Epidemiological behavior of Chagas disease in Brazil: impacts and perspectives for preventing oral transmission
DOI:
https://doi.org/10.33448/rsd-v12i6.41898Keywords:
Chagas disease; Food contamination; Epidemiology.Abstract
Chagas disease persists as an important parasitosis that affects humanity, being classically transmitted by the feces and urine of triatomines, which are deposited on the skin during hematophagy, thus allowing the penetration of metacyclic trypomastigotes forms of the protozoan Trypanosoma cruzi. Despite being classic, the referred route of transmission has been superimposed on oral transmission, given several factors, among which the control of populations of triatomines and housing improvements, as well as the increase in food consumption, with emphasis on Amazonian fruits, to the example of açaí. Therefore, this research aimed to demonstrate and discuss the relevance of oral transmission of Chagas disease (DCO), and to investigate aspects related to this process, in order to raise possible strategies to minimize it. To this end, a retrospective cross-sectional study was carried out over a period of 10 years (2011-2020) with a quantitative approach, through the collection and processing of data available on government websites, with emphasis on DATASUS. It was observed that the oral route of transmission persists as the main form of acquisition of DCO in Brazil, with a higher incidence of cases in the North region, probably because it is a region traditionally producing and consuming Amazonian fruits, such as açaí and cupuaçu. In this sense, it is important to implement prevention methods and strategies aimed at the extractive and processing processes of Amazonian fruits and other foods potentially contaminated by triatomine excretions, as a way to minimize the negative impacts of this disease, such as the introduction or reinforcing adherence to food sterilization techniques such as blanching and high isostatic pressure - HIP.
References
Almeida, A. M. V. de, Soares, J. A. B. de M., Crizanto, L. M. P., Pereira, M. do S. V., & Mota, C. de A. X. (2021). Doença de Chagas: Aspectos epidemiológicos, fisiopatológicos e de transmissão / Chagas disease: Epidemiological, physiopathological and transmission aspects. Brazilian Journal of Health Review, 4(5), 18931–18944. https://doi.org/10.34119/bjhrv4n5-037
Andrade, S. G., Campos, R. F., Steindel, M., Guerreiro, M. L., Magalhães, J. B., Almeida, M. C. de, Reis, J. N., Santos, V. C., Valadares, H. M. S., Reis, M. G. dos, & Macedo, A. M. (2009). Biological, biochemical and molecular features of Trypanosoma cruzi strains isolated from patients infected through oral transmission during a 2005 outbreak in the state of Santa Catarina, Brazil: Its correspondence with the new T. cruzi Taxonomy Consensus. Memorias Do Instituto Oswaldo Cruz, 106(8), 948–956. https://doi.org/10.1590/s0074-02762011000800009
Barbosa, R. L., Dias, V. L., Pereira, K. S., Schmidt, F. L., Franco, R. M. B., Guaraldo, A. M. A., Alves, D. P., & Passos, L. A. C. (2012). Survival in vitro and virulence of Trypanosoma cruzi in açaí pulp in experimental acute Chagas disease. Journal of Food Protection, 75(3), 601–606. https://doi.org/10.4315/0362-028X.JFP-11-233
Barbosa-Ferreira, J. M., Guerra, J. A. de O., Santana Filho, F. S. de, Magalhães, B. M. L., Coelho, L. I. A. R. C., & Barbosa, M. das G. V. (2010). Acometimento cardíaco em Casos de Doença de Chagas Aguda da Amazônia. Arquivos Brasileiros de Cardiologia, 94, 147–149. https://doi.org/10.1590/S0066-782X2010000600023
