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Manual De Vigilancia Y Control De La Enfermedad De Chagas En El Ecuador

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Manual De Vigilancia Y Control De La Enfermedad De Chagas En El Ecuador Manual de vigilancia y control de la enfermedad de Chagas en el Ecuador 2020 CENTRO DE REFERENCIA NACIONAL DE VECTORES Autoridades del Instituto Nacional de Investigación en Salud Pública - Dr. Leopoldo Izquieta Pérez Mgs. Solón Alberto Orlando Narváez, Director Ejecutivo (e), INSPILIP. Mgs. Alfredo Bruno Caicedo, Coordinador General Técnico (e), INSPILIP. Ph. D. William Patricio Ponce Yaulema, Coordinador Zonal 9, INSPILIP. Autoridades del Ministerio de Salud Pública del Ecuador Dr. Juan Carlos Zevallos López, Ministro de Salud Pública. Dr. Francisco Xavier Solórzano Salazar, Viceministro de Gobernanza y Vigilancia de la Salud – MSP. Dra. Natalia Cristina Romero Sandoval, Subsecretaria Nacional de Vigilancia de la Salud Pública –MSP. Dr. Inocente Franklin Bajaña Loor, Director Nacional de Estrategias de Prevención y Control – MSP. Equipo de redacción y autores Mgs. Diego Omar Morales Viteri, Experto Zonal de Laboratorio de Vigilancia Epidemiológica y Referencia Nacional –INSPILIP. Lic. Paúl Andrés Quinatoa Tutillo, Analista Técnico del Centro de Referencia Nacional de Vectores, INSPILIP. Lic. Dino David Sánchez Mackenzie, Analista Técnico del Centro de Referencia Nacional de Vectores, INSPILIP. Md. Jaen Carlos Cagua Ordóñez, Especialista de Enfermedades Crónicas no Transmisibles 1, Dirección Nacional de Estrategias de Prevención y Control – MSP. Dr. Héctor Raúl Veloz Pérez, Especialista Zonal de la Gestión Interna de la Estrategia de Prevención y Control de la Coordinación Zonal 8 – MSP. Equipo de revisión y validación Lcda. Cecilia Maribel Albuja Paillacho, Analista Técnico del Centro de Referencia Nacional de Vectores, INSPILIP. Msc. Fredy Fabián Delgado Morales, Analista Técnico del Centro de Referencia de Parasitología y Micología, INSPILIP. Mgs. Manuel Augusto González González, Director Técnico de Laboratorios de Vigilancia Epidemiológica y Referencia Nacional, INSPILIP. Lcdo. Roberto Jacobo Kaslin Ulloa, Analista Técnico del Centro de Referencia Nacional de Vectores, INSPILIP. Md. Diego Armando Masaquiza Moyolema, Especialista de Enfermedades Infecciosas con Potencial Epidémico y Pandémico 1 - Dirección Nacional de Estrategias de Prevención y Control – MSP. Md. Julio Rafael Rivera Bonilla, Especialista de Enfermedades Infecciosas con Potencial Epidémico y Pandémico 1 – MSP. Tlga. Paulina Margarita Ulloa Constante, Analista Técnico del Centro de Referencia Nacional de Vectores, INSPILIP. Dr. Armando Ulloa García. Entomólogo Médico. Profesor de Tiempo Completo e Investigador de la Facultad de Ciencias Químicas, Campus IV, Universidad Autónoma de Chiapas. Tapachula, Chiapas, México. CENTRO DE REFERENCIA NACIONAL DE VECTORES Mgs. Guillermo Mauricio Vallejo Rodríguez, Analista Zonal de Laboratorio de Vigilancia Epidemiológica y Referencia Nacional, Centro de Referencia Nacional de Vectores, INSPILIP. Equipo de colaboradores Dra. Aída Mercedes Soto Bravo, OPS/OMS Ecuador Ing. Tatiana Tipantiza, Analista Técnico de Episig, Instituto Nacional de Investigación en Salud Pública - Dr. Leopoldo Izquieta Pérez Edición general Dirección Técnica de Fomento y Transferencia del Conocimiento. Dra. Angélica Mirella Rivera Guapulema, Directora Mgs. Félix Patricio Vega Luzuriaga, Editor General de la revista científica INSPILIP. Publicado en octubre de 2020 DOI: 10.31790/inspilip.v4i4.113 CENTRO DE REFERENCIA NACIONAL DE VECTORES Tabla de contenidos Presentación ............................................................................................................... 6 Introducción ................................................................................................................ 6 Antecedentes y justificación ...................................................................................... 7 Objetivo. ................................................................................................................... 7 Alcance.. ................................................................................................................... 7 Glosario de términos .................................................................................................. 8 1. Capítulo 1............................................................................................................. 9 1.1. Agente etiológico ......................................................................................... 9 1.2. Trypanosoma cruzi ....................................................................................... 9 1.3. Ciclo de vida del parásito .......................................................................... 10 1.4. Vector ....................................................................................................... 