sanchez, Claudia; Baus, Esteban G; Guerrero, Darwin; Grijalva, Mario J

    2015-05-01

    Chagas disease is caused by Trypanosoma cruzi, which is mainly transmitted by the faeces of triatomine insects that find favourable environments in poorly constructed houses. Previous studies have documented persistent triatomine infestation in houses in the province of Loja in southern Ecuador despite repeated insecticide and educational interventions. We aim to develop a sustainable strategy for the interruption of Chagas disease transmission by promoting living environments that are designed to prevent colonisation of rural houses by triatomines. This study used positive deviance to inform the design of an anti-triatomine prototype house by identifying knowledge, attitudes and practices used by families that have remained triatomine-free (2010-2012). Positive deviants reported practices that included maintenance of structural elements of the house, fumigation of dwellings and animal shelters, sweeping with "insect repellent" plants and relocation of domestic animals away from the house, among others. Participants favoured construction materials that do not drastically differ from those currently used (adobe walls and tile roofs). They also expressed their belief in a clear connection between a clean house and health. The family's economic dynamics affect space use and must be considered in the prototype's design. Overall, the results indicate a positive climate for the introduction of housing improvements as a protective measure against Chagas disease in this region. PMID:25807468

  12. Positive deviance study to inform a Chagas disease control program in southern Ecuador

    Directory of Open Access Journals (Sweden)

    Claudia Nieto-Sanchez

    2015-05-01

    Full Text Available Chagas disease is caused by Trypanosoma cruzi, which is mainly transmitted by the faeces of triatomine insects that find favourable environments in poorly constructed houses. Previous studies have documented persistent triatomine infestation in houses in the province of Loja in southern Ecuador despite repeated insecticide and educational interventions. We aim to develop a sustainable strategy for the interruption of Chagas disease transmission by promoting living environments that are designed to prevent colonisation of rural houses by triatomines. This study used positive deviance to inform the design of an anti-triatomine prototype house by identifying knowledge, attitudes and practices used by families that have remained triatomine-free (2010-2012. Positive deviants reported practices that included maintenance of structural elements of the house, fumigation of dwellings and animal shelters, sweeping with "insect repellent" plants and relocation of domestic animals away from the house, among others. Participants favoured construction materials that do not drastically differ from those currently used (adobe walls and tile roofs. They also expressed their belief in a clear connection between a clean house and health. The family's economic dynamics affect space use and must be considered in the prototype's design. Overall, the results indicate a positive climate for the introduction of housing improvements as a protective measure against Chagas disease in this region.

  13. Chagas disease and housing improvement in northeastern Brazil: a cross-sectional survey.

    Science.gov (United States)

    Lima, Marli M; Carvalho-Costa, Filipe A; Toma, Helena K; Borges-Pereira, José; de Oliveira, Tiago Guedes; Sarquis, Otília

    2015-05-01

    Chagas disease was investigated in two new settlements of landless rural workers inhabiting prefabricated, triatomine-proof houses and in four neighboring older communities where mud huts were still well suitable for vectors. Through a cross-sectional survey and entomological assessment, we surveyed 148 houses/families in the two new settlements and in 47 houses/families in the four older localities. We determined seroprevalence of Chagas disease through IFI and Elisa (eluates) assays and searched for vectors in the domestic and peridomestic environments. Seroprevalence reached 0.6% (3/466) in the new settlements and 0.8% (1/115) in the older communities. Triatomines were not found in the new settlements, while 7 Triatoma brasiliensis, 4 T. pseudomaculata, 1 Panstrongylus lutzi, and 145 Rhodnius nasutus were collected in the older localities. In addition, a colony of T. brasiliensis (n = 55) was encountered inside a school attended by children of the region. Parasite strains isolated from the insects were characterized as T. cruzi I. Despite the low prevalence of Chagas disease in both scenarios, entomological surveillance must be strengthened and housing improvement reinforced in order to control vector transmission. The risk of infection by the vectors was lower in the settlements of improved homes, where conditions for colonization of the peridomestic environment by transmitting insects were not observed. PMID:25673077

  14. Morbidity of Chagas heart disease in the microregion of Rio Negro, Amazonian Brazil: a case-control study

    Directory of Open Access Journals (Sweden)

    Jose Rodrigues Coura

    2013-12-01

    Full Text Available A case-control study on the morbidity of Chagas heart disease was carried out in the municipality of Barcelos in the microregion of the Rio Negro, state of Amazonas. One hundred and six individuals, who were serologically positive for Trypanosoma cruzi infection, as confirmed by at least two techniques with different principles, were matched according to age and sex with an equal number of seronegative individuals. The cases and controls were evaluated using an epidemiological questionnaire and clinical, electrocardiograph and echocardiograph examinations. In the seroepidemiological evaluation, 62% of the interviewees recognised triatomines and most of them confirmed that they had seen these insects in the piassava plantations of the riverside communities of the Negro River tributaries. Of the seropositive patients, 25.8% affirmed that they had been stung by the triatomines and 11.7% denied having been stung. The principal clinical manifestations of the seropositive individuals were palpitations, chest pain and dyspnoea upon effort. Cardiac auscultation revealed extrasystoles, bradycardia and systolic murmurs. The electrocardiographic alterations were ventricular extrasystoles, left and right bundle branch block, atrioventricular block and primary T wave alterations. The echocardiogram was altered in 22.6% of the seropositive individuals and in 8.5% of the seronegative individuals.

  15. A Family Cluster of Chagas Disease Detected through Selective Screening of Blood Donors: A Case Report and Brief Review

    Directory of Open Access Journals (Sweden)

    Guillaume Mongeau-Martin

    2015-01-01

    Full Text Available Chagas disease (CD is a protozoan infection caused by Trypanosoma cruzi, which is transmitted by triatomine insect vectors in parts of Latin America. In a nonendemic country, such as Canada, spread can still occur via vertical transmission, and infected blood or organ donations. The Canadian Blood Services and Héma-Québec have both implemented selective screening of blood donors for CD based on risk factors. In 2011, Héma-Québec identified two seropositive ‘at-risk’ Chilean siblings who had donated blood in Montreal, Quebec. They were referred to the JD MacLean Centre for Tropical Diseases (Montreal, Quebec for confirmatory testing (T cruzi excreted-secreted antigen ELISA, polymerase chain reaction and/or radioimmunoprecipitation assay and follow-up. Screening of the rest of the family revealed two other seropositive family members (the mother and sister. While their geographical history in Chile suggests vectorial transmission, this family cluster of CD raises the possibility of vertical transmission. Congenital infection should always be considered among CD-positive mothers and pregnant women. With blood donor screening, Canadian physicians will increasingly see patients with CD and should know how to manage them appropriately. In addition to the case presentation, the authors review the transmission, screening and clinical management of CD in a nonendemic context.

  16. A family cluster of Chagas disease detected through selective screening of blood donors: A case report and brief review.

    Science.gov (United States)

    Mongeau-Martin, Guillaume; Ndao, Momar; Libman, Michael; Delage, Gilles; Ward, Brian J

    2015-01-01

    Chagas disease (CD) is a protozoan infection caused by Trypanosoma cruzi, which is transmitted by triatomine insect vectors in parts of Latin America. In a nonendemic country, such as Canada, spread can still occur via vertical transmission, and infected blood or organ donations. The Canadian Blood Services and Héma-Québec have both implemented selective screening of blood donors for CD based on risk factors. In 2011, Héma-Québec identified two seropositive 'at-risk' Chilean siblings who had donated blood in Montreal, Quebec. They were referred to the JD MacLean Centre for Tropical Diseases (Montreal, Quebec) for confirmatory testing (T cruzi excreted-secreted antigen ELISA, polymerase chain reaction and/or radioimmunoprecipitation assay) and follow-up. Screening of the rest of the family revealed two other seropositive family members (the mother and sister). While their geographical history in Chile suggests vectorial transmission, this family cluster of CD raises the possibility of vertical transmission. Congenital infection should always be considered among CD-positive mothers and pregnant women. With blood donor screening, Canadian physicians will increasingly see patients with CD and should know how to manage them appropriately. In addition to the case presentation, the authors review the transmission, screening and clinical management of CD in a nonendemic context. PMID:26236358

  17. Anaesthesia Management in a Patient with Waardenburg Syndrome and Review of the Literature.

    Science.gov (United States)

    Peker, Kevser; Ergil, Julide; Öztürk, İbrahim

    2015-10-01

    Waardenburg syndrome is a rare autosomal dominant disease that may cause hearing loss, pigmentary abnormalities, neurocristopathy and partial albinism. Incidence is estimated as 2%-3% among the cases of congenital deafness and 1/42,000 of the general population. Children with Waardenburg syndrome usually require anaesthesia for the cochlear implant operation in early age. The features of the syndrome that may bear importance for anaesthetic management are laryngomalacia, multiple muscle contractures, limited neck movements, cyanotic cardiopathy and electrolyte imbalance. Patients with Waardenburg syndrome stand for difficult airway. We aimed to report anaesthetic management of a child with Waardenburg syndrome who underwent surgery for cochlear implantation. PMID:27366529

  18. La circulation de Fontan dans le traitement des cardiopathies congénitales uni-ventriculaires : Approche clinique, physiopathologique et expérimentale

    OpenAIRE

    Henaine, Roland

    2012-01-01

    The Fontan surgery is a palliative surgery for univentricular congenital heart disease. On the longterm, heart failure, pulmonary arterial hypertension (PAH) and exudative enteropathy may lead tothe Fontan failure.A clinical adjustment has been realized by focusing secondarily on adult patients. The advantage, insome cases of total anomalous pulmonary venous return, of the bidirectional cavopulmonary (BCP),which is an intermediate stage of Fontan, has been described.In order to prepare future...

  19. Enfermedad de Chagas en poblaciones prehistóricas del norte de Chile Chagas disease in prehistoric populations of northern Chile

    Directory of Open Access Journals (Sweden)

    NANCY ORELLANA-HALKYER

    2010-12-01

    Full Text Available La enfermedad de Chagas es producida por el parásito Trypanosoma cruzi, el cual afecta tanto a seres humanos como a animales, en particular mamíferos marsupiales y placentarios. Las vías de transmisión son diversas, siendo una de las más importantes la vía vectorial, en la que participan insectos infectados con este parásito, animales y humanos. En este artículo de revisión discutimos los postulados sobre la vía de transmisión oral, los hallazgos de T. cruzi en momias de América y especialmente en las del norte de Chile. Presentamos además información que apunta a que la enfermedad de Chagas estuvo presente mucho antes de la conquista europea y de la construcción de viviendas de adobe. Comentamos las hipótesis sobre el vector domiciliado más importante de Sudamérica, Triatoma infestans, su antigüedad en la costa de Arica y los reportes más recientes de otros vectores silvestres. También se discute la información relacionada a la participación en el ciclo de T. cruzi de distintos mamíferos silvestres de Chile y asimismo proponemos el estudio paleoparasitológico en restos zooarqueológicos para conocer las especies de mamíferos reservónos de T. cruzi en la antigüedad.Chagas diseases is produced by a parasite named Trypanosoma cruzi, that affects humans and other marsupial and placental mammals. Transmission routes are diverse, but the most important transmission is the vector route, which involves the triatomine insects, wild and domestic infected animáis, and humans. Here we review the data about oral transmission route and the evidences of the etiological agent (Trypanosoma cruzi of Chagas disease in pre-Columbian American mummies, making a critical review of the infection in northern Chile. Moreover, we comment on the hypotheses suggested in relation to the most important vector of the infection in South América Triatoma infestans, its antiquity in the Arica coast, and the recent reports about other wild infected

  20. Miocárdio não compactado, Doença de Chagas e disfunção: relato de caso Miocardio no compactado, Enfermedad de Chagas y disfunción: caso clínico Noncompaction of the myocardium, Chagas' disease and dysfunction: a case report

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    Ronaldo Peixoto de Mello

    2010-07-01

    Full Text Available Relatamos a associação entre a cardiopatia associada ao miocárdio não compactado do ventrículo esquerdo (MNCVE à cardiopatia chagásica crônica (CCC em paciente com clínica de insuficiência cardíaca, acidente vascular cerebral isquêmico e arritmia cardíaca. As imagens típicas de MNCVE e CCC foram documentadas pela ressonância magnética cardíaca (RMC.Relatamos la asociación entre la cardiopatía asociada al miocardio no compactado del ventrículo izquierdo (MNCVI con la cardiopatía chagásica crónica (CCC en paciente con clínica de insuficiencia cardíaca, accidente vascular cerebral isquémico y arritmia cardíaca. Las imágenes típicas de MNCVI y CCC fueron documentadas por resonancia magnética cardíaca (RMC.We report the association between heart disease associated with noncompaction of the left ventricular myocardium (NCLVM and chronic Chagas' heart disease (CCHD in a patient with heart failure, ischemic stroke and cardiac arrhythmia. Images typical of NCLVM and CCHD were documented by cardiac magnetic resonance imaging (CMRI.

  1. Chagas disease: what is known and what is needed - A background article

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    José Rodrigues Coura

    2007-10-01

    Full Text Available Chagas disease began millions of years ago as an enzootic disease of wild animals and started to be transmitted to man accidentally in the form of an anthropozoonosis when man invaded wild ecotopes. Endemic Chagas disease became established as a zoonosis over the last 200-300 years through forest clearance for agriculture and livestock rearing and adaptation of triatomines to domestic environments and to man and domestic animals as a food source. It is estimated that 15 to 16 million people are infected with Trypanosoma cruzi in Latin America and 75 to 90 million people are exposed to infection. When T. cruzi is transmitted to man through the feces of triatomines, at bite sites or in mucosa, through blood transfusion or orally through contaminated food, it invades the bloodstream and lymphatic system and becomes established in the muscle and cardiac tissue, the digestive system and phagocytic cells. This causes inflammatory lesions and immune responses, particularly mediated by CD4+, CD8+, interleukin-2 (IL and IL-4, with cell and neuron destruction and fibrosis, and leads to blockage of the cardiac conduction system, arrhythmia, cardiac insufficiency, aperistalsis, and dilatation of hollow viscera, particularly the esophagus and colon. T. cruzi may also be transmitted from mother to child across the placenta and through the birth canal, thus causing abortion, prematurity, and organic lesions in the fetus. In immunosuppressed individuals, T. cruzi infection may become reactivated such that it spreads as a severe disease causing diffuse myocarditis and lesions of the central nervous system. Chagas disease is characterized by an acute phase with or without symptoms, and with entry point signs (inoculation chagoma or Romaña's sign, fever, adenomegaly, hepatosplenomegaly, and evident parasitemia, and an indeterminate chronic phase (asymptomatic, with normal results from electrocardiogram and x-ray of the heart, esophagus, and colon or with a

  2. [The assessment process within science and the nomination of Carlos Chagas for the Nobel prize for Physiology or Medicine].

    Science.gov (United States)

    Pittella, José Eymard Homem

    2009-01-01

    One of the greatest achievements in the history of medicine was the description of Chagas disease by the physician and scientist Carlos Chagas. A hundred years after the discovery of the disease, speculation still remains regarding the two official nominations of Carlos Chagas for the Nobel Prize, the biggest worldwide scientific award, in 1913 and in 1921. It has been accepted that the reason why the prize was not awarded to this brilliant scientist may have been the strong opposition that he faced in Brazil, from some physicians and researchers of that time. They went as far as questioning the existence of Chagas disease, thereby possibly influencing the decision of the Nobel Committee not to award the prize to him. Analysis of the database of the Nobel prize archives, with the revelation of the names of nominators, nominees and prizewinners spanning the years 1901-1951, brought information not only about what was considered to be a scientific achievement at that time, but also about who the important scientists were and what the relationships between them were. The non-recognition of Carlos Chagas' discoveries by the Nobel Committee appears to be more correctly explained by these factors than by the negative impact of the local opposition. PMID:19287939

  3. Sorologia positiva para sífilis, toxoplasmose e doença de Chagas em gestantes de primeira consulta em centros de saúde de área metropolitana, Brasil Positive sorology of syphilis, toxoplasmosis and Chagas' disease in pregnant women on their first visit to State Health Centes in a metropolitan area, Brazil

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    Adelaide José Vaz

    1990-10-01

    . Paulo's Health Care Centres in the subdistrict of Paz (Butantan, City of S. Paulo, Brazil, between April and October, 1988. Classified by trimester of pregnancy, 230 patients (47.8% fell into the first, 203 (42.2% into the second and 48 (10% into the third trimester. Of the 474 patients that declared their income, 309 (65.2% earned 1 MSPC (minimum salary per capita per month, which gives some indication of the low socioeconomic status of our patients is. The sorologic tests for syphilis, toxoplasmosis and Chagas' disease were analysed for each patient, more than one technique being used for each. The results were as follows: 25 patients (5.2% had a positive test for syphilis; in 67 patients (13.9% active toxoplasmosis was diagnosed (Presence of IgM antibodies in 6; 14 patients (2.9% were positive for Chagas' disease, among which 10 (71.4% came from the States of Bahia and Minas Gerais, where this disease has a high prevalence.

  4. Cardiac magnetic resonance tomography in the diagnostics of restrictive and unclassified cardiopathies; Kardiale Magnetresonanztomographie in der Diagnostik der restriktiven und unklassifizierten Kardiomyopathien

    Energy Technology Data Exchange (ETDEWEB)

    Kramer, U.; Mangold, S.; Krumm, P.; Claussen, C.D. [Universitaet Tuebingen, Abteilung fuer Diagnostische und Interventionelle Radiologie, Radiologische Klinik, Tuebingen (Germany); May, A.E. [Universitaet Tuebingen, Medizinische Klinik III, Abteilung fuer Kardiologie und Kreislauferkrankungen, Tuebingen (Germany)

    2013-01-15

    Besides ischemic heart disease cardiomyopathies are common causes of heart failure and sudden cardiac death. The diagnostic spectrum in cardiomyopathies comprises non-invasive and invasive examination techniques. The exact verification of certain cardiomyopathies necessitates knowledge of the latest classification of cardiomyopathies as well as dedicated examination protocols. Modern imaging modalities, such as echocardiography and cardiac magnetic resonance imaging (MRI) have emerged as useful imaging tools in the investigation of patients suspected of having many different types of cardiomyopathies. Based on a better understanding of the underlying pathophysiology several diagnostic criteria have been defined using cardiac MRI. In particular there is an increasing importance of cardiac MRI in the description of patients with restrictive and unclassified cardiomyopathies. Echocardiography still remains the modality of choice in the diagnostics of unclear left ventricular heart failure. Further diagnostic work-up should include cardiac MRI in case of any lack of clarity. (orig.) [German] Kardiomyopathien stellen neben den ischaemischen Herzerkrankungen eine wesentliche Ursache fuer die Entwicklung einer Herzinsuffizienz und den ploetzlichen Herztod dar. Das diagnostische Spektrum bei Kardiomyopathien umfasst nichtinvasive und invasive Untersuchungsmethoden. Die exakte Diagnosesicherung einzelner Krankheitsbilder erfordert zum einen die Kenntnis der aktuellen Klassifikationen der heterogenen Gruppe der Kardiomyopathien, zum anderen sind oft spezielle Untersuchungstechniken erforderlich. Moderne bildgebende Verfahren stellen einen zentralen Bestandteil der diagnostischen Moeglichkeiten bei der Abklaerung einer Kardiomyopathie dar. Neben der Echokardiographie ist hier insbesondere die kardiale Magnetresonanztomographie (MRT) zu nennen. Mit zunehmendem Verstaendnis ueber die Pathogenese einzelner Kardiomyopathien konnten diagnostische Kriterien fuer die kardiale MRT

  5. [A study of the antiherpetic activity of the chaga mushroom (Inonotus obliquus) extracts in the Vero cells infected with the herpes simplex virus].

    Science.gov (United States)

    Polkovnikova, M V; Nosik, N N; Garaev, T M; Kondrashina, N G; Finogenova, M P; Shibnev, V A

    2014-01-01

    The chaga mushroom (Inonotus obliquus) contains a wide range of excellent bioactive compounds. However, limited information exists on the antiviral activity of the compounds extracted from chaga. A number of subfractions of chaga were obtained using different solvents and different procedures. The subfractions of chaga extracted with water, alcohol, alkali were tested for their toxicity for the Vero cell culture and antiviral effect in the Vero cells infected with the Herpes simplex virus (HSV), Type 1. It was shown that most of the subfractions were not toxic for the Vero cells and had protective effect on the Vero cells infected with HSV. The subfraction IV in the concentration 5 microg/ml protected the Vero cells from cytodestructive action of HSV and no viral DNA was detected in infected cells treated with chaga extracts. Best protective effect was observed when compound was added before or within one hour after the Vero cells were infected with HSV. PMID:25069286

  6. Seroprevalence and sociocultural conditionants of Chagas disease in school aged children of marginal zones of Asunción

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    Vera Ninfa I.

    1998-01-01

    Full Text Available Chagas disease is becoming a public health problem in Latin America due to the wide distribution, the high prevalence, the magnitude of the damage caused and the difficulties to control it. In Paraguay, the disease is mainly distributed in the departments of Paraguari, Cordillera and Central. Prevalence in marginal zones, where migrations from rural populations and endemic areas make possible the urbanization of the disease, has no been studied yet. This is a descriptive study with a cross-sectional sampling and a probabilistic system recruitment carried out in school aged children from marginal zones of Asuncion to determine the prevalence of Chagas' disease. Serological methods, parasite isolation and questionnaires were used to achieve the goals. Nine hundred and fifty three children were studied to determine the prevalence of Chagas' disease in marginal zones which was 1.4%.

  7. Evaluation of the Chagas Disease Control Program in Açucena Municipality, Rio Doce Valley, State of Minas Gerais, Brazil

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    Adriana dos Santos

    2014-04-01

    Full Text Available Introduction Açucena Municipality, Rio Doce Valley, State of Minas Gerais, Brazil temporarily (2001-2005 interrupted epidemiological surveillance for Chagas disease. The objective of this work was to evaluate the Chagas Disease Control Program (CDCP in Açucena and to offer suggestions for improving local epidemiological surveillance. Methods This study was conducted in three phases: I a serological investigation of schoolchildren aged 5 to 15 years using an enzyme-linked immunosorbent assay (ELISA test performed on blood collected on filter paper followed by ELISA, indirect immunofluorescence (IIF and indirect hemaglutination (IHA on venous blood for borderline cases and those in the gray zone of reactivity; II vector evaluation using the data obtained by local health agents during 2006-2010; and III examination by ELISA, IIF and IHA of serum samples from the inhabitants of houses where infected Triatoma vitticeps was found and evaluation of their knowledge about Chagas disease. Results Five individuals had inconclusive results in the ELISA screening but were seronegative for Chagas disease. The triatomine evaluation revealed the presence of three species: Triatoma vitticeps, Panstrongylus megistus and Panstrongylus diasi. Triatoma vitticeps was the most prevalent and widespread, with a higher (67% index of Trypanosoma cruzi flagellates and evidence of colonization. Most of the inhabitants of the infested houses recognized triatomines and had basic knowledge about Chagas disease. Conclusions Although T. vitticeps is not clearly associated with Chagas disease transmission, these results highlight the importance of maintaining CDCP in endemic areas and the need for greater emphasis on epidemiological surveillance, especially in areas with important vectorial changes or that have been modified by human intervention.

  8. Carlos Chagas Filho: um articulador da história das ciências do Brasil Carlos Chagas Filho: an articulator of the history of sciences in Brazil

    OpenAIRE

    Heloisa Maria Bertol Domingues

    2012-01-01

    Uma carta enviada em 1982 por um grupo de cientistas ao presidente do Conselho Nacional de Desenvolvimento Científico e Tecnológico reivindicava uma política de preservação da cultura científica brasileira. O nome Carlos Chagas Filho encabeçava a lista de assinaturas, a mostrar seu engajamento naquela proposta, cuja estrutura ideológica fez parte da sua vivência na política científica, no Brasil e no exterior. Esse documento remete à prática da história das ciências no Brasil e à criação de l...

