Skip to main content
SpringerLink
Log in

Chagas Disease: An Unknown and Neglected Disease

  • Chapter
  • First Online:
Chagas Disease

Abstract

Chagas disease, formerly confined to the Latin-American sub-continent, is now diagnosed in vast numbers of T. cruzi chronically infected individuals living in the United States, Canada, virtually all European countries, Asia, and Oceania, because of recent population migratory and globalization patterns.

Much has been learned about the etiologic agent of Chagas disease during the last decades, including its high level of genetic, biochemical, and anatomical diversity. The fascinating history of the disease knowledge has now entered a phase of growing consensus about several features and aspects. The pathogenesis of chronic Chagas cardiomyopathy involves at least four mechanisms, among which the most important is related to parasite persistence in the cardiac tissue that triggers low-level but virtually incessant inflammation and fibrosis as well as adverse immune reactions. In contrast, the pathogenesis of gastrointestinal involvement caused by T. cruzi infection is directly related to damage of the autonomic control of organs such as the esophagus and colon. The natural history of Chagas disease comprises two phases with clinical manifestations encompassing sudden death, arrhythmia, heart failure, thromboembolic events, and the appearance of megaesophagus and megacolon. Although the role of etiologic treatment in the chronic phase has not been clearly defined, the lack of trypanocidal agents more effective than the half-a-century-old benznidazole and nifurtimox testifies to the neglected stigma of Chagas disease.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. El-Sayed NM, Myler PJ, Bartholomeu DC, et al. The genome sequence of Trypanosoma cruzi, etiologic agent of Chagas disease. Science. 2005;309:409–15.

    PubMed  CAS  Google Scholar 

  2. Moreira D, López-García P, Vickerman K. An updated view of kinetoplastid phylogeny using environmental sequences and a closer outgroup: proposal for a new classification of the class Kinetoplastea. Int J Syst Evol Microbiol. 2004;54:1861–75.

    PubMed  CAS  Google Scholar 

  3. Ruggiero MA, Gordon DP, Orrell TM, et al. A higher level classification of all living organisms. PLoS One. 2015;10:e0119248.

    PubMed  PubMed Central  Google Scholar 

  4. Teixeira ARL, Hecht MM, Guimaro MC, et al. Pathogenesis of Chagas’ disease: parasite persistence and autoimmunity. Clin Microbiol Rev. 2011;24:592–630.

    PubMed  PubMed Central  CAS  Google Scholar 

  5. Schenkman S, Pascoalino BDS, Nardelli SC. Nuclear structure of Trypanosoma cruzi. Adv Parasitol. 2011;75:251–83.

    PubMed  Google Scholar 

  6. Araújo A, Jansen AM, Reinhard K, et al. Paleoparasitology of Chagas disease – a review. Mem Inst Oswaldo Cruz. 2009;104(Suppl 1):9–16.

    PubMed  Google Scholar 

  7. De Souza W. Electron microscopy of trypanosomes – a historical review. Mem Inst Oswaldo Cruz. 2008;103:313–25.

    PubMed  Google Scholar 

  8. Gonçalves CS, Ávila AR, de Souza W, et al. Revisiting the Trypanosoma cruzi metacyclogenesis: morphological and ultrastructural analyses during cell differentiation. Parasit Vectors. 2018;11(1):83.

    PubMed  PubMed Central  Google Scholar 

  9. Ward H, Ajjampur SSR. Appendix 2. Parasitic protozoa. In: Farrar J, Hotez P, Junghanss T, Kang G, Lalloo D, Nicholas J, editors. Manson’s tropical diseases. 23rd ed. London: Elsevier Saunders; 2014. p. 1238–49.

    Google Scholar 

  10. Messenger LA, Yeo M, Lewis MD, et al. Molecular genotyping of Trypanosoma cruzi for lineage assignment and population genetics. Methods Mol Biol. 2015;1201:297–337.

    PubMed  CAS  Google Scholar 

  11. Andrade SG. Caracterização de cepas de Trypanosoma cruzi isoladas de Recôncavo Baiano. Rev Patol Trop. 1974;3:65–121.

    Google Scholar 

  12. Miles MA, Toye PJ, Oswald SC, et al. The identification by isoenzyme patterns of two distinct strain-groups of Trypanosoma cruzi, circulating independently in a rural area of Brazil. Trans R Soc Trop Med Hyg. 1977;71:217–25.

    PubMed  CAS  Google Scholar 

  13. Miles MA, Souza A, Povoa M, et al. Isozymic heterogeneity of Trypanosoma cruzi in the first autochthonous patients with Chagas’ disease in Amazonian Brazil. Nature. 1978;272:819–21.

    PubMed  CAS  Google Scholar 

  14. Tibayrenc M, Ward P, Moya A, et al. Natural populations of Trypanosoma cruzi, the agent of Chagas disease, have a complex multiclonal structure. Proc Natl Acad Sci U S A. 1986;83:115–9.

    PubMed  PubMed Central  CAS  Google Scholar 

  15. Tibayrenc M, Ayala FJ. Isoenzyme variability in Trypanosoma cruzi, the agent of Chagas’ disease. Genetical, taxonomical and epidemiological significance. Evolution. 1988;42:277–92.

    PubMed  Google Scholar 

  16. Morel C, Chiari E, Plessman Camargo E, et al. Strains and clones of Trypanosoma cruzi can be characterized by pattern of restriction endonuclease products of kinetoplast DNA minicircles. Proc Natl Acad Sci U S A. 1980;77:6810–4.

    PubMed  PubMed Central  CAS  Google Scholar 

  17. Tibayrenc M. Genetic epidemiology of parasitic protozoa and other infectious agents: the need for an integrated approach. Int J Parasitol. 1998;28:85–104.

    PubMed  CAS  Google Scholar 

  18. Guhl F. Epidemiología molecular de Trypanosoma cruzi. Rev Esp Salud Pública. 2013;2013:1–8.

    Google Scholar 

  19. Anonymous. Recommendations from a satellite meeting. Mem Inst Oswaldo Cruz. 1999;94:429–32.

    Google Scholar 

  20. Brisse S, Barnabé C, Tibayrenc M. Identification of six Trypanosoma cruzi phylogenetic lineages by random amplified polymorphic DNA and multilocus enzyme electrophoresis. Int J Parasitol. 2000;30:35–44.

    PubMed  CAS  Google Scholar 

  21. Brisse S, Verhoef J, Tibayrenc M. Characterisation of large and small subunit rRNA and mini-exon genes further supports the distinction of six Trypanosoma cruzi lineages. Int J Parasitol. 2001;31:1218–26.

    PubMed  CAS  Google Scholar 

  22. Zingales B, Andrade SG, Briones MRS, et al. A new consensus for Trypanosoma cruzi intraspecific nomenclature: second revision meeting recommends TcI to TcVI. Mem Inst Oswaldo Cruz. 2009;104:1051–4.

