de Sousa Andréa Silvestre, Vermeij Debbie, Ramos Alberto Novaes, Luquetti Alejandro O
Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil; Department of Internal Medicine, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
Lancet. 2024 Jan 13;403(10422):203-218. doi: 10.1016/S0140-6736(23)01787-7. Epub 2023 Dec 7.
Chagas disease persists as a global public health problem due to the high morbidity and mortality burden. Despite the possibility of a cure and advances in transmission control, epidemiological transformations, such as urbanisation and globalisation, and the emerging importance of oral and vertical transmission mean that Chagas disease should be considered an emerging disease, with new cases occurring worldwide. Important barriers to diagnosis, treatment, and care remain, resulting in repressed numbers of reported cases, which in turn leads to inadequate public policies. The validation of new diagnostic tools and treatment options is needed, as existing tools pose serious limitations to access to health care. Integrated models of surveillance, with community and intersectional participation, embedded in the concept of One Health, are essential for control. In addition, mitigation strategies for the main social determinants of health, including difficulties imposed by migration, are important to improve access to comprehensive health care in a globalised scenario.
由于高发病率和高死亡率负担，恰加斯病仍然是一个全球性的公共卫生问题。尽管存在治愈的可能性以及在传播控制方面取得了进展，但城市化和全球化等流行病学转变，以及经口传播和垂直传播的新的重要性意味着恰加斯病应被视为一种新兴疾病，全球都有新病例出现。诊断、治疗和护理方面仍存在重要障碍，导致报告病例数受到抑制，进而导致公共政策不足。由于现有工具对获得医疗保健构成严重限制，因此需要验证新的诊断工具和治疗方案。将社区和跨部门参与纳入“同一健康”概念的综合监测模式对于控制恰加斯病至关重要。此外，减轻主要健康社会决定因素的影响，包括移民带来的困难，对于在全球化背景下改善获得全面医疗保健的机会非常重要。
