O perfil dos portadores de doença de Chagas, com ênfase na forma digestiva, em hospital terciário de Ribeirão Preto, SP

Abstract

Para caracterizar o perfil clínico e demográfico dos portadores da forma digestiva da doença de Chagas atualmente atendidos no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, foram revistos 377 prontuários de pacientes com resultado positivo para reação sorológica para a doença de Chagas atendidos entre janeiro de 2002 a março de 2003. A idade mediana dos pacientes era de 67 anos e 210 (56%) eram mulheres. Megaesôfago e/ou megacólon chagásicos estavam presentes em 135 pacientes, dos quais, 59% apresentavam cardiopatia. Para 49% dos pacientes com doença digestiva, havia prescrição de pelo menos dois medicamentos para tratamento de doença cardiovascular. Em 66 pacientes, foram detectadas comorbidades crônicas. A população de portadores da forma digestiva da doença de Chagas do HCFMRP é majoritariamente geriátrica e apresenta freqüência elevada de doenças cardiovasculares, o que sugere risco elevado das modalidades de tratamento cirúrgico do megaesôfago e megacólon.

Current epidemiological profile of Chagasic megaesophagus in Central Brazil

“…Regarding distribution by gender, similar to the fi ndings of Rezende 13 , Rezende and Luquetti 18 and Vaz et al 21 , this study found that males were generally more prevalent (54% of cases) relative to females (46% of cases). However, studies performed by Kamiji and Oliveira 20 and Almeida et al 24 demonstrated a greater prevalence of female patients, and Peñaranda-Carrillo et al 25 and Oliveira et al 19 did not observe any gender differences in their studies. The predominance of CM in a given gender has resulted in many studies with controversial results.…”

“…For example, the median in the study performed by Kamiji and Oliveira 20 was 67 years, and the study conducted by Meneghelli et al 23 revealed that a median of 55 years. Thus, the prevalence of older patients (> 40 years old) with CM deserves special attention, not only with regard to esophagopathy but also other comorbidities that are prevalent in the population in this age group, such as cardiovascular and metabolic diseases 19 .…”

“…Improved sanitary measures, including the use of insecticides, along with educational campaigns and preventive measures against contamination by the vector, the kissing bug, have reduced the general incidence of the disease throughout the country. Better access to health care at the primary level and referral to the secondary and tertiary levels have also contributed to the adequate control and treatment of CM in its less advanced forms (Groups I and II) 20,21 .…”

“…This decline is most likely a consequence of better sanitary measures aimed at controlling the transmission of CD. These measures have decreased the general incidence of this disease in the country 7,20 .…”

Delayed Gastric Emptying for Semi-Solid Diets in Patients With Chagasic Megaesophagus

“…Chagas disease is a major public health problem that is largely restricted to South America, 1,2 where it affects 15 million individuals. The combined annual incidence is 42,000 cases in 21 countries 3 .…”