Sao Paulo Med. J. vol.113 número2

Linamara Rizzo 8attistella

Chagas' disease: The Brazilian experience

T

interest can be ascribed to som e factors:

- T he high prevalence of the disease that runs as high

as 23% in blood donors in som e countries such as B olivia.

- T he high populational m igration rate from rural to

urban areas. T his phenom enon contributes to the

dissem ination of the disease.

- T he m orbidity and m ortality rates caused by the

disease's cardiac, digestive, and nervous system

com plications.

T hese facts m entioned before account for the great

efforts that the distinct health program s are m aking in the

countries w here the C hagas' disease is very prevalent.

T hese countries are: B olivia, M exico, Paraguay, A rgentina,

V enezuela, C hile, Panam a, and other countries.

Several authors from countries as Japan, U SA ,

E ngland and France have, in association w ith other authors

from high prevalence countries or not, published in the

last few years epidem iological, clinical, im m unology

reports about C haga's disease. A dditionally, other reports

about the treatm ent of C hagas' infection and its

com plications in the different system s and organs clearly

dem onstrates the interest this m edical condition produces

in the research com m unity.

T he B razilian experience relates to a fundam ental

problem : the Public H ealth as a regional, nationw ide and

w orlw ide problem . In the search for a solution, it is

understood that som e reports in the m edical literature

indicate that C hagas' disease is the factor responsible for

0.9% of all deaths in the state of Sao Paulo alone, w ith a

higher prevalence in the m ale gender. O n the other hand,

other reports docum ent the m orbidity of the C hagas'

D isease in U SA im m igrants and the disease's transm ission

risks in the U S.

A t this present tim e, w hen boundaries, borders and

barriers are either flexible or absent, it is necessary to

contem plate the causes of the disease and contem plate the

m eans to protect the population.

In the year of 1994, the discussion entitled

E l i m i n a t i o n o f T r a n s m i s s i o n o f C h a g a s ' D i s e a s e i n t h e

S o u t h e r n m o s t L a t i n A m e r i c a w as held at the W orld H ealth

Forum . T his accounts for our earnest concern and

reinforces the real dem and for a w orldw ide public health

assistance strategic policy.

T he B razilian scientific com m unity is searching for

alternati ves and m ore efficient responses for these

questions. T his publication is a righteous instance of this

effort. R eports and research outcom es are presented in this

issue of the s a o P a u l o M e d i c a l J o u r n a l . T his w as aim ed

at inform ing, analyzing and discussing the State of the

A rt on C hagas' heart disease. T his essay m ay even becom e

a valuable instrum ent for the northern hem isphere

countries that are struggling against the dissem ination of

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the Chagas' disease as well struggling with efforts to

prevent its associated m orbidity and m ortality.

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