    PubMed  CAS  Google Scholar 

  23. Cura CI, Mejía-Jaramillo AM, Duffy T, et al. Trypanosoma cruzi I genotypes in different geographic regions and transmission cycles based on microsatellite motife of the intergenic spacer of spliced leader genes. Int J Parasitol. 2010;40:1599–607.

    PubMed  PubMed Central  CAS  Google Scholar 

  24. Ramírez JD, Duque MC, Montilla M, et al. Multilocus PCR-RFLP profiling in Trypanosoma cruzi I highlights an intraspecific genetic variation pattern. Infect Genet Evol. 2012;12:1743–50.

    PubMed  Google Scholar 

  25. Zingales B, Miles MA, Campbell DA, et al. The revised Trypanosoma cruzi subspecific nomenclature: rationale epidemiological relevance and research applications. Infect Genet Evol. 2012;12:240–53.

    PubMed  Google Scholar 

  26. Marcili A, Lima L, Cavazzana M Jr, et al. A new genotype of Trypanosoma cruzi associated with bats evidenced by phylogenetic analyses using SSU rDNA cytochrome b and Histone H2B genes and genotyping based on ITS1 rDNA. Parasitology. 2009;136:641–55.

    PubMed  CAS  Google Scholar 

  27. Muñoz C, Solari A, Apt W, et al. Caracterización de las Unidades Discretas de Tipificación de Trypanosoma cruzi según sus marcadores moleculares. Rev Ibero Latinoam Parasitol. 2013;72:5–21.

    Google Scholar 

  28. Tibayrenc M, Ayala FJ. The populations genetics of Trypanosoma cruzi revisited in the light of the predominant clonal evolution model. Acta Trop. 2015;151:156–65.

    PubMed  PubMed Central  Google Scholar 

  29. Aufderheide AC, Salo W, Madden M, et al. A 9,000-year record of Chagas’ disease. Proc Natl Acad Sci U S A. 2004;101(7):2034–9.

    PubMed  PubMed Central  CAS  Google Scholar 

  30. Fornaciari G, Castagna M, Viacava P, et al. Chagas’ disease in a Peruvian Inca mummy. Lancet. 1992;339:128–9.

    PubMed  CAS  Google Scholar 

  31. Guhl F, Jaramillo C, Yockteng R, et al. T. cruzi DNA in human mummies. Lancet. 1997;349:1370.

    PubMed  CAS  Google Scholar 

  32. Rothhammer F, Allison MJ, Nuñez L, et al. Chagas disease in pre-Columbian South America. Am J Phys Anthropol. 1985;68:495–8.

    PubMed  CAS  Google Scholar 

  33. Guhl F, Jaramillo C, Vallejo GA, et al. Isolation of T. cruzi DNA in 4,000-year-old mummified human tissue from northern Chile. Am J Phys Anthropol. 1999;108:401–7.

    PubMed  CAS  Google Scholar 

  34. Madden M, Salo WL, Streitz J, et al. Hybridization screening of very short PCR products for paleoepidemiological studies of Chagas’ disease. BioTechniques. 2001;30:102–4.

    PubMed  CAS  Google Scholar 

  35. Dias JCP, Schofield CJ. History of Chagas disease as a public health problem in Latin America. In: Teixeira A, Vinaud M, Castro AM, editors. Emerging Chagas disease. Sharjah: Benthan Science Publisher; 2011. p. 1–9.

    Google Scholar 

  36. Miles MA. The discovery of Chagas disease: progress and prejudice. Infect Dis Clin N Am. 2004;18:247–60.

    Google Scholar 

  37. Steverding D. The history of Chagas disease. Parasit Vectors. 2014;7:317.

    PubMed  PubMed Central  Google Scholar 

  38. Reyes López PA. Life and work of Carlos Chagas, on its centennial description of Chagas-Mazza disease. Arch Cardiol Mex. 2009;79(4):237–9.

    PubMed  Google Scholar 

  39. Werner Apt B, Arribada CA, Zulantay AI. Centennial of Chagas disease (1909–2009). Rev Med Chil. 2009;137(5):721–2.

    PubMed  CAS  Google Scholar 

  40. Coura JR, Viñas PA, Junqueira AC. Ecoepidemiology, short history and control of Chagas disease in the endemic countries and the new challenge for non-endemic countries. Mem Inst Oswaldo Cruz. 2014;109(7):856–62.

    PubMed  PubMed Central  Google Scholar 

  41. Chagas C. Nova tripanozomiaze humana. Estudos sobre a morfolojia e o ciclo evolutivo de Schizotrypanum cruzi n. gen., n. sp., ajente etiolojico de nova entidade morbida do homem. Mem Inst Oswaldo Cruz. 1909;1:159–218.

    Google Scholar 

  42. Kropf SP, Sá MR. The discovery of Trypanosoma cruzi and Chagas disease (1908–1909): tropical medicine in Brazil. Hist Cienc Saude Manguinhos. 2009;16(suppl 1):13–34.

    PubMed  Google Scholar 

  43. Morel CM. Chagas disease, from discovery to control – and beyond: history, myths and lessons to take home. Mem Inst Oswaldo Cruz. 1999;94(Suppl 1):3–16.

    PubMed  Google Scholar 

  44. Tarleton RL, Reithinger R, Urbina JA, et al. The challenges of Chagas disease—grim outlook or glimmer of hope? PLoS Med. 2007;4(12):e332.

    PubMed  PubMed Central  Google Scholar 

  45. Zingales B. Trypanosoma cruzi genetic diversity: something new for something known about Chagas disease manifestations, serodiagnosis and drug sensitivity. Acta Trop. 2018;184:38–52.

    PubMed  CAS  Google Scholar 

  46. Alarcón de Noya B, Noya González O. An ecological overview on the factors that drives to Trypanosoma cruzi oral transmission. Acta Trop. 2015;151:94–102.

    Google Scholar 

  47. Kirchhoff LV. Epidemiology of American trypanosomiasis (Chagas disease). Adv Parasitol. 2011;75:1–18.

    PubMed  Google Scholar 

  48. Coura JR, Albajar PV. Chagas disease: a new worldwide challenge. Nature. 2010;465(7301):S6–7.

    PubMed  Google Scholar 

  49. Barreto de Albuquerque J, Silva dos Santos D, . Stein JV et al (2018). Oral versus intragastric inoculation: similar pathways of Trypanosoma cruzi experimental infection? From target tissues, parasite evasion, and immune response. Front Immunol 9:1734.

