Contribuição ao estudo da doença de Chagas
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Data
2011-07-18
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Universidade Federal de Goiás
Resumo
The main papers published on the last five years on the area of human Chagas disease, mainly
on parasitological, serological and therapeutic aspects, reflecting areas of recent involvment
of the author, were selected. As a baseline, briefly comments on publications on the last 40
years were included. Parasitemia profile measured by hemoculture during the chronic
infection was the subject of the first two. The first (published in 2006) included six
hemocultures from each of 27 patients, the last three after specific treatment. Results were
compared with those of 13 non treated, infected patients. The supressive effect of
benznidazole was demonstrated in 89% of the patients and treatment failure was registered in
three cases (11%) during the two year follow-up. In the second paper (2011) a single
hemoculture was performed in 152 infected women, 101 pregnant. Parasitemic pregnant
women doubled the number of non-pregnant, mainly during the first months of pregnancy. A
new ELISA test was developed (2010) by employing two recombinant proteins and two
synthetic peptides. Sensitivity was 99.3% on 165 positive sera, and specificity of 100% (216
negatives). A multicentric study was done (2009) with participation of laboratories of North
America (Mexico), Central America (Honduras) and South America (Brazil) with 98 serum
samples from patients of Mexico employing reagents made from Tc1 and Tc2 strains. Results
showed good agreement among laboratories demonstrating the feasibility of using reagents
prepared from both types of T. cruzi. In another multicentric study (Bolivia, Argentina and
Brazil) xenodiagnosis performed in 17 patients after a 60 days course of allopurinol treatment,
remained positive, showing the lack of effect of this drug in the chronic phase. A national
serological survey in children born after insecticide spraying (below five years old) with filter
paper, involved 104,954 samples, tested with ELISA and indirect immuofluorescence. Only
11 samples (0.01%) were identified as by vector transmission (negative mothers) mainly from
the northeast of the country, areas without Triatoma infestans. These findings (2011) confirm
the effectivity of house spraying for the control of the disease. As a sub-product of this
investigation, an unusual number of cases of congenital transmission (n = 12) was found only
in the State of Rio Grande do Sul, where TcV-TcVI circulates. When compared with other
states (n=8) the proportion was 10 times higher. This is the first report on geographical
differences related to congenital transmission in Brazil. We considered that all these findings
contributed significantly to a better knowledge on different aspects of Chagas disease.
Descrição
Citação
OSTERMAYER, Alejandro Luquetti. Contributions for the study of Chagas disease. 2011. 57 f. Tese (Doutorado em Ciências da Saúde) - Universidade Federal de Goiás, Goiânia, 2011.