Aspectos epidemiológicos, clínicos e parasitológicos da doença de Chagas em Mato Grosso do Sul

Abstract

RESUMOCom o objetivo de avaliar aspectos epidemiológicos, clínicos e parasitológicos da doença de Chagas crônica, em pacientes do Hospital Universitário da Universidade Federal de Mato Grosso do Sul, realizamos um estudo seccional envolvendo 120 chagásicos e 120 controles não-chagásicos, de ambos os sexos, com idades de 16 a 82 anos. Os aspectos epidemiológicos foram avaliados por questionário, a cardiopatia por exame clínico, eletrocardiograma convencional, radiologia e ecodopplercardiograma e a presença de Trypanosoma cruzi no sangue por xenodiagnóstico e teste da reação em cadeia da polimerase. Os resultados mostraram predominância de alóctones com baixa escolaridade e referência de contato prévio com triatomíneos entre os chagásicos. Abortamento espontâneo foi mais freqüente nas mulheres chagásicas. A cardiopatia devido ao componente chagásico foi estimada em 20,2%. Apresentou-se com 7,5% de cardiomegalia, 6,2% de aneurisma de ventrículo esquerdo e com predominância de dispnéia, palpitações e hipertensão arterial. O xenodiagnóstico foi positivo em 26,1% dos chagásicos enquanto a PCR foi positiva em 53,7%. A análise dos resultados indicou que a doença de Chagas no grupo estudado apresenta características clínicas e parasitológicas que revelam peculiaridades regionais. Palavras-chaves: Doença de Chagas. Estudo transversal. Aspectos parasitológicos. Aspectos clínicos. ABSTRACTWith the objective of evaluating epidemiologic, clinical and parasitologic aspects of chronic Chagas' disease in patients from the University Hospital of the Federal University of Mato Grosso do Sul, a cross-sectional study was performed with groups of 120 chagasic and non-chagasic patients aged from 16 to 82 years. Epidemiologic aspects were evaluated by means of a questionnaire, cardiopathy by clinical examination, conventional electrocardiogram, radiology and Doppler echocardiograms (only in chagasic patients) and the presence of Trypanosoma cruzi in the blood stream by way of xenodiagnosis and polymerase chain reaction test. The results obtained indicated that the chagasic patients are predominantly alloctones with low-grade schooling, and were exposed to triatomines. The frequency of spontaneous abortion was higher in chagasic women. Chronic chagasic cardiopathy, estimated to occur in 20.2% of the patients, showed 7.5% cardiomegaly, 6.2% aneurysm of the left ventricle, and with a predominance of dyspnea, palpitations and arterial hypertension. Xenodiagnosis was positive for 26.1% of the chagasics and the PCR was positive for 53.7%, and was significantly higher in males and alloctones. An analysis of the results shows that Chagas' disease, in the group studied, presented clinical and parasitologic characteristics demonstrating significant regional differences.

Analysis of the seroprevalence of and factors associated with Chagas disease in an endemic area in Northeastern Brazil

“…CD positivity was 5 times higher among those who had only partially attended elementary school compared with those who completed elementary school. This result was also observed in previous studies, regardless of the region of the country 23,27,28,29 , indicating that a higher education level is associated with a lower CD prevalence.…”

Seroepidemiology of Trypanosoma cruzi infection in the semiarid rural zone of the State of Rio Grande do Norte, Brazil

“…The profile of seropositive individuals regarding education level revealed a predominance of individuals with low levels of education, suggesting that infection is closely related to the development of the population, generally affecting the poorest individuals and those with less education. Several authors have reported similar findings 6,26,32,34 , including one study characterizing illiteracy as the principal social marker of Chagas infection 23 .…”

Molecular and serological detection of tick-borne pathogens in dogs from an area endemic for Leishmania infantumin Mato Grosso do Sul, Brazil

“…(VEXENAT et al, 1996;LUCIANO et al, 2009). In our study, cross-reactivity between dog serum samples positive to T. cruzi and L. braziliensis could not be discarded, since the occurrence of T. cruzi and L. braziliensis among dogs is documented in the state of Mato Grosso do Sul (POMPILIO et al, 2005;SAVANI et al, 2009;SOUZA et al, 2009;CORVALAN et al, 2011). One dog that tested positive in the Leishmania spp.…”