  9. Pneumonia lipoídica associada à forma digestiva da doença de Chagas Digestive Chagas disease with concomitant lipoid pneumonia

    OpenAIRE

    Marcelo Fernando Ranzani; Nilson Sebastião Miranda; Ulisses Frederigue Junior; Sérgio Marrone Ribeiro; Jussara Marcondes Machado

    2004-01-01

    Mulher de 50 anos com megaesôfago e megacólon chagásico apresentou quadro clínico de tosse seca, dor torácica e dispnéia leves. O raio X de tórax mostrou opacidade do tipo alveolar bilateral sugestivo de pneumonia. Após biópsia a céu aberto chegou-se ao diagnóstico de pneumonia lipoídica. A doença foi causada pelo uso crônico de laxantes à base de óleo mineral, utilizados nos últimos três anos. Os autores discutem a associação da forma digestiva da doença de Chagas com pneumonia lipoídica, e ...

  10. Current epidemiological trends for Chagas disease in Latin America and future challenges in epidemiology, surveillance and health policy

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    Álvaro Moncayo

    2009-07-01

    Full Text Available Chagas disease, named after Carlos Chagas, who first described it in 1909, exists only on the American Continent. It is caused by a parasite, Trypanosoma cruzi, which is transmitted to humans by blood-sucking triatomine bugs and via blood transfusion. Chagas disease has two successive phases: acute and chronic. The acute phase lasts six-eight weeks. Several years after entering the chronic phase, 20-35% of infected individuals, depending on the geographical area, will develop irreversible lesions of the autonomous nervous system in the heart, oesophagus and colon, and of the peripheral nervous system. Data on the prevalence and distribution of Chagas disease improved in quality during the 1980s as a result of the demographically representative cross-sectional studies in countries where accurate information was not previously available. A group of experts met in Brasilia in 1979 and devised standard protocols to carry out countrywide prevalence studies on human T. cruzi infection and triatomine house infestation. Thanks to a coordinated multi-country programme in the Southern Cone countries, the transmission of Chagas disease by vectors and via blood transfusion was interrupted in Uruguay in 1997, in Chile in 1999 and in Brazil in 2006; thus, the incidence of new infections by T. cruzi across the South American continent has decreased by 70%. Similar multi-country initiatives have been launched in the Andean countries and in Central America and rapid progress has been reported towards the goal of interrupting the transmission of Chagas disease, as requested by a 1998 Resolution of the World Health Assembly. The cost-benefit analysis of investment in the vector control programme in Brazil indicates that there are savings of US$17 in medical care and disabilities for each dollar spent on prevention, showing that the programme is a health investment with very high return. Many well-known research institutions in Latin America were key elements of a

  11. Los domingos del mes del Chagas en el Museo de La Plata 2012 : Conociendo a nuestros visitantes

    OpenAIRE

    Scazzola, María Soledad; Ceccarelli, Soledad; Reche, Vanina Anadina; Sanmartino, Mariana; Mordeglia, Cecilia; Amieva, Carolina

    2013-01-01

    En este trabajo compartimos el análisis de algunos de los resultados obtenidos a partir de las actividades desarrolladas durante los fines de semana de agosto en el Museo de La Plata (Buenos Aires). Éstas se enmarcaron en el “Mes del Chagas 2012”, organizado por el Proyecto de Extensión Universitaria “¿De qué hablamos cuando hablamos de Chagas? Estrategias y recursos didácticos para abordar el tema en diferentes contextos educativos” (Universidad Nacional de La Plata). Más de 6000 personas co...

  12. Stairway to Heaven or Hell? Perspectives and Limitations of Chagas Disease Chemotherapy.

    Science.gov (United States)

    Salomao, Kelly; Menna-Barreto, Rubem Figueiredo Sadok; de Castro, Solange Lisboa

    2016-01-01

    In this review, we intend to provide a general view of the evolution of experimental studies in the area of chemotherapy for Chagas disease. We can follow the process of drug development through three phases. The first phase began almost at the same time as the discovery made by Carlos Chagas and proceeds to 1970, during which time an extensive list of compounds was subjected to preclinical and clinical trials. The second phase began with the introduction of nifurtimox and benznidazole into the clinical setting, followed with the search for alternative drugs. In this phase, a dichotomy existed between rational and empirical approaches in preclinical studies. The third phase began with the unravelling of the T. cruzi genome. The development of transgenic parasites has allowed the development of solid HTS protocols, and the establishment of bioluminescent T. cruzi has allowed in vivo drug evaluations using a reduced number of animals. Among the wide variety of compounds subjected to preclinical studies, we have discovered azolic and non-azolic inhibitors of sterol C14α-demethylase (CYP51) and nitro compounds. Two compounds evaluated during the second phase, namely, MK-436 and allopurinol, could be revisited. Clinical studies of posaconazole and E1224 yielded disappointing results, and it is critical to understand the reason for their failure as a monotherapy. Currently, the combination and repositioning of drugs with different mechanisms of action are complementary approaches. The use of drug combinations, particularly those of nitro compounds with CYP51 inhibitors, is considered a real alternative for the treatment of Chagas disease. PMID:27072716

  13. Cultivation-independent methods reveal differences among bacterial gut microbiota in triatomine vectors of Chagas disease.

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    Fabio Faria da Mota

    Full Text Available BACKGROUND: Chagas disease is a trypanosomiasis whose agent is the protozoan parasite Trypanosoma cruzi, which is transmitted to humans by hematophagous bugs known as triatomines. Even though insecticide treatments allow effective control of these bugs in most Latin American countries where Chagas disease is endemic, the disease still affects a large proportion of the population of South America. The features of the disease in humans have been extensively studied, and the genome of the parasite has been sequenced, but no effective drug is yet available to treat Chagas disease. The digestive tract of the insect vectors in which T. cruzi develops has been much less well investigated than blood from its human hosts and constitutes a dynamic environment with very different conditions. Thus, we investigated the composition of the predominant bacterial species of the microbiota in insect vectors from Rhodnius, Triatoma, Panstrongylus and Dipetalogaster genera. METHODOLOGY/PRINCIPAL FINDINGS: Microbiota of triatomine guts were investigated using cultivation-independent methods, i.e., phylogenetic analysis of 16s rDNA using denaturing gradient gel electrophoresis (DGGE and cloned-based sequencing. The Chao index showed that the diversity of bacterial species in triatomine guts is low, comprising fewer than 20 predominant species, and that these species vary between insect species. The analyses showed that Serratia predominates in Rhodnius, Arsenophonus predominates in Triatoma and Panstrongylus, while Candidatus Rohrkolberia predominates in Dipetalogaster. CONCLUSIONS/SIGNIFICANCE: The microbiota of triatomine guts represents one of the factors that may interfere with T. cruzi transmission and virulence in humans. The knowledge of its composition according to insect species is important for designing measures of biological control for T. cruzi. We found that the predominant species of the bacterial microbiota in triatomines form a group of low

  14. Amazonian Triatomine Biodiversity and the Transmission of Chagas Disease in French Guiana: In Medio Stat Sanitas.

    Science.gov (United States)

    Péneau, Julie; Nguyen, Anne; Flores-Ferrer, Alheli; Blanchet, Denis; Gourbière, Sébastien

    2016-02-01

    The effects of biodiversity on the transmission of infectious diseases now stand as a cornerstone of many public health policies. The upper Amazonia and Guyana shield are hot-spots of biodiversity that offer genuine opportunities to explore the relationship between the risk of transmission of Chagas disease and the diversity of its triatomine vectors. Over 730 triatomines were light-trapped in four geomorphological landscapes shaping French-Guiana, and we determined their taxonomic status and infection by Trypanosoma cruzi. We used a model selection approach to unravel the spatial and temporal variations in species abundance, diversity and infection. The vector community in French-Guiana is typically made of one key species (Panstrongylus geniculatus) that is more abundant than three secondary species combined (Rhodnius pictipes, Panstrongylus lignarius and Eratyrus mucronatus), and four other species that complete the assemblage. Although the overall abundance of adult triatomines does not vary across French-Guiana, their diversity increases along a coastal-inland gradient. These variations unravelled a non-monotonic relationship between vector biodiversity and the risk of transmission of Chagas disease, so that intermediate biodiversity levels are associated with the lowest risks. We also observed biannual variations in triatomine abundance, representing the first report of a biannual pattern in the risk of Chagas disease transmission. Those variations were highly and negatively correlated with the average monthly rainfall. We discuss the implications of these patterns for the transmission of T. cruzi by assemblages of triatomine species, and for the dual challenge of controlling Amazonian vector communities that are made of both highly diverse and mostly intrusive species. PMID:26867025

  15. Amazonian Triatomine Biodiversity and the Transmission of Chagas Disease in French Guiana: In Medio Stat Sanitas.

    Directory of Open Access Journals (Sweden)

    Julie Péneau

    2016-02-01

    Full Text Available The effects of biodiversity on the transmission of infectious diseases now stand as a cornerstone of many public health policies. The upper Amazonia and Guyana shield are hot-spots of biodiversity that offer genuine opportunities to explore the relationship between the risk of transmission of Chagas disease and the diversity of its triatomine vectors. Over 730 triatomines were light-trapped in four geomorphological landscapes shaping French-Guiana, and we determined their taxonomic status and infection by Trypanosoma cruzi. We used a model selection approach to unravel the spatial and temporal variations in species abundance, diversity and infection. The vector community in French-Guiana is typically made of one key species (Panstrongylus geniculatus that is more abundant than three secondary species combined (Rhodnius pictipes, Panstrongylus lignarius and Eratyrus mucronatus, and four other species that complete the assemblage. Although the overall abundance of adult triatomines does not vary across French-Guiana, their diversity increases along a coastal-inland gradient. These variations unravelled a non-monotonic relationship between vector biodiversity and the risk of transmission of Chagas disease, so that intermediate biodiversity levels are associated with the lowest risks. We also observed biannual variations in triatomine abundance, representing the first report of a biannual pattern in the risk of Chagas disease transmission. Those variations were highly and negatively correlated with the average monthly rainfall. We discuss the implications of these patterns for the transmission of T. cruzi by assemblages of triatomine species, and for the dual challenge of controlling Amazonian vector communities that are made of both highly diverse and mostly intrusive species.

  16. ELISA versus PCR for diagnosis of chronic Chagas disease: systematic review and meta-analysis

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    Hasslocher-Moreno Alejandro M

    2010-11-01

    Full Text Available Abstract Background Most current guidelines recommend two serological tests to diagnose chronic Chagas disease. When serological tests are persistently inconclusive, some guidelines recommend molecular tests. The aim of this investigation was to review chronic Chagas disease diagnosis literature and to summarize results of ELISA and PCR performance. Methods A systematic review was conducted searching remote databases (MEDLINE, LILACS, EMBASE, SCOPUS and ISIWeb and full texts bibliography for relevant abstracts. In addition, manufacturers of commercial tests were contacted. Original investigations were eligible if they estimated sensitivity and specificity, or reliability -or if their calculation was possible - of ELISA or PCR tests, for chronic Chagas disease. Results Heterogeneity was high within each test (ELISA and PCR and threshold effect was detected only in a particular subgroup. Reference standard blinding partially explained heterogeneity in ELISA studies, and pooled sensitivity and specificity were 97.7% [96.7%-98.5%] and 96.3% [94.6%-97.6%] respectively. Commercial ELISA with recombinant antigens studied in phase three investigations partially explained heterogeneity, and pooled sensitivity and specificity were 99.3% [97.9%-99.9%] and 97.5% [88.5%-99.5%] respectively. ELISA's reliability was seldom studied but was considered acceptable. PCR heterogeneity was not explained, but a threshold effect was detected in three groups created by using guanidine and boiling the sample before DNA extraction. PCR sensitivity is likely to be between 50% and 90%, while its specificity is close to 100%. PCR reliability was never studied. Conclusions Both conventional and recombinant based ELISA give useful information, however there are commercial tests without technical reports and therefore were not included in this review. Physicians need to have access to technical reports to understand if these serological tests are similar to those included in

  17. Training the Next Generation of Scientists: System Dynamics Modeling of Chagas Disease (American Trypanosomiasis) transmission.

    Science.gov (United States)

    Goff, P.; Hulse, A.; Harder, H. R.; Pierce, L. A.; Rizzo, D.; Hanley, J.; Orantes, L.; Stevens, L.; Justi, S.; Monroy, C.

    2015-12-01

    A computational simulation has been designed as an investigative case study by high school students to introduce system dynamics modeling into high school curriculum. This case study approach leads users through the forensics necessary to diagnose an unknown disease in a Central American village. This disease, Chagas, is endemic to 21 Latin American countries. The CDC estimates that of the 110 million people living in areas with the disease, 8 million are infected, with as many as 300,000 US cases. Chagas is caused by the protozoan parasite, Trypanosoma cruzi, and is spread via blood feeding insect (vectors), that feed on vertebrates and live in crevasses in the walls and roofs of adobe homes. One-third of the infected people will develop chronic Chagas who are asymptomatic for years before their heart or GI tract become enlarged resulting in death. The case study has three parts. Students play the role of WHO field investigators and work collaboratively to: 1) use genetics to identify the host(s) and vector of the disease 2) use a STELLA™ SIR (Susceptible, Infected, Recovered) system dynamics model to study Chagas at the village scale and 3) develop management strategies. The simulations identify mitigation strategies known as Ecohealth Interventions (e.g., home improvements using local materials) to help stakeholders test and compare multiple optima. High school students collaborated with researchers from the University of Vermont, Loyola University and Universidad de San Carlos, Guatemala, working in labs, interviewing researchers, and incorporating mulitple field data as part of a NSF-funded multiyear grant. The model displays stable equilibria of hosts, vectors, and disease-states. Sensitivity analyses show measures of household condition and presence of vertebrates were significant leverage points, supporting other findings by the University research team. The village-scale model explores multiple solutions to disease mitigation for the purpose of producing

  18. Serum-Mediated Activation of Macrophages Reflects TcVac2 Vaccine Efficacy against Chagas Disease

    OpenAIRE

    Gupta, Shivali; Silva, Trevor S.; Osizugbo, Jessica E.; Tucker, Laura; Spratt, Heidi M.; Garg, Nisha J.

    2014-01-01

    Chagas disease is endemic in Latin America and an emerging infectious disease in the United States. No effective treatments are available. The TcG1, TcG2, and TcG4 antigens are highly conserved in clinically relevant Trypanosoma cruzi isolates and are recognized by B and T cells in infected hosts. Delivery of these antigens as a DNA prime/protein boost vaccine (TcVac2) elicited lytic antibodies and type 1 CD8+ T cells that expanded upon challenge infection and provided >90% control of parasit...

  19. Estado actual de nuestros conocimientos sobre la enfermedad de chagas en la Republica Mexicana

    OpenAIRE

    Jorge Tay; Paz Ma. Salazar S.; Martha Irene Bucio; Renato Zarate; Lauren Zarate

    1981-01-01

    Se presentan los datos obtenidos de la revisión minuciosa en relación a enfermedad de Chagas de la literatura médica de la República Mexicana y extranjera desde el afio de 1939 en que por primeira vez se reporta a Trypanosoma cruzi en México, hasta el ano de 1976. Mediante mapas, tablas y cuadros se senalan las localidades en donde se han encontrado casos humanos, reservorios no humanos y transmisores. Se hacen comentários acerca de los resultados obtenidos y se seffala la importancia de incr...

  20. Training Systems Modelers through the Development of a Multi-scale Chagas Disease Risk Model

    Science.gov (United States)

    Hanley, J.; Stevens-Goodnight, S.; Kulkarni, S.; Bustamante, D.; Fytilis, N.; Goff, P.; Monroy, C.; Morrissey, L. A.; Orantes, L.; Stevens, L.; Dorn, P.; Lucero, D.; Rios, J.; Rizzo, D. M.

    2012-12-01

    The goal of our NSF-sponsored Division of Behavioral and Cognitive Sciences grant is to create a multidisciplinary approach to develop spatially explicit models of vector-borne disease risk using Chagas disease as our model. Chagas disease is a parasitic disease endemic to Latin America that afflicts an estimated 10 million people. The causative agent (Trypanosoma cruzi) is most commonly transmitted to humans by blood feeding triatomine insect vectors. Our objectives are: (1) advance knowledge on the multiple interacting factors affecting the transmission of Chagas disease, and (2) provide next generation genomic and spatial analysis tools applicable to the study of other vector-borne diseases worldwide. This funding is a collaborative effort between the RSENR (UVM), the School of Engineering (UVM), the Department of Biology (UVM), the Department of Biological Sciences (Loyola (New Orleans)) and the Laboratory of Applied Entomology and Parasitology (Universidad de San Carlos). Throughout this five-year study, multi-educational groups (i.e., high school, undergraduate, graduate, and postdoctoral) will be trained in systems modeling. This systems approach challenges students to incorporate environmental, social, and economic as well as technical aspects and enables modelers to simulate and visualize topics that would either be too expensive, complex or difficult to study directly (Yasar and Landau 2003). We launch this research by developing a set of multi-scale, epidemiological models of Chagas disease risk using STELLA® software v.9.1.3 (isee systems, inc., Lebanon, NH). We use this particular system dynamics software as a starting point because of its simple graphical user interface (e.g., behavior-over-time graphs, stock/flow diagrams, and causal loops). To date, high school and undergraduate students have created a set of multi-scale (i.e., homestead, village, and regional) disease models. Modeling the system at multiple spatial scales forces recognition that

  1. Estudo experimental sobre o congelamento do plasma e implicações referentes à transmissão da doença de chagas em serviços de hemoterapia

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    Vicente Amato Neto

    1975-06-01

    Full Text Available Plasmas de indivíduos normais e de pacientes com a forma crônica da doença de Chagas foram, intencionalmente, contaminados com cepa muito virulenta do Trypanosoma cruzi e, a seguir, congelados a -20°C, durante seis e 24 horas, como também no decurso de três ,sete, 14 e 21 dias. Depois de descongelamento em temperatura ambiente, ocorreram exame microsc��pico a fresco em contraste de fase, cultivo em meio de Warren e inoculação em camundongos, com subseqüente análise histopatológica do coração. Através dessas pesquisas, a sobrevivência do flagelado ficou avaliada, tendo sido verificado que o congelamento por três e 24 horas não impediu a persistência do parasita infetante. Salientaram os Autores que a investigação que levaram a efeito procurou contribuir no sentido de prestar orientação quanto às transfusões de plasmas, em Serviços de Hemoterapia, convindo frisar que no Brasil elas são efetuadas com razoável freqüênêcia, mediante utilização de doadores acometidos pela doença de Chagas e com a convicção de que baixas temperaturas promovem segura esterilização.The plasmas of normal subjets and of patients with chronic Chagas' disease were intentionally contaminated with a very virulent strain of Trypanosoma cruzi. The specimens were frozen to -20°C during three and twenty-four hours and for three, seven, fourteen and twenty-one days. After the aliquots were warmed to ambient temperature, they were examined as a fresh smearunder contrast phase microscopy, cultivated in Warren’s medium and inoculated in mice for subsequent histopathological examination of the heart. The results indicated that freezing durlng three and twenty-four hours did not prevent survival of the infecting parasite. The purpose of the study was to contribute to the orientation of plasma transfusion in blood transfusion centers. Since plasma transfusion is commonplace in, this country, many times colleeted from infected donors with Chagas

  2. Doença de Chagas em Virgem da Lapa, Minas Gerais, Brasil. IV. Aspectos clínicos e epidemiológicos do aneurisma ventricular esquerdo Chagas' disease in Virgem da Lapa County, Minas Gerais State, Brazil. IV. Clinical and epidemiological aspects of the left ventricle aneurism

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    José Borges-Pereira

    1998-10-01

    Full Text Available Com o objetivo de avaliar as características clínicas e epidemiológicas do aneurisma ventricular esquerdo na doença de Chagas crônica, 388 indivíduos não selecionados: 298 chagásicos e 90 não-chagásicos, foram submetidos ao exame ecocardiográfico. A função ventricular foi avaliada ao modo M através do cálculo da fração de ejeção e ao bidimensional através da análise subjetiva da função sistólica global e a contratilidade regional foi avaliada pelo modelo da Sociedade Americana de Ecocardiografia. Foram diagnosticados 56 (18,8% aneurismas do ventrículo esquerdo, todos entre os chagásicos, sendo 38 (12,7% no segmento apical, 10 (3,4% no septo interventricular, 2 (0,7% ápico-septal, 2 (0,7% na parede posterior, 2 (0,7% na parede inferior e 2 (0,7% no segmento ínfero-posterior. Não houve diferença significativa nas freqüências dos aneurismas em relação à faixa etária, ao sexo e à etnia. Não houve associação entre aneurismas e hipertensão arterial. Dos 56 indivíduos com aneurismas, 55 (98,2% eram sintomáticos com predominância de palpitações, 53 (94,6,% apresentaram ECG anormais, com predominância de extra-sístoles ventriculares, seguidas de alterações da condução e 34 (60,7% apresentaram comprometimento da função ventricular, sem diferença quanto ao segmento acometido. Diante destes resultados podemos considerar o aneurisma ventricular esquerdo, principalmente apical, como um marcador de doença de Chagas e um indicador da alta morbidade da infecção humana pelo T. cruzi em Virgem da Lapa.The study aimed at the evaluation of the clinical and epidemiological characteristics of the aneurism found in the left ventricle in chronic Chagas' disease patients. Three handred, eighty eight people (298 chagasic patients and 90 randomly selected healthy individuals were submitted to echocardiography. The ventricular function was assessed in the M mode by calculating the fraction of ejection, and in the

  3. The Sex Distribution of Congenital Cardiopathies

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    Sampayo, F.; Pinto, MF

    1994-01-01

    Apresenta-se a distribuição por sexos em 4150 crianças, de idade inferior a 13 anos, com cardiopatias congénitas bem definidas, estudadas num periodo de 17 anos. Globalmente a distribuição foi equilibrada, sendo 2108 do fenotipo masculino (50,8%) e 2042 do fenotipo feminino(49,2%), com um quociente Q = 1,03. Verificou-se um predomínio franco do sexo masculino para as seguintes cardiopatias: estenose aórtica valvular e subvalvular fixa (70%), coarctação da aorta(66%), transposição das grand...

  4. Conventional serological performance in diagnosis of Chagas' disease in southern Brazil

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    Anelise Bergmann Araújo

    2013-04-01

    Full Text Available Results of Chagas' disease diagnosis show disagreement. The aim of this study was to compare commercial tests for Chagas' disease serodiagnosis in southern Brazil. A total of 161 samples were evaluated. Three enzyme-linked immunosorbent assays, one indirect hemagglutination and one indirect immunofluorescence were assessed. Trypomastigote excreted-secreted antigen-blot was a confirmatory method. From 161 samples, 65.84% were positive in all tests, while 34.16% presents mismatch result in at least one of the tests. All techniques tested presented false-positive and/or false-negative results as follows: Enzyme-linked immunosorbent assay 1 had more false-positive results (lower specificity, indirect immunofluorescence had the highest rate of false-negative results (lower sen sitivity, enzyme-linked immunosorbent assays had fewer false-negative results (higher sensitivity, while indirect hemagglutination showed no false-positive result (higher specificity. Knowing the characteristics of techniques make it possible to combine them and obtain more reliable diagnosis. Therefore, it seems useful to combine techniques for diagnosing this infection.