    PubMed  PubMed Central  Google Scholar 

  50. Bern C. Chagas’ disease. N Engl J Med. 2015;373:456–66.

    PubMed  CAS  Google Scholar 

  51. Prata A. Clinical and epidemiological aspects of Chagas disease. Lancet Infect Dis. 2001;1:92–100.

    PubMed  CAS  Google Scholar 

  52. Gascón J, Bern C, Pinazo MJ. Chagas disease in Spain, the United States and other non-endemic countries. Acta Trop. 2010;115:22–7.

    PubMed  Google Scholar 

  53. Schmunis GA, Yadon ZE. Chagas disease: a Latin American health problem becoming a world health problem. Acta Trop. 2010;115:14–21.

    PubMed  Google Scholar 

  54. Rassi A Jr, Rassi A, Marin-Neto JA. Chagas disease. Lancet. 2010;375(9723):1388–402.

    PubMed  Google Scholar 

  55. Rassi A Jr, Rassi A, Marcondes de Rezende J. American trypanosomiasis (Chagas disease). Infect Dis Clin N Am. 2012;26(2):275–91.

    Google Scholar 

  56. Bern C, Martin DL, Gilman RH. Acute and congenital Chagas disease. Adv Parasitol. 2011;75:19–47.

    PubMed  Google Scholar 

  57. Córdova E, Maiolo E, Corti M, et al. Neurological manifestations of Chagas’ disease. Neurol Res. 2010;32:238–44.

    PubMed  Google Scholar 

  58. Cura C, Schijman AG. Relación entre los genotipos de T. cruzi y la presentación clínica de la enfermedad de Chagas. Rev Esp Salud Pública. 2013;86:9–16.

    Google Scholar 

  59. Álvarez-Hernández DA, Franyuti-Kellya GA, Díaz-López-Silva R, et al. Chagas disease: current perspectives on a forgotten disease. Rev Med Hosp Gen Méx. 2018;81(3):154–64.

    Google Scholar 

  60. de la Rosa E, Paglini-Oliva P, Prato LB, et al. Early detection of chronic asymptomatic Chagas infection. Med Sci Monit. 2018;24:4567–71.

    PubMed  PubMed Central  Google Scholar 

  61. Alonso-Padilla J, Cortés-Serra N, Pinazo MJ, et al. Strategies to enhance access to diagnosis and treatment for Chagas disease patients in Latin America. Expert Rev Anti Infect Ther. 2019;17(3):145–57.

    PubMed  CAS  Google Scholar 

  62. Balouz V, Agüero F, Buscaglia CA. Chagas disease diagnostic applications: present knowledge and future steps. Adv Parasitol. 2017;97:1–45.

    PubMed  CAS  Google Scholar 

  63. Alonso-Padilla J, Gállego M, Schijman AG, et al. Molecular diagnostics for Chagas disease: up to date and novel methodologies. Expert Rev Mol Diagn. 2017;17(7):699–710.

    PubMed  CAS  Google Scholar 

  64. Schijman AG. Molecular diagnosis of Trypanosoma cruzi. Acta Trop. 2018;184:59–66.

    PubMed  CAS  Google Scholar 

  65. Bern C. A new epoch in antitrypanosomal treatment for chagas disease. J Am Coll Cardiol. 2017;69(8):948–50.

    PubMed  Google Scholar 

  66. Chatelain E. Chagas disease research and development: is there light at the end of the tunnel? Comput Struct Biotechnol J. 2016;15:98–103.

    PubMed  PubMed Central  Google Scholar 

  67. Viotti R, Vigliano C, Lococo B, et al. Long-term cardiac outcomes of treating chronic Chagas disease with benznidazole versus no treatment: a nonrandomized showing greater effectiveness in patients. Ann Intern Med. 2006;144(10):724–34.

    PubMed  CAS  Google Scholar 

  68. Okumura M, Brito T, Silva LHP, Silva AC, Netto AC. The pathology of experimental Chagas’ disease in mice. I. Digestive tract changes with special reference to necrotizing arteritis. Rev Inst Med Trop São Paulo. 1960;2:17.

    Google Scholar 

  69. Teixeira AR, Teixeira ML, Santos-Buch CA. The immunology of experimental Chagas’ disease. IV. Production of lesions in rabbits similar to those of chronic Chagas’ disease in man. Am J Pathol. 1975;80:163.

    PubMed  PubMed Central  CAS  Google Scholar 

  70. Andrade ZA, Andrade SG, Correa R, Sadigursky M, Ferrans VJ. Myocardial changes in acute Trypanosoma cruzi infection. Ultrastructural evidence of immune damage and the role of microangiopathy. Am J Pathol. 1994;144(6):1403.

    PubMed  PubMed Central  CAS  Google Scholar 

  71. Coates BM, Sullivan DP, Makanji MY, Du NY, Olson CL, Muller WA, et al. Endothelial transmigration by Trypanosoma cruzi. PLoS One. 2013;8(12):e81187.

    PubMed  PubMed Central  Google Scholar 

  72. Laranja FS, Dias E, Miranda A, Nobrega G. Chagas’ disease; a clinical, epidemiologic, and pathologic study. Circulation. 1956;14:1035.

    PubMed  Google Scholar 

  73. Kumar R, Kline IK, Abelmann WH. Experimental Trypanosoma cruzi myocarditis: relative effects upon the right and left ventricles. Am J Pathol. 1969;57:31.

    PubMed  PubMed Central  CAS  Google Scholar 

  74. Bastos CJ, Aras R, Mota G, Reis F, Dias JP, de Jesus RS, Freire MS, de Araújo EG, Grassi MF. Clinical outcomes of thirteen patients with acute Chagas disease acquired through oral transmission from two urban outbreaks in northeastern Brazil. PLoS Negl Trop Dis. 2010;4(6):e711.

    PubMed  PubMed Central  Google Scholar 

  75. Tarleton RL, Koller BH, Latour A, Postan M. Susceptibility of 𝛽2-microglobulin-deficient mice to Trypanosoma cruzi infection. Nature. 1992;356(6367):338.

    PubMed  CAS  Google Scholar 

  76. Köberle F. Chagas’ disease and Chagas’ syndromes: the pathology of American trypanosomiasis. Adv Parasitol. 1968;6:63.

    PubMed  Google Scholar 

  77. Meneghelli UG. Chagas’ disease: a model of denervation in the study of digestive tract motility. Braz J Med Biol Res. 1985;18:255.

    PubMed  CAS  Google Scholar 

  78. Marin-Neto JA, Cunha-Neto E, Maciel BC, Simões MV. Pathogenesis of chronic Chagas heart disease. Circulation. 2007;115:1109.

    PubMed  Google Scholar 

  79. Amorim DS, Manço JC, Gallo L Jr, Marin Neto JA. Chagas’ heart disease as an experimental model for studies of cardiac autonomic function in man. Mayo Clin Proc. 1982;57(Suppl):48.

