Ramos Júnior Alberto Novaes, Correia Dalmo, Almeida Eros Antônio, Shikanai-Yasuda Maria Aparecida
Department of Community Health, Faculty of Medicine, Federal University of Ceará, Ceará, Brazil.
J Infect Dev Ctries. 2010 Nov 24;4(11):682-8. doi: 10.3855/jidc.1176.
In countries with endemic Chagas disease, coinfection involving Trypanosoma cruzi and HIV is expected to become more frequent. There is a clear need to structure a comprehensive care network aimed at dealing with this situation, with mobilization going from primary care to care at the highest level of technological complexity. The objective of this study was to describe the Brazilian response to the challenges of Chagas disease: the history, current issues, and future of the Brazilian Network for attending and studying T. cruzi/HIV coinfection.
This descriptive study reviewed technical documents relating to the basis and structuring process of the Brazilian network for attending and studying T. cruzi/HIV coinfection.
The process of setting up the network was marked by technical and political debates in technical-scientific meetings going back to the 1990s. This process made it possible to expand and focus on different aspects of comprehensive care for Chagas disease in Brazil, regardless of the associated immunosuppressive conditions. These meetings produced a structure of national technical guidelines and standards, health care and research protocols and research priorities, along with mobilization and awareness-raising among HIV/AIDS reference centers regarding occurrences of coinfection.
The creation of the Brazilian network was a milestone for the country in terms of integration of control programs, with the reference point of quality of care and comprehensiveness. The possibility of extending this network to form a Latin American network is seen as a strategy for dealing more effectively with this condition.
在恰加斯病流行的国家，克氏锥虫和艾滋病毒合并感染的情况预计会更加频繁。显然需要构建一个全面的护理网络来应对这种情况，动员范围从初级护理到技术复杂性最高的护理层面。本研究的目的是描述巴西对恰加斯病挑战的应对措施：巴西克氏锥虫/艾滋病毒合并感染诊治与研究网络的历史、当前问题及未来发展。
本描述性研究回顾了与巴西克氏锥虫/艾滋病毒合并感染诊治与研究网络的基础及构建过程相关的技术文件。
该网络的建立过程以可追溯至20世纪90年代的技术科学会议上的技术和政治辩论为标志。这一过程使得能够在巴西扩大并关注恰加斯病综合护理的不同方面，而不论相关的免疫抑制状况如何。这些会议产生了国家技术指南和标准、医疗保健及研究方案以及研究重点的架构，同时在艾滋病毒/艾滋病参考中心中就合并感染的发生情况进行了动员和提高认识。
巴西网络的创建在控制项目整合方面是该国的一个里程碑，以护理质量和全面性为参照点。将这个网络扩展形成拉丁美洲网络的可能性被视为更有效应对这种情况的一项战略。
