Laboratory of Molecular Epidemiology and Systematics, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, RJ 21040-900, Brazil.
Fiocruz Piauí Regional Office, Teresina, Piauí, Brazil.
Trans R Soc Trop Med Hyg. 2020 Nov 6;114(11):820-829. doi: 10.1093/trstmh/traa070.
In northeastern Brazil, the wild nature of Trypanosoma cruzi vectors has challenged control actions. This study aims to describe the entomological and epidemiological scenario of Chagas disease in rural communities in the state of Piauí.
A cross-sectional study (n=683 individuals/244 dwellings) was carried out to obtain serum samples, sociodemographic data and intra- and peridomestic triatomines.
The overall seroprevalence rate was 8.1%, with no positive tests among subjects <30 y of age. Prevalence rates reached 34.3% and 39.1% among subjects 61-75 and >75 y of age, respectively; 1474 triatomines were collected, of which 90.3% were found in peridomiciliary structures and 9.7% inside houses; 87.2% were classified as Triatoma brasiliensis. T. cruzi infection rates in insects were 0.5% by light microscopy and 0.9% by culture in NNN/LIT medium. Five cultivated isolates were submitted to molecular genotyping, three of which were identified as T. cruzi I and two as T. cruzi II.
Although no vector transmission currently occurs, prevalence rates are high in adults and the elderly. This disease should be targeted by primary healthcare providers. Insect surveillance and control activities should not be discontinued in an environment favourable to the perpetuation of house colonization by triatomines.
在巴西东北部，克氏锥虫传播媒介的野生习性给防控工作带来了挑战。本研究旨在描述皮奥伊州农村社区中查加斯病的昆虫学和流行病学情况。
进行了一项横断面研究（n=683 人/244 户），以获取血清样本、社会人口学数据以及户内和户周围的锥蝽。
总血清阳性率为 8.1%，年龄<30 岁的人群中没有阳性检测结果。61-75 岁和>75 岁的人群中，阳性率分别达到 34.3%和 39.1%；共收集到 1474 只锥蝽，其中 90.3%在户周围结构中发现，9.7%在房屋内发现；87.2%被分类为巴西锥蝽。通过光学显微镜和 NNN/LIT 培养基培养，昆虫中的 T. cruzi 感染率分别为 0.5%和 0.9%。对五个培养的分离株进行了分子基因分型，其中三个被鉴定为 T. cruzi I，两个为 T. cruzi II。
尽管目前没有媒介传播，但成年人和老年人的患病率仍然很高。初级保健提供者应将该病作为目标。在有利于三带喙库蚊在房屋内持续定殖的环境中，不应停止对昆虫的监测和控制活动。
