The various meanings of Brazil's certification as free of Chagas disease

Abstract

The article discusses Brazil's recent certification as free of Chagas disease transmission by Triatoma infestans, analyzing the various meanings ascribed to this position. Resulting mainly from measures by both the Chagas Disease Control Program (PCDCh) established in Brazil in 1975 and the Southern Cone Initiative launched in 1991, this certification has been interpreted in ways that lead to confusion between the elimination of Chagas disease transmission by T. infestans and eradication of the disease. The present status of vector transmission control in Brazil is discussed, with emphasis on the Northeast, in most States of which T. infestans is not the main species involved in transmission. The article highlights the need to broaden the discussion of the readings and consequences involved in the present control achievements in light of possible harm from misinterpretations that might jeopardize further efforts to control the disease.