Paleoparasitology of Chagas disease: a review

One hundred years since the discovery of Chagas disease associated with Trypanosoma cruzi infection, growing attention has focused on understanding the evolution in parasite-human host interaction. This interest has featured studies and results from paleoparasitology, not only the description of lesions in mummified bodies, but also the recovery of genetic material from the parasite and the possibility of analyzing such material over time. The present study reviews the evidence of Chagas disease in organic remains excavated from archeological sites and discusses two findings in greater detail, both with lesions suggestive of chagasic megacolon and confirmed by molecular biology techniques. One of these sites is located in the United States, on the border between Texas and Mexico and the other in state of Minas Gerais, in the Brazilian cerrado (savannah). Dated prior to contact with Europeans, these results confirm that Chagas disease affected prehistoric human groups in other regions outside the Andean altiplanos and other transmission areas on the Pacific Coast, previously considered the origin of T. cruzi infection in the human host.

Pre-Columbian Chagas disease in Brazil: Trypanosoma cruzi I in the archaeological remains of a human in Peruaçu Valley, Minas Gerais, Brazil

We evaluated the presence and distribution of Trypanosoma cruzi DNA in a mummy presenting with megacolon that was dated as approximately 560 ± 40 years old. The mummy was from the Peruaçu Valley in the state of Minas Gerais, Brazil. All samples were positive for T. cruzi minicircle DNA, demonstrating the presence and broad dissemination of the parasite in this body. From one sample, a mini-exon gene fragment was recovered and characterized by sequencing and was found to belong to the T. cruzi I genotype. This finding suggests that T. cruzi I infected humans during the pre-Columbian times and that, in addition to T. cruzi infection, Chagas disease in Brazil most likely preceded European colonization.

Miguel Dias Pimenta (1661-1715) e a história do megaesôfago e do megacólon chagásicos / Miguel Dias Pimenta (1661-1715) and the history of chagasic megaesophagus and megacolon

Procurou-se analisar, sob o ponto de vista clínico, as descriçoes contidas no livro "Noticias do que he o achaque do bicho", de Miguel Dias Pimenta (1661-1715), que sao consideradas por alguns autores como as primeiras referências ao megaesôfago e ao megacólon chagásicos que aparecem na história. Nas descriçoes tidas como referentes ao megaesôfago, além de nao se reconhecer a disfagia, o principal sintoma desta doença, identificam-se manifestaçoes próprias de afecçao irritativa, inflamatória ou ulcerativa nao do esôfago, mas do estômago. Naquelas referidas como do megacólon, os sintomas e sinais descritos sugerem a possibilidade diagnóstica de hemorróidas e do próprio achaque do bicho, nao lembrando, em absoluto, o quadro clínico da afecçao chagásica. Assim sendo, nao há razao para que se mantenha o "Noticias do que he o achaque do bicho" dentro da história da forma digestiva da moléstia de Chagas.

Megacolon primario adquirido del adulto: tratamiento quirúrgico / Surgical treatment of the adquired adult primary megacolon

Los autores presentan 56 pacientes operados por megacolon entre 1955 y 1985. La anatomía patológica y la epiopatogenia de la afección, es detallada. Las técnicas quirúrgicas empleadas son mencionadas y la operación de Black es seleccionada como la mejor. Esta técnica quirúrgica es descripta minuciosamente. Las complicaciones postoperatorias y la mortalidad son mencionadas.