title: Ecoepidemiology, short history and control of Chagas disease in the endemic countries and the new challenge for non-endemic countries.
abstract: Chagas disease is maintained in nature through the interchange of three cycles: the wild, peridomestic and domestic cycles. The wild cycle, which is enzootic, has existed for millions of years maintained between triatomines and wild mammals. Human infection was only detected in mummies from 4,000-9,000 years ago, before the discovery of the disease by Carlos Chagas in 1909. With the beginning of deforestation in the Americas, two-three centuries ago for the expansion of agriculture and livestock rearing, wild mammals, which had been the food source for triatomines, were removed and new food sources started to appear in peridomestic areas: chicken coops, corrals and pigsties. Some accidental human cases could also have occurred prior to the triatomines in peridomestic areas. Thus, triatomines progressively penetrated households and formed the domestic cycle of Chagas disease. A new epidemiological, economic and social problem has been created through the globalisation of Chagas disease, due to legal and illegal migration of individuals infected by Trypanosoma cruzi or presenting Chagas disease in its varied clinical forms, from endemic countries in Latin America to non-endemic countries in North America, Europe, Asia and Oceania, particularly to the United States of America and Spain. The main objective of the present paper was to present a general view of the interchanges between the wild, peridomestic and domestic cycles of the disease, the development of T. cruzi among triatomine, their domiciliation and control initiatives, the characteristics of the disease in countries in the Americas and the problem of migration to non-endemic countries.
authors.affiliation: Laboratório de Doenças Parasitárias, Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro, RJ, Brasil.
authors.forename: José Rodrigues
authors.initials: JR
authors.lastname: Coura
authors.affiliation: World Health Organization, Geneve, Switzerland.
authors.forename: Pedro Albajar
authors.initials: PA
authors.lastname: Viñas
authors.affiliation: Laboratório de Doenças Parasitárias, Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro, RJ, Brasil.
authors.forename: Angela Cv
authors.initials: AC
authors.lastname: Junqueira
mesh_terms: D000818:Animals; D014355:Chagas Disease / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission; D003247:Conservation of Natural Resources; D004641:Emigration and Immigration; D019353:Endemic Diseases / Q000517:prevention & control*; D005060:Europe / Q000453:epidemiology; D006798:Housing; D006801:Humans; D007300:Insect Control / Q000379:methods; D007303:Insect Vectors / Q000469:parasitology; D007843:Latin America / Q000453:epidemiology; D058069:Neglected Diseases / Q000453:epidemiology* / Q000517:prevention & control; D065227:Transfusion Reaction; D014225:Triatominae / Q000469:parasitology*; D014349:Trypanosoma cruzi / Q000469:parasitology