Morbidade da doença de Chagas em áreas do Sertão da Paraíba e da Caatinga do Piauí

Coura,; Borges-Pereira, José; Fi, Alves Filho; Ja, de Castro; Rv, da Cunha; Costa, Wagner Alexandre dos Santos; Ac, Junqueira

doi:10.1590/s0037-86821996000200012

Cited by 21 publications

(19 citation statements)

References 11 publications

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“…Megaesophagus was detected at different stages in the present study, which supports the data from other Brazilian regions (31) and studies that reported high prevalences of the digestive form in central Brazil and other South American countries (32) . Although cases of grade 2-3 megacolon were diagnosed in the present study, the majority of cases were grade 1 with a sigmoid colon diameter of >5.0cm.…”

Section: Discussionsupporting

confidence: 92%

Chagas disease: morbidity profile in an endemic area of Northeastern Brazil

Andrade

Câmara

Nunes

et al. 2015

Rev. Soc. Bras. Med. Trop.

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Section: Discussionsupporting

confidence: 92%

Chagas disease: morbidity profile in an endemic area of Northeastern Brazil

Andrade

Câmara

Nunes

et al. 2015

Rev. Soc. Bras. Med. Trop.

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“…Prevalences of CRBBB as high as 16% have been reported, but in seropositive adults living in rural and also in urban areas of Brazil. 7,8,17 The epidemiology and clinical evolution of Chagas' disease among children has not been extensively reported. In areas under vector control, the serologic screening of a defined age cohort of school children seems to be the recommended strategy for surveillance monitoring to detect residual transmission.…”

Section: Discussionmentioning

confidence: 99%

Early electrocardiographic abnormalities in Trypanosoma cruzi-seropositive children.

Andrade¹,

Zicker²,

Rassi³

et al. 1998

The American Journal of Tropical Medicine and Hygiene

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Abstract. As part of a major epidemiologic study on Chagas' disease, we compared the prevalence of electrocardiographic (ECG) abnormalities among 141 school children 7-12 years of age and seropositive for Trypanosoma cruzi, and 282 age-, sex-, and school-matched seronegative children in an endemic area in Brazil. The prevalence of ECG abnormalities was 11.3% among seropositive children and 3.5% among seronegative children (odds ratio ϭ 3.5, 95% confidence interval [CI] ϭ 1.5-8.4). The prevalence rate of ECG alterations was 10.7% for seropositive males versus 8.9% for seropositive females. Complete right bundle branch block (CRBBB), which is highly suggestive of Chagas' disease cardiopathy, was diagnosed in nine (6.4%) seropositive children and in only one (0.3%) seronegative child (odds ratio ϭ 18.5, 95% CI ϭ 2.3-146.5, attributable fraction ϭ 58.3%). Five incident new cases of CRBBB were diagnosed after a 36-month follow-up of seropositive children who were enrolled in an independent clinical field trial. No case of frequent and/or multifocal ventricular premature beats was found in the cohort of children. The surprisingly high frequency of early ECG abnormalities, which indicates a rapid evolution from infection to disease, suggests the existence of endemic areas with a particular accelerated disease progression that was not described before. Under such conditions, a public health chemotherapy program focusing on the treatment of young seropositive children would be recommended.The knowledge of the natural history of Chagas' disease cardiopathy has been built on hospital-and clinic-based observations and from a small number of population-based long-term investigations conducted in endemic areas. [1][2][3] The comparison between studies and the understanding of evolving patterns of the disease, however, have been limited to some extent due to the geographic difference of vector species, levels of endemicity, and the lack of standard procedures for selecting and examining study participants. 4 In endemic areas, infection by Trypanosoma cruzi occurs early in life; the prevalence rate of positive serology increases with age up to the fifth decade of life and decreases afterwards. 5 Electrocardiographic (ECG) alterations are usually the first clinical evidence of disease progression, but the onset of these abnormalities is rarely detected, since they tend to be asymptomatic at the beginning and heart involvement is usually clinically detected in adult life. 6,7 In cross-sectional observations the prevalence of ECG abnormalities increases with age with a peak at the fourth to fifth decade of life, while the differential risk of ECG abnormalities comparing seropositive with seronegative subjects decreases with age. 8 Cardiopathy seems to occur in family clusters, but no single risk factor has been clearly associated with disease progression at individual or population levels. 4 It is estimated that approximately 20-30% of seropositive subjects will develop heart disease during the course of their lives. 9 The prevale...

