Chagas disease: comments on the 2018 PAHO Guidelines for diagnosis and management.

摘要: Background Chagas disease, or American trypanosomiasis, is a protozoan infectious disease endemic throughout most of the Americas, caused by trypanosome, Trypanosoma cruzi, and mainly transmitted to humans reduviid kissing bugs. Some progress has been achieved in control areas, but migration flows have acted as drivers for emergence non-endemic areas Europe North America. Most imported cases are reported migrants from highly countries such Bolivia Paraguay, reports travellers extremely rare. Methods Pan Health Organization (PAHO) recently updated their guidelines on diagnosis management Chagas. These applicability reviewed. Results PAHO recommends use two serological tests chronic infection (allowing single sensitive test followed confirmation special settings screening potential blood donors). The indication specific trypanocidal treatment acute infections, children women child-bearing age remains before, with either benznidazole nifurtimox being choice. For with/without organ damage, recommendations less well defined. Although generally not recommended patients visceral involvement, decisions regarding need be tailored individual. Either may used initial treatment. Conclusions recent Guidelines provide framework aid this infection, several aspects underdiagnosis multidisciplinary approach patient management, investigation novel biomarkers progression/response development new strategies which should further strengthened.