PAHO/HDM/CD/512-2008 UUppddaattee of Ameriican Trypanosomiiasiis and Leiishmaniiasiis Controll and Research: FFiinnaall RReeppoorrtt (Rio de Janeiro, Braziill, 6–7 November 2007) Organiizers: Pan Ameriican Heallth Organiizatiion / Worlld Heallth Organiizatiion (PAHO/WHO) Sociiedade de Pediiatriia do Estado de Riio de Janeiiro (SOPERJ) Table of Contents Introduction .................................................................................................................................................... 1 Lecturers ..................................................................................................................................................... 1 Narrators ..................................................................................................................................................... 3 Participants ................................................................................................................................................ 3 American Trypanosomiasis........................................................................................................................... 4 Control of Vector Transmission Of Chagas Disease, Its Limits and the Research of Situations or Areas with Persistent Infestation by Introduced Species .................................................................... 5 Critical Aspects of T. cruzi Infection and Chagas Disease in the Ecuadorian Amazonía: Considerations for Other Amazon Areas with Probable Endemic Transmission ........................... 18 Introduction ......................................................................................................................................... 18 Seroepidemiology in the Amazonía ................................................................................................ 19 Risk Factors........................................................................................................................................... 19 Triatominae and Palm Trees.............................................................................................................. 20 Modes of T. cruzi Transmission Identified in the Amazonía........................................................... 22 Some Questions that Have to Be Answered as an Operative Base for Control....................... 23 References........................................................................................................................................... 25 Wild Triatoma infestans: Scientific Curiosity or Potential Threat?..................................................... 27 Distribution of Wild Foci...................................................................................................................... 28 The Different Morphs of Wild T. infestans and Some Traits of Their Bioecology (Table 1) ........ 29 Genetic Diversity and Dispersal Ability for Wild T. infestans at High Altitude (2,750 m asl) ..... 31 Acknowledgements........................................................................................................................... 32 References........................................................................................................................................... 33 Ecosystem Approach Intervention for Long-Term Control of Triatoma Dimidiata in Guatemala ................................................................................................................................................................... 35 Introduction ......................................................................................................................................... 35 Methodology and Main Results ....................................................................................................... 35 References........................................................................................................................................... 38 Geometric Morphometrics Applied to the Study of Triatominae ................................................... 39 Morphological Variability .................................................................................................................. 39 Geometric Morphometrics................................................................................................................ 40 Triatominae Studies Based in Morphometrics ................................................................................ 40 Acknowledgments ............................................................................................................................. 47 References........................................................................................................................................... 48 Advances in Community Surveillance of Trypanosoma cruzi Transmission ................................... 49 Methods ............................................................................................................................................... 50 Social Evaluation of Interactions among the Social Networks Members within the Community. ......................................................................................................................................... 52 Monitoring............................................................................................................................................ 52 ii Results ................................................................................................................................................... 53 Discussion ............................................................................................................................................. 54 Acknowledgement ............................................................................................................................ 56 References........................................................................................................................................... 57 New Triatomine Control and Detection Tools: Use Perspectives..................................................... 58 References........................................................................................................................................... 61 Insecticide Impregnated Curtains and Bed Nets for Control of Cutaneous Leishmaniasis and Chagas Disease In Venezuela .............................................................................................................. 64 Abstract................................................................................................................................................ 64 Eradication of Chagas Disease: What Are Its Possibilities?............................................................... 65 References........................................................................................................................................... 72 Clinical Advances in American Trypanosomiasis .............................................................................. 73 Determinants and Pathogenesis of Chagas disease ................................................................... 73 Clinical Phases and Forms: Morbidity and Mortality ..................................................................... 76 Chagas Disease in the Amazon Region ......................................................................................... 78 References........................................................................................................................................... 80 Recent Advances in Chemotherapy of American Trypanosomiasis ............................................. 83 Abstract................................................................................................................................................ 83 The Need for Chemotherapy of Chagas’ Disease ....................................................................... 83 Possible Approaches to the Chemotherapy of Chagas’ Disease ............................................. 84 Potential Targets for Further Development of Chemoterapeutic Drugs against Chagas’ Disease ................................................................................................................................................. 85 Conclusions.......................................................................................................................................... 88 Acknowledgments ............................................................................................................................. 89 References........................................................................................................................................... 90 Trypanosoma cruzi: Congenital and Transfusional American Trypanosomiasis............................ 96 Transfusional Chagas Disease .......................................................................................................... 98 References......................................................................................................................................... 100 Conclusions related to American Trypanosomiasis Control and Research................................. 101 1. Dr. Antonio Carlos Silveira, Control of Vector Transmission of chagas disease, Its Limits and the Research of Situations or Areas with Persistent Infestation by Introduced Species ........ 101 2) Dr. Marcelo Aguilar, Critical Aspects of T. cruzi Infection