    PubMed  Google Scholar 

  80. Soares Barreto-Filho JA, Consolim-Colombo FM, Ferreira Lopes H, Martins Sobrinho CR, Guerra-Riccio GM, Krieger EM. Dysregulation of peripheral and central chemoreflex responses in Chagas’ heart disease patients without heart failure. Circulation. 2001;104:1792.

    PubMed  CAS  Google Scholar 

  81. Ribeiro ALP, Moraes RS, Ribeiro JP, Ferlin EL, Torres RM, Oliveira E, et al. Parasympathetic dysautonomia precedes left ventricular systolic dysfunction in Chagas disease. Am Heart J. 2001;141:260.

    PubMed  CAS  Google Scholar 

  82. Köberle F. Cardiopathia parasympathicopriva. Munch Med Wochenschr. 1959;101:1308.

    Google Scholar 

  83. Marin-Neto JA, Gallo L Jr, Manco JC, Rassi A, Amorim DS. Mechanisms of tachycardia on standing: studies in normal individuals and in chronic Chagas’ heart patients. Cardiovasc Res. 1980;14:541.

    PubMed  CAS  Google Scholar 

  84. Marin-Neto JA, Rassi A Jr, Maciel BC, Simoes MV, Schmidt A. Chagas heart disease. In: Yusuf S, Cairns JA, Camm AJ, Fallen EL, Gersh BJ, editors. Evidence-based cardiology. 3rd ed. London: BMJ Books; 2010. p. 823–41.

    Google Scholar 

  85. Simões MV, Pintya AO, Bromberg-Marin G, Sarabanda AV, Antloga CM, Pazin-Filho A, Maciel BC, Marin-Neto JA. Relation of regional sympathetic denervation and myocardial perfusion disturbance to wall motion impairment in Chagas’ cardiomyopathy. Am J Cardiol. 2000;86:975–81.

    PubMed  Google Scholar 

  86. Miranda CM, Figueiredo AB, Maciel BC, Marin-Neto JA, Simões MV. Sustained ventricular tachycardia is associated with regional myocardial sympathetic denervation assessed with 123I-metaiodobenzylguanidine in chronic Chagas cardiomyopathy. J Nucl Med. 2011;52:504.

    PubMed  CAS  Google Scholar 

  87. Miranda CH, Gadioli LP, Pintya AO, Figueiredo AB, Maciel BC, Schmidt A, Marin-Neto JA. The severity of ventricular arrhythmia correlates with the extent of myocardial sympathetic denervation, but not with myocardial fibrosis extent in chronic Chagas cardiomyopathy. Am J Nucl Med. 2018;25(1):75–83.

    Google Scholar 

  88. Cuba MB, Machado MPR, Farnesi TS, Alves AC, Martins LA, Oliveira LF, et al. Effects of cholinergic stimulation with pyridostigmine bromide on chronic chagasic cardiomyopathic mice. Mediat Inflamm. 2014:475946. 13 pages.

    Google Scholar 

  89. Rossi MA. Microvascular changes as a cause of chronic cardiomyopathy in Chagas’ disease. Am Heart J. 1990;120:233.

    PubMed  CAS  Google Scholar 

  90. Marin-Neto JA, Marzullo P, Marcassa C, Gallo L Jr, Maciel BC, Bellina CR, et al. Myocardial perfusion abnormalities in chronic Chagas’ disease as detected by thallium-201 scintigraphy. Am J Cardiol. 1992;69:780.

    PubMed  CAS  Google Scholar 

  91. Hiss FC, Lascala TF, Maciel BC, Marin-Neto JA, Simões MV. Changes in myocardial perfusion correlate with deterioration of left ventricular systolic function in chronic Chagas’ cardiomyopathy. JACC Cardiovasc Imaging. 2009;2:164.

    PubMed  Google Scholar 

  92. Rossi MA, Tanowitz HB, Malvestio LM, Celes MR, Campos EC, Blefari V, et al. Coronary microvascular disease in chronic Chagas cardiomyopathy including an overview on history, pathology, and other proposed pathogenic mechanisms. PLoS Negl Trop Dis. 2010;4(8):e674. https://doi.org/10.1371/journal.pntd.0000674. Review.

    Article  PubMed  PubMed Central  Google Scholar 

  93. Freeman BD, Machado FS, Tanowitz HB, Desruisseaux MS. Endothelin-1 and its role in the pathogenesis of infectious diseases. Life Sci. 2014; https://doi.org/10.1016/j.lfs.2014.04.0210.

  94. Torres FW, Acquatella H, Condado JA, Dinsmore R, Palacios IF. Coronary vascular reactivity is abnormal in patients with Chagas’ heart disease. Am Heart J. 1995;129:995.

    PubMed  CAS  Google Scholar 

  95. Marin-Neto JA, Simões MV, Rassi JR A. Pathogenesis of chronic Chagas cardiomyopathy: the role of coronary microvascular derangements. Rev Soc Bras Med Trop. 2013;46(4). https://doi.org/10.1590/0037-8682-0028-2013.

  96. Sambiase NV, Higuchi ML, Benvenuti LA. Narrowed lumen of the right coronary artery in chronic Chagasic patients is associated with ischemic lesions of segmental thinnings of ventricles. Investig Clin. 2010;51(4):531.

    Google Scholar 

  97. Lemos de Oliveira LF, Thackeray JT, Marin Neto JA, Dias Romano MM, Vieira de Carvalho EE, Mejia J, Tanaka DM, Kelly da Silva G, Abdalla DR, Malamut C, Bengel FM, de Lourdes Higuchi M, Schmidt A, Cunha-Neto E, Simões MV. Regional myocardial perfusion disturbance in experimental chronic Chagas cardiomyopathy. J Nucl Med. 2018;59(9):1430–6.

    PubMed  Google Scholar 

  98. Tanaka DM, de Oliveira LFL, Marin-Neto JA, Romano MMD, de Carvalho EEV, de Barros Filho ACL, Ribeiro FFF, Cabeza JM, Lopes CD, Fabricio CG, Kesper N, Moreira HT, Wichert-Ana L, Schmidt A, Higuchi ML, Cunha-Neto E, Simões MV. Prolonged dipyridamole administration reduces myocardial perfusion defects in experimental chronic Chagas cardiomyopathy. J Nucl Cardiol. 2018; https://doi.org/10.1007/s12350-018-1198-7. [Epub ahead of print].

  99. Macedo LGR, Lemos DC, Lago IM, Figueiredo GL, Lima Filho MO, Schmidt A, Marin-Neto JA. Desenho de Estudo. Base racional e plano de estudo prospectivo para avaliar o efeito de terapêutica antiplaquetária e vasodilatadora microcirculatória em pacientes com cardiopatia chagásica crônica e distúrbios microvasculares coronários. Rev Bras Cardiol Invasiva. 2012;20(1):82.

