[Chagas' disease in the southern coastal region of Brazil].
OBJECTIVE
To analyze serological data collected in two different periods, from the late 1960's to 1983, when these data was first added to the available information about vector triatomines found in the state of São Paulo, and from 1984 to 1999, a period when serology was used to describe endemic Chagas' disease in the state.


METHODS
Serological surveillance data from schoolchildren (during the late 1960s and between 1973 and 1983), and the general population (between 1980 and 1982) of the municipalities of Cananéia, Iguape and Peruíbe were analyzed together with data collected on the vectors.


RESULTS
Seropositivity among schoolchildren remained low and constant in the period from 1973 to 1982, and was no more detected in 1983. Cananéia showed titer distribution patterns typical of a non-endemic area, while Iguape and Peruíbe indicated low endemicity. Most of the cases came from other states; autochthonous cases were suggestive of oral transmission. There were reports of infestation by vector triatomines in 1,261 domiciliary units (main species: Panstrongylus megistus and Triatoma tibiamaculata). A total of 5,338 blood samples were collected and 40 were seropositive (0.75%). Triatomines captured within domiciles were mostly adults, and about half of them having fed upon human blood. Serological results of residents living in households where triatomines infected with Trypanosoma cruzi had been found did not differ from those living in houses infested only with non-infected insects.


CONCLUSIONS
In addition to educational activities aimed at the local population, there is a need to develop a collaboration between scientific institutions to isolate and characterize trypanosoma strains from vectors, reservoirs (sylvatic or other) and humans. Thus, evolutional, ecological, pathological and other pertinent characteristics of different strains of such parasites could be better understood.
Carvalho
Maria Esther de
ME
Superintendência de Controle de Endemias, Secretaria de Estado da Saúde de São Paulo, São Paulo, SP, Brasil. esther@sucen.sp.gov.br
da Silva
Rubens Antonio
RA
Barata
José Maria Soares
JM
Domingos
Maria de Fátima
Mde F
Ciaravolo
Ricardo Mário de Carvalho
RM
Zacharias
Fabiana
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000913:Antibodies, Protozoan / Q000097:blood*; D001938:Brazil / Q000453:epidemiology; D014355:Chagas Disease / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007303:Insect Vectors / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D016036:Seroepidemiologic Studies; D014225:Triatominae / Q000469:parasitology; D014349:Trypanosoma cruzi / Q000276:immunology* / Q000302:isolation & purification
D000913:Antibodies, Protozoan