  5. Geographic Distribution of Chagas Disease Vectors in Brazil Based on Ecological Niche Modeling

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    Rodrigo Gurgel-Gonçalves

    2012-01-01

    Full Text Available Although Brazil was declared free from Chagas disease transmission by the domestic vector Triatoma infestans, human acute cases are still being registered based on transmission by native triatomine species. For a better understanding of transmission risk, the geographic distribution of Brazilian triatomines was analyzed. Sixteen out of 62 Brazilian species that both occur in >20 municipalities and present synanthropic tendencies were modeled based on their ecological niches. Panstrongylus geniculatus and P. megistus showed broad ecological ranges, but most of the species sort out by the biome in which they are distributed: Rhodnius pictipes and R. robustus in the Amazon; R. neglectus, Triatoma sordida, and T. costalimai in the Cerrado; R. nasutus, P. lutzi, T. brasiliensis, T. pseudomaculata, T. melanocephala, and T. petrocchiae in the Caatinga; T. rubrovaria in the southern pampas; T. tibiamaculata and T. vitticeps in the Atlantic Forest. Although most occurrences were recorded in open areas (Cerrado and Caatinga, our results show that all environmental conditions in the country are favorable to one or more of the species analyzed, such that almost nowhere is Chagas transmission risk negligible.

  6. Soro-epidemiologia da doença de Chagas em Santa Catarina

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    BR Schlemper Jr

    1983-12-01

    Full Text Available Em Santa Catarina, o Inquérito Sorológico Nacional para doença de Chagas (CNPq-SUCAM revelou positividade de 1,3% em cerca de 74.000 amostras de soro processadas pela reação de imunofluorescência indireta em papel de filtro, com 15 municípios apresentando prevalências de 5,4% a 41,3%. Na presente investigação, em 9 dos municípios com alta prevalência, foram obtidas amostras de sangue, por punção venosa, de 222 indivíduos dos quais 140 haviam sido sorologicamente positivos e 58 negativos no Inquérito Nacional. Em 24 outros indivíduos a reação foi executada pela primeira vez. Os testes sorológicos (imunofluorescência indireta, hemaglutinação indireta, aglutinação direta com e sem 2-mercaptoetanol e fixação do complemento realizados em 3 diferentes laboratórios evidenciaram 220 soros negativos e apenas 2 positivos. Dados epidenúológicos obtidos nas áreas trabalhadas confirmaram estes resultados negativos. Os resultados discordam daqueles encontrados pelo Inquérito Sorológico Nacional e confirmam a inexistência de focos domiciliares de transmissão da doença de Chagas em Santa Catarina.

  7. The effect of Ageratum fastigiatum extract on Rhodnius nasutus, vector of Chagas disease

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    Bethânia A. Avelar-Freitas

    2013-04-01

    Full Text Available Control of Chagas disease is based on insecticide spraying in domiciles in order to exterminate triatomine populations. However, since the vectors differ in susceptibility to currently used insecticides, the screening of the toxic potential of Brazilian flora may identify new molecules lethal to triatomines. This study evaluated the toxicity of ethanolic extract of Ageratum fastigiatum (Gardner R.M. King & H. Rob., Asteraceae, on Rhodnius nasutus, a known vector of Chagas disease. Ethanolic extracts of the aerial parts of A. fastigiatum were prepared at 25 and 50 mg/mL concentrations, and 5 µL was applied to fifth-instar nymphs of R. nasutus (n=30. Controls included nymphs that were treated with 5 µL ethanol (n=30 or left untreated (n=30. The percentage of dead insects in each group was observed at 24, 48, 72, 96 and 120 h after application. The extracts of A. fastigiatum showed a mortality rate of about 37% and 77% after 120 h, at concentrations of 25 and 50 mg/mL, respectively. In control groups, the mortality rate remained under 7%. The extract of A. fastigiatum contains a coumarin, a molecule with recognized toxicity in insects, and which may be responsible for killing the triatomines.

  8. [Epidemiological status of Chagas disease in the endemic area from Region II of Antofagasta].

    Science.gov (United States)

    Cáceres, J; Burchard, L; Bahamonde, M I; Contreras, M C; García, A; Rojas, A; Schenone, H; Lorca, M

    1999-01-01

    During 1997 a seroepidemiological study on Chagas' disease was carried out in 18 localities of three provinces (Tocopilla, El Loa and Antofagasta) of Region II (20 degrees 56'-26 degrees South Lat.; 70 degrees 38'-67 degrees West Long.), in order to assess the impact of the control program against Triatoma infestans launched in 1988, based on insecticide spraying of dwellings. By means of ELISA and an indirect hemagglutination test for Chagas' disease blood samples from 1,034 children under 10 years of age were examined, arising a 0.5% (3 cases) positivity. Test resulted positive in 2 (0.9%) children from the locality of San Pedro de Atacama and 1 (0.4%) from Calama city, all in the age group 6-10 year-old. However, none of their dwellings were found infested with T. infestants. These results indicate that the control program has a good possibility to prevent new human infections. It is advisable to continue the seroepidemiological and entomological vigilance and remark the necessity of increasing the effort in the study of transmission through other routes, to adopt or reinforce the pertinent preventive measures. PMID:10488587

  9. Impact of Chagas Disease in Bolivian Immigrants Living in Europe and the Risk of Stigmatization

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    Rafael M. Ortí-Lucas

    2014-01-01

    Full Text Available Background. The prevalence of Chagas disease in endemic countries varies with the kind of vector involved and the socioeconomic conditions of the population of origin. Due to recent immigration it is an emerging public health problem in Europe, especially in those countries which receive immigrant populations with a high prevalence of carriers. The study reviews the impact of the disease on Bolivian immigrants living in Europe, the preventive measures and regulations applied in European countries, and their repercussion on possible stigmatization of certain population groups. Methods. The Bolivian immigrant population resident in 2012 was estimated and the affected population in different European countries was calculated with data on carrier prevalence that were recently published. The preventive measures and regulations available in Europe were also reviewed. MEDLINE-PubMed, GoPubMed, and Embase were consulted for the literature review. Results. The Bolivian immigrant population has the highest prevalence of Chagas carriers (6.7%–25% compared to the overall Latin American population (1.3%–2.4%. Only in Spain, France, Belgium, UK, Portugal, Italy, Switzerland, The Netherlands, and Germany, preventive measures are applied to this population. The established regulations are insufficient and completely different criteria are applied in the different countries and this could reflect a certain degree of stigmatization.

  10. Opportunities for improved chagas disease vector control based on knowledge, attitudes and practices of communities in the yucatan peninsula, Mexico.

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    Kathryn Rosecrans

    2014-03-01

    Full Text Available BACKGROUND: Chagas disease is a vector-borne parasitic disease of major public health importance. Current prevention efforts are based on triatomine vector control to reduce transmission to humans. Success of vector control interventions depends on their acceptability and value to affected communities. We aimed to identify opportunities for and barriers to improved vector control strategies in the Yucatan peninsula, Mexico. METHODOLOGY/PRINCIPAL FINDINGS: We employed a sequence of qualitative and quantitative research methods to investigate knowledge, attitudes and practices surrounding Chagas disease, triatomines and vector control in three rural communities. Our combined data show that community members are well aware of triatomines and are knowledgeable about their habits. However, most have a limited understanding of the transmission dynamics and clinical manifestations of Chagas disease. While triatomine control is not a priority for community members, they frequently use domestic insecticide products including insecticide spray, mosquito coils and plug-in repellents. Families spend about $32 US per year on these products. Alternative methods such as yard cleaning and window screens are perceived as desirable and potentially more effective. Screens are nonetheless described as unaffordable, in spite of a cost comparable to the average annual spending on insecticide products. CONCLUSION/SIGNIFICANCE: Further education campaigns and possibly financing schemes may lead families to redirect their current vector control spending from insecticide products to window screens. Also, synergism with mosquito control efforts should be further explored to motivate community involvement and ensure sustainability of Chagas disease vector control.

  11. El ensayo inmunoenzimatico en microgotas sobre nitrocelulosa (Dot-ELISA en el diagnostico de la enfermedad de Chagas: I. Estudio comparativo de dos preparaciones antigenicos de Trypanosoma cruzi The Dot-Enzyme linked immunosorbent assay (Dot-ELISA in the diagnosis of Chagas-disease: I. Comparative study of two antigenic preparations of Trypanosoma cruzi

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    Rosa M. de Hubsch

    1988-09-01

    Full Text Available Se estudia el Ensayo Inmunoenzimático en Microgotas sobre Nitrocelulosa (Dot-ELISAcomparando dos preparados antigénicos de formas epimastigotas de cultivo de T. cruzi: 1 la fracción citoplasmática (antígeno citoplasmático y 2 el parásito total fijado previamente con formaldehido (antígeno integral. Se usaron sueros de: 95 pacientes chagásicos con serología convencional positiva, cardiopatía crónica y algunos con xenodiagnóstico positivo; 42 personas sanas y 32 con miocardipatía crónica con serología negativa y 74 pacientes con diferentes patologías incluyendo: sífilis, toxoplasmosis, lupus eritematoso diseminado, con factor reumatoide, leishmaniasis visceral, y leishmaniasis cutánea. Definidos los títulos diagnósticos (cut-off de 1:512 con antígeno citoplasmático y de 1: 128 con antígeno integral, la especificidad fue 96% para el primero y de 100% para el segundo; mientras que la sensibilidad fue de 100% para ambas. En el estudio comparativo con las pruebas serológicas convencionales examinando 147 sueros tomados de personas referidas al laboratório, Dot-ELISA con antígeno citoplasmático presentó índices deco-positividad de 1,0, co-negatividad de 0,989 y eficiencia 0,993. Dot-ELIS con antígeno integral dió 1,0, 0,979 y 0,986 respectivamente. De acuerdo con esta evaluación, la técnica Dot-ELISA con antígeno integral se presenta como una alternativa práctica para el diagnóstico serológico de la enfermedad de Chagas.Using the Dot-ELISA technique, two antigenic preparations of Trypanosoma cruzi epimastigote forms have been compared for the diagnosis of Chagas' disease: (1 The citoplasmic fraction (citoplasmic antigen and (2 whole fixed epimastigotes (integral antigen. There was been used sera from 95 chagasic patients with chronic cadiomyopathy, positive conventional serology and either positive or negative xenodiagnosis; 74 subjects with negative conventional serology, and either clinically normal or presenting

  12. Epidemiología de la enfermedad de Chagas en el estado de Veracruz Epidemiology of Chagas disease in the state of Veracruz

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    Elsa L Segura

    2005-06-01

    Full Text Available OBJETIVO: Identificar la seroprevalencia de enfermedad de Chagas, los factores de riesgo de la vivienda e índices entomológicos, para proponer medidas de control en 11 jurisdicciones sanitarias del estado de Veracruz. MATERIAL Y MÉTODOS: Entre 1997 y 2001 se hizo un estudio transversal cuya muestra quedó integrada por 281 localidades, 2 526 viviendas y 9 782 individuos. Se aplicó un cuestionario sobre factores de riesgo, se tomó sangre en papel filtro y se buscaron triatominos en el intra y peridomicilio. Se obtuvo la prevalencia de exposición a factores de riesgo y de seropositividad para la enfermedad. Se hizo análisis bivariado mediante la razón de momios, ji de Mantel y Haenszel e intervalo de confianza a 95% como prueba de significancia estadística. El análisis multivariado se hizo mediante la regresión logística no condicional y se incluyeron las variables que durante el análisis bivariado mostraron un valor de p hasta de 0.20. El impacto potencial se estimó con base en la fracción etiológica en expuestos. RESULTADOS: La prevalencia de enfermedad de Chagas fluctuó entre 0 y 2.8%. Las jurisdicciones con mayor riesgo fueron Tuxpan, Pánuco y Córdoba, y sin riesgo, Orizaba. Los principales factores de riesgo de la vivienda fueron el techo y muro de palma/zacate y piso de tierra, así como la presencia del vector y la ventilación. CONCLUSIONES: Es necesario realizar vigilancia epidemiológica basada en educación para la salud, mejoramiento de la vivienda y uso de insecticidas.OBJECTIVE: To assess the seroprevalence, household risk factors, and entomological indicators, in order to frame control measures in 11 Sanitary Jurisdictions of the state. MATERIAL AND METHODS: This study included 281 towns, 2 526 households, and 9782 individuals. Data were collected using a questionnaire. Blood was obtained in filter paper and a search for triatomines was conducted inside of and around dwellings. Prevalence rates were used to

  13. Globalização, iniqüidade e doença de Chagas Globalization, inequity and Chagas disease

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    João Carlos Pinto Dias

    2007-01-01

    Full Text Available A doença de Chagas (tripanossomíase americana, apresenta múltiplos aspectos sócio-culturais e político-econômicos que envolvem questões de iniqüidade e globalização. São relações presentes tanto nos processos de produção da doença como nas possibilidades de sua prevenção e manejo. Apesar da pobreza da região, envolvendo questões de iniqüidade e globalização, a doença tem sido controlada em várias áreas, o que reforça a auto-estima dos países. Para o futuro, problemas e desafios podem ser esperados, principalmente em termos da assistência médica para os indivíduos já infectados e da sustentação de uma vigilância epidemiológica permanente. Ambos estes pontos dependem de um melhor desempenho dos sistemas nacionais de saúde, principalmente em termos de sua competência e da superação de situações de iniqüidade. Particularmente, tem cabido à comunidade científica e acadêmica latino-americana um papel de grande destaque na implementação e sustentação de políticas de controle da doença, que hoje evoluíram para estratégias de ação compartida entre países, o que pode significar importante avanço no contexto político da região.Chagas disease (American trypanosomiasis bears a close relationship to multiple social and political aspects involving issues of globalization and inequity. Such relations concern the process of disease production and control in parallel with medical management. Despite the poverty in Latin America and various problems related to inequities and globalization, Chagas disease has been controlled in several areas, a fact that reinforces the countries' self-reliance. Several problems and challenges related to the disease can be expected in the future, mainly concerning medical care for already infected individuals and the sustainability of effective epidemiological surveillance. Both points depend heavily on improved performance by the national health systems, principally in

  14. Serological survey for Chagas disease in the rural areas of Manaus, Coari, and Tefé in the Western Brazilian Amazon

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    Belisa Maria Lopes Magalhães

    2011-12-01

    Full Text Available INTRODUCTION: Deforestation, uncontrolled forest, human population migration from endemic areas, and the large number of reservoirs and wild vectors naturally infected by Trypanosoma cruzi promote the endemicity of Chagas disease in the Amazon region. METHODS: We conducted an initial serological survey (ELISA in a sample of 1,263 persons; 1,095 (86.7% were natives of the State of Amazonas, 666 (52.7% were male, and 948 (75.1% were over 20 years old. Serum samples that were found to be reactive, indeterminate, or inconclusive by indirect immunofluorescence (IFI or positive with low titer by IFA were tested by Western blot (WB. Serologically confirmed patients (WB were evaluated in terms of epidemiological, clinical, ECG, and echocardiography characteristics. RESULTS: Fifteen patients had serologically confirmed T. cruzi infection, and 12 of them were autochthonous to the state of Amazonas, for an overall seroprevalence of 1.2% and 0.9% for the state of Amazonas. Five of the 15 cases were males, and the average age was 47 years old; most were farmers with low education. One patient who was not autochthonous, having originated from Alagoas, showed right bundle branch block, bundle branch block, and anterosuperior left ventricular systolic dysfunction with an ejection fraction of 54%. CONCLUSIONS: The results of this study ratify the importance of monitoring CD cases in Amazonia, particularly in the state of Amazonas.

  15. Neglect of a Neglected Disease in Italy: The Challenge of Access-to-Care for Chagas Disease in Bergamo Area.

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    Ernestina Carla Repetto

    2015-09-01

    Full Text Available Chagas disease (CD represents a growing problem in Europe; Italy is one of the most affected countries but there is no national framework for CD and access-to-care is challenging. In 2012 Médecins Sans Frontières (MSF started an intervention in Bergamo province, where many people of Latin American origin (PLAO are resident. A new model-of-care for CD, initiated by Centre for Tropical Diseases of Sacro Cuore Hospital, Negrar (CTD, the NGO OIKOS and the Bolivian community since 2009 in the same area, was endorsed. Hereby, we aim to describe the prevalence of CD and the treatment management outcomes among PLAO screened from 1st June 2012 to 30th June 2013.Retrospective cohort study using routine program data. Screening sessions were done in Bergamo at OIKOS outpatient service and serological confirmation, staging and treatment for CD was offered at the CTD. MSF provided health education on CD, awareness generation prior to screening days, pre-test and post-test counselling through cultural mediators of Latin American origin.Of 1305 PLAO screened, 223(17% had CD. Among 210 patients eligible for treatment, 102(49% were lost-to-follow-up before treatment. The median delay from diagnosis to treatment was 4 months (range 0.7-16.6 months. Among 108 started on treatment, 63(58% completed treatment, 36(33% interrupted treatment, (33 for drug side-effects, two for patients decision and one due to pregnancy, 6(6% were lost-to-follow-up and 3(3% were on treatment at study censuring.In this first study focusing on process of care for CD in Italy, less than 30% of patients completed treatment with drop-outs along the cascade of care. There is an urgent need to involve affected communities and local regional health authorities to take part to this model-of-care, adapting it to the local epidemiology. The Italian health authorities should take steps in advocating for a change in the current paradigm.

  16. A field trial of alternative targeted screening strategies for Chagas disease in Arequipa, Peru.

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    Gabrielle C Hunter

    2012-01-01

    Full Text Available BACKGROUND: Chagas disease is endemic in the rural areas of southern Peru and a growing urban problem in the regional capital of Arequipa, population ∼860,000. It is unclear how to implement cost-effective screening programs across a large urban and periurban environment. METHODS: We compared four alternative screening strategies in 18 periurban communities, testing individuals in houses with 1 infected vectors; 2 high vector densities; 3 low vector densities; and 4 no vectors. Vector data were obtained from routine Ministry of Health insecticide application campaigns. We performed ring case detection (radius of 15 m around seropositive individuals, and collected data on costs of implementation for each strategy. RESULTS: Infection was detected in 21 of 923 (2.28% participants. Cases had lived more time on average in rural places than non-cases (7.20 years versus 3.31 years, respectively. Significant risk factors on univariate logistic regression for infection were age (OR 1.02; p = 0.041, time lived in a rural location (OR 1.04; p = 0.022, and time lived in an infested area (OR 1.04; p = 0.008. No multivariate model with these variables fit the data better than a simple model including only the time lived in an area with triatomine bugs. There was no significant difference in prevalence across the screening strategies; however a self-assessment of disease risk may have biased participation, inflating prevalence among residents of houses where no infestation was detected. Testing houses with infected-vectors was least expensive. Ring case detection yielded four secondary cases in only one community, possibly due to vector-borne transmission in this community, apparently absent in the others. CONCLUSIONS: Targeted screening for urban Chagas disease is promising in areas with ongoing vector-borne transmission; however, these pockets of epidemic transmission remain difficult to detect a priori. The flexibility to adapt to the

  17. Modeling horizontal gene transfer (HGT in the gut of the Chagas disease vector Rhodnius prolixus

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    Durvasula Ravi V

    2011-05-01

    Full Text Available Abstract Background Paratransgenesis is an approach to reducing arthropod vector competence using genetically modified symbionts. When applied to control of Chagas disease, the symbiont bacterium Rhodococcus rhodnii, resident in the gut lumen of the triatomine vector Rhodnius prolixus (Hemiptera: Reduviidae, is transformed to export cecropin A, an insect immune peptide. Cecropin A is active against Trypanosoma cruzi, the causative agent of Chagas disease. While proof of concept has been achieved in laboratory studies, a rigorous and comprehensive risk assessment is required prior to consideration of field release. An important part of this assessment involves estimating probability of transgene horizontal transfer to environmental organisms (HGT. This article presents a two-part risk assessment methodology: a theoretical model predicting HGT in the gut of R. prolixus from the genetically transformed symbiont R. rhodnii to a closely related non-target bacterium, Gordona rubropertinctus, in the absence of selection pressure, and a series of laboratory trials designed to test the model. Results The model predicted an HGT frequency of less than 1.14 × 10-16 per 100,000 generations at the 99% certainty level. The model was iterated twenty times, with the mean of the ten highest outputs evaluated at the 99% certainty level. Laboratory trials indicated no horizontal gene transfer, supporting the conclusions of the model. Conclusions The model treats HGT as a composite event, the probability of which is determined by the joint probability of three independent events: gene transfer through the modalities of transformation, transduction, and conjugation. Genes are represented in matrices and Monte Carlo method and Markov chain analysis are used to simulate and evaluate environmental conditions. The model is intended as a risk assessment instrument and predicts HGT frequency of less than 1.14 × 10-16 per 100,000 generations. With laboratory studies that

  18. Chagas disease in an area of recent occupation in Cochabamba, Bolivia

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    Albarracin-Veizaga Hugo

    1999-01-01

    Full Text Available INTRODUCTION: A descriptive, entomological and seroepidemiological study on Chagas disease was conducted in a place of recent occupation on the outskirts of Cochabamba, Bolivia: Avaroa/Primer de Mayo (population:3,000, where the socio-economic level is low and no control measures have been made available. METHODS: The immunofluorescent antibody test (IFAT was used for IgG and IgM anti-Trypanosoma cruzi antibodies in filter paper bloodspot eluates from 128 subjects (73 females, 55 males selected by systematic sampling. Concerning each subject age, gender, birthplace, occupation, duration of residence and building materials used in their houses were recorded. Vectors were captured both in domestic and peridomestic environments. RESULTS: Seropositive, 12.5% (16/128: females, 15.1% (11/73; males, 9.1% (5/55. Average time of residence: 6.1 years for the whole population sample and 7.4 years for the seropositive subjects. Most houses had adobe walls (76.7% , n= 30, galvanized iron rooves (86.7% and earthen floors (53.4% 80% of the walls had crevices. One hundred forty seven specimens of Triatoma infestans were captured, of which 104 (70.7% were domestic, and 1 peridomestic Triatoma sordida. Precipitin host identification: birds, 67.5%; humans, 27.8%; rodents, 11.9%; dogs, 8.7%; cats, 1.6%. House infestation and density indices were 53.3 and 493.0 respectively. We found 21 (14.3% specimens of T. infestans infected with trypanosomes, 18 (85.7% of which in domestic environments. DISCUSSION: The elements for the vector transmission of Chagas disease are present in Avaroa/Primer de Mayo and the ancient custom of keeping guinea pigs indoors adds to the risk of human infection. In neighboring Cochabamba, due to substandard quality control, contaminated blood transfusions are not infrequent, which further aggravates the spread of Chagas disease. Prompt action to check the transmission of this infection, involving additionally the congenital and transfusional

  19. Development of a Fluorescence-based Trypanosoma cruzi CYP51 Inhibition Assay for Effective Compound Triaging in Drug Discovery Programmes for Chagas Disease.

    OpenAIRE

    Jennifer Riley; Stephen Brand; Michael Voice; Ivan Caballero; David Calvo; Kevin D Read

    2015-01-01

    Chagas disease, caused by the protozoan parasite Trypanosoma cruzi (T. cruzi), is a life threatening global health problem with only two drugs available for treatment (benznidazole and nifurtimox), both having variable efficacy in the chronic stage of the disease and high rates of adverse drug reactions. Inhibitors of sterol 14α-demethylase (CYP51) have proven effective against T. cruzi in vitro and in vivo in animal models of Chagas disease. Consequently two azole inhibitors of CYP51 (posaco...

  20. Evaluation of the rabbit as a model for Chagas disease - II: histopathologic studies of the heart, digestive tract and skeletal muscle

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    Arnaldo Moreira da Silva

    1996-04-01

    Full Text Available In order to investigate the value of the rabbit as an experimental model for Chagas' disease, seventy one animals were inoculated with different Trypanosoma cruzi strains and routes. The rabbits were submitted to necropsy in acute (earlier than three months of infection, recent chronic (three to six months and late chronic (later than six months phases. Myocarditis, generally focal and endomysial, occurred in 94.1%, 66.7% and 70.8% of the infected rabbits respectively in the acute, recent chronic and late chronic phases. The myocardial inflammatory exudate was composed by mononuclear cells, and also polymorphonuclear cells in the acute phase. In most cases of the late chronic phase, the myocarditis was similar to that described in the indeterminate form of human chagasic patients. Initial fibrosis occurred in the three phases but was more severe and frequent in the early chronic. Advanced fibrosis occurred only in the late chronic phase. Tissue parasites occurred only in the acute phase. The digestive tract and skeletal muscles showed mild and occasional lesions. Our data indicate that experimentally infected chagasic rabbits repeat some lesions similar to that of humans chagasic patients, specially that of the indeterminate form. So, it may be a useful, however not an ideal, model.