    Google Scholar 

  100. Rossi MA. The pattern of myocardial fibrosis in chronic Chagas’ heart disease. Int J Cardiol. 1991;30:335.

    PubMed  CAS  Google Scholar 

  101. Bellotti G, Bocchi EA, de Moraes AV, Higuchi ML, Barbero-Marcial M, Sosa E, et al. In vivo detection of Trypanosoma cruzi antigens in hearts of patients with chronic Chagas’ heart disease. Am Heart J. 1996;131:301.

    PubMed  CAS  Google Scholar 

  102. Higuchi ML, De Brito T, Reis MM, Barbosa A, Bellotti G, Pereira-Barreto AC, et al. Correlation between T.cruzi parasitism and myocardial inflammatory infiltrate in human chronic chagasic myocarditis: light microscopy and immunohistochemical findings. Cardiovasc Pathol. 1993;2:101.

    Google Scholar 

  103. Tarleton RL. Trypanosoma cruzi and Chagas disease: cause and effect. In: Tyler KM, Miles MA, editors. World class parasites: American trypanosomiasis, vol. 7. Dordrecht: Kluwer Academic Publisher; 2003. p. 107.

    Google Scholar 

  104. Kierszenbaum F. Mechanisms of pathogenesis in Chagas disease. Acta Parasitol. 2007;52:1.

    CAS  Google Scholar 

  105. Bonney KM, Engman DM. Chagas heart disease pathogenesis: one mechanism or many? Curr Mol Med. 2008;8:510.

    PubMed  PubMed Central  CAS  Google Scholar 

  106. Zhang L, Tarleton RL. Parasite persistence correlates with disease severity and localization in chronic Chagas’disease. J Infect Dis. 1999;180:480.

    PubMed  CAS  Google Scholar 

  107. Bustamante JM, Rivarola HW, Fernández AR, Enders JE, Fretes R, Palma JA, et al. Trypanosoma cruzi reinfections in mice determine the severity of cardiac damage. Int J Parasitol. 2002;32:889.

    PubMed  Google Scholar 

  108. Storino R, Auger S, Caravello O, Urrutia MI, Sanmartino M, Jörg M. Chagasic cardiopathy in endemic area versus sporadically infected patients. Rev Saude Publica. 2002;36:755.

    PubMed  Google Scholar 

  109. Andrade SG, Stocker-Guerret S, Pimentel AS, Grimaud JA. Reversibility of cardiac fibrosis in mice chronically infected with Trypanosoma cruzi, under specific chemotherapy. Mem Inst Oswaldo Cruz. 1991;86:187.

    PubMed  CAS  Google Scholar 

  110. Garcia S, Ramos CO, Senra JF, Vilas-Boas F, Rodrigues MM, Campos-de-Carvalho AC, et al. Treatment with benznidazole during the chronic phase of experimental Chagas’ disease decreases cardiac alterations. Antimicrob Agents Chemother. 2005;49:1521.

    PubMed  PubMed Central  CAS  Google Scholar 

  111. de Andrade AL, Zicker F, de Oliveira RM, Almeida Silva S, Luquetti A, Travassos LR, Almeida IC, de Andrade SS, de Andrade JG, Martelli CM. Randomised trial of efficacy of benznidazole in treatment of early Trypanosoma cruzi infection. Lancet. 1996;348(9039):1407–13.

    PubMed  Google Scholar 

  112. Sosa-Estani S, Segura EL, Ruiz AM, Velazquez E, Porcel BM, Yampotis C. Efficacy of chemotherapy with benznidazole in children in the indeterminate phase of Chagas’ disease. Am J Trop Med Hyg. 1998;59(4):526–9.

    PubMed  CAS  Google Scholar 

  113. Viotti RJ, Vigliano C, Lococo B, Bertocchi G, Petti M, Alvarez MG, et al. Long-term cardiac outcomes of treating chronic Chagas disease with benznidazole versus no treatment: a nonrandomized trial. Ann Intern Med. 2006;144:724.

    PubMed  CAS  Google Scholar 

  114. Fabbro DL, Streiger ML, Arias ED, Bizai ML, del Barco M, Amicone NA. Trypanocide treatment among adults with chronic Chagas disease living in Santa Fe city (Argentina), over a mean follow-up of 21 years: parasitological, serological and clinical evolution. Rev Soc Bras Med Trop. 2007;40:1.

    PubMed  Google Scholar 

  115. Pérez-Molina JA, Pérez-Ayala A, Moreno S, Fernández-González MC, Zamora J, López-Velez R. Use of benznidazole to treat chronic Chagas’ disease: a systematic review with a meta-analysis. J Antimicrob Chemother. 2009;64(6):1139–47.

    PubMed  Google Scholar 

  116. Rassi A Jr, Marin-Neto JA, Rassi A. Chronic Chagas cardiomyopathy: a review of the main pathogenic mechanisms and the efficacy of aetiological treatment following the BENznidazole Evaluation for Interrupting Trypanosomiasis (BENEFIT) trial. Mem Inst Oswaldo Cruz. 2017;112(3):224–35.

    PubMed  PubMed Central  CAS  Google Scholar 

  117. Morillo CA, Marin-Neto JA, Avezum A, Sosa-Estani S, Rassi A Jr, Rosas F, Villena E, Quiroz R, Bonilla R, Britto C, Guhl F, Velazquez E, Bonilla L, Meeks B, Rao-Melacini P, Pogue J, Mattos A, Lazdins J, Rassi A, Connolly SJ, Yusuf S, BENEFIT Investigators. Randomized trial of benznidazole for chronic Chagas’ cardiomyopathy. N Engl J Med. 2015;373(14):1295–306.

    PubMed  CAS  Google Scholar 

  118. Jones EM, Colley DG, Tostes S, Lopes ER, Vnencak-Jones CL, McCurley TL. A Trypanosoma cruzi DNA sequence amplified from inflammatory lesions in human chagasic cardiomyopathy. Trans Assoc Am Phys. 1992;105:182.

    PubMed  CAS  Google Scholar 

  119. Salomone OA, Juri D, Omelianiuk MO, Sembaj A, Aguerri AM, Carriazo C, et al. Prevalence of circulating Trypanosoma cruzi detected by polymerase chain reaction in patients with Chagas’ cardiomyopathy. Am J Cardiol. 2000;85:1274.

    PubMed  CAS  Google Scholar 

  120. Andrade JP, Marin Neto JA, Paola AA, Vilas-Boas F, Oliveira GM, Bacal F, Bocchi EA, Almeida DR, Fragata Filho AA, Moreira Mda C, Xavier SS, Oliveira Junior WA, Dias JC. I. Latin American Guidelines for the diagnosis and treatment of Chagas’ heart disease: executive summary. Arq Bras Cardiol. 2011;96(6):434–42.