Barroso Ferreira, R. T., Branquinho, M. R., & Cardarelli-Leite, P. (2014). Transmissão oral da doença de Chagas pelo consumo de açaí: Um desafio para a Vigilância Sanitária. Vigilância Sanitária em Debate, 2(4), 358/160. https://doi.org/10.3395/vd.v2i4.358
Bezerra, V. S., Freitas-Silva, O., Damasceno, L. F., Mamede, A. M. G. N., & Cabral, L. M. C. (2017). Sensory Analysis and Consumers Studies of Açai Beverage After Thermal, Chlorine and Ozone Treatments of the Fruits: Sensory Analysis and Consumers Studies. Journal of Food Processing and Preservation, 41(3), e12961. https://doi.org/10.1111/jfpp.12961
Bittencourt, A. L. (1992). Possible risk factors for vertical transmission of Chagas’ disease. Revista do Instituto de Medicina Tropical de São Paulo, 34(5), 403–408. https://doi.org/10.1590/S0036-46651992000500006
Chao, C., Leone, J. L., & Vigliano, C. A. (2020). Chagas disease: Historic perspective. Biochimica Et Biophysica Acta. Molecular Basis of Disease, 1866(5), 165689. https://doi.org/10.1016/j.bbadis.2020.165689
CONAB - COMPANHIA NACIONAL DE ABASTECIMENTO. Boletim da Sociobiodiversidade, Brasília, DF, v. 6, n. 3, dezembro de 2022. https://www.conab.gov.br/component/k2/item/download/45547_58746f92aa4275ad9bde9ce204ff7ed3
Conde, L., Maciel, G., de Assis, G. M., Freire-de-Lima, L., Nico, D., Vale, A., Freire-de-Lima, C. G., & Morrot, A. (2022). Humoral response in Leishmaniasis. Frontiers in Cellular and Infection Microbiology, 12, 1063291. https://doi.org/10.3389/fcimb.2022.1063291
Coura, J. R., & Junqueira, A. C. (2012). Risks of endemicity, morbidity and perspectives regarding the control of Chagas disease in the Amazon Region. Memorias Do Instituto Oswaldo Cruz, 107(2), 145–154. https://doi.org/10.1590/s0074-02762012000200001
Cunha, L. N. A. da, Rodrigues, R. P. P., Nascimento, F. das C. A. do, Frazão, A. das G. F., Rezende, A. L. da S., Silva, L. M. C. da, & Rodrigues, A. D. D. P. S. (2021). A ascendência da doença de Chagas aguda como uma doença veiculada por alimentos na região Norte do Brasil / The ancestry of acute Chagas disease as a foodborne illness in the northern region of Brazil. Brazilian Journal of Development, 7(12), 117507–117524. https://doi.org/10.34117/bjdv7n12-485
da Rocha Siriano, L., Marchiol, A., Pereira Certo, M., Cubides, J.-C., Forsyth, C., & Augusto de Sousa, F. (2020). Mandatory Notification of Chronic Chagas Disease: Confronting the Epidemiological Silence in the State of Goiás, Brazil. Tropical Medicine and Infectious Disease, 5(2), Artigo 2. https://doi.org/10.3390/tropicalmed5020092
de Souza, W., de Carvalho, T. M. U., & Barrias, E. S. (2010). Review on Trypanosoma cruzi: Host Cell Interaction. International Journal of Cell Biology, 2010, 295394. https://doi.org/10.1155/2010/295394
Dias, F. B. S., Bezerra, C. M., Machado, E. M. de M., Casanova, C., & Diotaiuti, L. (2008). Ecological aspects of Rhodnius nasutus Stål, 1859 (Hemiptera: Reduviidae: Triatominae) in palms of the Chapada do Araripe in Ceará, Brazil. Memórias Do Instituto Oswaldo Cruz, 103, 824–830. https://doi.org/10.1590/S0074-02762008000800014
Dias, J. C. P., Amato Neto, V., & Luna, E. J. de A. (2011). [Alternative transmission mechanisms of Trypanosoma cruzi in Brazil and proposals for their prevention]. Revista Da Sociedade Brasileira De Medicina Tropical, 44(3), 375–379. https://doi.org/10.1590/s0037-86822011005000032
Echavarría, N. G., Echeverría, L. E., Stewart, M., Gallego, C., & Saldarriaga, C. (2021). Chagas disease: Chronic chagas cardiomyopathy. Current Problems in Cardiology, 46(3), 100507. https://doi.org/10.1016/j.cpcardiol.2019.100507