  1. A doença de Chagas em Minas Gerais: esbôco crítico dos trabalhos publicados até 1951 Chagas' disease in Minas Geraes: a critical sudy of the papers published up to 1951

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    J. Pellegrino

    1953-12-01

    Full Text Available O grande impulso que têm tornado, nestes últimos anos, as investigações sôbre a doença de Chagas, não sòmente em Minas Gerais, como também em outros Estados do Brasil e países do novo continente atingidos pela endemia; o interêsse cada vez mais crescente por parte dos médicos em geral e a facilidade com que vêm sendo por êles assimiladas as recentes contribuições ao estudo desta entidade mórbida; a importância médico-social e a repercussão econômica que tem sido atribuída à esquizotripanose como fator de letalidade e de incapacidade relativa ou total para o trabalho, depois de conhecidos os resultados de inquéritos clínico-epidemiológicos realizados em zonas infestadas por triatomíneos; a recente adoção, por parte das autoridades responsáveis pela saúde publica, de medidas concretas de contrôle da doença pelo combate aos seus transmissores domiciliares, por meio de inseticidas de ação residual aplicados em larga escala; e, principalmente, a escassez de trabalhos de conjunto e de fácil acesso, com referencias bibliográficas adequadas e extensas, que facilitassem aos não especializados no assunto, o conhecimento e a consulta das investigações já realizadas sôbre êste importante problema de medicina tropical; tais são os principais motivos que sugeriram a elaboração de um esbôço crítico do desenvolvimento dos trabalhos até agora publicados sôbre a esquizotripanose em Minas Gerais. De fato, foi aí descoberta a nova entidade mórbida do homem, foram aí estudados e esclarecidos problemas relativos à etiologia, epidemiologia, aspectos clínicos e anatomo-patológicos da esquizotripanose, foram aí realizadas investigações experimentais e desenvolvidos métodos de profilaxia, constituindo, em conjunto, os trabalhos realizados sôbre a esquizotripanose em Minas Gerais, fundamentados nos alicerces sólidos legados pelo seu grande descobridor, uma obra verdadeiramente monumental, que tanto orgulha e

  2. Gamma-irradiation improves the color and antioxidant properties of Chaga mushroom (Inonotus obliquus) extract.

    Science.gov (United States)

    Kim, Jae-Hun; Sung, Nak-Yun; Kwon, Sun-Kyu; Srinivasan, Periasamy; Song, Beom-Seok; Choi, Jong-Il; Yoon, Yohan; Kim, Jin Kyu; Byun, Myung-Woo; Kim, Mee-Ree; Lee, Ju-Woon

    2009-12-01

    The objective of this study was to evaluate the effect of ionizing radiation on color and antioxidative properties of Chaga mushroom (Inonotus obliquus) extract (CME). CME (10 mg/mL) was gamma-irradiated at 0, 3, 5, 7, and 10 kGy, and color, antioxidant activity, and total phenolic compound levels were then determined. The lightness and yellowness were increased (P < .05), and the redness was decreased (P < .05), as irradiation dose increased. The antioxidant parameters such as the 2-diphenyl-1-picrylhydrazyl, superoxide, and hydroxyl radical scavenging activities, ferric reducing/antioxidant power, and inhibition of lipid peroxidation increased as the irradiation dose increased. Also, the total phenolic compound levels of CME were increased (P < .05) by gamma-irradiation. These results suggest that gamma-irradiation could be considered a means for improving the antioxidant properties and the color of CME. PMID:20041791

  3. Development of a Novel Multiplex Immunoassay Multi-cruzi for the Serological Confirmation of Chagas Disease

    Science.gov (United States)

    Granjon, Elodie; Dichtel-Danjoy, Marie-Laure; Saba, Esber; Sabino, Ester; Campos de Oliveira, Lea; Zrein, Maan

    2016-01-01

    Background Chagas disease is due to the parasite Trypanosoma cruzi, a protist disseminated by a Triatome vector. This disease is endemic to Latin America and considered by WHO as one of the 17 world’s neglected diseases. In Europe and in North America, imported cases are also detected, due to migration of population outside of the endemic region. Diagnosis of T. cruzi infection is usually made indirectly by the detection of specific antibodies to T. cruzi antigens. Following initial diagnostic evaluation or screening test (qualifying or discarding blood donation), a confirmation test is performed for samples initially reactive. The test presented in this study aims at the confirmation/refutation of the infectious status of human blood samples and will permit taking appropriate clinical measures. Methodology/Principal Findings We designed a novel array of twelve antigens and printed these antigens onto 96-well plates. We tested 248 positive samples T. cruzi, 94 unscreened blood donors’ samples from non-endemic area, 49 seronegative blood donors, 7 false-positive and 3 doubtful samples. The observed reactivities were analyzed to propose a decision-tree algorithm that correctly classifies all the samples, with the potential to discriminate false-positive results and sticky samples. We observed that antibodies levels (Sum of all antigens) was significantly higher for PCR positive than for PCR negative samples in all studied groups with Multi-cruzi. Conclusion/Significance The results described in this study indicate that the Multi-cruzi improves the serological confirmation of Chagas disease. Moreover the “sum of all antigens” detected by Multi-cruzi could reflect parasitemia level in patients–like PCR signals does—and could serve as an indicator of parasite clearance in longitudinal follow-ups. Validation of this assay is still required on an independent large collection of well characterized samples including typical false-reactive samples such as

  4. Chagas' disease: an emergent urban zoonosis. The caracas valley (Venezuela) as an epidemiological model.

    Science.gov (United States)

    Urdaneta-Morales, Servio

    2014-01-01

    The unprecedented emergence of important public health and veterinary zoonoses is usually a result of exponential population growth and globalization of human activities. I characterized Chagas' disease as an emergent zoonosis in the Caracas Valley (Venezuela) due to the following findings: the presence of reservoirs (Didelphis marsupialis, Rattus rattus) and vectors (Panstrongylus geniculatus, Panstrongylus rufotuberculatus) infected with Trypanosoma cruzi in urbanized or marginalized areas; the elevated contact between P. geniculatus and human beings detected by parasitological and molecular examinations of triatomine feces demonstrated the possibility of transmission risks; a study of outbreaks of urban Chagas' disease reported the first proven case of oral transmission of T. cruzi to human beings; the risk of transmission of glandular metacyclic stages from marsupials by experimental ocular and oral instillation; mice genitalia infected with T. cruzi contaminated blood resulted in the formation of amastigotes very close to the lumen suggesting that there may be a possibility of infection via their release into the urine and thence to the exterior; the ubiquitous histotropism and histopathology of T. cruzi was demonstrated using a mouse model; the presence of experimental T. cruzi pseudocysts in adipose, bone-cartilage, and eye tissue indicated a potential risk for transplants. Socio-sanitary programs that include improvements in housing, vector control, and access to medical treatment, as well as strategies aimed at combating social inequalities, poverty, and underdevelopment should be undertaken in those areas where zoonoses are most prevalent. Disciplines, such as Ecology, Epidemiology, Medical Entomology, Human and Veterinary Medicine, Environmental Studies, Public Health, Social and Political Studies, Immunology, Microbiology, and Pharmacology could all provide important contributions that aim to reduce the occurrence of factors governing the spread of

  5. Present situation and new strategies for Chagas disease chemotherapy: a proposal

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    José Rodrigues Coura

    2009-07-01

    Full Text Available Treatments for Chagas disease have been administered since the first attempts by Mayer & Rocha Lima (1912, 1914 and up to the drugs currently in use (nifurtimox and benznidazole, along with potential drugs such as allopurinol and first, second and third-generation antifungal agents (imidazoles and triazoles, in separate form. Several diseases such as tuberculosis, leprosy and AIDS only came under control after they were treated with associations of drugs with different mechanisms of action. This not only boosts the action of the different compounds, but also may avoid the development of parasite resistance .To this end, over the short term, we propose experimental studies on laboratory animals and clinical trials with the following associations: (i nifurtimox (8 mg/kg/day + benznidazole (5 mg/kg/day x 60 consecutive days; (ii nifurtimox (8 mg/kg/day or benznidazole (5 mg/kg/day + allopurinol (8-10 mg/kg/day x 60 days and (iii nifurtimox (8 mg/kg/day or benznidazole (5 mg/kg/day + ketoconazole, fluconazole or itraconazole (5-6 mg/kg/day x 60 consecutive days. The doses of the drugs and the treatment schedules for the clinical trials must be adapted according to the side effects. From these, other double or triple associations could be made, using drugs with different mechanisms of action. This proposal does not exclude investigations on new drugs over the median and long terms, targeting other aspects of the metabolism of Trypanosoma cruzi. Until such time as the ideal drug for specific treatment of Chagas disease might be discovered, we need to develop new strategies for achieving greater efficacy with the old drugs in associations and to develop rational experimentation with new drugs.

  6. Epidemiology of and impact of insecticide spraying on Chagas disease in communities in the Bolivian Chaco.

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    Aaron M Samuels

    Full Text Available BACKGROUND: Chagas disease control campaigns relying upon residual insecticide spraying have been successful in many Southern American countries. However, in some areas, rapid reinfestation and recrudescence of transmission have occurred. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a cross-sectional survey in the Bolivian Chaco to evaluate prevalence of and risk factors for T. cruzi infection 11 years after two rounds of blanket insecticide application. We used a cubic B-spline model to estimate change in force of infection over time based on age-specific seroprevalence data. Overall T. cruzi seroprevalence was 51.7%. The prevalence was 19.8% among children 2-15, 72.7% among those 15-30 and 97.1% among participants older than 30 years. Based on the model, the estimated annual force of infection was 4.3% over the two years before the first blanket spray in 2000 and fell to 0.4% for 2001-2002. The estimated annual force of infection for 2004-2005, the 2 year period following the second blanket spray, was 4.6%. However, the 95% bootstrap confidence intervals overlap for all of these estimates. In a multivariable model, only sleeping in a structure with cracks in the walls (aOR = 2.35; 95% CI = 1.15-4.78, age and village of residence were associated with infection. CONCLUSIONS/SIGNIFICANCE: As in other areas in the Chaco, we found an extremely high prevalence of Chagas disease. Despite evidence that blanket insecticide application in 2000 may have decreased the force of infection, active transmission is ongoing. Continued spraying vigilance, infestation surveillance, and systematic household improvements are necessary to disrupt and sustain interruption of infection transmission.

  7. Different Infective Forms Trigger Distinct Immune Response in Experimental Chagas Disease

    Science.gov (United States)

    Vieira, Paula Melo de Abreu; Francisco, Amanda Fortes; Machado, Evandro Marques de Meneses; Nogueira, Nívia Carolina; Fonseca, Kátia da Silva; Reis, Alexandre Barbosa; Teixeira-Carvalho, Andrea; Martins-Filho, Olindo Assis; Tafuri, Washington Luiz; Carneiro, Cláudia Martins

    2012-01-01

    Although metacyclic and blood trypomastigotes are completely functional in relation to parasite-host interaction and/or target cell invasion, they differ in the molecules present on the surface. Thus, aspects related to the variability that the forms of T. cruzi interacts with host cells may lead to fundamental implications on the immune response against this parasite and, consequently, the clinical evolution of Chagas disease. We have shown that BT infected mice presented higher levels of parasitemia during all the acute phase of infection. Moreover, the infection with either MT or BT forms resulted in increased levels of total leukocytes, monocytes and lymphocytes, specifically later for MT and earlier for BT. The infection with BT forms presented earlier production of proinflammatory cytokine TNF-α and later of IFN-γ by both T cells subpopulations. This event was accompanied by an early cardiac inflammation with an exacerbation of this process at the end of the acute phase. On the other hand, infection with MT forms result in an early production of IFN-γ, with subsequent control in the production of this cytokine by IL-10, which provided to these animals an immunomodulatory profile in the end of the acute phase. These results are in agreement with what was found for cardiac inflammation where animals infected with MT forms showed intense cardiac inflammation later at infection, with a decrease in the same at the end of this phase. In summary, our findings emphasize the importance of taking into account the inoculums source of T. cruzi, since vectorial or transfusional routes of T. cruzi infection may trigger distinct parasite-host interactions during the acute phase that may influence relevant biological aspects of chronic Chagas disease. PMID:22412949

  8. Moléstia de Chagas e ecologia profunda: a "luta antivetorial" em questão Chagas's disease and deep ecology: the anti-vectorial fight in question

    OpenAIRE

    Rodrigo Siqueira-Batista; Andréia Patrícia Gomes; Giselle Rôças; Rosângela Minardi Mitre Cotta; Eduardo Cárdenas Nogueira Rubião; Alcides Pissinatti

    2011-01-01

    As inter-relações entre o homem e o meio ambiente estão entre os principais temas debatidos no contexto atual da saúde pública brasileira. Neste horizonte se inscrevem as questões atinentes à moléstia de Chagas especialmente no âmbito das ações de controle dirigidas aos triatomíneos, a luta antivetorial , a qual permanece, mesmo após quase um século de sua descrição por Carlos Chagas, como uma condição de grande impacto epidemiológico na América Latina. Com base nestas considerações, o presen...

  9. Alterações quantitativas das células de purkinje na moléstia de chagas experimental no camundongo Quantitative study of Purkinje cells in the acute phase of experimental Chagas' disease

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    Edymar Jardim

    1967-09-01

    Full Text Available O autor estudou quantitativamente as células de Purkinje em cortes semi-seriados do cerebelo de camundongos inoculados experimentalmente com T. cruzi,tendo verificado considerável destruição neuronal na fase aguda da enfermidade.A quantitative study of Purkinje cells was done through semi-serial sections of cerebellum of mice experimentally innoculated by Trypanosoma cruzi. Avery marked neuronal destruction was found in the acute phase of Chagas' disease.

  10. Chagas disease

    Science.gov (United States)

    Insect control with insecticides and houses that are less likely to have high insect populations will help control the spread of the disease. Blood banks in Central and South America screen donors for ...

  11. Chagas disease

    Science.gov (United States)

    ... the walls Living in Central or South America Poverty Receiving a blood transfusion from a person who ... heart or digestive problems. Abnormal heart rhythms may cause sudden death. Once heart failure develops, death usually ...

  12. Left ventricle function in patients with ischemic cardiopathy: determination of the expulsion fraction of the left ventricle with gated-SPECT. Experience in the CMN 20 de Noviembre ISSSTE

    International Nuclear Information System (INIS)

    The objective of this work is to correlate the expulsion fraction of the left ventricle (FEVI) obtained by means of g-SPECT and other diagnostic methods: ECO 2D and ventriculography for heart catheterization (CTT). (Author)

  13. The importance of the multidisciplinary approach to deal with the new epidemiological scenario of Chagas disease (global health).

    Science.gov (United States)

    Pinazo, Maria-Jesus; Gascon, Joaquim

    2015-11-01

    There are currently two major factors that have modified the epidemiology of Chagas disease in the last decades: climate change and migration flows. In this new scenario, there are new challenges to control and prevent Trypanosoma cruzi infection in endemic countries, such as the control of a wider distribution of triatomine vectors or the reinforcement of vertical transmission programs. In non-endemic areas, few countries are aware of the emergence of this new disease and have established changes in their health systems. To address this new public health challenge, the priorities should be control programs to avoid new cases of T. cruzi infection acquired through vertical transmission, blood transfusion or organ transplant. In both, endemic and non-endemic areas, the international community and all the actors involved in Chagas disease must join efforts mainly in two directions: better management of the infection in affected individuals and more research to cover the knowledge gap mainly in physiopathology, diagnosis and treatment. PMID:26187358

  14. Autochthonous Chagas' disease in Santa Catarina State, Brazil: report of the first case of digestive tract involvement

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    Maegawa Felipe Antonio Boff

    2003-01-01

    Full Text Available We report the first case of digestive tract pathology (megaesophagus determined by Trypanosoma cruzi infection in Santa Catarina State, southern Brazil. A 63-year- old female had presumptive clinical diagnosis of Chagas' disease, which was confirmed by imaging (endoscopy and esophagogram and immunological methods. Further molecular diagnosis was carried out with esophagus and blood samples collected during corrective surgery. Polymerase chain reaction tested positive for Trypanosoma cruzi in both esophagus and buffy coat samples.

  15. Ethanol extract of Innotus obliquus (Chaga mushroom) induces G1 cell cycle arrest in HT-29 human colon cancer cells

    OpenAIRE

    Lee, Hyun Sook; Kim, Eun Ji; Kim, Sun Hyo

    2015-01-01

    BACKGROUND/OBJECTIVES Inonotus obliquus (I. obliquus, Chaga mushroom) has long been used as a folk medicine to treat cancer. In the present study, we examined whether or not ethanol extract of I. obliquus (EEIO) inhibits cell cycle progression in HT-29 human colon cancer cells, in addition to its mechanism of action. MATERIALS/METHODS To examine the effects of Inonotus obliquus on the cell cycle progression and the molecular mechanism in colon cancer cells, HT-29 human colon cancer cells were...

  16. Bats, Trypanosomes, and Triatomines in Ecuador: New Insights into the Diversity, Transmission, and Origins of Trypanosoma cruzi and Chagas Disease

    OpenAIRE

    C. Miguel Pinto; Sofía Ocaña-Mayorga; Tapia, Elicio E.; Lobos, Simón E.; Zurita, Alejandra P.; Fernanda Aguirre-Villacís; Amber MacDonald; Anita G Villacís; Luciana Lima; Teixeira, Marta M. G.; Mario J Grijalva; Perkins, Susan L.

    2015-01-01

    The generalist parasite Trypanosoma cruzi has two phylogenetic lineages associated almost exclusively with bats-Trypanosoma cruzi Tcbat and the subspecies T. c. marinkellei. We present new information on the genetic variation, geographic distribution, host associations, and potential vectors of these lineages. We conducted field surveys of bats and triatomines in southern Ecuador, a country endemic for Chagas disease, and screened for trypanosomes by microscopy and PCR. We identified parasite...

  17. Extraction of Trypanosoma cruzi DNA from food: a contribution to the elucidation of acute Chagas disease outbreaks

    OpenAIRE

    Renata Trotta Barroso Ferreira; Aline Martins Melandre; Maria Luiza Cabral; Maria Regina Branquinho; Paola Cardarelli-Leite

    2016-01-01

    Abstract: INTRODUCTION: Before 2004, the occurrence of acute Chagas disease (ACD) by oral transmission associated with food was scarcely known or investigated. Originally sporadic and circumstantial, ACD occurrences have now become frequent in the Amazon region, with recently related outbreaks spreading to several Brazilian states. These cases are associated with the consumption of açai juice by waste reservoir animals or insect vectors infected with Trypanosoma cruzi in endemic areas. Altho...

  18. Genome of Rhodnius prolixus, an insect vector of Chagas disease, reveals unique adaptations to hematophagy and parasite infection

    OpenAIRE

    Lowenberger, Carl; Rivera Pomar, Rolando; Monteiro, Fernando A.; Minx, Patrick; Spieth, John; Bernardo Carvalho, A.; Panzera, Francisco; Lawson, Daniel; Torres, Andre Q.; Ribeiro, Jose M. C.; Sorgine, Marcos H. F.; Waterhouse, Robert M; Montague, Michael J.; Abad Franch, Fernando; Alves Bezerra, Michele

    2015-01-01

    Rhodnius prolixus not only has served as a model organism for the study of insect physiology, but also is a major vector of Chagas disease, an illness that affects approximately seven million people worldwide. We sequenced the genome of R. prolixus, generated assembled sequences covering 95% of the genome (similar to 702 Mb), including 15,456 putative protein-coding genes, and completed comprehensive genomic analyses of this obligate blood-feeding insect. Although immune-deficiency (IMD)-medi...

  19. Modeling the spatial distribution of Chagas disease vectors using environmental variables and people´s knowledge

    OpenAIRE

    Hernández, Jaime; Núñez, Ignacia; Bacigalupo, Antonella; PEDRO E. CATTAN

    2013-01-01

    Background Chagas disease is caused by the protozoan Trypanosoma cruzi, which is transmitted to mammal hosts by triatomine insect vectors. The goal of this study was to model the spatial distribution of triatomine species in an endemic area. Methods Vector’s locations were obtained with a rural householders’ survey. This information was combined with environmental data obtained from remote sensors, land use maps and topographic SRTM data, using the machine learning algorithm Random Forests to...

  20. Opportunities for Improved Chagas Disease Vector Control Based on Knowledge, Attitudes and Practices of Communities in the Yucatan Peninsula, Mexico

    OpenAIRE

    Kathryn Rosecrans; Gabriela Cruz-Martin; Ashley King; Eric Dumonteil

    2014-01-01

    BACKGROUND: Chagas disease is a vector-borne parasitic disease of major public health importance. Current prevention efforts are based on triatomine vector control to reduce transmission to humans. Success of vector control interventions depends on their acceptability and value to affected communities. We aimed to identify opportunities for and barriers to improved vector control strategies in the Yucatan peninsula, Mexico. METHODOLOGY/PRINCIPAL FINDINGS: We employed a sequence of qualitative...

  1. Analysis of Children's Perception of Triatomine Vectors of Chagas Disease through Drawings: Opportunities for Targeted Health Education

    OpenAIRE

    Yevstigneyeva, Violetta; Camara-Mejia, Javier; Dumonteil, Eric

    2014-01-01

    Background Chagas disease is a tropical parasitic disease affecting about 10 million people, mostly in the Americas, and transmitted mainly by triatomine bugs. Insect vector control with indoor residual insecticides and the promotion of housing improvement is the main control intervention. The success of such interventions relies on their acceptance and appropriation by communities, which depends on their knowledge and perceptions of both the disease and the vector. In this study, we investig...

  2. Analysis of children's perception of triatomine vectors of chagas disease through drawings: opportunities for targeted health education.

    OpenAIRE

    Violetta Yevstigneyeva; Javier Camara-Mejia; Eric Dumonteil

    2014-01-01

    Chagas disease is a tropical parasitic disease affecting about 10 million people, mostly in the Americas, and transmitted mainly by triatomine bugs. Insect vector control with indoor residual insecticides and the promotion of housing improvement is the main control intervention. The success of such interventions relies on their acceptance and appropriation by communities, which depends on their knowledge and perceptions of both the disease and the vector. In this study, we investigated school...

  3. Combining Public Health Education and Disease Ecology Research: Using Citizen Science to Assess Chagas Disease Entomological Risk in Texas.

    Directory of Open Access Journals (Sweden)

    Rachel Curtis-Robles

    2015-12-01

    Full Text Available Chagas disease is a zoonotic parasitic disease well-documented throughout the Americas and transmitted primarily by triatomine 'kissing bug' vectors. In acknowledgment of the successful history of vector control programs based on community participation across Latin America, we used a citizen science approach to gain novel insight into the geographic distribution, seasonal activity, and Trypanosoma cruzi infection prevalence of kissing bugs in Texas while empowering the public with information about Chagas disease.We accepted submissions of kissing bugs encountered by the public in Texas and other states from 2013-2014 while providing educational literature about Chagas disease. In the laboratory, kissing bugs were identified to species, dissected, and tested for T. cruzi infection. A total of 1,980 triatomines were submitted to the program comprised of at least seven species, of which T. gerstaeckeri and T. sanguisuga were the most abundant (85.7% of submissions. Triatomines were most commonly collected from dog kennels and outdoor patios; Overall, 10.5% of triatomines were collected from inside the home. Triatomines were submitted from across Texas, including many counties which were not previously known to harbor kissing bugs. Kissing bugs were captured primarily throughout April-October, and peak activity occurred in June-July. Emails to our dedicated account regarding kissing bugs were more frequent in the summer months (June-August than the rest of the year. We detected T. cruzi in 63.3% of tested bugs.Citizen science is an efficient approach for generating data on the distribution, phenology, and infection prevalence of kissing bugs-vectors of the Chagas disease parasite-while educating the public and medical community.

