BIGG

Guía para el diagnóstico y el tratamiento de la enfermedad de Chagas

Ano de publicação: 2019

This document is a valuable working tool for anyone who works in the health networks of Latin American countries. It describes the most recent basic and fundamental guidelines for the diagnosis and treatment of American trypanosomiasis (Chagas disease) based on the evidence published to date, and is now being put into the hands of all interested parties by the Pan American Health Organization (PAHO). The work carried out by a team of Chagas disease specialists in coordination with experts in the GRADE methodology (Grading of Recommendations Assessment, Development and Evaluation), provides the highest guarantees and scientific credibility, giving health workers and patients clinical knowledge that is based on the most up-to-date and reliable evidence and knowledge available. Chagas disease is a neglected infectious disease that affects between six and eight million people in the Americas. Current estimates indicate that there are roughly 28,000 new acute cases each year, and nearly 65 million people live at continuous risk of contracting the disease by vector-borne transmission, blood or congenital transmission, or food-borne transmission. For these reasons, PAHO recognizes that there are substantial needs in terms of increasing access, coverage, and quality of care within national health care systems, mainly in primary care networks. This document is without question a significant contribution to the training of new health workers. We hope that it will effectively contribute to basic and refresher training for all healthcare personnel in the public and private sectors, and that it will help standardize the required knowledge and procedures for the diagnosis and treatment of this endemic parasitosis. These guidelines were developed as part of the Chagas-related commitments made by the PAHO Directing Council in Resolution CD55. R9 (2016): Plan of Action for the Elimination of Neglected Infectious Diseases and Post-Elimination Actions, 2016-2022.
Esta guía está enfocada en emitir recomendaciones para el diagnóstico y el tratamiento de la enfermedad de Chagas, como infección por Trypanosoma cruzi, agente protozoario de una parasitosis sistémica.

Metodología:

La presente guía de práctica clínica fue confeccionada siguiendo los métodos de elaboración de guías de la OMS (5). De forma general, se conformó un grupo desarrollador multidisciplinario compuesto por expertos temáticos, epidemiólogos, metodólogos y usuarios. Dado que no se identificaron guías susceptibles de ser adaptadas, la guía se desarrolló de novo. Se realizaron búsquedas de revisiones sistemáticas y estudios primarios hasta agosto de 2017, en bases de datos electrónicas (PubMed, EMBASE, Cochrane) y mediante búsqueda manual. Posteriormente, se elaboró la síntesis y los perfiles de evidencia utilizando el enfoque GRADE (Grading of Recommendations Assessment, Development and Evaluation). Las recomendaciones fueron graduadas en un panel de expertos en enfermedad de Chagas. La guía fue evaluada por pares temáticos y metodológicos. Todos los participantes del panel y del grupo desarrollador firmaron una declaración de conflicto de intereses, los cuales fueron analizados por la coordinación de la guía.

Recomendaciones:

La presente guía provee recomendaciones de diagnóstico y tratamiento para pacientes adultos y pediátricos.

Las siguientes recomendaciones conciernen a individuos con:

1) sospecha de enfermedad de Chagas; 2) exposición a la enfermedad de Chagas; 3) diagnóstico de enfermedad de Chagas crónica; y 4) diagnóstico de enfermedad de Chagas aguda.