Chronical Chagas Illnes : Controversial aspects about its ethiological treatment

The treatment of Chagas illness in its chronic phase has arised many controversies about its application. In the 80's many investigators began to use those compounds in this phase of the illness, with the justification of controlling an evolutive known process; to be able to erradicate the parasite from the blood and eliminate with this, the human reserves of the parasite designed to interrupt the chain of transmission; diminish the incidence both post transfusional and congenital Chagas and thus preventing the appearance of cardiopaties. The published studies about the clinical evolution of the illness after the treatment, offer controversial results due to the methods used for the evaluation, the scarce of cases and also for the control of the studies. Among the serological methods we use the indirect hemaglutination (HAI), indirect inmunofluorescence (TIF) and the Elisa. The diagnosis rules since 1995 already stated the treatment in latent phase till 5 years and according to medical criteria, the convenience of extending till older children. Those rules were modified in 1998 and stated the treatment in latent phase and adults. We think that scientific reliable information must be produced, though multicentric studies, to put light on dark points and we should revise criteria to evaluate cure; this is a particularly complex situation that creates difficulties in relation to clinical, serological and parasitological aspects. At the same time, we think it is advisable to go on searching new drugs for the treatment of the illness with the requirements of WHO.