STUDY OF CONGENITAL CHAGAS' DISEASE

查加斯氏病显示了每个地区的不同情况，例如玻利维亚的圣克鲁斯，孕妇中克氏锥虫抗体的血清阳性率为2-25%。另一方面，先天性恰加斯病在巴西东北部(圣雷蒙多诺纳托、马卡帕拉纳、布雷霍)虽然已是流行区，但尚未见报道。通过对上述地区媒介生物生活状况、克氏毛滴虫感染率和血清流行病学诊断的研究，选择试点地区。部分研究是由我们的合作者完成的。1)用IFA、HAI和EL ISA检测玻利维亚圣克鲁斯阿帕波地区居民的克雷氏旋毛虫抗体。同时进行微量红细胞压积检查，检查急性期寄生虫血症。虽然未发现寄生虫血症，但60-79%的居民有克氏毛滴虫抗体。令人遗憾的是，我们的合作伙伴之一市立妇产医院在我们访问期间未能见到疑似先天性感染的病例。我们在居民家里和他们家旁边的鸡舍里捕获了许多三聚氰胺，现在我们正在将克鲁兹毛虫与它们隔离开来。2)巴西东北部未见先天性恰加斯病的报道，无论是健康教育的效果如何，在1988-1989年的媒介控制工作中，我们几乎找不到屋内的三聚氰胺的生存环境。但一些居民抱怨说，他们晚上到自己的房子里，巴西三角霉菌，居民带来了受感染的克鲁兹毛虫。克氏毛滴虫抗体阳性率为2~45%，地区间差异有统计学意义。

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.