Enriquez, G. F., Bua, J., Orozco, M. M., Wirth, S., Schijman, A. G., Gürtler, R. E., & Cardinal, M. V. (2014). High levels of Trypanosoma cruzi DNA determined by qPCR and infectiousness to Triatoma infestans support dogs and cats are major sources of parasites for domestic transmission. Infection, Genetics and Evolution, 25, 36–43. https://doi.org/10.1016/j.meegid.2014.04.002
Epting, C. L., Coatesa, B. M., & Engmanb, D. M. (2010). Molecular Mechanisms of Host Cell Invasion by Trypanosoma cruzi. Experimental parasitology, 126(3), 283–291. https://doi.org/10.1016/j.exppara.2010.06.023
Ferreira, R. T. B., Cabral, M. L., Martins, R. S., Araujo, P. F., da Silva, S. A., Britto, C., Branquinho, M. R., Cardarelli-Leite, P., & Moreira, O. C. (2018). Detection and genotyping of Trypanosoma cruzi from açai products commercialized in Rio de Janeiro and Pará, Brazil. Parasites & Vectors, 11(1), 233. https://doi.org/10.1186/s13071-018-2699-6
Fidalgo, A. S. O. de B. V., Costa, A. C. da, Ramos Júnior, A. N., Leal, L. K. A. M., Martins, A. M. C., Silva Filho, J. D. da, Ferreira, A. F., Nunes, F. M. M., Marinho Júnior, F. A. A., Lacerda, J. M., & Oliveira, M. de F. (2021). Seroprevalence and risk factors of Chagas disease in a rural population of the Quixeré municipality, Ceará, Brazil. Revista Da Sociedade Brasileira de Medicina Tropical, 54, e0247. https://doi.org/10.1590/0037-8682-0247-2020
Franco-Paredes, C., Villamil-Gómez, W. E., Schultz, J., Henao-Martínez, A. F., Parra-Henao, G., Rassi, A., Rodríguez-Morales, A. J., & Suarez, J. A. (2020). A deadly feast: Elucidating the burden of orally acquired acute Chagas disease in Latin America – Public health and travel medicine importance. Travel Medicine and Infectious Disease, 36, 101565. https://doi.org/10.1016/j.tmaid.2020.101565
Freitas, N. E. M., Habib, F. L., Santos, E. F., Silva, Â. A. O., Fontes, N. D., Leony, L. M., Sampaio, D. D., de Almeida, M. C., Dantas-Torres, F., & Santos, F. L. N. (2022). Technological advances in the serological diagnosis of Chagas disease in dogs and cats: A systematic review. Parasites & Vectors, 15, 343. https://doi.org/10.1186/s13071-022-05476-4
Henao-Martínez, A. F., Colborn, K., & Parra-Henao, G. (2017). Overcoming research barriers in Chagas disease—Designing effective implementation science. Parasitology Research, 116(1), 35–44. https://doi.org/10.1007/s00436-016-5291-z
Jansen, A. M., Xavier, S. C. das C., & Roque, A. L. R. (2018). Trypanosoma cruzi transmission in the wild and its most important reservoir hosts in Brazil. Parasites & Vectors, 11, 502. https://doi.org/10.1186/s13071-018-3067-2
Jansen, A. M., Xavier, S. C. das C., & Roque, A. L. R. (2020). Landmarks of the Knowledge and Trypanosoma cruzi Biology in the Wild Environment. Frontiers in Cellular and Infection Microbiology, 10, 10. https://doi.org/10.3389/fcimb.2020.00010
Jesus, A. L. T. de, Leite, T. S., & Cristianini, M. (2018). High isostatic pressure and thermal processing of açaí fruit (Euterpe oleracea Martius): Effect on pulp color and inactivation of peroxidase and polyphenol oxidase. Food Research International (Ottawa, Ont.), 105, 853–862. https://doi.org/10.1016/j.foodres.2017.12.013
Marconi, M. de A., & Lakatos, E. M. (2021). Metodologia Científica (8th ed., Vol. 1, Ser. 1). Editora Atlas Ltda.
Marinho, M. de M., Sousa, T. D. G. F., Rodrigues, G., Alves, S. O., de Souza, G. M., de Menezes, F. C., Serra, F. R., & de Souza, Ê. C. M. (2022). Boletim da Sociobiodiversidade. BOLETIM DA SOCIOBIODIVERSIDADE (Vol. 6). Retrieved May 26, 2023, from https://www.conab.gov.br/info-agro/analises-do-mercado-agropecuario-e-extrativista/boletim-da-sociobiodiversidade/boletim-sociobio.
