Intro -- Contents -- 1. Introduction -- 2. Basic inforomation on Chagas disease -- 2.1 Clinical forms -- 2.1.1 Acute phase -- 2.1.2 Chronic phase -- 2.2 Pathology -- 2.2.1 Acute phase -- 2.2.2 Chronic phase: heart pathology -- 2.2.3 Chronic phase: digestive form -- 2.2.4 Chagas disease and AIDS -- 2.2.5 Pathogenesis of chronic lesions -- 2.3 Laboratory diagnosis -- 2.3.1 Parasitological diagnosis -- 2.3.2 Immunodiagnosis -- 2.4 Clinical management and treatment -- 2.4.1 Trypanosomicidal treatment -- 2.4.2 Drug development -- 2.4.3 Acute phase -- 2.4.4 Chronic phase -- 2.4.5 Assessment of cure -- 3. Parasitology -- 3.1 Taxonomy -- 3.2 Isolation and maintenance of T. cruzi strains -- 3.3 Biological characteristics -- 3.4 Genetic characteristics -- 3.5 The parasite genome and the T. cruzi genome project -- 4. Vectors -- 4.1 Taxonomy -- 4.2 Geographical distribution -- 4.3 Biology -- 4.4 Ecology and behaviour of triatomines -- 4.4.1 Species strictly domiciliated or exceptionally found in wild ecotopes -- 4.4.2 Species found in both domestic and wild ecotopes, with frequent domiciliated colonies -- 4.4.3 Species mainly wild, but sometimes captured in the domestic environment -- 4.4.4 Wild species, with adults seldom found in dwellings -- 4.4.5 Species found only in wild ecotopes -- 4.5 Climatic factors and dispersion and adaptation of triatomines -- 4.5.1 Sylvatic ecotopes and the domiciliation process -- 4.5.2 The changes associated with domiciliation -- 4.6 Population genetics -- 4.7 Epidemiological application of the new tools -- 4.7.1 Systematics -- 4.7.2 Population structure -- 4.7.3 Population movements and reinfestation -- 4.7.4 Historical population movements -- 5. Natural reservoirs -- 5.1 Domestic and synanthropic reservoirs -- 5.2 Wild reservoirs -- 5.3 Importance of birds and other terrestrial vertebrates.

6. Epidemiology and incidence trends -- 6.1 Modes of transmission and ecological factors -- 6.1.1 Transmission by vectors -- 6.1.2 Transmission by blood transfusion -- 6.1.3 Congenital transmission -- 6.1.4 Transmission by organ transplantation -- 6.1.5 Accidental transmission -- 6.1.6 Oral transmission -- 6.1.7 Ecological factors -- 6.1.8 Anthropogenic environmental changes -- 6.2 Prevalence and geographical distribution of the disease -- 6.3 Epidemiological trends and changes in the period 1983-2000 -- 7. Prevention and control -- 7.1 Chemical control -- 7.1.1 Introduced and native species -- 7.1.2 Inputs and equipment -- 7.1.3 Programme organization -- 7.2 Physical control -- 7.3 Health education and community participation -- 7.4 Improvement of living conditions -- 7.5 Programme implementation in the context of primary health care -- 7.6 Evaluation of vector resistance to insecticides -- 7.6.1 Laboratory bioassays -- 7.6.2 Insecticidal effect of formulations -- 7.6.3 Resistance and tolerance -- 8. Subregional initiatives for the interruption of transmission -- 8.1 Southern Cone Initiative -- 8.1.1 Situation analysis -- 8.1.2 The formal decision -- 8.1.3 Strategies and methods -- 8.1.4 Intercountry mechanisms -- 8.1.5 Resources -- 8.1.6 Results -- 8.1.7 Overall impact of the initiative in the region -- 8.1.8 Cost-effectiveness studies in Brazil -- 8.2 Andean Initiative -- 8.2.1 Andean Pact agreement -- 8.2.2 Situation analysis -- 8.3 Central American Initiative -- 8.3.1 Central American agreement -- 8.3.2 Situation analysis -- 9. Development of human resources -- 10. Research priorities -- 10.1 Clinical pathology and diagnostic tests -- 10.1.1 Clinical pathology -- 10.1.2 Diagnostic tests -- 10.1.3 New tools for use in evaluating vector control -- 10.2 Biochemistry, functional genomics, and drug development -- 10.3 Social and economic research.

11. Recommendations -- Acknowledgements -- References -- Annex 1: Safety precautions for laboratory work with Trypanosoma cruzi -- Annex 2: Labelling of Trypanosoma cruzi isolates -- Annex 3: List of sylvatic and domestic or peridomestic animal reservoir hosts of Trypanosoma cruzi and countries in which they have been found infected.

This report of a WHO Expert Committee reviews current knowledge of Chagas disease and its pathogenesis, discusses the causative parasite, the triatomine vectors, and the natural reservoirs of infection, and considers the epidemiology and incidence trends of the disease. Prevention and control strategies are described, as are the various formal initiatives for interruption of disease transmission. The report concludes by identifying priorities for research and offering guidance for the planning, implementation, and strengthening of national control programmes.

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Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, 2018. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries.