Introduction Chagas disease is still a relevant health problem in Latin America. In 1981, it was estimated that Brazil had about 5 million infected people. Since then, a control program consolidated in 1983 has produced evidences of reduction in transmission.
Methods A survey was held in a representative sample of rural Brazilian children up to 5 years of age. Blood was collected on filter paper from 104 954 children and screened with IFI and ELISA. Samples with positive or undetermined results were tested by western blot. From all children with confirmed positive result, as well as from their mothers, a whole blood sample was collected.
Results Infection was confirmed in only 32 children (0.03%). From them, 20 (0.02%) had maternal positive results, suggesting congenital transmission; 11 (0.01%) had non-infected mothers, indicating possible vector transmission. In further 41 the infection was confirmed only in the mothers, suggesting passive transference of antibodies. The 11 children presumably infected through vector were distributed mainly in the Northeast region. Remarkably, 60% of the 20 cases of probably congenital transmission were from the State of Rio Grande do Sul. This is the first demonstration of regional differences in vertical transmission of Chagas disease in Brazil, probably reflecting the predominant Trypanosoma cruzi groups (TcV and TC VI) found in this State.
Conclusion A systematic control program, together with socio-economic improvement in the last decades, practically interrupted Chagas disease vector transmission in Brazil. It is essential to maintain the preventive activities to consolidate this great achievement in public health.
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