Special issue on Chagas disease

Special issue on Chagas diseaseThis special issue of Memórias do Instituto Oswaldo Cruz was based on studies presented by invited speakers at the 13th International Congress of Parasitology, which was held in Mexico City from 10-15 August 2014.These speakers participated in symposia on different scenarios of Chagas disease transmission, disease control, congenital transmission of this disease, transmission of Trypanosoma cruzi in the Orinoco region of Colombia, importance of transmission by Triatoma rubrofasciata and the need to monitor this in Vietnam, Triatoma infestans in the Gran Chaco of Argentina, prospects for a vaccine against T. cruzi infection, markers for therapeutic response in treatments for chronic Chagas disease, phylogenetics of the interrelationships between the main lineages of T. cruzi, infection of populations of golden lion tamarin (Leontopithecus spp) by T. cruzi and other topics of relevance to Chagas disease and to T. cruzi and its reservoirs and vectors.The main scenarios for Chagas disease transmission by vectors relate to T. infestans, Panstrongylus megistus, Rhodnius prolixus, Triatoma brasiliensis, Triatoma dimidiata, Triatoma pseudomaculata, Triatoma sordida, Triatoma maculata, Panstrongylus geniculatus, Rhodnius ecuatoriensis and Rhodnius pallescens, which are distributed across South America, Central America and Mexico.T. infestans has been brought under control in Uruguay, Chile and Brazil and R. prolixus in some Central American countries.In addition to the fact that vector transmission is not under control in many countries, the other great challenge is transmission through blood transfusion, for which controls only exist in these same three South American countries and in a few Central American countries.Congenital transmission of T. cruzi is a worldwide problem in both endemic and nonendemic countries.In the latter, this is due to migrations of women infected with T. cruzi from endemic areas.The mean congenital transmission rate is between 2-5% among children born from infected mothers with variations according to the region.Given that it is possible to treat neonates that are infected with T. cruzi, it is important that the children of mothers with Chagas disease should be monitored through serological tests to investigate IgG until the age of nine months, along with polymerase chain reaction at birth.The strategies for controlling Chagas disease include actions to prevent vector, blood transfusion, vertical (congenital) and oral forms of transmission, complemented by monitoring, diagnosing of infections and appropriate treatment for acute and chronic cases.Community education is the foundation for this.All of these actions should be implemented in a comprehensive manner, so as to achieve the best result possible.It needs to be borne in mind that Chagas disease cannot be eradicated, given the diversity of its transmission scenarios.This is especially so because of the large number of vector and reservoir species and, moreover, because of the wild and peridomestic cycles of the disease, which interchange with the domestic cycle (Figure ).Furthermore, it is impossible to cure a large proportion of the chronic cases of the disease.