  4. Development of peptide-based lineage-specific serology for chronic Chagas disease: geographical and clinical distribution of epitope recognition.

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    Tapan Bhattacharyya

    2014-05-01

    Full Text Available BACKGROUND: Chagas disease, caused by infection with the protozoan Trypanosoma cruzi, remains a serious public health issue in Latin America. Genetically diverse, the species is sub-divided into six lineages, known as TcI-TcVI, which have disparate geographical and ecological distributions. TcII, TcV, and TcVI are associated with severe human disease in the Southern Cone countries, whereas TcI is associated with cardiomyopathy north of the Amazon. T. cruzi persists as a chronic infection, with cardiac and/or gastrointestinal symptoms developing years or decades after initial infection. Identifying an individual's history of T. cruzi lineage infection directly by genotyping of the parasite is complicated by the low parasitaemia and sequestration in the host tissues. METHODOLOGY/PRINCIPAL FINDINGS: We have applied here serology against lineage-specific epitopes of the T. cruzi surface antigen TSSA, as an indirect approach to allow identification of infecting lineage. Chagasic sera from chronic patients from a range of endemic countries were tested by ELISA against synthetic peptides representing lineage-specific TSSA epitopes bound to avidin-coated ELISA plates via a biotin labelled polyethylene glycol-glycine spacer to increase rotation and ensure each amino acid side chain could freely interact with their antibodies. 79/113 (70% of samples from Brazil, Bolivia, and Argentina recognised the TSSA epitope common to lineages TcII/TcV/TcVI. Comparison with clinical information showed that a higher proportion of Brazilian TSSApep-II/V/VI responders had ECG abnormalities than non-responders (38% vs 17%; p<0.0001. Among northern chagasic sera 4/20 (20% from Ecuador reacted with this peptide; 1/12 Venezuelan and 1/34 Colombian samples reacted with TSSApep-IV. In addition, a proposed TcI-specific epitope, described elsewhere, was demonstrated here to be highly conserved across lineages and therefore not applicable to lineage-specific serology. CONCLUSIONS

  5. Chagas' disease in Aboriginal and Creole communities from the Gran Chaco Region of Argentina: Seroprevalence and molecular parasitological characterization.

    Science.gov (United States)

    Lucero, R H; Brusés, B L; Cura, C I; Formichelli, L B; Juiz, N; Fernández, G J; Bisio, M; Deluca, G D; Besuschio, S; Hernández, D O; Schijman, A G

    2016-07-01

    clustered according to their original localities, but in a few cases, signatures from one locality clustered with signatures from other village, suggesting circulation of the same strains in the area. Parasitic loads ranged from undetectable to around 50 parasite equivalents/mL, showing higher values than those generally observed in chronic Chagas disease patients living in urban centers of Argentina. Our findings reveal the persistence of high levels of infection in these neglected populations. PMID:27057620

  6. Chagas disease: serological and electrocardiographic studies in Wichi and Creole communities of Misión Nueva Pompeya, Chaco, Argentina.

    Science.gov (United States)

    Moretti, Edgardo; Castro, Irma; Franceschi, Claudio; Basso, Beatriz

    2010-08-01

    Chagas disease, which is caused by Trypanosoma cruzi, affects nearly 16 million people in Latin America and causes 75-90 million people to be at risk of infection. The disease is urbanizing and globalizing due to frequent migrations. There are regions of high prevalence of infection, including the north-eastern provinces of Argentina and the entire phytogeographic region known as the Gran Chaco. In the province of Chaco, Argentina, there are places inhabited by native populations such as the Wichi and Toba communities, among others. Many Creole populations resulting from miscegenation with European colonists and immigrants coexist within these communities. It has been widely accepted that in the chronic phase of the disease, between 25-30% of individuals develop some form of cardiac disease, with the right bundle-branch block being the most typical condition described so far. The aim of this work was to study the prevalence of Chagas infection and its electrocardiographic profile in the Wichi and Creole populations of Misión Nueva Pompeya, in the area known as Monte Impenetrable in Chaco, to determine the prevalence and the pattern of heart diseases produced by Chagas disease in this region. PMID:20835607

  7. Feeding sources and trypanosome infection index of Rhodnius pallescens in a Chagas disease endemic area of Amador County, Panama.

    Science.gov (United States)

    Pineda, Vanessa; Montalvo, Edilma; Alvarez, Dayra; Santamaría, Ana María; Calzada, Jose Eduardo; Saldaña, Azael

    2008-01-01

    The sylvatic triatomine Rhodnius pallescens is considered to be the most important and widespread vector of Trypanosoma cruzi and Trypanosoma rangeli in Panama. However, its behavior and biological characteristics have only been partially investigated. Thus, to achieve sustainable and efficient control over Chagas disease in Panama, a better understanding of the ecology and biology of R. pallescens is essential. In this study we evaluated R. pallescens host feeding sources using a dot-blot assay, and the trypanosome infection index by PCR analysis in a Chagas disease endemic area of central Panama. It was found that in peridomestic palm trees, 20.3% of the examined bugs had fed on opossums (Didelphis marsupialis). However, we observed an increased anthropophagy (25.4%) for those bugs collected inside houses. Considering the domestic and peridomestic habitats as a whole, the proportion of collected R. pallescens infected with trypanosomes was 87.4%. In the two habitats the predominant infection was with T. cruzi (80-90%). Between 47-51% of the analyzed triatomines were infected with T. rangeli. Mixed infections (40-51%) were also detected. These findings provide a better basis for the implementation of a rational control and surveillance program for Chagas disease in regions where R. pallescens is endemic. PMID:18488091

  8. Evasion and Immuno-Endocrine Regulation in Parasite Infection: Two Sides of the Same Coin in Chagas Disease?

    Science.gov (United States)

    Morrot, Alexandre; Villar, Silvina R.; González, Florencia B.; Pérez, Ana R.

    2016-01-01

    Chagas disease is a serious illness caused by the protozoan parasite Trypanosoma cruzi. Nearly 30% of chronically infected people develop cardiac, digestive, or mixed alterations, suggesting a broad range of host-parasite interactions that finally impact upon chronic disease outcome. The ability of T. cruzi to persist and cause pathology seems to depend on diverse factors like T. cruzi strains, the infective load and the route of infection, presence of virulence factors, the parasite capacity to avoid protective immune response, the strength and type of host defense mechanisms and the genetic background of the host. The host-parasite interaction is subject to a constant neuro-endocrine regulation that is thought to influence the adaptive immune system, and as the infection proceeds it can lead to a broad range of outcomes, ranging from pathogen elimination to its continued persistence in the host. In this context, T. cruzi evasion strategies and host defense mechanisms can be envisioned as two sides of the same coin, influencing parasite persistence and different outcomes observed in Chagas disease. Understanding how T. cruzi evade host's innate and adaptive immune response will provide important clues to better dissect mechanisms underlying the pathophysiology of Chagas disease.

  9. Spatiotemporal analysis of reported cases of acute Chagas disease in the State of Pernambuco, Brazil, from 2002 to 2013

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    Fred Luciano Neves Santos

    2015-04-01

    Full Text Available INTRODUCTION: Control strategies to eliminate the transmission of Chagas disease by insect vectors have significantly decreased the number of reported acute cases in Brazil. However, data regarding the incidence and distribution of acute Chagas disease cases in the State of Pernambuco are unavailable in the literature. METHODS: A geographical information system was used to delineate the spatiotemporal distribution profile of the cases from 2002 to 2013 in 185 municipalities of Pernambuco based on the municipality where notification occurred. The results were presented in digital maps generated by the TerraView software (INPE. RESULTS: A total of 302 cases of acute disease were recorded in 37.8% of the municipalities, for a total of 0.13 cases per 1,000,000 inhabitants per year. Out of the 302 cases, 99.3% were reported between 2002 and 2006. The most affected municipalities were Carnaubeira da Penha, Mirandiba and Terra Nova. The risk maps showed a significant decrease in the number of notifications and a concentration of cases in the Midwest region. CONCLUSIONS: This study highlights a significant decrease in new cases of acute Chagas disease in Pernambuco starting in 2006 when Brazil received an international certification for the interruption of vectorial transmission by Triatoma infestans. However, control strategies should still be encouraged because other triatomine species can also transmit the parasite; moreover, other transmission modes must not be neglected.

  10. Chagas disease: serological and electrocardiographic studies in Wichi and Creole communities of Misión Nueva Pompeya, Chaco, Argentina

    Directory of Open Access Journals (Sweden)

    Edgardo Moretti

    2010-08-01

    Full Text Available Chagas disease, which is caused by Trypanosoma cruzi, affects nearly 16 million people in Latin America and causes 75-90 million people to be at risk of infection. The disease is urbanizing and globalizing due to frequent migrations. There are regions of high prevalence of infection, including the north-eastern provinces of Argentina and the entire phytogeographic region known as the Gran Chaco. In the province of Chaco, Argentina, there are places inhabited by native populations such as the Wichi and Toba communities, among others. Many Creole populations resulting from miscegenation with European colonists and immigrants coexist within these communities. It has been widely accepted that in the chronic phase of the disease, between 25-30% of individuals develop some form of cardiac disease, with the right bundle-branch block being the most typical condition described so far. The aim of this work was to study the prevalence of Chagas infection and its electrocardiographic profile in the Wichi and Creole populations of Misión Nueva Pompeya, in the area known as Monte Impenetrable in Chaco, to determine the prevalence and the pattern of heart diseases produced by Chagas disease in this region.

  11. Analysis of children's perception of triatomine vectors of chagas disease through drawings: opportunities for targeted health education.

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    Violetta Yevstigneyeva

    2014-10-01

    Full Text Available Chagas disease is a tropical parasitic disease affecting about 10 million people, mostly in the Americas, and transmitted mainly by triatomine bugs. Insect vector control with indoor residual insecticides and the promotion of housing improvement is the main control intervention. The success of such interventions relies on their acceptance and appropriation by communities, which depends on their knowledge and perceptions of both the disease and the vector. In this study, we investigated school-aged children's knowledge and perception on triatomine vectors and Chagas disease to further understand how communities view this vector and the disease in Yucatan, Mexico.We performed an analysis of children's drawings on the theme of triatomines and their house in several rural villages, to explore in an open-ended manner their views, understanding and misconceptions. A total of 261 drawings were collected from children ages 6-12 from four villages. We found that children are very familiar with triatomine vectors, and know very well many aspects of their biology and ecology, and in particular their blood-feeding habits. On the other hand, their drawings suggest that the role of triatomines as vectors of a chronic and severe cardiac disease is less understood, and the main perceived health threat appears limited to the bite itself, as previously observed in adults.These results have important implications for the specific design of future education materials and campaigns, and for the promotion of the inclusion of children in raising Chagas disease awareness in these endemic communities.

  12. Co-Morbid Infections in Hansen's Disease Patients in the United States: Considerations for Treatment

    OpenAIRE

    Bilodeau, Madeline; Burns, Stephanie; Gawoski, John; Moschella, Samuel; Ooi, Winnie

    2013-01-01

    120 patients attending a Hansen's disease public health satellite clinic were evaluated for selected latent co-morbidities, consisting of strongyloidiasis, Chagas disease, hepatitis B, HIV, and tuberculosis, and potential exacerbation by immunosuppressive therapy. Implications for treatment of Hansen's disease are discussed.

  13. A doença de Chagas e seu controle na América Latina: uma análise de possibilidades Chagas' disease and its control in Latin America: an analysis of possibilities

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    João Carlos P. Dias

    1993-06-01

    Full Text Available A doença de Chagas segue como importante agravo à saúde na maior parte da América Latina, afetando 16 milhões de pessoas e colocando sob risco outras dezenas de milhões de indivíduos, geralmente de origem rural, pobres e socialmente marginalizados. As estratégias e insumos ao controle da endemia concentram-se no controle do vetor e da transmissão transfusional, mostrando-se eficientes e estando disponíveis há pelo menos duas décadas. Sua implementação depende basicamente de vontade política e de disponibilidade técnica e orçamentária, como demonstrado no exemplo brasileiro. São discutidos aspectos epidemiológicos e operacionais da luta antichagásica, o que envolve um horizonte de reformulação e aprimoramento dos próprios sistemas de saúde dos países endêmicos. O controle da doença é viável, constituindo-se num desafio às autoridades sanitárias e à opção dos países pela esfera social. Em particular, a superação da doença de Chagas pode ser um importante fator de catálise para a almejada unidade latino-americana.Chagas' disease is still a major public health problem in Latin America, affecting about 15 million individuals and leaving tens of millions of others at risk, most of whom are from rural areas and are socially marginalized. The main strategies and tools for the control of the disease are related to the vectorial and transfusional transmission of the parasite. Regular programs have proven effective, as in Brazil, and they depend basically on political will and basic technical and financial conditions. Epidemiologic and operational aspects of Chagas' disease control are discussed in this study, involving the reformulation and improvement of the health systems in affected countries. The fact that control can be attained is emphasized as a challenge to Latin American governments and public health officials. Control of Chagas' disease may be an additional part of the dream of Latin American unity.

  14. Antibodies to ribosomal P proteins of Trypanosoma cruzi in Chagas disease possess functional autoreactivity with heart tissue and differ from anti-P autoantibodies in lupus.

    Science.gov (United States)

    Kaplan, D; Ferrari, I; Bergami, P L; Mahler, E; Levitus, G; Chiale, P; Hoebeke, J; Van Regenmortel, M H; Levin, M J

    1997-09-16

    Anti-P antibodies present in sera from patients with chronic Chagas heart disease (cChHD) recognize peptide R13, EEEDDDMGFGLFD, which encompasses the C-terminal region of the Trypanosoma cruzi ribosomal P1 and P2 proteins. This peptide shares homology with the C-terminal region (peptide H13 EESDDDMGFGLFD) of the human ribosomal P proteins, which is in turn the target of anti-P autoantibodies in systemic lupus erythematosus (SLE), and with the acidic epitope, AESDE, of the second extracellular loop of the beta1-adrenergic receptor. Anti-P antibodies from chagasic patients showed a marked preference for recombinant parasite ribosomal P proteins and peptides, whereas anti-P autoantibodies from SLE reacted with human and parasite ribosomal P proteins and peptides to the same extent. A semi-quantitative estimation of the binding of cChHD anti-P antibodies to R13 and H13 using biosensor technology indicated that the average affinity constant was about 5 times higher for R13 than for H13. Competitive enzyme immunoassays demonstrated that cChHD anti-P antibodies bind to the acidic portions of peptide H13, as well as to peptide H26R, encompassing the second extracellular loop of the beta1 adrenoreceptor. Anti-P antibodies isolated from cChHD patients exert a positive chronotropic effect in vitro on cardiomyocytes from neonatal rats, which resembles closely that of anti-beta1 receptor antibodies isolated from the same patient. In contrast, SLE anti-P autoantibodies have no functional effect. Our results suggest that the adrenergic-stimulating activity of anti-P antibodies may be implicated in the induction of functional myocardial impairments observed in cChHD. PMID:9294205

  15. O processo de avaliação em ciência e a indicação de Carlos Chagas ao prêmio Nobel de Fisiologia ou Medicina The assessment process within science and the nomination of Carlos Chagas for the Nobel prize for Physiology or Medicine

    OpenAIRE

    José Eymard Homem Pittella

    2009-01-01

    Uma das maiores realizações na história da medicina foi a descrição da doença de Chagas pelo médico e cientista Carlos Chagas. Ao completar 100 anos da descoberta da doença de Chagas, permanecem ainda especulações a respeito das duas indicações oficiais de Carlos Chagas à maior premiação mundial em ciência, o Nobel, em 1913 e 1921. Admite-se que a não premiação do genial cientista possa ter ocorrido em razão da forte oposição que enfrentou no Brasil por parte de alguns médicos e pesquisadores...

  16. Irradiated T. cruzi and resistant consomic animals can be useful in Chagas disease studies

    International Nuclear Information System (INIS)

    Human Chagas disease is considered the most significant parasitic disease in Latin America. It is estimated that 16-18 million people are infected by T. cruzi. As a consequence, approximately 50,000 deaths occur every year. The acute infection usually goes unrecognized and enters into a chronic stage that persists throughout the host's life span. However, roughly 30% of infected individuals eventually will develop disease with an array of possible manifestations affecting the heart, the digestive tract, and/or the peripheral nervous system. This disease is commonly modeled in inbred mice even though mouse strains used to simulate experimental infection vary considerably. In this way, Wrightsman and Trischmann showed that chromosome 17 was directly involved in a T. cruzi resistance, showing the influence of host's genetic constitution on disease severity. Additionally, in 2003, Passos and Graefe, working separately, quantified parasite burdens in resistant and susceptible strains and applied a backcross strategy to map the genomic loci linked to susceptibility and resistance in inbred mice. The genomes of the animals were scanned with microsatellite markers and the results found by these authors showed that the resistance mechanism is polygenic and is under the control of a complex network. In the particular case of Y strain, in vivo assays indicated that survival was related to the chromosomes 7,11,14,17 and 19. In order to evaluate the influence of each isolated chromosome as well as their interactions, we employed susceptible isogenic mice to construct consomic lineages for each one of those chromosomes. The consomic strains were injected with irradiated and native forms of Y strain T. cruzi, and the infectivity parameters were evaluated by quantitative methods. Radiation caused inability of trypanosomes to infect and kill mice, when these parasites were irradiated with 1 kGy of gamma rays from a 60Co source. In this experiment we used 101, 102, 103, 104 and 105

  17. Trypanocide treatment of women infected with Trypanosoma cruzi and its effect on preventing congenital Chagas.

    Science.gov (United States)

    Fabbro, Diana L; Danesi, Emmaria; Olivera, Veronica; Codebó, Maria Olenka; Denner, Susana; Heredia, Cecilia; Streiger, Mirtha; Sosa-Estani, Sergio

    2014-11-01

    With the control of the vectorial and transfusional routes of infection with Trypanosoma cruzi, congenital transmission has become an important source of new cases. This study evaluated the efficacy of trypanocidal therapy to prevent congenital Chagas disease and compared the clinical and serological evolution between treated and untreated infected mothers. We conducted a multicenter, observational study on a cohort of mothers infected with T. cruzi, with and without trypanocidal treatment before pregnancy. Their children were studied to detect congenital infection. Among 354 "chronically infected mother-biological child" pairs, 132 were treated women and 222 were untreated women. Among the children born to untreated women, we detected 34 infected with T. cruzi (15.3%), whose only antecedent was maternal infection. Among the 132 children of previously treated women, no infection with T. cruzi was found (0.0%) (p<0.05). Among 117 mothers with clinical and serological follow up, 71 had been treated and 46 were untreated. The women were grouped into three groups. Group A: 25 treated before 15 years of age; Group B: 46 treated at 15 or more years of age; Group C: untreated, average age of 29.2 ± 6.2 years at study entry. Follow-up for Groups A, B and C was 16.3 ± 5.8, 17.5 ± 9.2 and 18.6 ± 8.6 years respectively. Negative seroconversion: Group A, 64.0% (16/25); Group B, 32.6% (15/46); Group C, no seronegativity was observed. Clinical electrocardiographic alterations compatible with chagasic cardiomyopathy: Group A 0.0% (0/25); B 2.2% (1/46) and C 15.2% (7/46). The trypanocidal treatment of women with chronic Chagas infection was effective in preventing the congenital transmission of Trypanosoma cruzi to their children; it had also a protective effect on the women's clinical evolution and deparasitation could be demonstrated in many treated women after over 10 years of follow up. PMID:25411847

  18. Trypanosoma cruzi (Chagas' disease agent reduces HIV-1 replication in human placenta

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    Cappa Stella

    2008-07-01

    Full Text Available Abstract Background Several factors determine the risk of HIV mother-to-child transmission (MTCT, such as coinfections in placentas from HIV-1 positive mothers with other pathogens. Chagas' disease is one of the most endemic zoonoses in Latin America, caused by the protozoan Trypanosoma cruzi. The purpose of the study was to determine whether T. cruzi modifies HIV infection of the placenta at the tissue or cellular level. Results Simple and double infections were carried out on a placental histoculture system (chorionic villi isolated from term placentas from HIV and Chagas negative mothers and on the choriocarcinoma BeWo cell line. Trypomastigotes of T. cruzi (VD lethal strain, either purified from mouse blood or from Vero cell cultures, 24 h-supernatants of blood and cellular trypomastigotes, and the VSV-G pseudotyped HIV-1 reporter virus were used for the coinfections. Viral transduction was evaluated by quantification of luciferase activity. Coinfection with whole trypomastigotes, either from mouse blood or from cell cultures, decreased viral pseudotype luciferase activity in placental histocultures. Similar results were obtained from BeWo cells. Supernatants of stimulated histocultures were used for the simultaneous determination of 29 cytokines and chemokines with the Luminex technology. In histocultures infected with trypomastigotes, as well as in coinfected tissues, IL-6, IL-8, IP-10 and MCP-1 production was significantly lower than in controls or HIV-1 transducted tissue. A similar decrease was observed in histocultures treated with 24 h-supernatants of blood trypomastigotes, but not in coinfected tissues. Conclusion Our results demonstrated that the presence of an intracellular pathogen, such as T. cruzi, is able to impair HIV-1 transduction in an in vitro system of human placental histoculture. Direct effects of the parasite on cellular structures as well as on cellular/viral proteins essential for HIV-1 replication might influence

  19. Epidemiology of Chagas disease in non endemic countries: the role of international migration

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    Gabriel A Schmunis

    2007-10-01

    Full Text Available Human infection with the protozoa Trypanosoma cruzi extends through North, Central, and South America, affecting 21 countries. Most human infections in the Western Hemisphere occur through contact with infected bloodsucking insects of the triatomine species. As T. cruzi can be detected in the blood of untreated infected individuals, decades after infection took place; the infection can be also transmitted through blood transfusion and organ transplant, which is considered the second most common mode of transmission for T. cruzi. The third mode of transmission is congenital infection. Economic hardship, political problems, or both, have spurred migration from Chagas endemic countries to developed countries. The main destination of this immigration is Australia, Canada, Spain, and the United States. In fact, human infection through blood or organ transplantation, as well as confirmed or potential cases of congenital infections has been described in Spain and in the United States. Estimates reported here indicates that in Australia in 2005-2006, 1067 of the 65,255 Latin American immigrants (16 per 1000 may be infected with T. cruzi, and in Canada, in 2001, 1218 of the 131,135 immigrants (9 per 1000 whose country of origin was identified may have been also infected. In Spain, a magnet for Latin American immigrants since the 2000, 5125 of 241,866 legal immigrants in 2003 (25 per 1000, could be infected. In the United States, 56,028 to 357,205 of the 7,20 million, legal immigrants (8 to 50 per 1000, depending on the scenario, from the period 1981-2005 may be infected with T. cruzi. On the other hand, 33,193 to 336,097 of the estimated 5,6 million undocumented immigrants in 2000 (6 to 59 per 1000 could be infected. Non endemic countries receiving immigrants from the endemic ones should develop policies to protect organ recipients from T. cruzi infection, prevent tainting the blood supply with T. cruzi, and implement secondary prevention of congenital

  20. Chagas disease: current epidemiological trends after the interruption of vectorial and transfusional transmission in the Southern Cone countries

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    Moncayo Alvaro

    2003-01-01

    Full Text Available Chagas disease, named after Carlos Chagas who first described it in 1909, exists only on the American Continent. It is caused by a parasite, Trypanosoma cruzi, transmitted to humans by blood-sucking triatomine bugs and by blood transfusion. Chagas disease has two successive phases, acute and chronic. The acute phase lasts 6 to 8 weeks. After several years of starting the chronic phase, 20% to 35% of the infected individuals, depending on the geographical area will develop irreversible lesions of the autonomous nervous system in the heart, esophagus, colon and the peripheral nervous system. Data on the prevalence and distribution of Chagas disease improved in quality during the 1980's as a result of the demographically representative cross-sectional studies carried out in countries where accurate information was not available. A group of experts met in Brasília in 1979 and devised standard protocols to carry out countrywide prevalence studies on human T. cruzi infection and triatomine house infestation. Thanks to a coordinated multi-country program in the Southern Cone countries the transmission of Chagas disease by vectors and by blood transfusion has been interrupted in Uruguay in1997, in Chile in 1999, and in 8 of the 12 endemic states of Brazil in 2000 and so the incidence of new infections by T. cruzi in the whole continent has decreased by 70%. Similar control multi-country initiatives have been launched in the Andean countries and in Central America and rapid progress has been recorded to ensure the interruption of the transmission of Chagas disease by 2005 as requested by a Resolution of the World Health Assembly approved in 1998. The cost-benefit analysis of the investments of the vector control program in Brazil indicate that there are savings of US$17 in medical care and disabilities for each dollar spent on prevention, showing that the program is a health investment with good return. Since the inception in 1979 of the Steering

  1. Utilização da fração semipurificada da proteinase do Trypanosoma cruzi no imunodiagnóstico da doença de Chagas The use of a semipurified fraction of Trypanosoma cruzi proteinase in immunodiagnosis of Chagas' disease

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    Ajax Mercês Atta

    1984-12-01

    Full Text Available Foram sensibilizadas hemácias humanas 0 Rh negativo com a fração semipurificada (Fp da proteinase do Trypanosoma cruzi, e testadas quanto a antigenicidade com soros de pacientes portadores de tripanossomíase americana crônica e de outras doenças parasitárias não relacionadas. Reações de hemaglutinação positivas foram observadas com os soros de pacientes chagásicos e com alguns soros de indivíduos portadores de leishmaniose cutaneo-mucosa. Não foram observadas reações cruzadas com os soros de pacientes portadores de leishmaniose visceral, malária, toxoplasmose, sífilis, esquistossomose e mononucleose. Os resultados obtidos são favoráveis ao emprego desta fração antigênica em testes de imunodiagnóstico da tripanossomíase americana.Group 0 Rh negative human erytrocytes were coated with the semipurified fraction of T. cruzi proteinase and tested with sera both from patients with chagas' disease and from others with unrelated parasitic diseases. Positive haemagglutination reactions were only observed with the sera from the former and with that from two patients with mucocutaneous leishmaniasis. No crossed reactions were observed with visceral leishmaniasis, malaria, toxoplasmosis syphilis, schistosomiasis or mononucleosis sera. Results suggest that this purified fraction can be used in immunodiagnosis of American Trypanosomiasis.

