Research that factor and morbid state, of Congenital Chagas disease in South America

这项研究始于玻利维亚的先天性查格斯病的流行病学研究，但现在发展到南美洲各地，包括巴西东北部塞亚州的独立地区。在玻利维亚，我们可以追踪服用苯硝唑三年的先天性查加斯婴儿。经苯硝唑治疗后，95%以上新生儿血中病原体消失，也未见肝脾肿大。但有些人在第三年的时候从他们的血液中检测到了病原体，我们认为没有完成用药的原因是因为在他们的随访中与媒介(Triatoma)的接触可能会被拒绝。很明显，所有先天感染的母亲都是携带者(32/32)，但没有观察到治疗的必要性，因此我们需要向包括医务人员在内的人传播知识。2003年7月24日至27日，三浦在玻利维亚圣克鲁斯举行的第12届泛美人日经/健康大会(2003年8月至27日)上谈到了上述问题，并申请支持日本国际协力事业团伙伴计划。巴西东北部没有先天性恰加斯病病例，但慢性携带者仍然存在，而且媒介仍然生活在那里，因此这种疾病可能会以复发性感染的形式传播。从这两个国家分离到的病原体(克氏锥虫)具有不同的特征，我们正在对遗传差异进行评估。

This study started with epidemiological research of congenital Chags' disease in Bolivia, but now evolve to all around in South America including Independencia area in Ceara state in Northeast Brazil. In Bolivia, we could follow up congenital Chagas' babies who had medicated Benznidazole for three years. After medication by Benznidazole, the pathogen disappeared from the blood of more than 95% of neonate, and swelling of the liver and splenomegaly could not be observed, either. But some were detected pathogen from their blood on the third year, we consider the reason uncompleted medication because the contact with the vector (Triatoma) could deny during their follow-up. It is clear that all of the congenital infected mothers are carriers (32/32), but the necessity of treatment has not been observed, so we need to spread knowledge to people including medical workers.From July 24 to 27 in 2003, Miura spoke about the above-mentioned at the 12th Convention Panamericans' NIKKEI-/Health Section (Aug-2003) in Santa Cruz, Bolivia, and apply for support to JICA Partnership Program. There's no case of congenital Chagas' disease in Northeast Brazil but chronic carriers are still exist and also the vector is still living there, so it is possible that this disease would spread as revival infection. The pathogens (Trypanosoma cruzi) which were isolated from the two countries' were different characteristic, we are evaluating about hereditary difference.