Using a Chagas disease hospital database: a clinical and epidemiological patient profile

Abstract

Introduction: Chagas disease (CD) prevention and control rely on studies of its distribution, characteristics of individuals affected and mode of transmission. CD data in Brazil are scarce; a retrospective analysis of the clinical characteristics of 80 patients treated at the Clinical Hospital of UNICAMP, Campinas, Brazil, was performed. Methods: Patient data records were analyzed. Results: Thirty percent of the patients probably got infected through vector-borne transmission, 65% came from endemic areas, a predominance of cardiac and cardiodigestive forms was found among males, and the cardiac form prevailed (51%). Conclusions: The results update the view on the epidemiology of CD in Campinas, Brazil.

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

“…Field studies performed between 1960 and the early 2000s reported a progressive increase in the mean age of patients with chronic CD over time, from less than 25 to 45 years 31 - 33 . Studies on the clinical epidemiological profile of patients with chronic CD in urban centers reported that the mean age showed the same increasing trend in the last decades, ranging from 37.7 to 67.5 years 12 , 13 , 15 , 20 - 22 . Studies conducted in nonendemic regions of the Northern Hemisphere, where patients migrated from South America, especially Bolivia and Central America, reported younger patients with chronic CD with a mean age ranging from 28.5 to 47 years 16 - 18 , 34 - 37 , reflecting the lack of CD vectorial transmission control in their countries of origin and that CD vectorial transmission remained active in rural areas.…”

“…This finding indicates the knowledge deficit regarding CD among these patients, which reinforces why most of them do not consider living with triatomine bugs as a threat to their health 30 . Several studies on transmission mechanisms have also reported the vector route as the primary route of disease transmission 12 , 13 , 20 .…”

“…With globalization, the disease has spread to countries in the Northern Hemisphere, particularly in the United States and Spain 11 . Because of this new geographic rearrangement of CD, studies describing the clinical and epidemiological profile of patients with chronic CD have been conducted in urban healthcare facilities in both endemic 12 - 15 and nonendemic regions 16 - 19 . Some of these facilities have also become reference centers for the treatment of CD that offer specialized care 20 - 23 .…”

Doença de Chagas: serviço de referência e epidemiologia

“…Diante disso, é primordial a intersetorialidade na gestão, para que atuem na determinação social da doença e na busca contínua do enfrentamento às injustiças sociais (14) . Em um estudo realizado em um hospital de São Paulo (28) e outro em Salvador (23) , observou-se que a maioria dos usuários tem familiares com DCH, o que difere do presente estudo, sendo necessário enfatizar a busca ativa dos familiares.…”

“…Em relação às formas clínicas, houve divergência sobre a forma mais prevalente deste estudo (cardíaca), seguida da indeterminada e digestiva, com os dados do Consenso de Chagas e da OMS, em que a metade dos casos são assintomáticos (21) , seguidos de 30% com distúrbios cardíacos e 10% digestivos (1) , e de outro estudo, com predomínio da forma indeterminada (25) . Entretanto outros estudos também apresentam a forma cárdica como sendo a mais prevalente, seguida da indeterminada (22,23,26,28) .…”