    PubMed  Google Scholar 

  121. Dias JC, Ramos AN Jr, Gontijo ED, Luquetti A, Shikanai-Yasuda MA, Coura JR, Torres RM, Melo JR, Almeida EA, Oliveira W Jr, Silveira AC, Rezende JM, Pinto FS, Ferreira AW, Rassi A, Filho AAF, Sousa AS, Correia D, Jansen AM, Andrade GM, Britto CF, Pinto AY, Rassi A Jr, Campos DE, Abad-Franch F, Santos SE, Chiari E, Hasslocher-Moreno AM, Moreira EF, Marques DS, Silva EL, Marin-Neto JA, Galvão LM, Xavier SS, Valente SA, Carvalho NB, Cardoso AV, Silva RA, Costa VM, Vivaldini SM, Oliveira SM, Valente VD, Lima MM, Alves RV. 2 nd Brazilian Consensus on Chagas Disease, 2015. Rev Soc Bras Med Trop. 2016;49(Suppl 1):3–60. https://doi.org/10.1590/0037-8682-0505-2016. Erratum in: Rev Soc Bras Med Trop. 2017 Jan–Feb;50(1):149.

    Article  Google Scholar 

  122. Zingales B, Miles MA, Campbell DA, Tibayrenc M, Macedo AM, Teixeira MMG, et al. The revised Trypanosoma cruzi subspecific nomenclature: rationale, epidemiological relevance and research applications. Infect Genet Evol. 2012;12:240.

    PubMed  Google Scholar 

  123. Zingales B, Miles MA, Moraes CB, Luquetti A, Guhl F, Schijman AG, et al. Drug discovery for Chagas disease should consider Trypanosoma cruzi strain diversity. Mem Inst Oswaldo Cruz. 2014;109(6):828.

    PubMed  PubMed Central  Google Scholar 

  124. Marin-Neto JA, Rassi Jr A, Maciel BC. Pathology and pathogenesis of Chagas disease. In: UpToDate; 2014.

    Google Scholar 

  125. Minoprio P. Parasite polyclonal activators: new targets for vaccination approaches? Int J Parasitol. 2001;31:588.

    PubMed  CAS  Google Scholar 

  126. Cunha-Neto E, Bilate AM, Hyland KV, Fonseca SG, Kalil J, Engman DM. Induction of cardiac autoimmunity in Chagas heart disease: a case for molecular mimicry. Autoimmunity. 2006;39(1):41. Review.

    PubMed  CAS  Google Scholar 

  127. Teixeira AR, Gomes C, Nitz N, Sousa AO, Alves RM, Guimaro MC, et al. Trypanosoma cruzi in the chicken model: Chagas-like heart disease in the absence of parasitism. PLoS Negl Trop Dis. 2011;5(3):e1000. https://doi.org/10.1371/journal.pntd.0001000.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  128. Tarleton RL. Chagas disease: a role for autoimmunity? Trends Parasitol. 2003;19:447.

    PubMed  CAS  Google Scholar 

  129. Tarleton RL, Zhang L. Chagas disease etiology: autoimmunity or parasite persistence? Parasitol Today. 1999;15:94–9.

    PubMed  CAS  Google Scholar 

  130. Tarleton RL, Zhang L, Downs MO. “Autoimmune rejection” of neonatal heart transplants in experimental Chagas disease is a parasite-specific response to infected host tissue. Proc Natl Acad Sci U S A. 1997;94:3932.

    PubMed  PubMed Central  CAS  Google Scholar 

  131. Soares MB, Pontes-De-Carvalho L, Ribeiro-Dos-Santos R. The pathogenesis of Chagas’ disease: when autoimmune and parasite-specific immune responses meet. An Acad Bras Cienc. 2001;73:547.

    PubMed  CAS  Google Scholar 

  132. Rassi A, Amato Neto V, de Siqueira AF, Doles J, Leite MS, Silva OQ, et al. The influence of corticoids, in chronic Chagas disease, administered in virtue of associated disorders. Rev Soc Bras Med Trop. 1997;30:93.

    PubMed  CAS  Google Scholar 

  133. Sartori AM, Ibrahim KY, Nunes Westphalen EV, Braz LM, Oliveira OC Jr, Gakiya E, et al. Manifestations of Chagas disease (American trypanosomiasis) in patients with HIV/AIDS. Ann Trop Med Parasitol. 2007;101:31.

    PubMed  CAS  Google Scholar 

  134. Dutra WO, Gollob KJ. Current concepts in immunoregulation and pathology of human Chagas disease. Curr Opin Infect Dis. 2008;21(3):287.

    PubMed  PubMed Central  Google Scholar 

  135. Ferreira LRP, Frade AF, Baron MA, Navarro IC, Kalil J, Chevillard C, et al. Interferon-γ and other inflammatory mediators in cardiomyocyte signaling during Chagas disease cardiomyopathy. World J Cardiol. 2014;6(8):782.

    PubMed  PubMed Central  Google Scholar 

  136. Nogueira LG, Santos RH, Fiorelli AI, Mairena EC, Benvenuti LA, Bocchi EA, et al. Myocardial gene expression of T-bet, GATA-3, Ror-γt, FoxP3, and hallmark cytokines in chronic Chagas disease cardiomyopathy: an essentially unopposed TH1-type response. Mediat Inflamm. 2014;2014:914326, . 9 pages. https://doi.org/10.1155/2014/914326.

    Article  CAS  Google Scholar 

  137. Dias FC, Medina Tda S, Mendes-Junior CT, Dantas RO, Pissetti CW, Rodrigues Junior V, et al. Polymorphic sites at the immunoregulatory CTLA-4 gene are associated with chronic Chagas disease and its clinical manifestations. PLoS One. 2013;8(10):e78367. https://doi.org/10.1371/journal.pone.0078367. eCollection 2013.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  138. Frade AF, Teixeira PC, Ianni BM, Pissetti CW, Saba B, Wang LH, et al. Polymorphism in the alpha cardiac muscle actin 1 gene is associated to susceptibility to chronic inflammatory cardiomyopathy. PLoS One. 2013;8(12):e83446. https://doi.org/10.1371/journal.pone.0083446. eCollection 2013.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  139. Cunha-Neto E, Chevillard C. Chagas disesase cardiomyopathy: immunopathology and Genetics. Mediat Inflamm. 2014;2014:683230.

    Google Scholar 

  140. Álvarez JM, Fonseca R, Borges da Silva H, Marinho CR, Bortoluci KR, Sardinha LR, et al. Chagas disease: still many unsolved issues. Mediat Inflamm. 2014;2014:912965, . 9 pages. https://doi.org/10.1155/2014/912965.

