BARRIERS TO THE ERADICATION OF CHAGAS DISEASE IN THE LEGAL AMAZON

Abstract

Introduction: Chagas disease, caused by the protozoan Trypanosoma cruzi, remains a significant public health problem, especially in the Legal Amazon region, where socioeconomic, environmental, and structural factors hinder its control. Objective: To analyze the main barriers to the eradication of Chagas disease in this region. Methodology: This is a narrative review conducted in the Virtual Health Library, including articles published in the last five years, in Portuguese, English, and Spanish. In the end, 19 studies were selected and analyzed. Results: Antiparasitic treatment is highly effective in the acute phase, but its indication in the chronic phase remains controversial, with limited short-term clinical benefits, despite the reduction in parasite load. The definition of cure is based on laboratory criteria, the negativity of which can take years or decades, hindering clinical follow-up. Furthermore, limitations in epidemiological surveillance, such as the late inclusion of the chronic form in mandatory notification, contribute to underreporting and data fragility. Conclusion: The persistence of the disease is related to diagnostic difficulties, therapeutic limitations, barriers to access to health services, and socioeconomic vulnerabilities. The need to strengthen public policies, expand access to diagnosis and treatment, and train health professionals is highlighted.