Clinical and epidemiological aspects of chronic Chagas disease from Southern Brazil

Abstract

Introduction: Patients with Chagas disease (CD), caused by Trypanosoma cruzi, present a higher risk of developing other chronic diseases, which may contribute to CD severity. Since CD is underreported in the southern state of Paraná, Brazil, we aimed to characterize clinical and epidemiological aspects of individuals chronically infected with T. cruzi in Southern Brazil. Methods: A community hospital-based study was performed, recording clinical/demographic characteristics of 237 patients with CD from Southern Brazil. To estimate the association between different forms of CD and sociodemographic and clinical variables, multiple logistic regression models were built using the Akaike information criterion. Results: Mean age was 57.5 years and 59% were females. Most patients' (60%) place of origin/birth was within Paraná and they were admitted to the CD outpatient clinic after presenting with cardiac/digestive symptoms (64%). The predominant form of CD was cardiac (53%), followed by indeterminate (36%), and digestive (11%). The main electrocardiographic changes were in the right bundle branch block (39%) and left anterior fascicular block (32%). The average number of comorbidities per patient was 3.9±2.3; systemic arterial hypertension was most common (64%), followed by dyslipidemia (34%) and diabetes (19%); overlapping comorbidities were counted separately. Male sex was associated with symptomatic cardiac CD (OR=2.92; 95%CI: 1.05-8.12; p=0.040). Conclusions: This study provided greater understanding of the distribution and clinical profile of CD patients in Southern Brazil, indicating a high prevalence of comorbidities among these patients who are a vulnerable group due to advanced age and substantial risk of morbidity.

Chronic Chagas cardiomyopathy: characterization of cases and possibilities of action in primary healthcare

“…This study evinced that 72.9% of patients diagnosed with CCC tended to show a stabilized disease. These findings show the slow and gradual evolution of the disease over time and, thus, the possibility of continued PHC practice involvement 24 . Furthermore, 16.6% of the cases improved, showing stage regression, and 10.5% progressed to more severe stages.…”

Exhausted PD-1+ TOX+ CD8+ T Cells Arise Only in Long-Term Experimental Trypanosoma cruzi Infection

“…However, it has been shown that there are increased pathological changes, including myocardial damage in male mice (79) and that female mice are more resistant to T. cruzi infection than male mice (80). In addition to sex differences, studies have shown a high prevalence of comorbidities in Chagas patients, probably due to advanced age (81). The infection with T. cruzi triggered a strong systemic induction of pro-inflammatory cytokines.…”

Perfil Epidemiológico Da Doença De Chagas Aguda No Brasil De 2011-2020

“…Já o estudo de Dos Santos et al (2020), mostra que as taxas foram semelhantes entre homens e mulheres (7,7% e 8,4%, respectivamente). No entanto, na pesquisa de Lidani et al (2020), as mulheres constituíram uma proporção maior de pacientes idosos com DC.…”