    Article  CAS  Google Scholar 

  141. Chagas C. Tripanosomiase americana. Forma aguda da moléstia. Mem Inst Oswaldo Cruz. 1916;8:37–60.

    Google Scholar 

  142. Neiva A, Penna B. Viagem científica pelo norte da Bahia, sudeste do Piauí e de norte a sul de Goias. Mem Inst Oswaldo Cruz. 1916;8:74–224.

    Google Scholar 

  143. Schmunis GA, Yadon ZE. Chagas disease: a Latin américa health problem becoming a world health problem. Acta Trop. 2010;115:14–21.

    PubMed  Google Scholar 

  144. Perez-Ayala A, Perez-Molina JA, Norman F, Maillo-Merige B, Faro MV, Lopez-Velez R. Gastrointestinal Chagas disease in migrants to Spain. Prevalence and methods for early diagnosis. Ann Trop Med Parasitol. 2011;105:23–9.

    Google Scholar 

  145. Dias JCP. Doença de Chagas em Bambuí, Minas Gerais, Brasil. Estudo clínico-epidemiológico a partir da fase aguda, entre 1940 e 1982. Tese de Doutoramento, Universidade Federal de Minas Gerais, Belo Horizonte; 1982.

    Google Scholar 

  146. Dias JCP, Camacho LAB, Silva JC, Magalhães JS, Krieger H. Esofagopatia chagásica na área endêmica de Bambui, MG, Brasil. Rev Soc Bras Med Trop. 1983;16:46–57.

    Google Scholar 

  147. Rassi A, Rezende JM. Estudo clínico-radiológico do esôfago e dos cólons na fase aguda da doença de Chagas com relato de tres casos de remissão espontânea da aperistalse do esôfago do grupo I. Rev Soc Bras Med Trop. 2011;44(1):70–5.

    PubMed  Google Scholar 

  148. Hagger R, Finlayson C, Kahn F, De Oliveira R, Chimelli L, Kumar D. A deficiency of interatitial cells of Cajal in Chagasic megacolon. J Auton Nerv Syst. 2000;80:108–11.

    PubMed  CAS  Google Scholar 

  149. Iantorno G, Bassotti G, Kogan Z, Lumi CM, Cabanne AM, Fisogni S, et al. The enteric nervous system in chagasic and idiopathic megacolon. Am J Surg Pathol. 2007;31:460–8.

    PubMed  Google Scholar 

  150. Godoy RA, Vieira CB. Effects of cholinergic drugs on the esophagus of patients with Chagas’ disease. Acta Physiol Latinoam. 1961;11:107.

    Google Scholar 

  151. Meneghelli UG, Dantas RO, Godoy RA. Effect of caerulein on the lower esophageal sphincter in chagasic esophagopathy. Book of abstracts of the 4th Congress of Organization d’Etudes Statistiques pour les maladies de ’Oesophage (OESO), 1993, Paris, p 180.

    Google Scholar 

  152. Oliveira RB, Troncon LEA, Meneghelli UG, Padovan W, Dantas RO, Godoy RA. Impaired gastric accommodation to distension and rapid gastric emptying in patients with Chagas’ disease. Dig Dis Sci. 1980;25:790–4.

    PubMed  CAS  Google Scholar 

  153. Meneghelli UG. Motilidade do sigmoide e do reto de portadores da moléstia de Chagas em condições basais e sob a ação da pentagastrina. Tese: Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo; 1977.

    Google Scholar 

  154. Troncon LEA, Oliveira RB, Meneghelli UG, Dantas RO, Godoy RA. Fasting and food-stimulated plasma gastrin levels in chronic Chagas disease. Digestion. 1984;29:171–6.

    PubMed  CAS  Google Scholar 

  155. Adad SJ, Andrade DCS, Lopes ER, Chapadeiro E. Contribuição ao estudo da anatomia patológica do megaesôfago chagásico. Rev Inst Med Trop São Paulo. 1991;33:443–50.

    PubMed  CAS  Google Scholar 

  156. D’Avila Reis D, Lemos EM, Silva GC, Adad SJ, McCurley T, et al. Phenotypic characterization of the inflammatory cells in chagasic mega-esophagus. Trans R Soc Trop Med Hyg. 2001;95:177–8.

    PubMed  Google Scholar 

  157. Da Silveira ABM, Arantes RME, Vago AR, Lemos EM, Adad SJ, et al. Comparative of the presence of Trypanosoma cruzi kDNA, inflammation and denervation in chagasic patients with and without megaesophagus. Parasitology. 2005;131:627–34.

    PubMed  Google Scholar 

  158. Da Silveira ABM, Adad SJ, Correa-Oliveira R, Furness JB, Dávila RD. Morphometric study of eosinophils, mast cells, macrophages, and fibrosis in the colono of chronic chagasic patients with and without megacolon. Parasitology. 2007;134:789–96.

    PubMed  Google Scholar 

  159. Martins PR, Nascimento RD, Lopes JG, Santos MM, Oliveira CA, et al. Mast cell in the colon of Trypanosoma cruzi-infected patients: are they involved in the recruitment, survival and/or activation of eosinophils? Parasitol Res. 2015;114:1847–56.

    PubMed  Google Scholar 

  160. Dias FC, Medina TDS, Mendes-Junior CT, Dantas RO, Pissetti CW, Rodrigues Junior V, Dellalibera-Joviliano R, Marin-Neto JÁ, et al. Polymorphic sites at the immunoregulatory CTLA-4 gene are associated with chronic Chagas disease and its clinical manifestations. PLoS One. 2013;8:e78367.

    PubMed  PubMed Central  CAS  Google Scholar 

  161. http://siteresources.worldbank.org/BRAZILINPOREXTN/Resources/3817166-1302102548192/Brazil_Aging_Full_Eng_final.pdf.

  162. Meneguelli UG, Ejima FH, Rosa e Silva L. Evidências do declínio da ocorrência do megaesôfago e do megacólon: Estudo epidemiológico no Hospital das Clínicas de Ribeirão Preto. Medicina Ribeirão Preto. 1991;24:218–24.

    Google Scholar 

  163. Kamiji MM, Oliveira RB. O perfil dos portadores de doença de Chagas com ênfase na forma digestiva, em hospitsl terciário de Ribeirão Preto, SP. Ver Soc Bras Med Trop. 2005;38:305–9.

    Google Scholar 

  164. Souza DHS, Vaz MGM, Fonseca CR, Luquetti A, Rezende-Filho J, Oliveira EC. Current epidemiological profile of Chagasic megaesophagus in Central Brazil. Rev Soc Bras Med Trop. 2013;46:316–21.