Massaro, D. C., Rezende, D. S., & Camargo, L. M. A. (2008). Estudo da fauna de triatomíneos e da ocorrência de doença de Chagas em Monte Negro, Rondônia, Brasil. Revista Brasileira de Epidemiologia, 11(2), 228–240. https://doi.org/10.1590/S1415-790X2008000200005
Mazumder, R., & Lee, J. K. (2022). Epileptogenesis in Common Parasitic Infections. Current Neurology and Neuroscience Reports, 22(4), 285–291. https://doi.org/10.1007/s11910-022-01187-6
Medeiros, C. de A., Silva, M. B. de A., Oliveira, A. L. S. de, Alves, S. M. M., Barros, M. das N. D. da S., Cavalcanti, M. da G. A. de M., Oliveira, G. M. de A., Carrazzone, C. de F. V., Oliveira Jr, W. A. de, & Medeiros, Z. M. de. (2022). Mapping the morbidity and mortality of Chagas disease in an endemic area in Brazil. Revista Do Instituto de Medicina Tropical de São Paulo, 64, e5. https://doi.org/10.1590/S1678-9946202264005
Melo, C. M., Cruz, A. C. F. G., Lima, A. F. V. A., Silva, L. R., Madi, R. R., Jeraldo, V. de L. S., & Mercado, R. (2018). Triatomine Fauna and Recent Epidemiological Dynamics of Chagas Disease in an Endemic Area of Northeast Brazil. The Canadian Journal of Infectious Diseases & Medical Microbiology = Journal Canadien des Maladies Infectieuses et de la Microbiologie Médicale, 2018, 7020541. https://doi.org/10.1155/2018/7020541
Miles, M. A., Arias, J. R., & de Souza, A. A. (1983). Chagas’ disease in the Amazon basin: V. Periurban palms as habitats of Rhodnius robustus and Rhodnius pictipes--triatomine vectors of Chagas’ disease. Memorias Do Instituto Oswaldo Cruz, 78(4), 391–398. https://doi.org/10.1590/s0074-02761983000400002
Monsalve-Lara, J., Lilioso, M., Valença-Barbosa, C., Thyssen, P. J., Miguel, D. C., Limeira, C., Gadelha, F. R., Fontes, F. V. H. M., Pires-Silva, D., Dornak, L. L., Lima, M. M., Donalisio, M. R., & Almeida, C. E. (2021). The risk of oral transmission in an area of a Chagas disease outbreak in the Brazilian northeast evaluated through entomological, socioeconomic and schooling indicators. Acta Tropica, 215, 105803. https://doi.org/10.1016/j.actatropica.2020.105803
Moraes, M. H. da S., Jesus, A. C. de, Madeira, F. P., Moresco, G. G., Oliveira, J. de, Rosa, J. A. da, Camargo, L. M. A., Bernarde, P. S., & Meneguetti, D. U. de O. (2020). Triatominae (Hemiptera, Reduviidae) in homes: Report of their occurrence in the municipality of Cruzeiro do Sul, Acre, South Western Amazon. Revista Da Sociedade Brasileira De Medicina Tropical, 54, e20200296. https://doi.org/10.1590/0037-8682-0296-2020
Pereira A. S. et al. (2018). Metodologia da pesquisa científica. [free e-book]. Santa Maria/RS. Ed. UAB/NTE/UFSM. https://repositorio.ufsm.br/bitstream/handle/1/15824/Lic_Computacao_Metodologia-Pesquisa-Cientifica.pdf
Rocha, C. A. de O., Santana, G. B. de A., Leal, T. C., Paiva, J. P. S. de, Silva, L. F. da, Santos, L. G., Nunes, B. E. B. R., Carmo, R. F. do, & Souza, C. D. F. de. (2022). Impact of the COVID-19 pandemic on compulsory notification of meningitis during the first wave of the pandemic in Brazil: An ecological study using P-score. Sao Paulo Medical Journal = Revista Paulista De Medicina, 140(2), 305–309. https://doi.org/10.1590/1516-3180.2021.0732.15092021
Roque, A. L. R., Xavier, S. C. C., Gerhardt, M., Silva, M. F. O., Lima, V. S., D’Andrea, P. S., & Jansen, A. M. (2013). Trypanosoma cruzi among wild and domestic mammals in different areas of the Abaetetuba municipality (Pará State, Brazil), an endemic Chagas disease transmission area. Veterinary Parasitology, 193(1–3), 71–77. https://doi.org/10.1016/j.vetpar.2012.11.028
Rosa, S. F.; Araújo, M. L. C. .; Coêlho, M. D. G. (2021). Food poisonings in Brazil – the impacts of the pandemic and its prevention perspectives. Research, Society and Development, 10(13), e436101321291, 2021. DOI: 10.33448/rsd-v10i13.21291. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/21291.
