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

本研究从玻利维亚先天性Chags病的流行病学研究开始，现已发展到南美各地，包括巴西东北部塞阿拉州的Independencia地区。在玻利维亚，我们可以对服用苯并硝唑的先天性恰加斯病患儿进行为期三年的随访。经苯并硝唑治疗后，95%以上新生儿血液中病原菌消失，未见肝肿胀、脾肿大。但有些患者在第三年血液中检出病原体，我们认为未完成药物治疗的原因是随访时可能否认与病媒（Triatoma）的接触。显然，所有先天性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工作者在内的人们传播知识。2003年7月24日至27日，三浦在玻利维亚圣克鲁斯举行的第十二届泛美卫生大会（2003年8月）上谈到了上述情况，并申请支持日本国际协力机构伙伴关系方案。巴西东北部没有先天性恰加斯病的病例，但慢性携带者仍然存在，而且病媒仍然生活在那里，因此这种疾病有可能以复活感染的方式传播。两国分离的克氏锥虫病原学特征不同，现对其遗传差异进行评价。

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.