  2. A role for extracellular amastigotes in the immunopathology of Chagas disease

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    Julio Scharfstein

    1999-09-01

    Full Text Available In spite of the growing knowledge obtained about immune control of Trypanosoma cruzi infection, the mechanisms responsible for the variable clinico-pathological expression of Chagas disease remain unknown. In a twist from previous concepts, recent studies indicated that tissue parasitism is a pre-requisite for the development of chronic myocarditis. This fundamental concept, together with the realization that T. cruzi organisms consist of genetically heterogeneous clones, offers a new framework for studies of molecular pathogenesis. In the present article, we will discuss in general terms the possible implications of genetic variability of T. cruzi antigens and proteases to immunopathology. Peptide epitopes from a highly polymorphic subfamily of trans-sialidase (TS antigens were recently identified as targets of killer T cell (CTL responses, both in mice and humans. While some class I MHC restricted CTL recognize epitopes derived from amastigote-specific TS-related antigens (TSRA, others are targeted to peptide epitopes originating from trypomastigote-specific TSRA. A mechanistic hypothesis is proposed to explain how the functional activity and specificity of class I MHC restricted killer T cells may control the extent to which tissue are exposed to prematurely released amastigotes. Chronic immunopathology may be exacerbated due the progressive accumulation of amastigote-derived antigens and pro-inflammatory molecules (eg. GPI-mucins and kinin-releasing proteases in dead macrophage bodies.

  3. Atlas of Mexican Triatominae (Reduviidae: Hemiptera and vector transmission of Chagas disease

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    Janine M Ramsey

    2015-05-01

    Full Text Available Chagas disease is one of the most important yet neglected parasitic diseases in Mexico and is transmitted by Triatominae. Nineteen of the 31 Mexican triatomine species have been consistently found to invade human houses and all have been found to be naturally infected with Trypanosoma cruzi. The present paper aims to produce a state-of-knowledge atlas of Mexican triatomines and analyse their geographic associations with T. cruzi, human demographics and landscape modification. Ecological niche models (ENMs were constructed for the 19 species with more than 10 records in North America, as well as for T. cruzi. The 2010 Mexican national census and the 2007 National Forestry Inventory were used to analyse overlap patterns with ENMs. Niche breadth was greatest in species from the semiarid Nearctic Region, whereas species richness was associated with topographic heterogeneity in the Neotropical Region, particularly along the Pacific Coast. Three species, Triatoma longipennis, Triatoma mexicana and Triatoma barberi, overlapped with the greatest numbers of human communities, but these communities had the lowest rural/urban population ratios. Triatomine vectors have urbanised in most regions, demonstrating a high tolerance to human-modified habitats and broadened historical ranges, exposing more than 88% of the Mexican population and leaving few areas in Mexico without the potential for T. cruzi transmission.

  4. Intrusive versus domiciliated triatomines and the challenge of adapting vector control practices against Chagas disease

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    Etienne Waleckx

    2015-05-01

    Full Text Available Chagas disease prevention remains mostly based on triatomine vector control to reduce or eliminate house infestation with these bugs. The level of adaptation of triatomines to human housing is a key part of vector competence and needs to be precisely evaluated to allow for the design of effective vector control strategies. In this review, we examine how the domiciliation/intrusion level of different triatomine species/populations has been defined and measured and discuss how these concepts may be improved for a better understanding of their ecology and evolution, as well as for the design of more effective control strategies against a large variety of triatomine species. We suggest that a major limitation of current criteria for classifying triatomines into sylvatic, intrusive, domiciliary and domestic species is that these are essentially qualitative and do not rely on quantitative variables measuring population sustainability and fitness in their different habitats. However, such assessments may be derived from further analysis and modelling of field data. Such approaches can shed new light on the domiciliation process of triatomines and may represent a key tool for decision-making and the design of vector control interventions.

  5. Extract of Chaga mushroom (Inonotus obliquus) stimulates 3T3-L1 adipocyte differentiation.

    Science.gov (United States)

    Joo, Jeong In; Kim, Dong Hyun; Yun, Jong Won

    2010-11-01

    Chaga mushroom (Inonotus obliquus) has long been used as a folk medicine due to its numerous biological functions such as antibacterial, antiallergic, antiinflammatory and antioxidative activities. In the present study, it was found that the I. obliquus hot water extract (IOWE) activated adipogenesis of 3T3-L1 preadipocytes. Even in the absence of adipogenic stimuli by insulin, the IOWE strongly induced adipogenesis of 3T3-L1 preadipocytes. The major constituent of IOWE was glucose-rich polysaccharides with a molecular mass of 149  kDa. IOWE enhanced the differentiation of 3T3-L1 preadipocytes, increasing TG (triacylglycerol) accumulation that is critical for acquisition of the adipocyte phenotype, in a dose-dependent manner. IOWE stimulated gene expression of C/EBPα (CCAAT/enhancer-binding protein α) and PPARγ (peroxisome proliferator-activated receptors γ) during adipocyte differentiation, and induced the expression of PPARγ target genes such as aP2 (adipocyte protein 2), LPL (lipoprotein lipase) and CD36 (fatty acid translocase). Immunoblot analysis revealed that IOWE increased the expression of adipogenic makers such as PPARγ and GLUT4 (glucose transporter 4). The luciferase reporter assay demonstrated that IOWE did not exhibit PPARγ ligand activity. Although these results require further investigation, the ability of natural mushroom product to increase PPARγ transcriptional activities may be expected to be therapeutic targets for dyslipidemia and type 2 diabetes. PMID:21031614

  6. Oral transmission of Chagas disease: importance of Trypanosoma cruzi biodeme in the intragastric experimental infection.

    Science.gov (United States)

    Camandaroba, Edson Luiz P; Pinheiro Lima, Clarissa M; Andrade, Sonia G

    2002-01-01

    Oral transmission of Trypanosoma cruzi has been suspected when epidemic episodes of acute infection were observed in areas devoid of domiciled insect vectors. Considering that the distribution of T. cruzi biodemes differs in sylvatic and domestic cycles, results of studies on biodemes can be of interest regarding oral transmission. The infectivity of T. cruzi strains of different biodemes was tested in mice subjected to infection by the digestive route (gavage). Swiss mice were infected either with the Peruvian strain (Biodeme Type I, Z2b) or the Colombian strain (Biodeme Type III, Z1, or T. cruzi I); for control, intraperitoneal inoculation was performed in a group of mice. The Colombian strain revealed a similar high infectivity and pathogenicity when either route of infection was used. However, the Peruvian strain showed contrasting levels of infectivity and pathogenicity, being high by intraperitoneal inoculation and low when the gastric route was used. The higher infectivity of the Colombian strain (Biodeme Type III) by gastric inoculation is in keeping with its role in the epidemic episodes of acute Chagas disease registered in the literature, since strains belonging to Biodeme III are most often found in sylvatic hosts. PMID:12048547

  7. Oral transmission of Chagas disease: importance of Trypanosoma cruzi biodeme in the intragastric experimental infection

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    CAMANDAROBA Edson Luiz P.

    2002-01-01

    Full Text Available Oral transmission of Trypanosoma cruzi has been suspected when epidemic episodes of acute infection were observed in areas devoid of domiciled insect vectors. Considering that the distribution of T. cruzi biodemes differs in sylvatic and domestic cycles, results of studies on biodemes can be of interest regarding oral transmission. The infectivity of T. cruzi strains of different biodemes was tested in mice subjected to infection by the digestive route (gavage. Swiss mice were infected either with the Peruvian strain (Biodeme Type I, Z2b or the Colombian strain (Biodeme Type III, Z1, or T. cruzi I; for control, intraperitoneal inoculation was performed in a group of mice. The Colombian strain revealed a similar high infectivity and pathogenicity when either route of infection was used. However, the Peruvian strain showed contrasting levels of infectivity and pathogenicity, being high by intraperitoneal inoculation and low when the gastric route was used. The higher infectivity of the Colombian strain (Biodeme Type III by gastric inoculation is in keeping with its role in the epidemic episodes of acute Chagas disease registered in the literature, since strains belonging to Biodeme III are most often found in sylvatic hosts.

  8. Voltammetric behavior of nitrofurazone and its hydroxymethyl prodrug with potential anti-Chagas activity

    Energy Technology Data Exchange (ETDEWEB)

    La-Scalea, Mauro Aquiles [Sao Paulo Univ., SP (Brazil). Faculdade de Ciencias Farmaceuticas; Sao Paulo Univ., SP (Brazil). Inst. de Quimica]. E-mail: scalea@usp.br; Menezes, Carla Maria de Souza; Ferreira, Elizabeth Igne [Sao Paulo Univ., SP (Brazil). Faculdade de Ciencias Farmaceuticas; Juliao, Murilo Sergio da Silva [Sao Paulo Univ., SP (Brazil). Inst. de Quimica; Universidade Estadual Vale do Acaraju, Fortaleza, CE (Brazil). Centro de Ciencias Exatas e Tecnologicas; Man Chin Chung [UNESP, Araraquara, SP (Brazil). Faculdade de Ciencias Farmaceuticas; Serrano, Silvia Helena Pires [Sao Paulo Univ., SP (Brazil). Inst. de Quimica

    2005-07-15

    Chagas' disease is a serious health problem for Latin America. The situation is worsened by the lack of efficient chemotherapy. The two available commercial drugs, benznidazole and nifurtimox, are more effective in the acute phase of the disease. Nitrofurazone is active against Trypanosoma cruzi, however its high toxicity precludes its current use in parasitosis. Hydroxymethyl nitrofurazone is a prodrug of nitrofurazone. It is more active against Trypanosoma cruzi than nitrofurazone, besides being less toxic. This work shows the voltammetric behavior of nitrofurazone and a comparison with those of metronidazole and chloramphenicol using cyclic, linear sweep and differential pulse voltammetries. For these drugs also the prediction of the diffusion coefficients using Wilke-Chang equation was performed. The reduction of nitrofurazone is pH-dependent and in acidic medium the hydroxylamine derivative, involving four electrons, is the principal product formed. In aqueous-alkaline medium and with a glassy carbon electrode pre-treatment the reduction of nitrofurazone occurs in two steps, the first involving one electron to form the nitro-radical anion and the second corresponding to the hydroxylamine derivative formation. Hydroxymethyl nitrofurazone presented the same voltammetric behavior and electroactivity, indicating that the molecular modification performed in nitrofurazone did not change its capacity to be reduced. A brief discussion regarding the differences in biological activity between the two compounds is also presented. (author)

  9. Population Structure of the Chagas Disease Vector Triatoma infestans in an Urban Environment

    Science.gov (United States)

    Khatchikian, Camilo E.; Foley, Erica A.; Barbu, Corentin M.; Hwang, Josephine; Ancca-Juárez, Jenny; Borrini-Mayori, Katty; Quıspe-Machaca, Victor R.; Naquira, Cesar; Brisson, Dustin; Levy, Michael Z.

    2015-01-01

    Chagas disease is a vector-borne disease endemic in Latin America. Triatoma infestans, a common vector of this disease, has recently expanded its range into rapidly developing cities of Latin America. We aim to identify the environmental features that affect the colonization and dispersal of T. infestans in an urban environment. We amplified 13 commonly used microsatellites from 180 T. infestans samples collected from a sampled transect in the city of Arequipa, Peru, in 2007 and 2011. We assessed the clustering of subpopulations and the effect of distance, sampling year, and city block location on genetic distance among pairs of insects. Despite evidence of genetic similarity, the majority of city blocks are characterized by one dominant insect genotype, suggesting the existence of barriers to dispersal. Our analyses show that streets represent an important barrier to the colonization and dispersion of T. infestans in Arequipa. The genetic data describe a T. infestans infestation history characterized by persistent local dispersal and occasional long-distance migration events that partially parallels the history of urban development. PMID:25646757

  10. Invasion speeds of Triatoma dimidiata, vector of Chagas disease: An application of orthogonal polynomials method.

    Science.gov (United States)

    Mesk, Mohammed; Mahdjoub, Tewfik; Gourbière, Sébastien; Rabinovich, Jorge E; Menu, Frédéric

    2016-04-21

    Demographic processes and spatial dispersal of Triatoma dimidiata, a triatomine species vector of Chagas disease, are modeled by integrodifference equations to estimate invasion capacity of this species under different ecological conditions. The application of the theory of orthogonal polynomials and the steepest descent method applied to these equations, allow a good approximation of the abundance of the adult female population and the invasion speed. We show that: (1) under the same mean conditions of demography and dispersal, periodic spatial dispersal results in an invasion speed 2.5 times larger than the invasion speed when spatial dispersal is continuous; (2) when the invasion speed of periodic spatial dispersal is correlated to adverse demographic conditions, it is 34.7% higher as compared to a periodic dispersal that is correlated to good demographic conditions. From our results we conclude, in terms of triatomine population control, that the invasive success of T. dimidiata may be most sensitive to the probability of transition from juvenile to adult stage. We discuss our main theoretical predictions in the light of observed data in different triatomines species found in the literature. PMID:26807809

  11. An innovative ecohealth intervention for Chagas disease vector control in Yucatan, Mexico

    Science.gov (United States)

    Waleckx, Etienne; Camara-Mejia, Javier; Ramirez-Sierra, Maria Jesus; Cruz-Chan, Vladimir; Rosado-Vallado, Miguel; Vazquez-Narvaez, Santos; Najera-Vazquez, Rosario; Gourbière, Sébastien; Dumonteil, Eric

    2015-01-01

    Background Non-domiciliated (intrusive) triatomine vectors remain a challenge for the sustainability of Chagas disease vector control as these triatomines are able to transiently (re-)infest houses. One of the best-characterized examples is Triatoma dimidiata from the Yucatan peninsula, Mexico, where adult insects seasonally infest houses between March and July. Methods We focused our study on three rural villages in the state of Yucatan, Mexico, in which we performed a situation analysis as a first step before the implementation of an ecohealth (ecosystem approach to health) vector control intervention. Results The identification of the key determinants affecting the transient invasion of human dwellings by T. dimidiata was performed by exploring associations between bug presence and qualitative and quantitative variables describing the ecological, biological and social context of the communities. We then used a participatory action research approach for implementation and evaluation of a control strategy based on window insect screens to reduce house infestation by T. dimidiata. Conclusions This ecohealth approach may represent a valuable alternative to vertically-organized insecticide spraying. Further evaluation may confirm that it is sustainable and provides effective control (in the sense of limiting infestation of human dwellings and vector/human contacts) of intrusive triatomines in the region. PMID:25604765

  12. Intrusive versus domiciliated triatomines and the challenge of adapting vector control practices against Chagas disease

    Science.gov (United States)

    Waleckx, Etienne; Gourbière, Sébastien; Dumonteil, Eric

    2015-01-01

    Chagas disease prevention remains mostly based on triatomine vector control to reduce or eliminate house infestation with these bugs. The level of adaptation of triatomines to human housing is a key part of vector competence and needs to be precisely evaluated to allow for the design of effective vector control strategies. In this review, we examine how the domiciliation/intrusion level of different triatomine species/populations has been defined and measured and discuss how these concepts may be improved for a better understanding of their ecology and evolution, as well as for the design of more effective control strategies against a large variety of triatomine species. We suggest that a major limitation of current criteria for classifying triatomines into sylvatic, intrusive, domiciliary and domestic species is that these are essentially qualitative and do not rely on quantitative variables measuring population sustainability and fitness in their different habitats. However, such assessments may be derived from further analysis and modelling of field data. Such approaches can shed new light on the domiciliation process of triatomines and may represent a key tool for decision-making and the design of vector control interventions. PMID:25993504

  13. Two approaches to discovering and developing new drugs for Chagas disease

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    JH McKerrow

    2009-07-01

    Full Text Available This review will focus on two general approaches carried out at the Sandler Center, University of California, San Francisco, to address the challenge of developing new drugs for the treatment of Chagas disease. The first approach is target-based drug discovery, and two specific targets, cytochrome P450 CYP51 and cruzain (aka cruzipain, are discussed. A "proof of concept" molecule, the vinyl sulfone inhibitor K777, is now a clinical candidate. The preclinical assessment compliance for filing as an Investigational New Drug with the United States Food and Drug Administration (FDA is presented, and an outline of potential clinical trials is given. The second approach to identifying new drug leads is parasite phenotypic screens in culture. The development of an assay allowing high throughput screening of Trypanosoma cruzi amastigotes in skeletal muscle cells is presented. This screen has the advantage of not requiring specific strains of parasites, so it could be used with field isolates, drug resistant strains or laboratory strains. It is optimized for robotic liquid handling and has been validated through a screen of a library of FDA-approved drugs identifying 65 hits.

  14. Spontaneous morphogenetic juvenilization observed in laboratory populations of vector species of Chagas disease (Triatominae

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    Alina Perlowagora-Szumlewicz

    1973-08-01

    Full Text Available Reported are observations on spontaneous occurring morphogenetic juvenilization in laboratory populations of vector species of Chagas disease. Two general effects have been observed: arrested development and uncoordinated development. These are manifested by supernumerary nymphs (6th stage, intermediate nymphal-adult stages, badly deformed adults developed from 5th instar nymphs, uncoordinated development manifested by grotesque forms of adults, supernumerary adults unable to complete metamorphosis and complete supernumerary adults produced by 6th stage nymphs. The reoccurrence of insects with identical grades of juvenilization in the population is an indication that this is a genetic trait that might be inherited. The factors responsible for morphogenetic juvenilization cannot be transmitted through the juvenilized insects because they are sterile, than they were transmitted through normal insects probably as a recessive or a group recessive factors. The spontaneous morphogenetic juvenilization observed in laboratory populations has a striking similarity to juvenilizing effects induced by application of juvenile hormone analogues, described in the literature and also obtained in our laboratory in a study to be published. Thus it is suggested that both; the altered phenotypes occurring in wild populations and their "phenocopies" induced by the application of juvenile hormone analogues are products of gene controlled identical reactions.

  15. Population structure of the Chagas disease vector Triatoma infestans in an urban environment.

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    Camilo E Khatchikian

    2015-02-01

    Full Text Available Chagas disease is a vector-borne disease endemic in Latin America. Triatoma infestans, a common vector of this disease, has recently expanded its range into rapidly developing cities of Latin America. We aim to identify the environmental features that affect the colonization and dispersal of T. infestans in an urban environment. We amplified 13 commonly used microsatellites from 180 T. infestans samples collected from a sampled transect in the city of Arequipa, Peru, in 2007 and 2011. We assessed the clustering of subpopulations and the effect of distance, sampling year, and city block location on genetic distance among pairs of insects. Despite evidence of genetic similarity, the majority of city blocks are characterized by one dominant insect genotype, suggesting the existence of barriers to dispersal. Our analyses show that streets represent an important barrier to the colonization and dispersion of T. infestans in Arequipa. The genetic data describe a T. infestans infestation history characterized by persistent local dispersal and occasional long-distance migration events that partially parallels the history of urban development.

  16. Increase of reactive oxygen species by desferrioxamine during experimental Chagas' disease

    Science.gov (United States)

    Francisco, Amanda Fortes; de Abreu Vieira, Paula Melo; Arantes, Jerusa Marilda; Silva, Maisa; Pedrosa, Maria Lúcia; Elói-Santos, Silvana Maria; Martins-Filho, Olindo Assis; Teixeira-Carvalho, Andréa; Araújo, Márcio Sobreira Silva; Tafuri, Washington Luiz; Carneiro, Cláudia Martins

    2010-01-01

    Oxidative stress is common in inflammatory processes associated with many diseases including Chagas' disease. The aim of the present study was to evaluate, in a murine model, biomarkers of oxidative stress together with components of the antioxidant system in order to provide an overview of the mechanism of action of the iron chelator desferrioxamine (DFO). The study population comprised 48 male Swiss mice, half of which were treated daily by intraperitoneal injection of DFO over a 35-day period, while half were administered sterile water in a similar manner. On the 14th day of the experiment, 12 DFO-treated mice and an equal number of untreated mice were experimentally infected with Trypanosoma cruzi. Serum concentrations of nitric oxide and superoxide dismutase and hepatic levels of total glutathione, thiobarbituric acid reactive species and protein carbonyl, were determined on days 0, 7, 14 and 21 post-infection. The results obtained revealed that DFO enhances antioxidant activity in the host but also increases oxidative stress, indicating that the mode of action of the drug involves a positive contribution to the host together with an effect that is not beneficial to the parasite. PMID:20663295

  17. Inoculação experimental de Equus asinus com Leishmania chagasi Cunha & Chagas, 1937

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    Cerqueira Elúzio José Lima

    2003-01-01

    Full Text Available Quatro Equus asinus foram inoculados com promastigotas de Leishmania chagasi Cunha & Chagas, 1937 e acompanhados durante 12 meses através de: pesquisa de amastigotas em esfregaços e culturas de sangue periférico em fragmentos de tecido do lábio inferior, medula óssea, baço e fígado e de testes de ELISA e TRALd. Estes foram positivos nos 8º, 10º e 12º meses após a inoculação. O exame histopatológico pós necropsia, demonstrou discreto número de amastigotas no fígado de dois dos eqüídeos inoculados. Apesar de desafiados com elevado número de promastigotas, os animais não desenvolveram infecções patentes e não infectaram experimentalmente a vetora Lutzomya longipalpis. Os resultados induzem a acreditar que os eqüídeos são desprovidos de importância como reservatórios na cadeia de transmissão da leishmaniose visceral, embora sirvam como boa fonte de alimentação sangüínea e proliferação da vetora Lutzomyia longipalpis.

