Laboratório de Doenças Parasitárias, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil.
Rev Soc Bras Med Trop. 2012 Jun;45(3):286-96. doi: 10.1590/s0037-86822012000300002.
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.
本研究广泛回顾了有关克氏锥虫病的知识现状和有待改进之处，不仅分析了已发表的相关主题的主要研究，而且在很大程度上还基于过去 50 年（1961-2011 年）积累的经验。在涵盖的主题中，我们重点介绍了克氏锥虫感染的发病机制和演变、现有药物和治疗克氏锥虫病的新策略；用于诊断和监测感染治愈的血清学检测；疾病的流行率、发病率和治疗反应的区域差异；不同种类的三锥虫中克氏锥虫的循环生殖与传播克氏锥虫感染的能力；野生三锥虫适应人类住所的风险；在亚马逊地区对克氏锥虫病进行监测和控制的必要性，以及在拉丁美洲和墨西哥以及非流行国家控制克氏锥虫病的优先倡议的必要性，这是当今一个重大的国际难题。最后，我们提出需要在大查科地区（涉及阿根廷、玻利维亚和巴拉圭的部分地区）建立新的克氏锥虫病控制倡议。
