The beginning of Chagas Disease control (homage to Dr. Emmanuel Dias, the pioneer of Chagas Disease control, in the year of his birth centenary)

摘要

Very soon Carlos Chagas took into account the need of trypanosomiasis control, considering its great social impact and geographical dispersion The vector was considered the more vulnerable target and housing improvement the basic strategy to face the disease. In parallel, it was required a more clinical visibility for the disease, as an argument for its control. The first concrete tentative ocorred in 1918 when Souza Araújo dedicating his efforts in Paraná, trying housing improvement. He was followed by Ezequiel Dias et al, in 1921, employing chemical compounds against the vector, The chemical fight will be retaken by Emmanuel Dias in 1944, assaying several old compounds, fire thrower and cyanidric gas. In 1946, DDT showed to be ineffective, but one year later Dias & Pellegrino described the insecticide gammexane, higly effective against domestic triatomines. Working with Mario Pinotti, expanded trials occurred in Minas Gerais (Triangle Region), justifying the expansion of the campaing to other endemic regions, with the rationale of continuous work in contiguous areas. In 1957 Pedreira de Freitas proposed the selective spraying, which was the model for the future strategy of program evaluation, by SUVEN and SUCAN organizations. In 1975 the national program is reorganized, launching two national surveys (entomology and serology). In 1979 the new pyrethroid compounds are tried and im 1983 the national program is expanded. Transfusion transmitted Chagas Disease was studied since the 1950 by the Nussenzweig group in S. Paulo, showing to be vulnerable to chemoprophylaxis and blood donor pre transfusional serologic screening. Nevertheless, these preventive measures only were implemented in the 1980 decade, following the emergence of HIV/AIDS pandemic. Practically, since the pioneer essays, the control of Chagas Disease transmission showed to be efficient against vector and blood bank mechanisms, depending on continuity, educative support and political will.