By controlling the transmission of Chagas disease, the challenge of providing assistance to millions of infected patients that reach old age arises. In this study, the socioeconomic, demographic and comorbidity records of all elderly chagasic patients followed at the Pharmaceutical Care Service of the Chagas Disease Research Laboratory were assessed. The information related to the clinical form of the disease was obtained from medical records provided by the Walter Cantídio University Hospital. The profile of the studied population was: women (50.5%); mean age of 67 years; retired (54.6%); married (51.6 %); high illiteracy rate (40.2%); and family income equal to the minimum wage (51.5%). The predominant clinical forms of Chagas disease were cardiac (65.3%) and indeterminate (14.7%). The main electrocardiographic changes were the right bundle branch block (41.0%), associated or not with the anterosuperior left bundle branch block (27.4%). The average number of comorbidities per patient was 2.23 ± 1.54, with systemic arterial hypertension being the main one found (67.0%). It was found that the elderly comprise a vulnerable group of patients that associate aging with cardiac and/or digestive disorders resulting from the evolution of Chagas disease and other comorbidities, which requires special attention from health services to ensure more appropriate medical and social care.

These results verify the presence of triatomines in both intra- and peridomiciliary areas, thereby ensuring persistence of the pathogen and consequently, the disease, as the presence of infected vectors in households is an important risk factor. According to these findings, the Chagas Disease Control Program should intensify its efforts in order to prevent the spread of the disease.

Revista da Sociedade Brasileira de Medicina Tropical 46(6):776-778, Nov-Dec, 2013http://dx.doi.org/10.1590/0037-8682-1646-2013 Short CommunicationClinical and serological evolution in chronic Chagas disease patients in a 4-year pharmacotherapy follow-up: a preliminary study ABSTRACT Introduction:The role of trypanocidal therapy in the chronic phase of Chagas disease remains controversial. Methods: A total of 13 patients with chronic Chagas disease were treated with benznidazole (5mg/kg/day/60 days) and surveyed via antibody measurement and conventional electrocardiogram over the course of 4 years. Results: The antibody titers were signifi cantly reduced after 4 years (p<0.05). Most of the patients showed maintenance of the initial clinical picture (electrocardiographic), with the exception of 4 cases. Conclusions: Although trypanocidal therapy in the chronic phase of Chagas disease was of limited effectiveness, we believe that it is benefi cial in treating these patients.

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Introduction: The transmission of Chagas disease (CD) through blood transfusion, organ transplantation, and oral transmission has gained greater visibility as a result of intensified vector control activities in endemic regions and to control CD in nonendemic regions. In Brazil, Ceará is one of the states that perform the most organ transplants. Therefore, the objective of this study was to assess the prevalence of Trypanosoma cruzi infection in organ donor candidates. Methods: A retrospective analysis was performed on data from potential organ donors at the Center of Transplantation of the State of Ceará from 2010-2015. Results: Data from a total of 2,822 potential donors were obtained, of which 1,038 were effective donors and 1,784 were excluded, likely due to lack of family authorization or medical contraindication. The prevalence of T. cruzi infection among these potential donors was 1.3% (n = 29). The majority of infected donors were males aged 41-60 years, residing in the interior of the state. Interestingly, 72.4% (n = 21) had positive or inconclusive serology for additional infections, such as cytomegalovirus, hepatitis B and C, and toxoplasmosis. Probability analysis revealed that stroke was the most common cause of death among potential donors with CD. Conclusions: There was a high prevalence of CD and other coinfections among potential solid organ donors in Ceará, and statistical tests have shown that these individuals are at increased risk of stroke when compared to potential non-reactive donors. This work highlights the importance of screening DC infection in potential donors.

This study demonstrated the seroprevalence of CD and identified factors associated with a high prevalence of CD.

SUMMARYChagas disease is caused by Trypanosoma cruzi and affects about two to three million people in Brazil, still figuring as an important public health problem. A study was conducted in a rural area of the municipality of Limoeiro do Norte - CE, northeastern Brazil, aiming to determine the prevalence of T. cruzi infection. Of the inhabitants, 52% were examined, among whom 2.6% (4/154) were seropositive in at least two serological tests. All seropositive individuals were older than 50 years, farmers, with a low education and a family income of less than three minimum wages. Active surveillance may be an alternative for early detection of this disease.

Introdução: A doença de Chagas (DC) é uma parasitose causada pelo agente infeccioso Trypanosoma cruzi. No Brasil, o tratamento específico da DC é realizado com o Benzonidazol (Bz), que devido à sua toxicidade pode levar ao aparecimento de várias reações adversas aos pacientes que fazem uso deste medicamento. Diante disso, existe uma preocupação em avaliar o paciente antes de iniciar a utilização do Bz, a fim de verificar possíveis alterações hematológicas e bioquímicas que eventualmente possam ser atribuídas à utilização deste medicamento. Objetivo: delinear o perfil dos parâmetros hematológicos e bioquímicos de pacientes com DC antes da farmacoterapia com Bz. Metodologia: Estudo retrospectivo que avaliou o perfil sociodemográfico e os parâmetros laboratoriais (eritrograma, leucograma, plaquetas, aspartato aminotransferase - TGO, alanina aminotransferase - TGP, ureia e creatinina) de 89 pacientes chagásicos crônicos atendidos no Serviço de Atenção Farmacêutica ao Paciente com doença de Chagas da Universidade Federal do Ceará no período de janeiro de 2010 a dezembro de 2015. Resultados: A população estudada se caracterizou feminina (52,8%), média de idade de 53,6 anos, de baixa renda e escolaridade, maioria aposentada, procedente do interior do estado do Ceará. No que se refere às análises hematológicas e bioquímicas, observa-se que todos os parâmetros se encontram dentro dos valores de referência. Na comparação entre gêneros, a análise estatística entre as médias demonstrou diferença significativa nos eritrócitos, no hematócrito, na hemoglobina, nas plaquetas e na contagem de linfócitos. Conclusão: Apesar da evidência de um perfil dentro dos valores normais de referência, o acompanhamento desses parâmetros laboratoriais é de suma importância no seguimento do paciente chagásico, visto que as reações adversas podem aparecer bem no início do tratamento com o Benzonidazol, levando muitas vezes à interrupção do medicamento.Palavras-chaves: Doença de Chagas; Parâmetros bioquímicos; Parâmetros hematológicos.