Influência da parasitemia na evolução da doença de Chagas crônica

Castro, Cleudson; Prata, Áluízio; Macêdo, Vanize

doi:10.1590/s0037-86822005000100001

Cited by 28 publications

(6 citation statements)

References 13 publications

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“…Nevertheless, no association was found between positive parasitemia and ECG progression, most likely due to the limited number of patients subjected to this evaluation protocol. The absence of an association between parasitemia and chronic CD progression was also described in other longitudinal studies [35].…”

Section: Discussionsupporting

confidence: 72%

Progression Rate from the Indeterminate Form to the Cardiac Form in Patients with Chronic Chagas Disease: Twenty-Two-Year Follow-Up in a Brazilian Urban Cohort

Hasslocher‐Moreno¹,

Xavier²,

Saraiva³

et al. 2020

TropicalMed

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Most patients with chronic Chagas disease (CD) present the indeterminate form and are at risk to develop the cardiac form. However, the actual rate of progression to the cardiac form is still unknown. Methods: In total, 550 patients with the indeterminate CD form were followed by means of annual electrocardiogram at our outpatient clinic. The studied endpoint was progression to cardiac form defined by the appearance of electrocardiographic changes typical of CD. The progression rate was calculated as the cumulative progression rate and the incidence progression rate per 100 patient years. Results: Thirty-seven patients progressed to the CD cardiac form within a mean of 73 ± 48 months of follow-up, which resulted in a 6.9% cumulative progression rate and incidence rate of 1.48 cases/100 patient years. Patients who progressed were older (mean age 47.8 ± 12.2 years), had a higher prevalence of associated heart diseases (p < 0.0001), positive xenodiagnosis (p = 0.007), and were born in the most endemic Brazilian states (p = 0.018). Previous co-morbidities remained the only variable associated with CD progression after multivariate Cox proportional hazards regression analysis (p = 0.002). Conclusion: The progression rate to chronic CD cardiac form is low and inferior to rates previously reported in other studies.

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Section: Discussionsupporting

confidence: 72%

Progression Rate from the Indeterminate Form to the Cardiac Form in Patients with Chronic Chagas Disease: Twenty-Two-Year Follow-Up in a Brazilian Urban Cohort

Hasslocher‐Moreno¹,

Xavier²,

Saraiva³

et al. 2020

TropicalMed

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“…ChD progression may result from changes in the patient's immune response during the course of T. cruzi infection 42 . Moreover, age influences the degree of parasitemia in patients 43,44 , and the decline in trypomastigote circulating forms is related to age 45 . However, we did not observe significant differences among BC results, patient age, and clinical form.…”

Section: Discussionmentioning

confidence: 99%

Combined parasitological and molecular-based diagnostic tools improve the detection of Trypanosoma cruzi in single peripheral blood samples from patients with Chagas disease

Volpato

Sousa

D’Ávila

et al. 2017

Rev. Soc. Bras. Med. Trop.

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Introduction:In order to detect Trypanosoma cruzi and determine the genetic profiles of the parasite during the chronic phase of Chagas disease (ChD), parasitological and molecular diagnostic methods were used to assess the blood of 91 patients without specific prior treatment. Methods: Blood samples were collected from 68 patients with cardiac ChD and 23 patients with an indeterminate form of ChD, followed by evaluation using blood culture and polymerase chain reaction. T. cruzi isolates were genotyped using three different genetic markers. Results: Blood culture was positive in 54.9% of all patients, among which 60.3% had the cardiac form of ChD, and 39.1% the indeterminate form of ChD. There were no significant differences in blood culture positivity among patients with cardiac and indeterminate forms. Additionally, patient age and clinical forms did not influence blood culture results. Polymerase chain reaction (PCR) was positive in 98.9% of patients, although comparisons between blood culture and PCR results showed that the two techniques did not agree. Forty-two T. cruzi stocks were isolated, and TcII was detected in 95.2% of isolates. Additionally, one isolate corresponded to TcIII or TcIV, and another corresponded to TcV or TcVI. Conclusions: Blood culture and PCR were both effective for identifying T. cruzi using a single blood sample, and their association did not improve parasite detection. However, we were not able to establish an association between the clinical form of ChD and the genetic profile of the parasite.

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“…The occurrence rate of this evolution is extremely variable, ranging from 10-60% from one region to another. Acute cases of greater severity resulting from a higher parasitic burden tend to evolve into clinical forms that are also more severe (Castro 1978, Dias 1982, Borges-Pereira 1997. In an observational study that we conducted in Rio de Janeiro over a 30-year period on 510 individuals from several Brazilian states who were serologically positive for Chagas infection (Coura et al 1983), 39% remained in the indeterminate form, 52.1% presented with cardiopathy and 14.3% presented with megaoesophagus and/or megacolon.…”

mentioning

confidence: 99%

Chronic phase of Chagas disease: why should it be treated? A comprehensive review

Coura

Borges-Pereira

2011

Mem. Inst. Oswaldo Cruz

108

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Influência da parasitemia na evolução da doença de Chagas crônica

Cited by 28 publications

References 13 publications

Progression Rate from the Indeterminate Form to the Cardiac Form in Patients with Chronic Chagas Disease: Twenty-Two-Year Follow-Up in a Brazilian Urban Cohort

Progression Rate from the Indeterminate Form to the Cardiac Form in Patients with Chronic Chagas Disease: Twenty-Two-Year Follow-Up in a Brazilian Urban Cohort

Combined parasitological and molecular-based diagnostic tools improve the detection of Trypanosoma cruzi in single peripheral blood samples from patients with Chagas disease

Chronic phase of Chagas disease: why should it be treated? A comprehensive review

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