11 1.5. Ciclos de transmisión vectorial .................................................................. 12 1.6. Reservorios animales ................................................................................ 13 1.7. Aspectos epidemiológicos ......................................................................... 13 1.8. Distribución de triatominos en Ecuador ..................................................... 17 1.9. Tribu Cavernicolini ...................................................................................... 19 1.10. Tribu Triatomini ........................................................................................... 19 1.11. Tribu Rhodninii ........................................................................................... 24 1.12. Vigilancia de la enfermedad de Chagas ................................................. 27 1.13. Focalización de la transmisión .................................................................... 28 1.14. Caracterización eco-epidemiológica de los conglomerados priorizados. ..... 28 1.15. Estratificación para el control de transmisión de la enfermedad de Chagas 30 1.16. Vigilancia epidemiológica de casos ........................................................... 33 1.16.1 Chagas agudo ........................................................................................... 33 1.16.2 Chagas crónico .......................................................................................... 34 1.17. Estrategias para la detección precoz y vigilancia epidemiológica ............... 35 1.17.1 Detección precoz de casos agudos ........................................................... 35 1.17.2 Detección activa de niños seropositivos a ser beneficiados con tratamiento etiológico…..……………………………………………………………………..36 1.17.3 Detección precoz de embarazadas o mujeres en edad fértil con enfermedad de Chagas en fase crónica .................................................... 36 1.17.4 Detección precoz de casos crónicos con cardiopatía incipiente ................. 36 1.17.5 Tamizaje de enfermedad de Chagas en donantes de sangre .................... 37 1.18. Indicadores epidemiológicos y operacionales ............................................. 38 1.19. Vigilancia entomológica ............................................................................. 41 1.19.1 Metodología de muestreo .......................................................................... 41 1.20. Indicadores entomológicos ......................................................................... 42 1.21. Caracterización de la vivienda .................................................................... 44 1.22. Control de vectores de la enfermedad de Chagas ..................................... 44 1.22.1Control físico............................................................................................... 45 1.22.2 Control químico ......................................................................................... 46 1.23. Evaluación de las actividades de control vectorial ...................................... 47 Abreviaturas utilizadas ............................................................................................. 48 Bibliografía ................................................................................................................ 49 CENTRO DE REFERENCIA NACIONAL DE VECTORES Índice de figuras Figura 1. T. cruzi en forma parasitaria de tripomastigota ............................................ 10 Figura 2. Ciclo de transmisión de T. cruzi ................................................................... 11 Figura 3. Ciclo de vida Rhodnius ecuadoriensis ......................................................... 12 Figura 4. Descomposición de serie temporal del total de casos confirmados de enfermedad de Chagas en Ecuador, 2013 – 2019 ...................................................... 15 Figura 5. Casos confirmados de enfermedad de Chagas por meses y tipo en Ecuador, 2013 – 2018 ................................................................................................................ 16 Figura 6. Cavernicola pilosa .................................................................................... 19 Figura 7. Eratyrus cuspidatus ................................................................................. 19 Figura 8. Eratyrus mucronatus . ............................................................................... 20 Figura 9. Panstrongylus chinai ................................................................................ 20 Figura 10. Panstrongylus geniculatus ..................................................................... 21 Figura 11. Panstrongylus howardi ........................................................................... 21 Figura 12. Panstrongylus lignarius .........................................................................
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