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Zoonoses importadas em Portugal : um caso de Doença de Chagas
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As zoonoses tropicais são doenças com baixo investimento na sua investigação, taxas diagnósticas reduzidas e terapêutica desatualizada, apesar de acarretarem carga de doença elevada e potencial epidémico. A globalização e as crises de refugiados levam a uma crescente importação de casos de doenças infeciosas, para áreas não endémicas, com sistemas de saúde despreparados para os identificar e gerir. A Doença de Chagas (DC), é uma infeção provocada por Trypanosoma cruzi, reconhecida como uma doença tropical negligenciada (DTN) que infeta mundialmente cerca de sete milhões de pessoas por ano e cerca de dez mil morrem, principalmente devido à miocardiopatia chagásica. No entanto, a maioria dos infetados não está diagnosticada e não há inovação na abordagem da doença. É endémica na América Latina(AL), onde o seu vetor está presente. Porém, devido à movimentação global cada vez mais desobstruída, na Europa e América do Norte a importação de casos e infeções autóctones por via vertical e transplantes/transfusões são uma problemática conhecida, com relevância em Portugal devido ao volume de imigrantes do Brasil. Em Portugal, indivíduos com DC diagnosticada são impedidos de doar sangue, contudo a abordagem a dadores de risco e a prevenção de infeções congénitas não está definida. A DC necessita de abordagens diagnósticas e terapêuticas específicas e reforço na educação de profissionais, entidades reguladoras, e da população. Deste modo, compilamos informação pertinente sobre a importação de zoonoses, expandindo o caso da DC, o seu contexto epidemiológico português e propostas para a sua abordagem clínica e epidemiológica.
Tropical zoonoses are diseases with low investment in research, low diagnostic rates, and outdated treatments, despite their high disease burden and epidemic potential. Globalization and refugee crises lead to an increasing import of cases of infectious diseases to non-endemic areas, with health systems unprepared to identify and manage them. Chagas disease (CD), is an infection caused by Trypanosoma cruzi, recognized as a neglected tropical disease (NTD) that infects about seven million people worldwide each year and about ten thousand die, mainly due to Chagas cardiomyopathy. However, most of the infected are not diagnosed and there is no innovation in the approach to the disease. It is endemic in Latin America (LA), where its vector is present. However, due to the increasingly unobstructed global movement, in Europe and North America, the import of cases and autochthonous infections by vertical transmission and transplants/transfusions are a known problem, with relevance in Portugal due to the volume of immigrants from Brazil. In Portugal, individuals with diagnosed CD are prevented from donating blood, but the approach to at-risk donors and the prevention of congenital infections is not defined. CD requires specific diagnostic and therapeutic approaches and reinforcement in the education of professionals, regulatory bodies, and the population. Therefore, we compiled relevant information on the import of zoonoses, expanding the case of CD, its Portuguese epidemiological context, and proposals for its clinical and epidemiological approach.
Tropical zoonoses are diseases with low investment in research, low diagnostic rates, and outdated treatments, despite their high disease burden and epidemic potential. Globalization and refugee crises lead to an increasing import of cases of infectious diseases to non-endemic areas, with health systems unprepared to identify and manage them. Chagas disease (CD), is an infection caused by Trypanosoma cruzi, recognized as a neglected tropical disease (NTD) that infects about seven million people worldwide each year and about ten thousand die, mainly due to Chagas cardiomyopathy. However, most of the infected are not diagnosed and there is no innovation in the approach to the disease. It is endemic in Latin America (LA), where its vector is present. However, due to the increasingly unobstructed global movement, in Europe and North America, the import of cases and autochthonous infections by vertical transmission and transplants/transfusions are a known problem, with relevance in Portugal due to the volume of immigrants from Brazil. In Portugal, individuals with diagnosed CD are prevented from donating blood, but the approach to at-risk donors and the prevention of congenital infections is not defined. CD requires specific diagnostic and therapeutic approaches and reinforcement in the education of professionals, regulatory bodies, and the population. Therefore, we compiled relevant information on the import of zoonoses, expanding the case of CD, its Portuguese epidemiological context, and proposals for its clinical and epidemiological approach.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2023
Palavras-chave
Zoonoses importadas Doenças tropicais negligenciadas Doença de Chagas Tripanossomíase americana Doenças transmissíveis