STUDY OF CONGENITAL CHAGAS' DISEASE

恰加斯病在每个地区表现出不同的情况，例如，在玻利维亚的圣克鲁斯，孕妇中抗克氏锥虫抗体的血清阳性率为2-25%。另一方面，巴西东北部（圣雷蒙多诺纳托、马卡帕拉纳、布雷霍）虽然是先天性恰加斯病的流行地区，但尚未报告。通过对上述地区媒介生物生活状况、克氏体感染率及血清流行病学诊断情况的研究，选择试点地区。部分研究是在我们合作者的房间里完成的。1)采用IFA、HAI和ELISA检测玻利维亚圣克鲁斯郊区Abapo地区居民克氏体抗体。我们也检查了微血细胞比容检查寄生虫病，急性期。虽然没有发现寄生虫病，但60-79%的居民有克氏t型抗体。遗憾的是，在我们的合作伙伴之一的市妇产医院，我们在访问期间未能见到疑似先天性感染的病例。我们在居民的房子和他们房子旁边的鸡舍里捕获了许多Triatomines，现在我们正在隔离T. cruzi。我们还对其种类进行了评价，结果表明，主要是三角瘤和索蒂达。2)巴西东北部地区未见先天性恰加斯病的报道，无论是健康教育的影响，在1988-89年病媒控制的同时，我们在家中几乎找不到锥蝽的生活环境。但是一些居民抱怨他们晚上到家里来，巴西Triatoma说居民带来了感染的克氏锥虫。克氏体抗体血清阳性率为2 ~ 45%，地区间存在差异。

Chagas' disease shows the different conditions in each areas, for instance, Santa Cruz in Bolivia in which the seroprevalence of anti-Trypanosoma cruzi (T. cruzi) antibodies among pregnant women shows 2-25%. On the other hand, congenital Chagas' disease has not been reported in Northeast Brazil (Sao Raimundo Nonato, Macaparana, Brejo) though they had been endemic area. We studied about the life situation of the vector, infection rate by T. cruzi and seroepidemiological diagnosis above areas to select pilot area. Part of the study were done in our collaborators'.1) The antibody against T. cruzi of the inhabitants in Abapo area of Santa Cruz environs in Bolivia were examined by IFA, HAI and ELISA. We also examined by Microhematocrit to check parasitemia, the acute stage. Though parasitemia did not be found, 60-79% of inhabitants had T. cruzi antibody. It is to be regretted that we couldn't meet the case suspected as congenital infection in the municipal hospital of maternity, one of our collaborator, during our visit. We captured many Triatomines in the inhabitants' house and the chicken coop next to their house, now we are isolating T. cruzi from them. We also evaluated about their species, most of them were Triatoma infestans and T. sordida.2) Congenital Chagas' disease has not been reported in Northeast Brazil, whether it is the effect of the health education, at the same time of vector control in 1988-89, we could hardly find the living environment of Triatomines in the house. But some inhabitants complaint that they come in their house at night, Triatoma braziliensis that the inhabitants brought infected T. cruzi. The seropositive rates of T. cruzi antibody were 2-45%, showed difference between the areas.