Doença de chagas sob a perspectiva da saúde única

Abstract

American trypanosomiasis, also known as Chagas disease (CD) in Brazil, is an illness caused by the protozoan Trypanosoma cruzi. To complete its life cycle, the etiological agent depends on the presence of insect vectors from the Triatominae genus, commonly known as kissing bugs. Other transmission modes include the ingestion of food contaminated with fragments and/or secretions from triatomines, transfusion of contaminated blood, transplacental transmission, and accidental contact with contaminated objects. The complications of the disease can lead to cardiovascular alterations, megaesophagus, constipation, and intestinal obstruction in chronic patients. In acute cases, symptoms such as fever, inoculation chagoma, Romaña's sign, malaise, lymphadenopathy, and hepatosplenomegaly may be observed. The prevalence of CD in Brazil varies by region due to specific risk factors such as living conditions, dietary habits, peridomestic animal rearing, population education level, and the presence of different species and food sources for triatomines, contributing to the diversity of cases. Despite being a long-recognized disease, there are only two therapeutically effective drugs officially approved and available from the Ministry of Health: benznidazole and nifurtimox. Both drugs have adverse effects and require strict dosing regimens. The main prophylactic strategies involve controlling the vectors to break the biological cycle of the agent. However, transmission through the ingestion of contaminated food has gained prominence, particularly in regions of Brazil where the consumption of products such as açaí, cupuaçu, and sugarcane juice is common. This underscores the need for more rigorous sanitary-hygienic regulations for these raw products. This literature review aims to address the main etiological, epidemiological, clinical, therapeutic, and preventive aspects of CD from a public health perspective. Additionally, it highlights the importance of veterinarians in controlling this zoonosis, which, though often neglected, still affects a significant portion of the Brazilian population.