Marsden P D
Rev Infect Dis. 1984 Nov-Dec;6(6):855-65. doi: 10.1093/clinids/6.6.855.
Despite much research, specific chemotherapy for Chagas' disease remains problematic, and prophylaxis by vaccination seems remote. A significant proportion of today's positive seroreactive patients will burden tomorrow's hospital services with persistent cardiac failure, arrhythmias requiring pacemaker implantation, and megasyndromes requiring corrective surgical procedures. Yet the control of transmission to humans in many endemic areas is feasible by programs of residual insecticide spraying and subsequent vigilance and, in some instances, house improvement, i.e., measures to combat domiciliated vector bugs. The success of such programs will vary, depending on the dominant bug vector and degree of development of the country's public health services. The fact that the Brazilian government voted a large sum of money in 1983 for bug control by the Ministry of Health enforces this view. Transmission of Trypanosoma cruzi to humans could decrease considerably in the next decade in Brazil as a result of this program. There is, however, still a need for research to define the cheapest ways of interrupting transmission in different epidemiologic situations so that the maximum number of people at risk can be reached with the funds available, for the children infected today may be hospital patients of the future for whom little can be done.
尽管进行了大量研究，但恰加斯病的特效化疗仍然存在问题，通过疫苗接种进行预防似乎还很遥远。如今，相当一部分血清反应呈阳性的患者将给未来的医院服务带来负担，他们会出现持续性心力衰竭、需要植入起搏器的心律失常以及需要进行矫正手术的巨大综合征。然而，在许多流行地区，通过残留杀虫剂喷洒计划以及随后的监测，在某些情况下还通过房屋改善措施，即防治居家传播媒介臭虫的措施，来控制向人类的传播是可行的。这些计划的成功程度会有所不同，这取决于主要的臭虫传播媒介以及该国公共卫生服务的发展程度。巴西政府在1983年为卫生部的臭虫防治工作拨出一大笔资金这一事实就证实了这一观点。由于这个计划，在未来十年里，巴西锥虫向人类的传播可能会大幅减少。然而，仍然需要进行研究，以确定在不同流行病学情况下中断传播的最经济方式，以便能用现有的资金惠及最多的高危人群，因为今天感染的儿童可能会成为未来的医院患者，而针对他们能做的事情很少。