  18. [Sword of Damocles or Russian roulette ... what everyone knows or ought to know about Chagas disease].

    Science.gov (United States)

    Pays, J F

    2009-12-01

    In 2006 the Pan American Health Organisation (PAHO) roughly estimated the prevalence of Chagas disease or American Human Trypanosomiasis, due to Trypanosoma cruzi, still to be eight million cases. The migration of people from the country into towns has resulted, in recent decades, in the urbanisation of this rural disease. Up to the mid-20th century, the epidemiology of the disease was closely linked to the extreme poverty of the peasant population and to their housing, the rancho, which offers a suitable habitat for the vectors and encourages their proliferation. A further barrier has recently been crossed with the arrival in non-endemic areas of numerous seropositive individuals. We shall draw attention in this article to the main clinical signs and to the manner of progression of the disease as well as to the problems posed by treatment of the different phases of this unique condition. It is not fanciful to describe it as resembling an adventure story, because of the place and manner of its discovery and of how the disease unfolds. PMID:20131420

  19. A Deep Insight into the Sialome of Rhodnius neglectus, a Vector of Chagas Disease

    Science.gov (United States)

    Santiago, Paula Beatriz; Assumpção, Teresa C. F.; de Araújo, Carla Nunes; Bastos, Izabela Marques Dourado; Neves, David; da Silva, Ionizete Garcia; Charneau, Sébastien; Queiroz, Rayner Myr L.; Raiol, Tainá; Oliveira, João Victor de Araújo; de Sousa, Marcelo Valle; Calvo, Eric; Ribeiro, José M. C.; Santana, Jaime M.

    2016-01-01

    Background Triatomines are hematophagous insects that act as vectors of Chagas disease. Rhodnius neglectus is one of these kissing bugs found, contributing to the transmission of this American trypanosomiasis. The saliva of hematophagous arthropods contains bioactive molecules responsible for counteracting host haemostatic, inflammatory, and immune responses. Methods/Principal Findings Next generation sequencing and mass spectrometry-based protein identification were performed to investigate the content of triatomine R. neglectus saliva. We deposited 4,230 coding DNA sequences (CDS) in GenBank. A set of 636 CDS of proteins of putative secretory nature was extracted from the assembled reads, 73 of them confirmed by proteomic analysis. The sialome of R. neglectus was characterized and serine protease transcripts detected. The presence of ubiquitous protein families was revealed, including lipocalins, serine protease inhibitors, and antigen-5. Metalloproteases, disintegrins, and odorant binding protein families were less abundant. Conclusions/Significance The data presented improve our understanding of hematophagous arthropod sialomes, and aid in understanding hematophagy and the complex interplay among vectors and their vertebrate hosts. PMID:27129103

  20. Doença de Chagas no Brasil: Uma Visão Geográfica de Conjunto | Chagas Disease in Brazil: A Geographical Overview

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    Guttierre Paschoa Catrolio da Silva

    2014-05-01

    Full Text Available Normal 0 21 false false false PT-BR X-NONE X-NONE Introdução: O projeto visa construir uma análise da Doença de Chagas no Brasil, elaborando uma visão de conjunto da situação geoepidemiológica da enfermidade, ainda endêmica no continente americano. Especificamente considerada enzoótica e negligenciada, tal infecção é causada pelo protozoário Trypanosoma cruzi e circula no ambiente em hospedeiros mamíferos intermediários e em vetores reduvideos triatomíneos. Atualmente sabendo que o problema, mesmo que subnotificado, é resultado de um processo histórico de reorganização do território que acompanha a revolução industrial em meados do século passado e ademais, quanto ao espectro da saúde, em função dos baixos índices de infestação do vetor e das taxas de incidência reduzidas, as ações de vigilância e controle têm sido executadas em áreas residuais, visando o estabelecimento de novos focos de transmissão vetorial. Metodologia/Desenvolvimento: Partindo-se da hipótese de que elementos dispersos - (casos agudos notificados e seus modos de infecção, localização de vetores e seus reservatórios naturais e antrópicos, casos crônicos e sua respectiva faixa etária em maioria oriundos de bancos de dados do Sistema Único de Saúde fazem parte de uma realidade a ser desvendada. Esta pesquisa usa de conhecimentos e procedimentos da ciência geográfica - através do geoprocessamento, geoestatística e cartomática - para compreender as interações espaciais destes dados clínicos, de morbimortalidade e eco-epidemiológicos e assim mapear os novos desafios da Tripanossomíase Americana no país, como a urbanização do ciclo e novos padrões de infecção em distintas temporalidades acumuladas e sobrepostas no espaço nosológico. Isto em um contexto de grandes mudanças socioambientais do meio rural e intenso processo de fragmentação das ações de monitoramento com a municipalização dos serviços de vigil

  1. Inquérito sôbre a Doença de Chagas em candidatos a doadores de sangue Survey on the incidence of Chaga's Disease among prospective blood donors

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    J. Pellegrino

    1951-03-01

    Full Text Available Em 576 indivíduos que se apresentaram ao Banco de Sangue do Hospital do Pronto Socorro de Belo Horizonte, para a prova de seleção de doadores de sangue, foi feita a reação de fixação do complemento (antígeno de cultura do S. cruzi para o diagnóstico da doença de CHAGAS. Em 14 casos a reação foi positiva. Sete candidatos a doador, com reação positiva, foram estudados clìnicamente, e nêles foi praticado xenodiagnóstico, eletrocardiograma e tele-radiografia do coração e vasos da base. Em todos os 7 casos estudados apurou-se que já haviam habitado casas infestadas por triatomíneos em zonas endêmicas e 3 deles apresentaram sinais de comprometimento miocárdico, revelando o eletrocardiograma, em dois, bloqueio do ramo direito, e, em um, bloqueio A-V total. Em 3 candidatos conseguiu-se a comprovação parasitológica da infecção chagásica pela positividade do xenodiagnóstico. Foram feitas considerações sobre o problema da transmissibilidade da doença de CHAGAS pela transfusão de sangue e da necessidade de se tornar obrigatória a inclusão da reação de fixação do complemento para esquizotripanose entre as provas de rotina exigidas na seleção de doadores de sangue.In the "Blood Bank" of the Hospital do Pronto Socorro in Belo Horizonte, Minas Gerais, Brazil, 576 individuals were submitted to the routine medical examination which is required before applicants are accepted as regular blood donors. Among the blood tests which were performed, it was included, this time, the complement-fixation test for CHAGAS' disease, the antigen being prepared from cultures of S. cruzi. Fourteen individuals showed positive reaction for CHAGAS' disease. Of these, 7 were submitted to xenodiagnosis, to electrocardiographic examination and to X-rays examination of the heart and of the basal vessels. All of the 7 individuals have lived in huts which harbored triatomid-bugs, in regions where CHAGAS' disease is endemic. The electrocardiograms

  2. Trypanosoma cruzi III from armadillos (Dasypus novemcinctus novemcinctus) from Northeastern Venezuela and its biological behavior in murine model. Risk of emergency of Chagas' disease.

    Science.gov (United States)

    Morocoima, Antonio; Carrasco, Hernán J; Boadas, Johanna; Chique, José David; Herrera, Leidi; Urdaneta-Morales, Servio

    2012-11-01

    Trypanosoma cruzi, etiological agent of Chagas' disease, was isolated from armadillos (Dasypus novemcinctus novemcinctus) captured in rural communities Northeastern Venezuela from Nueva Esparta State (no endemic for Chagas' disease), Monagas and Anzoátegui States (endemics). The isolates, genetically typed by PCR-RFLP as belonging to the TcIII DTU, have demonstrated in murine model heterogenic parasitemia, mortality and histotropism with marked parasitism in cardiac, skeletal, and smooth myocytes that showed correlation with lymphobasophilic inflammatory infiltrates. Our finding of T. cruzi infected armadillos in Isla Margarita (Nueva Esparta State), together with reports of triatomine vectors in this region, the accentuated synanthropy of armadillos, intense economic activity, migration due to tourism and the lack of environmental education programs all of them represent risks that could cause the emergence of Chagas' disease in this area. This is the first report of the TcIII DTU in Northeastern Venezuela, thus widening the geographic distribution of this DTU. PMID:22902748

  3. High similarity of Trypanosoma cruzi kDNA genetic profiles detected by LSSP-PCR within family groups in an endemic area of Chagas disease in Brazil

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    Sandra Maria Alkmim-Oliveira

    2014-10-01

    Full Text Available Introduction Determining the genetic similarities among Trypanosoma cruzi populations isolated from different hosts and vectors is very important to clarify the epidemiology of Chagas disease. Methods An epidemiological study was conducted in a Brazilian endemic area for Chagas disease, including 76 chronic chagasic individuals (96.1% with an indeterminate form; 46.1% with positive hemoculture. Results T. cruzi I (TcI was isolated from one child and TcII was found in the remaining (97.1% subjects. Low-stringency single-specific-primer-polymerase chain reaction (LSSP-PCR showed high heterogeneity among TcII populations (46% of shared bands; however, high similarities (80-100% among pairs of mothers/children, siblings, or cousins were detected. Conclusions LSSP-PCR showed potential for identifying similar parasite populations among individuals with close kinship in epidemiological studies of Chagas disease.

  4. Chagas disease prevention through improved housing using an ecosystem approach to health Prevención de la enfermedad de Chagas vía mejoramiento de la vivienda com un enfoque ecosistémico de la salud

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    Antonieta Rojas-de-Arias

    2001-01-01

    Full Text Available This Chagas disease prevention project via housing improvement aims to determine the efficiencyof different interventions in vector control. The following study describes the target communities, disease magnitude, and housing improvements. Transmission levels are analysed from an ecological and socioeconomic perspective. Special interest was focused on the peridomicile as the origin of domiciliary reinfestation. In the original project, three intervention programs were proposed, one for each of the three communities: (a an insecticide spraying program; (b a housing improvement program; and (c a combined program of spraying and housing improvement. The three communities currently have different risks of exposure to triatominae reinfestation as a consequence of the type of intervention carried out. A new multidisciplinary approach which integrates participatory, community-based research and socioeconomic dimensions will allow to determine the efficiency of models for territorial ordering, community education, and environmental interventions in Chagas disease control.El proyecto de prevención de la enfermedad de Chagas vía mejoramiento de la vivienda tuvo como objetivo determinar la efectividad de diferentes intervenciones para el control vectorial. El siguiente trabajo describe las comunidades intervenidas, la dimensión de la enfermedad y el mejoramiento de la vivienda en el contexto familiar. Los niveles de transmisión se analizan con una perspectiva ecológica y socioeconómica. Especial interés se ha dado al peridomicilio como lugar de origen de las reinfestaciones domiciliares. Tres programas de intervención fueron propuestos para estas tres comunidades: (a rociado con insecticidas; (b mejoramiento de la vivienda; y (c combinado de rociamiento y mejoramiento de la vivienda. En la actualidad, las tres comunidades tienen riesgos de exposición diferentes al proceso de reinfestación triatomínica como consecuencia del tipo de intervenci

  5. Chagas' disease: the rural environment and vector control in the state of São Paulo, Brazil Doença de Chagas: meio rural e controle de vetores no Estado de São Paulo, Brasil

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    Dalva Marli V. Wanderley

    1993-12-01

    Full Text Available In the first half of this century - a period of expanding coffee cultivation - there was a close relationship between the growth of cleared spaces, the domestication of triatomines, and the establishment of Chagas' disease in the state of São Paulo. However, the initiation of control mesuares in 1950 coincided with a period characterized by a progressive reversal of the conditions that had facilitated the establishment of Chagas' disease in the first place. Alterations were taking place in the agricultural environment, rural areas were becoming depopulated, and low-grade housing was being destroyed. Natural transmission of the endemic was interrupted in the mid-1970's, following the elimination of Triatoma infestans from homes. Subsequently, however, a challenge emerged from two extradomiciliary species, Triatoma sordida and Panstrongylus megistus. The invasive character of these species made it necessary to investigate their possible repercussions on human populations and to set up permanent programs of epidemiological surveillance involving direct participation by local populations.O presente estudo analisa as relações entre a expansão dos espaços abertos, a domiciliação triatomínea e a instalação da doença de Chagas no Estado de São Paulo durante a expansão da cultura cafeeira, na primeira metade do século. No período pós-50, o início das ações de controle coincide com a desestruturação das relações facilitadoras para a instalação da doença de Chagas, através da alteração do espaço agrário, êxodo rural e destruição de domicílios de pior qualidade. A partir da interrupção da transmissão natural da endemia, em meados da década de 70, conseqüência da eliminação de Triatoma infestans dos domicílios, enfrenta-se o desafio das populações triatomíneas extradomiciliares - Triatoma sordida e Panstrongylus megistus -, cujo caráter invasivo tem requerido a investigação das possíveis repercuss

  6. Ecological connectivity of Trypanosoma cruzi reservoirs and Triatoma pallidipennis hosts in an anthropogenic landscape with endemic Chagas disease.

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    Janine M Ramsey

    Full Text Available Traditional methods for Chagas disease prevention are targeted at domestic vector reduction, as well as control of transfusion and maternal-fetal transmission. Population connectivity of Trypanosoma cruzi-infected vectors and hosts, among sylvatic, ecotone and domestic habitats could jeopardize targeted efforts to reduce human exposure. This connectivity was evaluated in a Mexican community with reports of high vector infestation, human infection, and Chagas disease, surrounded by agricultural and natural areas. We surveyed bats, rodents, and triatomines in dry and rainy seasons in three adjacent habitats (domestic, ecotone, sylvatic, and measured T. cruzi prevalence, and host feeding sources of triatomines. Of 12 bat and 7 rodent species, no bat tested positive for T. cruzi, but all rodent species tested positive in at least one season or habitat. Highest T. cruzi infection prevalence was found in the rodents, Baiomys musculus and Neotoma mexicana. In general, parasite prevalence was not related to habitat or season, although the sylvatic habitat had higher infection prevalence than by chance, during the dry season. Wild and domestic mammals were identified as bloodmeals of T. pallidipennis, with 9% of individuals having mixed human (4.8% single human and other mammal species in bloodmeals, especially in the dry season; these vectors tested >50% positive for T. cruzi. Overall, ecological connectivity is broad across this matrix, based on high rodent community similarity, vector and T. cruzi presence. Cost-effective T. cruzi, vector control strategies and Chagas disease transmission prevention will need to consider continuous potential for parasite movement over the entire landscape. This study provides clear evidence that these strategies will need to include reservoir/host species in at least ecotones, in addition to domestic habitats.

  7. 100 años de Chagas (1909-2009: revisión, balance y perspectiva

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    Mariana SANMARTINO

    2009-01-01

    Full Text Available Cien años han transcurrido desde las primeras publicaciones de Carlos Chagas acerca de la enfermedad que lleva su nombre, del agente causal y de los insectos vectores. A propósito de tal conmemoración, el presente artículo pretende dar una breve revisión de ciertas cuestiones históricas, una mirada crítica a la situación actual y algunas pistas para el camino que queda por recorrer.

  8. Aspectos ecoepidemiológicos en la transmisión de la enfermedad de chagas en Santa Rosalia, Vichada

    OpenAIRE

    Castro Salas , Mirley

    2013-01-01

    Introducción: La existencia de la enfermedad de Chagas o tripanosomiasis americana en seres humanos es un hecho que se presenta sustancialmente de modo accidental, El contacto del hombre con los focos naturales puede provocar desequilibrios ecológicos a los triatominos infectados que se ven obligados a ocupar viviendas humanas y sus respectivos procesos de domiciliación, al encontrar en ellos refugio y fuente de alimentación en humanos y animales domésticos. Desde el punto de v...

  9. Prevalence of antibody to Trypanosoma cruzi in Hispanic-surnamed patients seen at Parkland Health & Hospital System, Dallas, Texas

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    Lenz Tim E

    2011-04-01

    Full Text Available Abstract Background Chagas disease constitutes an important public health threat in terms of morbidity and mortality in the areas in the United States where immigrant populations from Latin America are conspicuous. We conducted a survey to assess the prevalence of anti-T. cruzi antibody in Hispanic-surnamed patients seen at Parkland Memorial Hospital in Dallas, Texas. Findings Five hundred serum specimens from Hispanic-surnamed patients were tested by a preliminary ELISA method. On a subset of 50 sera confirmatory testing was also performed using an alternative ELISA, indirect immunofluorescence, and TESA immunoblot. For 274 of 500 Hispanic-surnamed patients, we were able to ascertain immigration status upon medical chart review. Of the 274 sera analyzed, one sample tested as positive for anti-T. cruzi antibody by the preliminary ELISA, and by the three confirmatory methods. Conclusions The goal of this study is to increase the awareness of T. cruzi infection and Chagas disease in areas where the Latin American immigrant communities are growing. Our study highlights the importance of testing for Chagas disease in the populations most at risk, and the need for current data on the actual seroprevalence in areas where such immigrant populations are conspicuous. Larger-scale epidemiologic surveys on Chagas disease in the immigrant communities from Latin America are warranted.

  10. The pathogenesis of Chagas' disease: when autoimmune and parasite-specific immune responses meet

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    MILENA B. P. SOARES

    2001-12-01

    Full Text Available Chagas' disease is a major health problem in Latin America, where it constitutes one of the leading causes of heart failure. About one fourth of Trypanosoma cruzi-infected individuals develop chronic chagasic cardiomyopathy (CChC, the most severe form of the disease. CChC is histologically characterized by the presence of multifocal inflammatory infiltrates in the heart, composed mainly by mononuclear cells, usually adhered to myocytes and leading to myocytolysis, and frequently by interstitial fibrosis. The pathogenesis of CChC is still unclear, despite intense investigations both in human beings and in animal models of the disease. Although tissue parasitism is rare in the chronic phase of infection, an immune response targeted to persistent parasites or parasite antigens is suggested, by some authors, as the pathogenic mechanism of CChC. Other researchers affirm that the lack of correlation between tissue parasitism and intensity of inflammation suggests, along with the presence of autoreactive immune responses, that CChC results from the action of an autoimmune response. Herein we review reports from the literature and our own data, which together indicate, on one hand, the participation of parasite-specific immune responses and, on the other hand, clearly demonstrate the participation of heart-specific immune responses in the pathogenesis of CChC. Moreover, multiple factors may determine whether an individual in the indeterminate form of the disease will develop CChC. The mechanisms by which T. cruzi breaks immunological tolerance to heart antigens are also discussed.A doença de Chagas constitui um grave problema de saúde pública na América Latina, onde é uma das principais causas de problemas cardíacos. A cardiopatia chagásica crônica (CChC, forma mais grave da doença, manifesta-se em cerca de 25% dos indivíduos infectados pelo Trypanosoma cruzi, e é caracterizada, a nível histopatológico, pela presença de infiltrados

  11. Irradiated T. cruzi and resistant consomic animals can be useful in Chagas disease studies

    Energy Technology Data Exchange (ETDEWEB)

    Dias, Viviane Liotti; Passos, Luiz Augusto Correa; Salgado, Andreia Ruis [Universidade Estadual de Campinas, SP (Brazil). Centro Multidisciplinar para a Investigacao Biologica (CEMIB/UNICAMP)], e-mail: viviliotti@cemib.unicamp.br; Spencer, Patrick Jack; Nascimento, Nanci do [Instituto de Pesquisas Energeticas e Nucleares (IPEN-CNEN/SP), Sao Paulo, SP (Brazil)

    2009-07-01

    Human Chagas disease is considered the most significant parasitic disease in Latin America. It is estimated that 16-18 million people are infected by T. cruzi. As a consequence, approximately 50,000 deaths occur every year. The acute infection usually goes unrecognized and enters into a chronic stage that persists throughout the host's life span. However, roughly 30% of infected individuals eventually will develop disease with an array of possible manifestations affecting the heart, the digestive tract, and/or the peripheral nervous system. This disease is commonly modeled in inbred mice even though mouse strains used to simulate experimental infection vary considerably. In this way, Wrightsman and Trischmann showed that chromosome 17 was directly involved in a T. cruzi resistance, showing the influence of host's genetic constitution on disease severity. Additionally, in 2003, Passos and Graefe, working separately, quantified parasite burdens in resistant and susceptible strains and applied a backcross strategy to map the genomic loci linked to susceptibility and resistance in inbred mice. The genomes of the animals were scanned with microsatellite markers and the results found by these authors showed that the resistance mechanism is polygenic and is under the control of a complex network. In the particular case of Y strain, in vivo assays indicated that survival was related to the chromosomes 7,11,14,17 and 19. In order to evaluate the influence of each isolated chromosome as well as their interactions, we employed susceptible isogenic mice to construct consomic lineages for each one of those chromosomes. The consomic strains were injected with irradiated and native forms of Y strain T. cruzi, and the infectivity parameters were evaluated by quantitative methods. Radiation caused inability of trypanosomes to infect and kill mice, when these parasites were irradiated with 1 kGy of gamma rays from a {sup 60}Co source. In this experiment we used 10{sup 1

  12. Aglutinina anti-T (Thomsen-Friedenreich na doença de Chagas

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    Marcos Palatnik

    1986-10-01

    Full Text Available Uma amostra de soros de pacientes e controles de uma área endêmica da Doença de Chagas do País foi titulada contra hemácias de grupo O tratadas pela neuraminidase (células OT ativadas e hemacias normais de grupo A e B (sistema ABO. Também foram feitos alguns testes de aglutinação de hemácias de pacientes com cardiomiopatia com as lectinas de amendoim (anti-T + anti-Tk e com anticorpo humano anti-T. O escore médio da aglutinina anti-T dos pacientes foi similar ao do grupo controle. En- tretanto, o escore médio dos indivíduos com a forma cardíaca íoi significantemente maior que o dos pacientes assintomáticos e também maior que o do grupo controle. A comparação entre indivíduos com sorologia diagnóstica positiva versus negativa foi não significante. Nem a sorologia para Chagas nem as variáveis raça, sexo, idade, idade ao quadrado, in-fecção intestinal parasitária, teor de proteínas do soro, volume globular eritrocitário (hema-tócrito, grau de palidez da mucosa bucal, cardíomiopatia e os termos de interação sexo x idade, sexo x idade ao quadrado, estão associados significativamente com o logaritmo do título ou com o logaritmo do escore de aglutinação. Os escores de aglutinação das aglutininas anti-A e anti-B do sistema de grupo sangüíneo ABO estão dentro da faixa de variação normal. As hemácias de pacientes com a forma cardíaca não são aglutinadas nem pelas lectinas de amendoim (antiT + anti-Tk e da soja (anti-T nem pela aglutinina anti-T de origem humana. A prova de Coombs direta foi negativa em todos os pacientes, demonstrando a aparente ausência de imunoglobulinas IgG e IgM na superfície eritrocitária. O fato de que o aumento dos níveis de anti-T só foi detectado em uma das formas clínicas da doença em pacientes da mesma área endêmica constitui um argumento contra a possibilidade de que a variação observada seja produzida por uma infecção concomitante.