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“…No Piauí, em pacientes com doença de Chagas crônica comprovada sorologicamente, verif icou-se positividade de 34% ao xenodiagnóstico, 25,7% à hemocultura e 59,5% à PCR. 25 No mesmo estudo, na Paraíba, os autores observaram positividade de 13% ao xenodiagnóstico e 44,6% à PCR; a hemocultura não foi realizada. Alguns fatores, que poderiam estar relacionados a tal variabilidade, não informados no trabalho, seriam o tempo de afastamento da área endêmica e a gravidade de formas clínicas.…”

Section: Xenodiagnóstico E Hemocultura Em Co-infecção Com Hivunclassified

“…29,54 A PCR apresenta-se como uma alternativa no controle pós-terapêutico pela sua maior sensibilidade frente às provas parasitológicas indiretas por essas terem baixa sensibilidade com resultados negativos e por vezes inconclusivos após tratamento. 13,25,29 Infelizmente os registros publicados na maioria das vezes representam cortes transversais após a terapêutica, demonstrando maior sensibilidade da PCR em relação às provas parasitológicas. 13,19,33 Considerando as dificuldades para o controle pós-terapêutico na forma crônica da doença com a persistência de anticorpos por longo período após o tratamento, é desejável verificar a contribuição de téc-nicas quantitativas ou semi-quantitativas na detecção de DNA do parasito, 13,19,33 comparativamente às técnicas parasitológicas clássicas, em estudos evolutivos, para se estabelecer o seu papel no controle de eficácia do tratamento.…”

Section: Aprimoramento Das Técnicas De Xenodiagnóstico Eunclassified

Doença de Chagas crônica: do xenodiagnóstico e hemocultura à reação em cadeia da polimerase

Portela-Lindoso

Shikanai-Yasuda

2003

Rev. Saúde Pública

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Embora tenham ocorrido aprimoramentos no diagnóstico parasitológico da doença de Chagas crônica, a baixa sensibilidade dos exames indiretos é uma limitação para sua aplicação ao diagnóstico e controle pós-terapêutico. A reação em cadeia da polimerase (PCR) tem seu emprego restrito na rotina diagnóstica pela necessidade de infra-estrutura adequada, facilidade de contaminação e custo elevado. Paralelamente, a variabilidade de resultados pela PCR observados em diferentes regiões do Brasil suscita questões relativas à sua aplicação ao diagnóstico. Sua alta especificidade aponta para sua aplicação como método confirmatório no diagnóstico de pacientes com provas sorológicas duvidosas e como método auxiliar no controle pós-terapêutico da doença crônica em comparação às técnicas sorológicas e parasitológicas. O objetivo do trabalho foi discutir e comparar a aplicação dos métodos moleculares e parasitológicos indiretos no diagnóstico e controle pós-terapêutico da doença de Chagas crônica, com base na literatura publicada no período de 1954-2001.

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Morbidade da doença de Chagas em áreas do Sertão da Paraíba e da Caatinga do Piauí

Cited by 21 publications

References 11 publications

Chagas disease: morbidity profile in an endemic area of Northeastern Brazil

Chagas disease: morbidity profile in an endemic area of Northeastern Brazil

Early electrocardiographic abnormalities in Trypanosoma cruzi-seropositive children.

Doença de Chagas crônica: do xenodiagnóstico e hemocultura à reação em cadeia da polimerase

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