    PubMed  Google Scholar 

  165. Rassi A Jr, Rassi A, Marin-Neto JA. Chagas disease. (Review). Lancet. 2010;375:1388–402.

    PubMed  Google Scholar 

  166. Macedo VO. Influencia da exposição à reinfecção na evolução da doença de Chagas. Rev Patol Trop. 1976;5:33–116.

    Google Scholar 

  167. Castro C, Rezende JM, Camargo C, Prata A, Macêdo V. Prevalência de esofagopatia chagásica no Município de Mambaí, Goiás—Brasil. Rev da Soc Bras Med Trop. 1987;20:13–7.

    CAS  Google Scholar 

  168. Pereira JB, Coura JR. Morbidade da doença de Chagas: estudo seccional em uma região endêmica, Virgem da Lapa, MG. Rev Soc Bras Med Trop. 1986;19:138–48.

    Google Scholar 

  169. Coura JR, Borges-Pereira J, Alves Filho FI, Castro JAF, Cunha RV, et al. Morbidade da doença de Chagas em áreas do sertão da Paraíba e da catinga do Piauí. Rev Soc Bras Med Trop. 1996;29:197–205.

    PubMed  CAS  Google Scholar 

  170. Penaranda-Carrillo R, Castro C, Rezende J, Prata A, Macedo A. Radiographic study of the esophagus of chagasic patients in 25 years of the Mambaí Project. Rev Soc Bras Med Trop. 2006;39:152–5.

    PubMed  Google Scholar 

  171. Coura JR, Abreu LL, Pereira JB, Willcox HP. Morbidade da Doença de Chagas: IV. Longitudinal study of 10 years in Pains and Iguatama, Minas Gerais, Brasil. Mem Inst O Cruz. 1985;80:73–80.

    CAS  Google Scholar 

  172. Borges Pereira J, Willcox HP, Coura JR. Morbidade da doença de Chagas. III. Estudo longitudinal de seis anos, em Virgem da Lapa, MG, Brasil. Mem Inst O Cruz. 1985;80:63–71.

    Google Scholar 

  173. Macedo VO, Silveira CA. Perspectiva de terapêutica específica na doença de Chagas—Experiência na forma indeterminada. Rev Soc Bras Med Trop. 1987;20(supl):24–6.

    Google Scholar 

  174. Castro C, Macedo V, Rezende JM, Prata A. Estudo radiológico longitudinal do esôfago em área endêmica de doença de Chagas, em um período de 13 anos. Rev Soc Bras Med Trop. 1994;27:227–33.

    PubMed  CAS  Google Scholar 

  175. Penaranda-Carrillo R, Moreira E, Silveira A, Leite J, Vinhaes M, et al. Evaluation of the impact of vector control programs through serological testings in Mambaí, Buritinópolis, Goias State. Rev Soc Bras Med Trop. 2002;35:331–8.

    PubMed  Google Scholar 

  176. Pereira JB, Coura JR. Morbidade da Doença de Chagas. Estudo Seccional em uma área Endêmica, Virgem da Lapa, MG. Rev Soc Bras Med Trop. 1986;19:139–48.

    PubMed  CAS  Google Scholar 

  177. Kahrilas PJ, Bredenoord AJ, Carlson DA, Pandolfino JE. Advances in management of esophageal motility disorders. Clin Gastroenterol Hepatol. 2018;16:1692–700.

    PubMed  PubMed Central  Google Scholar 

  178. Basile L, Jansa JM, Carlier Y, Salamanca DD, Angheben A, et al. Chagas’disease in European countries: the challenge of a surveillance system. Euro Surveill. 2011;16(37):19968.

    PubMed  Google Scholar 

  179. Perez-Ayala A, Perez-Molina JA, Norman F, Maillo-Monge B, Faro MV, Lopez-Velez R. Gastrointestinal Chagas disease in migrants to Spain. Prevalence and methods for early diagnosis. Ann Tro Med Parasitol. 2011;105:23–9.

    Google Scholar 

  180. Remes-Troche JM, Torres-Aguilera M, Antonio-Cruz KA, Vazquez-Jimenez G, De-La-Cruz-Patiño E. Esophageal motor disorders in subjects with incidentally discovered Chagas disease: a study using high-resolution manometry and the Chicago classification. Dis Esophagus. 2014;27:24–529.

    Google Scholar 

  181. Koberle F, Britto-Costa R, Mello de Oliveira JA, et al. Patologia da moléstia de Chagas. Medicina Ribeirão Preto. 1972;5:5–45.

    Google Scholar 

  182. Castro C, Hernandez EB, Rezende J, Prata A. Estudo radiológico do megacólon em área endêmica de doença de Chagas. Rev Soc Bras Med Trop. 2010;43:562–6.

    PubMed  Google Scholar 

  183. Castro C, Hernandez EB, Rezende J, Prata A. Occurrence of dolichocolon without megacolon in chronic Chagas disease patients. Rev Soc Bras Med Trop. 2012;45:353–6.

    PubMed  Google Scholar 

  184. Ximenes CA, Rezende JM, Moreira H, et al. Técnica simplificada para o diagnóstico radiológico do megacólon chagásico. Rev Soc Bras Med Trop. 1984;17(Suppl):23.

    Google Scholar 

  185. Sanches-Montalvá A, Moris M, Mego M, Salvador F, Accarino A, Ramírez K, et al. High resolution esophageal manometry in patients with Chagas disease: a cross-sectional evaluation. PLoS Negl Trop Dis. 2016;10:e0004416.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Medical School of Ribeirão Preto, University of São Paulo, São Paulo, Brazil

    Ricardo Brandt de Oliveira & J. Antonio Marin-Neto

  2. Parasitology Section, Department of Biology, Healthcare and the Environment, Faculty of Pharmacy and Food Sciences, Universitat de Barcelona, Barcelona, Spain

    Cristina Ballart & Montserrat Gállego

  3. Barcelona Institute for Global Health, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain

    Cristina Ballart & Montserrat Gállego

  4. Department of Biology, Universitat de Girona, Girona, Spain

    Alba Abràs

Authors
  1. Ricardo Brandt de Oliveira
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cristina Ballart
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alba Abràs
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Montserrat Gállego
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J. Antonio Marin-Neto
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ricardo Brandt de Oliveira .

Editor information

Editors and Affiliations

  1. Barcelona Institute for Global Health, Barcelona, Spain

    María-Jesús Pinazo Delgado

  2. Barcelona Institute for Global Health, Barcelona, Spain

    Joaquim Gascón

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

de Oliveira, R.B., Ballart, C., Abràs, A., Gállego, M., Marin-Neto, J.A. (2020). Chagas Disease: An Unknown and Neglected Disease. In: Pinazo Delgado, MJ., Gascón, J. (eds) Chagas Disease. Springer, Cham. https://doi.org/10.1007/978-3-030-44054-1_1

Download citation

Publish with us

Policies and ethics

Search

Navigation