Sampaio, G. H. F., da Silva, A. N. B., Brito, C. R. do N., Honorato, N. R. M., de Oliveira, L. M., da Câmara, A. C. J., & Galvão, L. M. da C. (2020). Epidemiological profile of acute Chagas disease in individuals infected by oral transmission in northern Brazil. Revista da Sociedade Brasileira de Medicina Tropical, 53, e20200088. https://doi.org/10.1590/0037-8682-0088-2020
Santo, M. C. C. do E., Gryschek, R. C. B., Farias, A. Q., Andraus, W., Carvalho, N. B., Leite, O. H. M., Castro, F. C., Cerri, G. G., Hypólitti, G. H., Carnevale, F. C., & Assis, A. M. de. (2022). Management and treatment of decompensated hepatic fibrosis and severe refractory Schistosoma mansoni ascites with transjugular intrahepatic portosystemic shunt. Revista Do Instituto De Medicina Tropical De Sao Paulo, 64, e26. https://doi.org/10.1590/S1678-9946202264026
Santos, É., & Menezes Falcão, L. (2020). Chagas cardiomyopathy and heart failure: From epidemiology to treatment. Revista Portuguesa de Cardiologia, 39(5), 279–289. https://doi.org/10.1016/j.repc.2019.12.006
Serra, F. R. (2019, April 4). Histórico Mensal Açaí. Conab. https://www.conab.gov.br/info-agro/analises-do-mercado-agropecuario-e-extrativista/analises-do-mercado/historico-mensal-de-acai
Serra, F. R. (2021, January 8). Histórico Mensal Açaí. Conab. https://www.conab.gov.br/info-agro/analises-do-mercado-agropecuario-e-extrativista/analises-do-mercado/historico-mensal-de-acai
Shikanai-Yasuda, M. A., & Carvalho, N. B. (2012). Oral Transmission of Chagas Disease. Clinical Infectious Diseases, 54(6), 845–852. https://doi.org/10.1093/cid/cir956
Silva-dos-Santos, D., Barreto-de-Albuquerque, J., Guerra, B., Moreira, O. C., Berbert, L. R., Ramos, M. T., Mascarenhas, B. A. S., Britto, C., Morrot, A., Villa-Verde, D. M. S., Garzoni, L. R., Savino, W., Cotta-de-Almeida, V., & Meis, J. de. (2017). Unraveling Chagas disease transmission through the oral route: Gateways to Trypanosoma cruzi infection and target tissues. PLOS Neglected Tropical Diseases, 11(4), e0005507. https://doi.org/10.1371/journal.pntd.0005507
Steindel, M., Kramer Pacheco, L., Scholl, D., Soares, M., De Moraes, M. H., Eger, I., Kosmann, C., Sincero, T. C. M., Stoco, P. H., Murta, S. M. F., De Carvalho-Pinto, C. J., & Grisard, E. C. (2008). Characterization of Trypanosoma cruzi isolated from humans, vectors, and animal reservoirs following an outbreak of acute human Chagas disease in Santa Catarina State, Brazil. Diagnostic Microbiology and Infectious Disease, 60(1), 25–32. https://doi.org/10.1016/j.diagmicrobio.2007.07.016
Vargas, A., Malta, J. M. A. S., Costa, V. M. da, Cláudio, L. D. G., Alves, R. V., Cordeiro, G. da S., Aguiar, L. M. A., & Percio, J. (2018). Investigação de surto de doença de Chagas aguda na região extra-amazônica, Rio Grande do Norte, Brasil, 2016. Cadernos de Saúde Pública, 34, e00006517. https://doi.org/10.1590/0102-311X00006517
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Estefano Enrico Pereira da Silva e Lima; Matheus Diniz Gonçalves Coêlho; Francine Alves da Silva Coêlho; Juliana da Silva Pereira Salgado
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
