The population of the Federal District will have a new system for monitoring Chagas disease by the E-SUS Notifica Program. The Health Secretariat (SES-DF) – which already monitors acute cases in the public health network – starts using the tool to also register the chronic form of the disease, which can develop when there is no cure in the acute phase. The new monitoring will improve epidemiological surveillance processes and ensure the quality of the recorded data.

Manager of Communicable Disease Surveillance, Kênia Oliveira explains that monitoring only occurred for acute cases, even without notifications in the DF. “The implementation of the Chagas Disease Notification System will make it possible to know who and where the affected people are and to understand the magnitude of the disease in the capital. Today, our focus has been on pregnant women and the children of positive mothers [for Chagas].” With the new strategy of the Ministry of Health, professionals will be able to give a more in-depth feedback on the disease.
Chagas disease is caused by the protozoan Trypanosoma cruzi, hosted by the kissing bug, a type of bedbug. It presents an acute phase, which may or may not be symptomatic, and a chronic phase, which may manifest itself in indeterminate (asymptomatic), cardiac, digestive or cardiodigestive forms.

It is important to highlight that the DF does not present a transmission scenario, that is, there is no record of recent infections of residents. Out of care, however, the disease remains in the attention of the Health area, which monitors infected patients in other regions of Brazil and with sequelae of the disease.

Vulnerability

Surveillance is fundamental, since, according to the Epidemiological Bulletin: Territorialization and vulnerability to Chronic Chagas Disease by the Ministry of Health, the DF has the third highest vulnerability index for chronic Chagas disease in the country, behind Goiás and Minas Gerais, respectively.

According to the technical area, monitoring Trypanosoma cruzi infection in the population will provide essential data for planning and defining epidemiological surveillance and health care strategies. The goal is to reduce the negative impacts that the disease causes on people’s lives.
SES-DF also monitors and works to prevent kissing bugs through Environmental Surveillance. Active in the area for over 40 years, Vilma Feitosa, a biologist at the Management of Environmental Surveillance of Vectors and Venomous Animals and Field Actions, points out that the insect’s circulation continues, mainly, in the rainy season, starting in October, with its presence in the DF in more than 90% in the rural area.

“It is much more difficult to find the animal in the urban area because it needs the necessary conditions to live. Today, houses are plastered and the insect has more difficulty hiding. It likes humid, dark, dirty places with gaps, in places very close to the food source”, warns the expert. Therefore, it was common to be found in wattle and daub houses. In the city, it can be located in backyards next to chicken coops and kennels, for example.

Control in the DF

If the citizen suspects that he has seen a barber, he can deliver the insect to one of the 84 points made available by the SES-DF. If there is confirmation that the bedbug is indeed the barber, a team returns to the home and carries out an inspection in search of other specimens and, if necessary, intervenes with the use of an appropriate insecticide.
In the last two years, 100 homes with the insect were visited. Until May 2023, only seven. Over the years, the department examined 799 locations and found 30 kissing bugs infected with Trypanosoma cruzi. The predominant species in the DF is Panstrongylus megistus.

Profile of patients at risk for Chagas disease

• Having lived or living in an area with reported presence of the transmitting vector (barber shop) and/or in a dwelling where contact with the transmitting vector may have occurred;
• Live in or come from an area with a record of Trypanosoma cruzi transmission or an epidemiological history suggestive of the occurrence of transmission of the disease;
• Have had a blood transfusion or blood components before 1992;
• Having family members or regular people who have been diagnosed with the disease, especially a mother and/or sibling(s) with proven infection.

Originally posted by the Health Department of the Federal District on 07/12/2023

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