Dias J C, Schofield C J
Fundação Oswaldo Cruz, Universidade Federal de Minas Gerais, Brasil.
Rev Soc Bras Med Trop. 1998 Jul-Aug;31(4):373-83. doi: 10.1590/s0037-86821998000400007.
The Southern Cone Initiative against Chagas' disease, was launched in 1991. The aim was to interrupt the transmission of Chagas disease by elimination of domestic populations of the major vector, Triatoma infestans, and by improved screening of blood donors. As a result of these activities, a marked reduction in the risk of transfusional transmission can now be seen throughout the programme area. In addition to specific legislation concerning the quality of transfused blood, a series of national and regional reference laboratories have been set up with the help of PAHO in order to improve the quality of pre-transfusional serodiagnosis. Results indicate a progressive reduction in the overall infection prevalence of blood donors, and show that the age-prevalence curve has shifted towards older age-groups. In this paper we analyse the changes in infection prevalence in the Southern Cone countries, drawing attention to the situation in Bolivia which has the highest indices of infection and lowest levels of coverage by the control programme. In this situation chemoprophylaxis of blood prior to transfusion may be recommended in accordance with PAHO criteria. In the medium term however, interruption of human Chagas disease transmission may be expected over most of the Southern Cone region, as long as the control activities are continued and consolidated through effective epidemiological surveillance.
南锥体地区查加斯病防治倡议于1991年启动。其目标是通过消灭主要病媒大劣按蚊的家庭种群以及改进献血者筛查来阻断查加斯病的传播。由于这些活动，目前在整个项目地区，输血传播风险已显著降低。除了关于输血质量的具体立法外，在泛美卫生组织的帮助下还建立了一系列国家和区域参考实验室，以提高输血前血清学诊断的质量。结果表明献血者总体感染率逐步下降，且年龄感染率曲线已向老年人群体偏移。在本文中，我们分析了南锥体国家感染率的变化，提请注意玻利维亚的情况，该国感染指数最高，而控制项目的覆盖率最低。在这种情况下，可根据泛美卫生组织的标准建议在输血前对血液进行化学预防。然而从中期来看，只要通过有效的流行病学监测继续并巩固控制活动，预计在南锥体大部分地区人类查加斯病传播将被阻断。
