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2000 - 2001年巴西亚马逊地区罗赖马州恰加斯病本土发病的可能性

On the possibility of autochthonous Chagas disease in Roraima, Amazon region, Brazil, 2000-2001.

作者信息

Luitgards-Moura José Francisco, Borges-Pereira José, Costa Jane, Zauza Patrícia Lago, Rosa-Freitas Maria Goreti

机构信息

Convênio FIOCRUZ-UFRR, Universidade Federal de Roraima, Centro de Ciências Biológicas e da Saúde, BR 174 s/n Jardim Floresta, 69310-270, Boa Vista, Roraima, RR, Brazil.

出版信息

Rev Inst Med Trop Sao Paulo. 2005 Jan-Feb;47(1):45-54. doi: 10.1590/s0036-46652005000100008. Epub 2005 Feb 23.

Abstract

Chagas disease has been almost entirely eradicated from the arid zones in Central and Northeastern Brazil where rare or no autochthonous cases have been reported. However, in the last 10 years the disease has increasingly been registered in the Amazon Region. Aiming to investigate the possibility of the occurrence of autochthonous cycle of Chagas disease in Roraima, triatomine collections, vectorial susceptibility studies (this one to be shown elsewhere), parasitological and serological analyses were conducted in three agricultural settlement areas (Rorainópolis, Passarão Project and Ilha Community). Blood-donor candidates were also investigated. This is the first epidemiological survey on Chagas disease conducted in agricultural settlements in Roraima. Triatomine species found were Triatoma maculata, Rhodnius pictipes, Rhodnius robustus and Panstrongylus geniculatus. Trypanosoma cruzi detection analyses included xenodiagnosis, indirect immunofluorescence, indirect hemaglutination, ELISA and kinetoplast PCR amplification. Natural triatomine infection was not found in intestinal contents. Twenty-five adult settlers (1.4% out of 1821, all > 15 year-old, 20 migrants) presented anti-T. cruzi antibodies. Two migrant settlers (from Minas Gerais and Maranhão) tested positive for more than two serological tests, besides either being positive for xenodiagnosis or PCR. Results show that Chagas disease is not endemic in the areas studied. However, all elements of the transmission cycle are present, demanding for an adequate and continuous vigilance.

摘要

恰加斯病在巴西中部和东北部的干旱地区几乎已被完全根除,在这些地区鲜有或没有本地病例报告。然而,在过去十年中,该病在亚马逊地区的登记病例越来越多。为了调查罗赖马州恰加斯病本地传播周期发生的可能性,在三个农业定居点地区(罗赖马诺波利斯、帕萨拉奥项目和伊利亚社区)进行了锥蝽采集、媒介易感性研究(此研究将在其他地方展示)、寄生虫学和血清学分析。还对献血候选人进行了调查。这是在罗赖马州农业定居点进行的首次恰加斯病流行病学调查。发现的锥蝽种类有黄斑锥蝽、图画罗蝽、粗壮罗蝽和膝状强棱蝽。克氏锥虫检测分析包括异种接种诊断、间接免疫荧光、间接血凝、酶联免疫吸附测定和动基体聚合酶链反应扩增。在肠道内容物中未发现自然感染锥蝽的情况。25名成年定居者(1821人中的1.4%,均年龄大于15岁,20名移民)呈现抗克氏锥虫抗体。两名移民定居者(分别来自米纳斯吉拉斯州和马拉尼昂州)除异种接种诊断或聚合酶链反应呈阳性外,两项以上血清学检测呈阳性。结果表明,恰加斯病在所研究地区并非地方病。然而,传播周期的所有要素都存在,需要进行充分和持续的监测。

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