Overview of Chagas disease in Amazonas: an integrated approach.

In the Amazon, Chagas disease (CD) transmission is associated with the consumption of contaminated foods -most notably açaí-and constitutes an important public health concern. In Brazil, the state of Amazonas ranks third in acute-phase notifications among states in the region, with 25% of municipalities having already reported acute CD cases, predominantly in outbreaks in rural areas. This study describes the current overview of knowledge on CD in Amazonas, bringing together research findings from the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD), developed in partnership with the graduate program in Tropical Medicine at the Universidade do Estado do Amazonas (UEA). The findings show that, in addition to oral transmission, accidental contact with the traditional vector (Triatominae) has been reported. The predominant transmission pattern represents an important shift in the dynamics of the disease and reinforces the need for surveillance strategies focused on controlling foodborne transmission. Among the main challenges are logistical difficulties for post-treatment clinical follow-up, especially in remote areas, and the absence of a structured and specialized network for continuous case monitoring and detection of new outbreaks. Added to this is the lack of systematic CD screening in women of childbearing age during prenatal care, which hinders surveillance of vertical transmission. These issues highlight the urgency of strengthening surveillance and preventing new incidences.