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[证据综合:恰加斯病诊断与治疗指南。恰加斯病诊断与治疗指南的证据综合]

[Synthesis of evidence: Guidance for the diagnosis and treatment of Chagas diseaseSíntese de evidências: Guia de diagnóstico e tratamento da doença de Chagas].

出版信息

Rev Panam Salud Publica. 2020 Jun 8;44:e28. doi: 10.26633/RPSP.2020.28. eCollection 2020.


DOI:10.26633/RPSP.2020.28
PMID:32523605
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7279121/
Abstract

INTRODUCTION: Chagas disease or American trypanosomiasis is caused by the flagellate protozoan , transmitted mainly by insect vectors (popularly known in the different areas of the Region of the Americas as "kissing bugs", "", "", or "" or ). The parasite is transmitted via the placenta and in transfusions, and less frequently, orally or during organ transplantation. Because it was necessary to strengthen the implementation of public policies and the management of clinical conditions, given the diagnostic and therapeutic difficulties that this systemic parasitosis presents, the Pan American Health Organization (PAHO) developed guidance for the management of American trypanosomiasis. OBJECTIVES: Synthesize the recommendations included in the Guide for Diagnosis and Treatment of Chagas Disease, published (in Spanish only) by the Pan American Health Organization in 2018, in order to present the proper diagnostic methods and treatment for Chagas disease and to address aspects of its implementation. METHODS: A summary was made of the guide and its recommendations. In addition, a systematic search was conducted in PubMed, Lilacs, Health Systems Evidence, Epistemonikos, and the gray literature for studies carried out in the Americas, in order to identify barriers, facilitators, and implementation strategies. RESULTS: Ten recommendations are made. These are applicable to adult and pediatric patients with suspected Chagas disease, exposure to , or a confirmed diagnosis of acute, chronic, or congenital Chagas disease. Reports that addressed aspects of implementation were identified. CONCLUSIONS: The recommendations seek to provide strategies for the timely diagnosis and treatment of Chagas disease, as well as considerations for the implementation of such strategies.

摘要

引言:恰加斯病或美洲锥虫病由鞭毛虫原生动物引起,主要通过昆虫媒介传播(在美洲地区的不同区域通俗地称为“接吻虫”、“ ”、“ ”、“ ”或“ ”)。该寄生虫可通过胎盘和输血传播,较少见的是经口传播或在器官移植过程中传播。鉴于这种全身性寄生虫病存在诊断和治疗困难,有必要加强公共政策的实施和临床病症的管理,泛美卫生组织(PAHO)制定了美洲锥虫病管理指南。 目的:综合泛美卫生组织于2018年发布(仅西班牙语)的《恰加斯病诊断和治疗指南》中的建议,以便介绍恰加斯病的正确诊断方法和治疗方法,并阐述其实施方面的问题。 方法:对该指南及其建议进行了总结。此外,在PubMed、Lilacs、卫生系统证据、Epistemonikos以及灰色文献中对在美洲开展的研究进行了系统检索,以确定障碍、促进因素和实施策略。 结果:提出了十条建议。这些建议适用于疑似恰加斯病、接触过 或确诊为急性、慢性或先天性恰加斯病的成年和儿科患者。还确定了涉及实施方面的报告。 结论:这些建议旨在为恰加斯病的及时诊断和治疗提供策略,以及实施这些策略的考虑因素。

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