Jose Antonio Marin Neto, Alfredo Jose Mansur,
Amanda Guerra Moraes Rego Souza
Introduction
C
h a g a s 'H e a r tp r o b le m in s e v e r a lD is e a s ec o u n tr ie s ,is a p r o m in e n ta n d o n e o f th e m o s tp u b lic h e a lth im p o r ta n t c a u s e s o f m o r b id ity a n d m o r ta lity inS o u th A m e r ic a . T h e d is e a s e w a s d is c o v e r e d in 1 9 0 9 b y
C a r lo s C h a g a s in B r a z il. I t is e n d e m ic in S o u th A m e r ic a ,
w ith a n e s tim a te o f a b o u t 1 6 m illio n p e o p le in f e c te d , a n d
n in e m illio n p e o p le r u n n in g s ig n if ic a n t r is k f o r in f e c tio n , w ith h ig h s o c ia l c o s ts .
S u c h a h e a v y s o c ia l b u r d e n h a s im p lic a tio n s f o r
p u b lic h e a lth p o lic ie s in r e g a r d to a s p e c ts s u c h a s b lo o d tr a n s f u s io n a n d o r g a n tr a n s p la n ta tio n .
C o n te m p o r a r y e x te n s iv e p o p u la tio n m ig r a tio n , f r o m
r u r a l to u r b a n a r e a s , a n d f r o m o n e c o u n tr y to a n o th e r , le d
to e p id e m io lo g ic m o d if ic a tio n s a n d d e te c tio n o f C h a g a s '
d is e a s e e v e n in c o u n tr ie s w h e r e it h a d n o t e x is te d b e f o r e ( e .g . U n ite d S ta te s ) .
I n a d d itio n , th e p a r a s ite o f C h a g a s ' d is e a s e ,
Trypanosoma cruzi,
d e v e lo p s a p e c u lia r r e la tio n s h ip w ith th e h u m a n h o s t, le a d in g to v e r y p e c u lia r p a th o p h y -s io lo g ic a l a n d c lin ic a l d e r a n g e m e n ts .A s a p u b lic h e a lth p r o b le m , m o s t m e d ic a l f a c ilitie s
in o u r c o u n tr y a r e c o m m itte d to th e s tu d y o f C h a g a s '
d is e a s e a n d to th e o f p a tie n ts . T h u s , c lin ic a l e x p e r tis e a n d
o b s e r v a tio n d e v e lo p e d in d if f e r e n t in s titu tio n s , u n iv e r s ity
-a f f ili-a te d o r n o t, a ll o v e r th e c o u n tr y .
C u r r e n tly c lin ic a l e x p e r ie n c e g r o w s f a s te r , a n d is
a c c o m p a n ie d b y s ig n if ic a n t a c h ie v e m e n ts in th e
u n d e r s ta n d in g o f p a th o p h y s io lo g y , a s a d ir e c t c o n s e q u e n c e
o f r e s e a r c h in th e f ie ld . H o w e v e r , th e b u lk o f s c ie n tif ic
c o n tr ib u tio n s in th e a r e a is p u b lis h e d in P o r tu g u e s e ,
r e n d e r in g its a c c e s s m o r e d if f ic u lt to n o n - P o r tu g u e s e
s p e a k in g r e a d e r s .
T h is is s u e o f th e " P a u lis ta " s e c tio n ( T h e S a o P a u lo
S ta te S o c ie ty o f C a r d io lo g y ) o f th e B r a z ilia n S o c ie ty o f
C a r d io lo g y , a n d th e C a r d io lo g y b r a n c h o f th e " P a u lis ta "
( i.e . f r o m S a o P a u lo S ta te ) s e c tio n o f th e B r a z ilia n M e d ic a l
A s s o c ia tio n c o n ta in s s o m e r e c e n t d a ta o n C h a g a s ' d is e a s e ,
f r o m S a o P a u lo S ta te I n s titu tio n s . I t in c lu d e s c o n tr ib u tio n s
o n e p id e m io lo g y , p a th o g e n e s is , p a th o lo g ic a n a to m y ,
d ia g n o s is , p a th o p h y s io lo g y , c lin ic a l a s p e c ts , a n d tr e a tm e n t.
W e h o p e th a t th e s u b je c ts r e v ie w e d in th is is s u e m a y
b e o f in te r e s t to d if f e r e n t r e s e a r c h e r s w o r k in g in th e w id e
v a r ie ty o f p r o b le m s in v o lv e d w ith C h a g a s 'h e a r t d is e a s e .
