Certificación serológica de la interrupción de la transmisión vectorial de la enfermedad de Chagas en Chile / Serological certification of the interruption of the vectorial transmission of Chagas disease in Chile

Background: In 1999 an International Commission of Experts evaluated the sanitary interventions that started in 1980 to eliminate Triatoma infestans, the biological vector of Chagas disease, to certify if the conditions needed to interrupt the transmission, were achieved. Aim: To report the data used by the International certification commission to certify the interruption of vectorial transmission of Chagas disease in Chile. Material and methods : A comparative evaluation of the prevalence of Trypanosoma cruzi antibodies in children surveyed between 1994 and 1995 and between 1995 and 1999. Results : In the first period, 5.948 children were surveyed and in the second, 5.069 children were studied. Twenty children (0.4 percent) were positive for Trypanosoma cruzi antibodies in the second survey. These figures were significantly lower than the 1.1 percent prevalence detected between 1994 and 1995. In only three of the 20 cases, the transmission through vectors was confirmed, which represents a 99.4 percent reduction of this way of transmission. Conclusions: Based on these findings, the Commission certified that Chile is the second country in Latin America to interrupt the vector transmission of Chagas disease. The successful public health program for Chagas disease will have a positive impact improving the quality of life of rural populations, that are most exposed to the disease

Situación epidemiológica de la enfermedad de Chagas en el área endémica de la II Región de Antofagasta, Chile / Epidemiological situation of Chagasï disease in the endemic area from the II Region of Antofagasta, Chile

During 1997 a seroepidemiological study on Chagas' disease was carried out in 18 localities of three provinces (Tocopilla,El Loa and Antofagasta) of Region II (20º 56'-26º south lat.; 70º 38'- 67º west long.), in order to asses the impact of the control program against triatoma infestans launched in 1988, based on insecticide spraying of dwellings. By means of ELISA and an indirect hemagglutination test for chagas' disease blood samples from 1,034 children under 10 years of age were examined, arising a 0.5 por ciento (3 cases) positivity. Test resulted positivite in 2 (0.9 percent) children from the locality of San Pedro de Atacama and 1 (0.4 percent) from Calama city, all in the age group 6-10 year -old. However, none of their dwellings were found infested with T.infestants. These result indicate that the control program has a good possibility to prevent new human infections. It is advisable to continue the seroepidemiological and entomological vigilance and remark the necessity of increasing the effort in the study of transmission through other routes, to adopt or reinforce the pertinent preventive measures

Estado actual de la seroprevalencia de la infección chagásica humana y canina en la comuna de San Pedro de Atacama, II Región de Antofagasta en Chile 1995 / Present status of seroprevalence of canine and human chagasic infection in San Pedro de Atacama, II Región, Antofagasta, Chile 1995

In order to assess the impact of a control program against triatoma infestans launched in 1988, based on insecticide spraying of dwellings, a serological survey for chagasic infection was carried out during 1995 in three localities from San Pedro de Atacama county (22º55' south lat., 68º12' west long.), II Region of Antofagasta in northern Chile. Blood samples from 531 children and adolescents and 65 dogs were subjected to ELISA test and indirect inmunofluorescent test for Chagas's disease respectively. Tests resulted positive in 12 (2,3 percent) persons, all above 5 years old, in contrast with the 16,8 percent serological positivity observed in 1985. Three (4,6 percent) dogs (two 0-12 months old) resulted positive. These results indicate that dwellings sprayings with long-term activity insecticides against T. infestans is a good tool to prevent new human infections with T. cruzi. However, active vector transmissiom among domestic animals (canines) could be recently acquired.

Evaluación de un programa de erradicación del triatoma infestans en viviendas rurales de la IV Región de Chile mediante serología para la enfermedad de Chagas en niños de 0 a 10 años de edad / Triatoma infestans eradication program assessment in rural dwellings from the IV Region of Chile by serology for Chagas' disease in children 0 to 10 years of age

The present study deals with the evaluation of the effectiveness of the measures employed in the control of triatoma infestans, the vector of trypanosoma cruzi infection (Chagas' disease), in the IV Region of Chile through a serological follow up program. For this reason, a serological survey has been carried out in 2,783 chidren, from 0 to 10 years, who live in rural high endemic areas of the region. The sera were tested using an indirect hemagglutination test (IHAT) and ELISA techniques with results agreeing in 99,9 for percent of the samples. In children with positive serology xenodiagnosis was perfomed and blood samples from the corresponding mothers were submitted to serology for Chagas's disease. These addicional tests should allow to distinguish between congenital infection and vectorial transmission. It was observed that vectorial transmission of T. cruzi was interrupted in some localities where entomological control has been applied for 10 years, or lowered in those which have been submitted to desinsectations in the last 5 years. On the other hand, a relatively high prevalence of the infection has been detected in some localities. These results suggest an apparent increase of vectorial transmision, indicating the need of readjusting the dwellings insecticide sprayings activities to improve the measures against the vector

Toxoplasmosis congénita: un problema vigente en Chile: análisis de 15 casos clínicos / Congenital toxoplasmosis: a current problem in Chile: analysis of 15 clinical cases

Se analiza el problema de la toxoplasmosis congénita mediante el estudio de quince casos, cuatro lactantes con infección aguda y once niños con compromiso acular. La importancia del reconocimiento oportuno de la infección en el recién nacido y lactante, basada en la sospecha clínica (síndrome de TORCH y examen de fondo de ojo) y el diagnóstico serológico precoz que confirma la etiología, se discute en relación con el efecto curativo del tratamiento específico. La mayoría de los casos se diagnosticaron y trataron en forma tardía. En cinco niños tratados precozmente se obtuvo resultado satisfactorio, evitándose la muerte del recién nacido, disminuyendo el desarrollo de la infección y la aparición de reactivaciones, aunque persistieron secuelas a nivel del SNC. En los casos restantes, se observó sólo un efecto parcial del tratamiento. Se concluye que la toxoplasmosis congénita es un problema vigente en Chile y que la mayoría de los casos no se diagnostican oportunamente. Se recomienda intensificar su detección a nivel clínico, porque se dispone de drogas específicas que, aplicadas en forma precoz, pueden prevenir o aminorar el desarrollo de secuelas en el SNC

Encuesta sobre síntomas de depresión en embarazadas de un consultorio urbano de atención primaria / Depression in pregnant women seen at an outpatient primary care facility of urban Santiago

We studied the frequency of depression as well as biomedical and social features of 179 pregnant women under control at an urban clinic in metropolitan Santiago. The random sample compriesed 38% of all controlled pregnancies. A questionnaire adapted and validated by Florenzano et al was used to appraise. The Graffar methodology was used to measure socioeconomic level. Frequency of depressive symtoms was 30% and mean age of depressed women was 27.3 years, similar to non depressed ones (26.1%). A significantly highler proportion of depression was found in single women and those having a dystocic last delivery. The high frequency of depression in this vulnerable group suggests the need for integrated obsterric-psychiatric units to provide a more comprehensive medical care to theses patients