  13. Paratransgenic triatomines for the control of Chagas Disease transmission: Perspectives from the field

    International Nuclear Information System (INIS)

    Full text: Chagas disease remains a leading public health concern throughout much of Central and South America. Over 16 million people were infected with Trypanosoma cruzi, the causative agent of Chagas Disease, and further 100 million were at risk, prior to the initiation of the regional vector control initiatives. With neither a cure nor vaccine available, control relies heavily on strategies that eliminate the domestic triatomine vectors of T. cruzi. Insecticide-based strategies have had initial success but are limited by problems of cost, sustainability, and the inability to control non-domiciliated bug populations. Extra-domiciliary bug populations present the risk of re-invading human dwellings in the absence of continued use of chemicals. For the past 10 years, our group has developed a novel strategy to render bugs incapable of T. cruzi transmission. This approach, termed paratransgenesis, involves genetic manipulation of symbiotic bacteria resident in the gut lumen of the bug, to export molecules that are toxic to T. cruzi. Triatomines disperse the symbiotic bacteria to their progeny via fecal contamination. Nymphs that probe feces of adult bugs rapidly establish gut infections with the symbiont. We have exploited the biology of bacterial transfer amongst triatomines to create a synthetic paste termed CRUZIGARD for field delivery of engineered bacteria. Viewed as an integrated control strategy, this method would complement and ensure the sustainability of the ongoing insecticide-based initiatives. The strategy is designed to completely block transmission by targeting bug populations that prove resilient to conventional methods. The novel concept of the auto-propagation of a transmission-blocking agent is based on the natural and efficient dispersal of genetically altered bacteria through lateral spread of fecal material in bug colonies, making it cost-effective and sustainable. Significant barriers still exist to field use of this technology. The efficacy

  14. Spontaneous morphogenetic juvenilization observed in laboratory populations of vector species of Chagas disease (Triatominae

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    Alina Perlowagora-Szumlewicz

    1973-08-01

    Full Text Available Reported are observations on spontaneous occurring morphogenetic juvenilization in laboratory populations of vector species of Chagas disease. Two general effects have been observed: arrested development and uncoordinated development. These are manifested by supernumerary nymphs (6th stage, intermediate nymphal-adult stages, badly deformed adults developed from 5th instar nymphs, uncoordinated development manifested by grotesque forms of adults, supernumerary adults unable to complete metamorphosis and complete supernumerary adults produced by 6th stage nymphs. The reoccurrence of insects with identical grades of juvenilization in the population is an indication that this is a genetic trait that might be inherited. The factors responsible for morphogenetic juvenilization cannot be transmitted through the juvenilized insects because they are sterile, than they were transmitted through normal insects probably as a recessive or a group recessive factors. The spontaneous morphogenetic juvenilization observed in laboratory populations has a striking similarity to juvenilizing effects induced by application of juvenile hormone analogues, described in the literature and also obtained in our laboratory in a study to be published. Thus it is suggested that both; the altered phenotypes occurring in wild populations and their "phenocopies" induced by the application of juvenile hormone analogues are products of gene controlled identical reactions.São relatadas observações sobre a ocorrência espontâea de juvenilização morfogenética em populações de espécies transmissoras da doença de Chagas, mantidas no laboratório. Dois efeitos gerais foram observados: a interrupção e a descoordenação do desenvolvimento. Tais efeitos são manifestados: 1 por ninfas supernumerárias (6º estádio, 2 por estágios intermediários (ninfa-adulto, 3 por adultos sensivelmente deformados, provenientes de ninfas do 5º estágio, 4 pelo desenvolvimento d

  15. Improvement of C peptide zero BMI 24-34 diabetic patients after tailored one anastomosis gastric bypass (BAGUA

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    M. Garcia-Caballero

    2013-01-01

    Full Text Available Background: Although bariatric surgery proved to be a very effective method in the treatment of patients in whose pancreas still produce insulin (type 2 diabetes, the accompanied metabolic syndrome and their diabetes complications, there is no information on the effect of this type of surgery in BMI24-34 patients when pancreas do not produce insulin at all (type 1, LADA and long term evolution type 2 diabetes among others. Patients and methods: We report preliminary data of a serie of 11 patients all with a C-peptide values below 0.0 ng/ml. They were followed for 6 to 60 months (mean 19 months after surgery. We studied the changes in glycemic control, evolution of the metabolic syndrome and diabetes complications after one anastomosis gastric bypass (BAGUA. Results: All values relative to glycemic control were improved HbA1c (from 8.9 ± 0.6 to 6.7 ± 0.2%, FPG (Fasting Plasma Glucose [from 222.36 ± 16.87 to 94 ± 5 (mg/dl] as well as the daily insulin requirement of rapid (from 40.6 ± 12.8 to 0 (U/d and long-lasting insulin (from 41.27 ± 7.3 U/day to 15.2 ± 3.3 U/day. It resolved 100% of the metabolic syndrome diseases as well as severe hypoglycaemia episodes present before surgery and improved some serious complications from diabetes like retinopathy, nephropathy, neuropathy, peripheral vasculopathy and cardiopathy. Conclusions: Tailored one anastomosis gastric bypass in BMI 24-34 C peptide zero diabetic patients eliminated the use of rapid insulin, reduced to only one injection per day long-lasting insulin and improved the glycemic control. After surgery disappear metabolic syndrome and severe hypoglycaemia episodes and improves significantly retinopathy, neuropathy, nephropathy, peripheral vasculopathy and cardiopathy.

  16. Miocardite na forma aguda da doença de Chagas

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    Eitel Duarte

    1948-12-01

    Full Text Available The autopsy of a case of CHAGAS'S disease or American tryponosomiasis (a girl, 5 years old, dead in the 22nd day of illness is reported. The anatomic diagnosis was a follows: Acute diffuse chagasic nyocarditis. Chagasic encephalitis. Chagasic lymphadenitis of the right posterior auricular node. Tuberculosis of the bronchial and pulmonary nodes. Chronic passive hyperemia and atelectasia of the lungs. Chronic passive congestion and hemorrhages of the spleen. Serous hepatitis. Parotiditis. Edema of the right eyelids. Bilateral hydrothorax. Hydropericardium. Hydroperitoneum. The morphology of Schizotrypanum cruzi in the myocardium is considered. Besides agglomerates with typical small oval or round intracellular bodies, pre-flagellate and flagellate organisms, others are found in which the great amount of parasites and marked pressure exerted by them against each other render very difficult their identification; sometimes the similitude of such agglamerates to Toxoplasma is striking (Fig. 1 and 1 A. In such a case, the structure of the blepharoplast (Fig. 1 and IA, usually preserved, is profitable and allows the identification of the pre-flagellate and flagellate forms of Schizotrypanum cruzi. Most of the small sensitive nerves in the epicardium shows mononuclear infiltration of the perineurium (perineuritis, Figs. 12-14. Microscopically there is extensive Zenker's degeneration (Figs. 6-8 and parasitism of the heart muscle fibers, marked cellular infiltration of the interstitial connective tissue, which are found in the ordinary musculature of every chamber of the heart (Figs. 10-11 as well as in Tawara's node (Fig. 9, main bundle (Fig. 2 and right (Fig. 4 and left (Fig. 5 septal divisions of the bundle of His, and perineuritis. Those anatomic changes are associated to an abnormal electrocardiogram presenting some similitude to that of an anemic infarct of the anterior wall of the heart and which will be discussed elsewhere (unpublished paper by

  17. Genetically modifying the insect gut microbiota to control Chagas disease vectors through systemic RNAi.

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    Mabel L Taracena

    2015-02-01

    Full Text Available Technologies based on RNA interference may be used for insect control. Sustainable strategies are needed to control vectors of Chagas disease such as Rhodnius prolixus. The insect microbiota can be modified to deliver molecules to the gut. Here, Escherichia coli HT115(DE3 expressing dsRNA for the Rhodnius heme-binding protein (RHBP and for catalase (CAT were fed to nymphs and adult triatomine stages. RHBP is an egg protein and CAT is an antioxidant enzyme expressed in all tissues by all developmental stages. The RNA interference effect was systemic and temporal. Concentrations of E. coli HT115(DE3 above 3.35 × 10(7 CFU/mL produced a significant RHBP and CAT gene knockdown in nymphs and adults. RHBP expression in the fat body was reduced by 99% three days after feeding, returning to normal levels 10 days after feeding. CAT expression was reduced by 99% and 96% in the ovary and the posterior midgut, respectively, five days after ingestion. Mortality rates increased by 24-30% in first instars fed RHBP and CAT bacteria. Molting rates were reduced by 100% in first instars and 80% in third instars fed bacteria producing RHBP or CAT dsRNA. Oviposition was reduced by 43% (RHBP and 84% (CAT. Embryogenesis was arrested in 16% (RHBP and 20% (CAT of laid eggs. Feeding females 105 CFU/mL of the natural symbiont, Rhodococcus rhodnii, transformed to express RHBP-specific hairpin RNA reduced RHBP expression by 89% and reduced oviposition. Modifying the insect microbiota to induce systemic RNAi in R. prolixus may result in a paratransgenic strategy for sustainable vector control.

  18. Antennal phenotype of Mexican haplogroups of the Triatoma dimidiata complex, vectors of Chagas disease.

    Science.gov (United States)

    May-Concha, Irving; Guerenstein, Pablo G; Ramsey, Janine M; Rojas, Julio C; Catalá, Silvia

    2016-06-01

    Triatoma dimidiata (Latreille) is a species complex that spans North, Central, and South America and which is a key vector of all known discrete typing units (DTU) of Trypanosoma cruzi, the etiologic agent of Chagas disease. Morphological and genetic studies indicate that T. dimidiata is a species complex with three principal haplogroups (hg) in Mexico. Different markers and traits are still inconclusive regarding if other morphological differentiation may indicate probable behavioral and vectorial divergences within this complex. In this paper we compared the antennae of three Mexican haplogroups (previously verified by molecular markers ND4 and ITS-2) and discussed possible relationships with their capacity to disperse and colonized new habitats. The abundance of each type of sensillum (bristles, basiconics, thick- and thin-walled trichoids) on the antennae of the three haplogroups, were measured under light microscopy and compared using Kruskal-Wallis non-parametric and multivariate non-parametric analyses. Discriminant analyses indicate significant differences among the antennal phenotype of haplogroups either for adults and some nymphal stages, indicating consistency of the character to analyze intraspecific variability within the complex. The present study shows that the adult antennal pedicel of the T. dimidiata complex have abundant chemosensory sensilla, according with good capacity for dispersal and invasion of different habitats also related to their high capacity to adapt to conserved as well as modified habitats. However, the numerical differences among the haplogroups are suggesting variations in that capacity. The results here presented support the evidence of T. dimidiata as a species complex but show females and males in a different way. Given the close link between the bug's sensory system and its habitat and host-seeking behavior, AP characterization could be useful to complement genetic, neurological and ethological studies of the closely

  19. Assessment of Autonomic Function by Phase Rectification of RRInterval Histogram Analysis in Chagas Disease

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    Olivassé Nasari Junior

    2015-06-01

    Full Text Available Background: In chronic Chagas disease (ChD, impairment of cardiac autonomic function bears prognostic implications. Phase‑rectification of RR-interval series isolates the sympathetic, acceleration phase (AC and parasympathetic, deceleration phase (DC influences on cardiac autonomic modulation. Objective: This study investigated heart rate variability (HRV as a function of RR-interval to assess autonomic function in healthy and ChD subjects. Methods: Control (n = 20 and ChD (n = 20 groups were studied. All underwent 60-min head-up tilt table test under ECG recording. Histogram of RR-interval series was calculated, with 100 ms class, ranging from 600–1100 ms. In each class, mean RR-intervals (MNN and root-mean-squared difference (RMSNN of consecutive normal RR-intervals that suited a particular class were calculated. Average of all RMSNN values in each class was analyzed as function of MNN, in the whole series (RMSNNT, and in AC (RMSNNAC and DC (RMSNNDC phases. Slopes of linear regression lines were compared between groups using Student t-test. Correlation coefficients were tested before comparisons. RMSNN was log-transformed. (α < 0.05. Results: Correlation coefficient was significant in all regressions (p < 0.05. In the control group, RMSNNT, RMSNNAC, and RMSNNDC significantly increased linearly with MNN (p < 0.05. In ChD, only RMSNNAC showed significant increase as a function of MNN, whereas RMSNNT and RMSNNDC did not. Conclusion: HRV increases in proportion with the RR-interval in healthy subjects. This behavior is lost in ChD, particularly in the DC phase, indicating cardiac vagal incompetence.

  20. Public street lights increase house infestation by the Chagas disease vector Triatoma dimidiata.

    Science.gov (United States)

    Pacheco-Tucuch, Freddy Santiago; Ramirez-Sierra, Maria Jesus; Gourbière, Sébastien; Dumonteil, Eric

    2012-01-01

    Triatoma dimidiata is one of the primary vectors of Chagas disease. We previously documented the spatio-temporal infestation of houses by this species in the Yucatan peninsula, Mexico, and found that non-domiciliated triatomines were specifically attracted to houses. However, the factors mediating this attraction remained unclear. Artificial light has been known for a long time to attract many insect species, and therefore may contribute to the spread of different vector-borne diseases. Also, based on the collection of different species of triatomines with light traps, several authors have suggested that light might attract triatomines to houses, but the role of artificial light in house infestation has never been clearly demonstrated and quantified. Here we performed a spatial analysis of house infestation pattern by T. dimidiata in relation to the distribution of artificial light sources in three different villages from the Yucatan peninsula, Mexico. In all three villages, infested houses were significantly closer to public street light sources than non-infested houses (18.0 ± 0.6 vs 22.6 ± 0.4 m), and street lights rather than domestic lights were associated with house infestation. Accordingly, houses closer to a public street lights were 1.64 times more likely to be infested than houses further away (OR, CI95% 1.23-2.18). Behavioral experiments using a dual-choice chamber further confirmed that adult male and females were attracted to white light during their nocturnal activity. Attraction was also dependent on light color and decreased with increasing wavelength. While public lighting is usually associated with increased development, these data clearly show that it also directly contributes to house infestation by non-domiciliated T. dimidiata. PMID:22558384

  1. Interactions Between Trypanosoma cruzi the Chagas Disease Parasite and Naturally Infected Wild Mepraia Vectors of Chile.

    Science.gov (United States)

    Campos-Soto, Ricardo; Ortiz, Sylvia; Cordova, Ivan; Bruneau, Nicole; Botto-Mahan, Carezza; Solari, Aldo

    2016-03-01

    Chagas disease, which ranks among the world's most neglected diseases, is a chronic, systemic, parasitic infection caused by the protozoan Trypanosoma cruzi. Mepraia species are the wild vectors of this parasite in Chile. Host-parasite interactions can occur at several levels, such as co-speciation and ecological host fitting, among others. Thus, we are exploring the interactions between T. cruzi circulating in naturally infected Mepraia species in all areas endemic of Chile. We evaluated T. cruzi infection rates of 27 different haplotypes of the wild Mepraia species and identified their parasite genotypes using minicircle PCR amplification and hybridization tests with genotype-specific DNA probes. Infection rates were lower in northern Chile where Mepraia gajardoi circulates (10-35%); in central Chile, Mepraia spinolai is most abundant, and infection rates varied in space and time (0-55%). T. cruzi discrete typing units (DTUs) TcI, TcII, TcV, and Tc VI were detected. Mixed infections with two or more DTUs are frequently found in highly infected insects. T. cruzi DTUs have distinct, but not exclusive, ecological and epidemiological associations with their hosts. T. cruzi infection rates of M. spinolai were higher than in M. gajardoi, but the presence of mixed infection with more than one T. cruzi DTU was the same. The same T. cruzi DTUs (TcI, TcII, TcV, and TcVI) were found circulating in both vector species, even though TcI was not equally distributed. These results suggest that T. cruzi DTUs are not associated with any of the two genetically related vector species nor with the geographic area. The T. cruzi vectors interactions are discussed in terms of old and recent events. By exploring T. cruzi DTUs present in Mepraia haplotypes and species from northern to central Chile, we open the analysis on these invertebrate host-parasite interactions. PMID:26771702

  2. Environmental and socio-economic risk modelling for Chagas disease in Bolivia

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    Paula Mischler

    2012-09-01

    Full Text Available Accurately defining disease distributions and calculating disease risk is an important step in the control and prevention of diseases. Geographical information systems (GIS and remote sensing technologies, with maximum entropy (Maxent ecological niche modelling computer software, were used to create predictive risk maps for Chagas disease in Bolivia. Prevalence rates were calculated from 2007 to 2009 household infection survey data for Bolivia, while environmental data were compiled from the Worldclim database and MODIS satellite imagery. Socio-economic data were obtained from the Bolivian National Institute of Statistics. Disease models identified altitudes at 500-3,500 m above the mean sea level (MSL, low annual precipitation (45-250 mm, and higher diurnal range of temperature (10-19 °C; peak 16 °C as compatible with the biological requirements of the insect vectors. Socio-economic analyses demonstrated the importance of improved housing materials and water source. Home adobe wall materials and having to fetch drinking water from rivers or wells without pump were found to be highly related to distribution of the disease by the receiver operator characteristic (ROC area under the curve (AUC (0.69 AUC, 0.67 AUC and 0.62 AUC, respectively, while areas with hardwood floors demonstrated a direct negative relationship (-0.71 AUC. This study demonstrates that Maxent modelling can be used in disease prevalence and incidence studies to provide governmental agencies with an easily learned, understandable method to define areas as either high, moderate or low risk for the disease. This information may be used in resource planning, targeting and implementation. However, access to high-resolution, sub-municipality socio-economic data (e.g. census tracts would facilitate elucidation of the relative influence of poverty-related factors on regional disease dynamics.

  3. Marcapasso com sensor de contratilidade regulado pelas variações do sistema nervoso autônomo na miocardiopatia chagásica crônica Chagas heart disease and contractility rate responsive pacing controlled by autonomic nervous system variations

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    Oswaldo Tadeu Greco

    1998-12-01

    Full Text Available OBJETIVO: Analisar o desempenho da estimulação cardíaca artificial com marcapasso do tipo VVIR cujo sensor é regulado pelas variações do sistema nervoso autônomo em pacientes chagásicos com distúrbio no sistema de condução. MÉTODOS: Estudados 47 chagásicos, 28 do sexo masculino, com idades entre 24 e 68 anos, 36 tinham bloqueio atrioventricular (AV total; 8, bloqueio AV de 2º grau 2; e 3 doença do nódulo sinusal, e encontravam-se, de acordo com a NYHA, em classe I (4, II (15, III (16 e IV (12. Após o implante de marcapasso do tipo VVIR os pacientes foram acompanhados durante 12 meses. A resposta de freqüência foi registrada em gravações de Holter de 24h e divididos em dois grupos de acordo com a FC em repouso - grupo 1: >65bpm e grupo 2: PURPOSE: To analyse the performance of the artificial cardiac stimulation with the VVIR pacemaker whose sensor is adjusted by the variations of the autonomic nervous system in Chagas disease patients with deficiency of the conduction system. METHODS: Forty-seven Chagas disease patients have been studied, 28 male between 24 and 68 years old, 36 patients had complete AV block, 8 had 2nd degree AV block and the other 3 had sinus node disease. The patients were in class I (4, II (15, III (16 and IV (12 according to the NYHA. A 12-month-follow-up with constant clinical evaluations was carried out after pacemaker implantation. Patients were divided in 2 different groups according to the HR at rest - group 1: >65 beats per minute (bpm and group 2: <=65bpm, for a comparative study considering: 1 HR at stress test after the implantation; 2 arterial blood pressure at rest after the implantation and, 3 evaluation of the identified electrodes such as TIR-60-UP and others. RESULTS: The group 1 had greater HR at rest, and a smaller variation of values at stress than group 2. This shows that with this type of stimulation system it is possible to control each patient separately. The values of blood pressure

  4. Inhibitory receptors are expressed by Trypanosoma cruzi-specific effector T cells and in hearts of subjects with chronic Chagas disease.

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    Rafael J Argüello

    Full Text Available We had formerly demonstrated that subjects chronically infected with Trypanosoma cruzi show impaired T cell responses closely linked with a process of T cell exhaustion. Recently, the expression of several inhibitory receptors has been associated with T cell dysfunction and exhaustion. In this study, we have examined the expression of the cytotoxic T lymphocyte antigen 4 (CTLA-4 and the leukocyte immunoglobulin like receptor 1 (LIR-1 by peripheral T. cruzi antigen-responsive IFN-gamma (IFN-γ-producing and total T cells from chronically T. cruzi-infected subjects with different clinical forms of the disease. CTAL-4 expression was also evaluated in heart tissue sections from subjects with severe myocarditis. The majority of IFN-γ-producing CD4(+ T cells responsive to a parasite lysate preparation were found to express CTLA-4 but considerably lower frequencies express LIR-1, irrespective of the clinical status of the donor. Conversely, few IFN-γ-producing T cells responsive to tetanus and diphtheria toxoids expressed CTLA-4 and LIR-1. Polyclonal stimulation with anti-CD3 antibodies induced higher frequencies of CD4(+CTAL-4(+ T cells in patients with severe heart disease than in asymptomatic subjects. Ligation of CTLA-4 and LIR-1 with their agonistic antibodies, in vitro, reduces IFN-γ production. Conversely, CTLA-4 blockade did not improved IFN-γ production in response to T. cruzi antigens. Subjects with chronic T. cruzi infection had increased numbers of CD4(+LIR-1(+ among total peripheral blood mononuclear cells, relative to uninfected individuals and these numbers decreased after treatment with benznidazole. CTLA-4 was also expressed by CD3(+ T lymphocytes infiltrating heart tissues from chronically infected subjects with severe myocarditis. These findings support the conclusion that persistent infection with T. cruzi leads to the upregulation of inhibitory receptors which could alter parasite specific T cell responses in the chronic phase

  5. Epidemiologia de um caso de doença de Chagas na Ilha do Mosqueiro - Pará

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    Adelson A.A. de Souza

    1988-12-01

    Full Text Available Os autores apresentam os resultados do estudo epidemiológico de um caso autóctone da fase aguda da doença de Chagas na ilha do Mosqueiro, Estado do Pará, aproximadamente 75km da capital, Belém. 0 caso já havia sido objeto de uma publicação anterior. Agora são apresentadas informações epidemiológicas. Nas proximidades da casa do paciente foram capturados em duas palmeiras de Inajá ('Maximilian regi ay e em uma de Mucajá (Acrocomia sclerocarpia 114 triatomíneos: Rhodnius pictipes, R. robustus, Panstrongylus lignarius, P. geniculatus e Microtriatoma trinidadensis, com tripanossomas em 31 deles. Na casa do paciente foram encontrados exemplares de Rhodnius pictipes, infectados com formas metacíclicas do Trypanosoma cruzi. Em 14 marsupiais, capturados na localidade, haviam 3 infectados com organismos semelhantes ao T. cruzi. A eletroforese dos isoenzimas nos tripanossomas isolados do paciente, de R. pictipes e de Didelphis marsupialis os classificou como zimodema 1. Os autores concluem que a doença de Chagas do paciente teve origem silvestre.

  6. Bats, Trypanosomes, and Triatomines in Ecuador: New Insights into the Diversity, Transmission, and Origins of Trypanosoma cruzi and Chagas Disease.

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    C Miguel Pinto

    Full Text Available The generalist parasite Trypanosoma cruzi has two phylogenetic lineages associated almost exclusively with bats-Trypanosoma cruzi Tcbat and the subspecies T. c. marinkellei. We present new information on the genetic variation, geographic distribution, host associations, and potential vectors of these lineages. We conducted field surveys of bats and triatomines in southern Ecuador, a country endemic for Chagas disease, and screened for trypanosomes by microscopy and PCR. We identified parasites at species and genotype levels through phylogenetic approaches based on 18S ribosomal RNA (18S rRNA and cytochrome b (cytb genes and conducted a comparison of nucleotide diversity of the cytb gene. We document for the first time T. cruzi Tcbat and T. c. marinkellei in Ecuador, expanding their distribution in South America to the western side of the Andes. In addition, we found the triatomines Cavernicola pilosa and Triatoma dispar sharing shelters with bats. The comparisons of nucleotide diversity revealed a higher diversity for T. c. marinkellei than any of the T. c. cruzi genotypes associated with Chagas disease. Findings from this study increased both the number of host species and known geographical ranges of both parasites and suggest potential vectors for these two trypanosomes associated with bats in rural areas of southern Ecuador. The higher nucleotide diversity of T. c. marinkellei supports a long evolutionary relationship between T. cruzi and bats, implying that bats are the original hosts of this important parasite.

  7. La prueba intradérmica de Montenegro (IDR en pacientes con enfermedad de