2009, Number 3
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Rev Biomed 2009; 20 (3)
Urban transmission of Chagas disease in Caracas, Venezuela: epidemiological, clinical and laboratorial aspects
Alarcón NB, Díaz-Bello Z, Colmenares C, Zavala-Jaspe R, Mauriello L, Díaz MP, Soto M, Aponte M, Ruiz-Guevara R, Losada S, Noya-Alarcón Ó, Noya-González Ó
Language: Spanish
References: 21
Page: 158-164
PDF size: 136.99 Kb.
ABSTRACT
Introduction. Classically, Chagas disease (ChD) is a rural disease with vectorial transmission. Oral transmission and the gradual increase of the finding of
Panstrongylus geniculatus in Caracas, Venezuela, warrant an update of the epidemiological situation.
Objective. To communicate the epidemiological, clinical and laboratorial diagnostic characteristics of
Trypanosoma cruzi human transmission in Caracas.
Materials and Methods. We selected cases of the Immunology Department at the Tropical Medicine Institute-Caracas studying also their contacts and inspecting the patient’s house. The laboratory diagnosis was based on parasite demonstration in blood and determination of specific antibodies by ELISA and indirect hemagglutination.
Results. Between 1998 and 2007, ChD was diagnosed in 75 persons born and living in Caracas. Three infants with acute myocarditis and demonstration of chagasic infection died during that period.
P. geniculatus was found in some patient’s houses. An outbreak of ChD in 103 persons, whose common risk was the ingestion of manually prepared juice in the morning snack, took place in an urban school. We explain the clinical characteristics of vectorial and oral cases in the city of Caracas and give particular diagnosis features.
Conclusions. Although
P. geniculatus is not an efficient vector, its coexistence with humans in Caracas is making food contamination possible and is forcing vectorial transmission. There must be an under recording of cases because the ChD screening is not done routinely. The demonstration of urban transmission of
Trypanosoma cruzi should lead to modifications in the control strategy of ChD.
REFERENCES
Feliciangeli MD, Campbell-Lendrum D, Martínez C, González D, Coleman P, Davies C. Chagas disease control in Venezuela: lessons for the Andean region and beyond. Trends Parasitol 2003; 19:44-9.
Añez N, Crisante G, Rojas A. Update on Chagas Disease in Venezuela: A review. Mem I Oswaldo Cruz 2004; 99:781-7.
Añez N, Crisante G, Parada H. Nuevos casos de enfermedad de Chagas en el Occidente de Venezuela. Salus 2007; 11:87-90
Morocoima A, Tineo Brito EJ, Ferrer E, Herrera L, Nuñez M. Enfermedad de Chagas en el estado Anzoátegui, Venezuela: Registro de un caso agudo y caracterización parasitológica y molecular del aislado. Bol Malar Salud Amb 2008; 48:121-6.
Losada M, Burdeinick I, Scharifker D. Miocarditis chagásica aguda fatal en lactante de 9 meses de edad del área urbana. Clin Med HCC 2000; 5:45-50.
Pifano F. El potencial enzoótico silvestre del complejo ecológico Schizotrypanum cruzi-Didelphis marsupialis-Panstrongylus geniculatus y sus incursiones a la vivienda humana del valle de Caracas, Venezuela. Bol Acad Cienc Fis Mat Nat 1986; 46:9-37.
Reyes M, Rodriguez-Acosta A. Domiciliation of the sylvatic Chagas disease vector Panstrongylus geniculatus Latreille, 1811 (Triatominae: Reduviidae) in Venezuela. Trans Roy Soc Trop Med Hyg 2000;94:508.
Carrasco H, Torrellas A, García C, Segovia M, Feliciangeli D. Risk of Trypanosoma cruzi (Kinetoplastida: Trypanosomatidae) transmission by Panstrongylus geniculatus (Hemíptera: Reduviidae) in Caracas (Metropolitan District) and neighbouring states, Venezuela. Int J Parasitol 2005; 35:1379-84.
Herrera L, Urdaneta-Morales S. Synanthropic rodent reservoirs of Trypanosoma (Schizotrypanum) cruzi in the valley of Caracas, Venezuela. Rev Inst Med Trop Sao Paulo 1997; 39:279-82.
Schmunis GA. Prevention of Transfusional Trypanosoma cruzi Infection in Latin America. Mem I Oswaldo Cruz 1999; 94 (Suppl 1):93-101.
Díaz Bello Z, Zavala-Jaspe R, Díaz-Villalobos M, Mauriello L, Maekelt A, Alarcón de Noya B. Diagnóstico confirmatorio de anticuerpos anti-Trypanosoma cruzi en donantes referidos por bancos de sangre en Venezuela. Invest Clin 2008; 49:141-50.
Alarcón de Noya B. Enfermedad de Chagas en Caracas. Salus 2008; 12:4-5.
Control of Chagas disease. World Health Organization. Second report of the WHO Expert Committee. Geneva. WHO Technical Report Series No 905; 2002.
Voller A, Barlett A, Bidwell D. Enzyme immunoassays for parasitic diseases, Trans Roy Soc Trop Med Hyg 1976; 70:98-105.
Jacobs L, Lunde MN. A hemagglutination test for toxoplasmosis. J Parasitol 1957; 43:308-14.
Sturm NR, Degrave W, Morel C, Simpson L. Sensitive detection and schizodeme classification of T. cruzi cells by amplification of kinetoplastid minicircle DNA sequences: use in diagnosis of Chagas disease. Mol Biochem Parasitol 1989; 33:205-14.
Schijman AG, Altcheh J, Burgos JM, Biancardi M, Bisio M, Levin MJ, et al. Aetiological treatment of congenital Chagas’ disease diagnosed and monitored by the polymerase chain reaction. J Antimicrob Chemother 2003; 52:441-9.
Censo poblacional y vivienda. Instituto Nacional de Estadística. República Bolivariana de Venezuela. http://www.ine.gov.ve/demografica/censopoblacionvivienda.asp
Wolf M, Castillo D. Evidencias de domesticación y aspectos biológicos de Panstrongylus geniculatus (Latreille, 1811) (Hemiptera: Reduviidae). Acta Entomol Chil 2000; 24:77-83.
Fagan WF, Cantrell RS, Cosner C. How habitat edges change species interactions. Am Nat 1999; 153: 165-82.
Alarcón de Noya B, Torres J, Suárez JA, Naranjo L, Noya O, Ruiz R. Guía para el diagnóstico, manejo y tratamiento de enfermedad de Chagas en fase aguda a nivel de los establecimientos de salud. Avances Cardiol 2008; 28:250-67.