Temporal changes in the clinical-epidemiological profile of patients with Chagas disease at a referral center in Brazil

Abstract

INTRODUCTION We aimed to describe the sociodemographic, epidemiological, and clinical characteristics of patients with chronic Chagas disease (CD) at an infectious disease referral center. Changes in patient profiles over time were also evaluated. METHODS This retrospective study included patients with CD from November 1986-December 2019. All patients underwent an evaluation protocol that included sociodemographic profile; epidemiological history; anamnesis; and physical, cardiologic, and digestive examinations. Trend differences for each 5-year period from 1986 to 2019 were tested using a nonparametric trend test for continuous and generalized linear models with binomial distribution for categorical variables. RESULTS A total of 2,168 patients (52.2% women) were included, with a mean age of 47.8 years old. White patients with low levels of education predominated. The reported transmission mode was vectorial in 90.2% of cases. The majority came from areas with a high prevalence (52.2%) and morbidity (67.8%) of CD. The most common clinical presentation was the indeterminate form (44.9%). The number of patients referred gradually decreased and the age at admission increased during the study period, as did the patients’ levels of education. CONCLUSIONS The clinical profile of CD is characterized by a predominance of the indeterminate form of the disease. Regarding the patients who were followed up at the referral center, there was a progressive increase in the mean age and a concomitant decrease in the number of new patients. This reflects the successful control of vector and transfusion transmission in Brazil as well as the aging population of patients with CD.

Impact of COVID-19 In-hospital Mortality in Chagas Disease Patients

“…The aging trend of our cohort and a higher prevalence of women had also been previously reported ( 10 ). Other study corroborates the previous aging trend and suggests an increase in the average age of the most severe cases ( 17 ). Similar to Molina et al ( 14 ), there was a higher frequency of women in the present study and higher mean age among CD patients admitted to the hospital due to COVID-19.…”

“…The mean age, sex, and comorbidities frequency presented by the patients of the present study were similar to those previously described in ambulatorial patients in our cohort ( 17 ). However, the prevalence of CHD patients in this study was higher (84% against 53.6%) than those previously described.…”

Cohort profile update: the main and new findings from the SaMi-Trop Chagas cohort

“…All patients received information regarding ChD and self-care strategies. According to our results, the demographic profile is similar to the one of participants from other studies conducted in other regions 29 - 31 . Around 50% of our participants were classified as class 1 according to the NYHA functional classification, which means they have no significant symptoms.…”

Epidemiological-clinical profile and mortality in patients coinfected with Trypanosoma cruzi/HIV: experience from a Brazilian reference center

“…They were migrants from four Brazilian states, predominantly Minas Gerais (45.4%) and Bahia (36.3%). These two states represent almost 50% of the INI CD cohort 28 . Similar data were shown in a study in which 45% of the patients were born in Bahia and Minas Gerais 16 .…”