Chaga's disease as endemic to the brazilian Amazon: risk or hypothesis?

Coura, José Rodrigues

doi:10.1590/s0037-86821990000200001

Cited by 19 publications

(12 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is noteworthy that out of the 15 identified cases of chagasic infection, three originated from endemic areas (states of Minas Gerais, Ceará, and Alagoas). This fact reinforces the evidence of the risks of the movement of CD cases in the Brazilian Amazonia being caused by human migrations from endemic areas to Amazonia due to the increasing proximity between the vectors, the trypanosome reservoir hosts and people [10][11][26][27] .…”

Section: Discussionsupporting

confidence: 80%

“…The finding of 15 cases reactive for chagasic infection among Amazon rural area inhabitants confirms what the literature has been alerting us to [26][27][28] : the emerging Chagas disease outbreak in the area. However, the transmission dynamics of this disease is not known by the majority of the inhabitants of the area, mainly because triatomines (the vectors) are not domiciliated.…”

Section: Discussionsupporting

confidence: 74%

“…In the forest areas where this work was accomplished, the presence of the vectors Rhodnius robustus, R. pictipes, and their reservoir host Didelphis marsupialis (naturally infected by T. cruzi) near human dwellings was demonstrated 36 . Hence, there is a real possibility of exposure of these inhabitants to contact with the etiological agent and therefore to the infection, as well as the possibility of contamination by marsupials urine 35 , reaffirming the potential risk of an endemic disease in Amazonia [2][3]10,[26][27] .…”

Section: Discussionmentioning

confidence: 99%

“…It is also unknown how the patients were infected and if such infection was related to their work because, as they have attested, they perform gathering activities and/or stay in the forest areas for great periods of time and/or live in rural areas and/or consume palm tree fruit juice and sylvatic animal meat. All these habits introduce these people into the presumable cycle of transmission of chagasic infection in the Amazon region 2,4,8,[26][27][28][31][32][33] . It is noteworthy that out of the 15 identified cases of chagasic infection, three originated from endemic areas (states of Minas Gerais, Ceará, and Alagoas).…”

Section: Discussionmentioning

confidence: 99%

“…Chagas disease is an emerging public health problem and an evolving anthropozoonosis arising from T. cruzi infection of vectors and sylvatic animals 2,4,8,[26][27][28]37 . The results of this study ratify the importance of monitoring CD cases in Amazonia, particularly in the state of Amazonas.…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Serological survey for Chagas disease in the rural areas of Manaus, Coari, and Tefé in the Western Brazilian Amazon

Magalhães

Coelho

Maciel

et al. 2011

Rev. Soc. Bras. Med. Trop.

Self Cite

View full text Add to dashboard Cite

Introduction: Deforestation, uncontrolled forest, human population migration from endemic areas, and the large number of reservoirs and wild vectors naturally infected by Trypanosoma cruzi promote the endemicity of Chagas disease in the Amazon region. Methods: We conducted an initial serological survey (ELISA) in a sample of 1,263 persons; 1,095 (86.7%) were natives of the State of Amazonas, 666 (52.7%) were male, and 948 (75.1%) were over 20 years old. Serum samples that were found to be reactive, indeterminate, or inconclusive by indirect immunofluorescence (IFI) or positive with low titer by IFA were tested by Western blot (WB). Serologically confirmed patients (WB) were evaluated in terms of epidemiological, clinical, ECG, and echocardiography characteristics. Results: Fifteen patients had serologically confirmed T. cruzi infection, and 12 of them were autochthonous to the state of Amazonas, for an overall seroprevalence of 1.2% and 0.9% for the state of Amazonas. Five of the 15 cases were males, and the average age was 47 years old; most were farmers with low education. One patient who was not autochthonous, having originated from Alagoas, showed right bundle branch block, bundle branch block, and anterosuperior left ventricular systolic dysfunction with an ejection fraction of 54%. Conclusions: The results of this study ratify the importance of monitoring CD cases in Amazonia, particularly in the state of Amazonas. Keywords: Chagas Disease. Serological Survey. Brazilian Amazon. RESUMOIntrodução: Na Amazônia, o desmatamento desordenado da floresta, as migrações populacionais humanas de áreas endêmicas e o grande número de reservatórios e vetores silvestres naturalmente infectados por Trypanosoma cruzi, favorece a endemicidade da doença de Chagas nessa região. Métodos: Foi realizado um inquérito sorológico inicial por ensaio imunoenzimático (ELISA), em uma amostra de 1.263 pessoas, 1.095 (86,7% ) as quais eram autóctones do Estado do Amazonas, 666 (52,7%) do sexo masculino, 948 (75,1%) com idade superior a 20 anos. As amostras de soro reativas, indeterminadas ou inconclusivas por imunofluorescência indireta (IFI) positivas ou com baixo título na IFI foram submetidas ao Western blot (WB). Os pacientes com sorologia confirmada (WB) foram avaliados do ponto de vista epidemiológico, clínico, eletro e ecocardiográfico. Resultados: Quinze pacientes tiveram sorologia confirmada para infecção por T. cruzi, 12 dos quais autóctones do Estado do Amazonas, com uma prevalência sorológica geral de 1,2% e de 0,9% para o Estado do Amazonas. Entre os 15 casos com sorologia positiva, cinco eram do sexo masculino, média de idade de 47 anos, baixa escolaridade e a maioria agricultores. Um paciente não autoctone, procedente de Alagoas, apresentou bloqueio de ramo direito, bloqueio divisional ântero-superior e disfunção sistólica ventricular esquerda com fração de ejeção de 54%. Conclusões:O resultado deste estudo reforça a importância do monitoramento de casos da doença de Chagas na Amazônia, em especial no Amazonas. Pa...

show abstract

Section: Discussionsupporting

confidence: 80%

Section: Discussionsupporting

confidence: 74%