Search

Introduction: Chagas disease (CD) is currently considered a neglected disease; hence, identifying the factors associated with its high prevalence is essential. This study aimed to identify the seroprevalence of and the possible factors associated with CD in inhabitants of the City of Limoeiro do Norte, northeastern Brazil. Methods: Between April and November 2013, blood collection was conducted and a semi-structured questionnaire was administered. Blood samples that showed positive or possible serology for anti- Trypanosoma cruzi antibodies based on indirect immunofluorescence, hemagglutination indirect, and an enzyme-linked immunosorbent assay were analyzed. Associations between CD positivity and the study variables were analyzed using prevalence ratios (PR) with 95% confidence intervals (CI). Results: A total of 812 individuals were analyzed, of which T. cruzi seropositivity was determined in 4.2% (34 individuals). Sociodemographic variables showing a significant association with T. cruzi positivity included age >50 years (PR = 27.6; 95% CI = 6.66-114.4), elementary level education (PR = 5.15; 95% CI = 1.83-14.47), and retirement (PR = 7.25; 95% CI = 3.72-14.14). Positivity for T. cruzi was 6.17 times higher in those who had a history of living in rammed earth houses compared with those who did not (95% CI = 2.19-17.37). There was no evidence of vertical transmission in the individuals studied. Among the individuals infected with T. cruzi , the majority reported having a comorbidity (p < 0.01). Conclusions: This study demonstrated the seroprevalence of CD and identified factors associated with a high prevalence of CD.

SUMMARY Chagas disease is caused by Trypanosoma cruzi and affects about two to three million people in Brazil, still figuring as an important public health problem. A study was conducted in a rural area of the municipality of Limoeiro do Norte - CE, northeastern Brazil, aiming to determine the prevalence of T. cruzi infection. Of the inhabitants, 52% were examined, among whom 2.6% (4/154) were seropositive in at least two serological tests. All seropositive individuals were older than 50 years, farmers, with a low education and a family income of less than three minimum wages. Active surveillance may be an alternative for early detection of this disease. RESUMO A doença de Chagas é causada pelo Trypanosoma cruzi e atinge cerca de dois a três milhões de pessoas no Brasil, permanecendo como importante problema de saúde pública. Foi realizado um estudo em área rural do município de Limoeiro do Norte - CE, nordeste do Brasil, com o objetivo de conhecer a prevalência da infecção chagásica. Foram examinados 52% dos habitantes, dentre os quais 2,6% (4/154) apresentaram sorologia reagente em pelo menos dois testes sorológicos. Todos os positivos tinham idade superior a 50 anos, eram agricultores, com baixa escolaridade e renda familiar inferior a três salários mínimos. A busca ativa pode ser uma alternativa para o diagnóstico precoce dessa doença.

Introduction: Chagas’ disease (DC) is a parasite caused by the infectious agent Trypanosoma cruzi. In Brazil, the specific treatment of CD is performed with Benzonidazole (Bz), which due to its toxicity, can lead to the appearance of several adverse reactions to patients who use it. Therefore, there is a certain concern in evaluating the patient before starting the use of Bz, in order to verify possible hematological and biochemical alterations that may be attributed to the use of benzonidazole. Objective: to delineate the profile of the hematological and biochemical parameters of patients with CD before the pharmacotherapy with Bz. Methodology: Retrospective study of sociodemographic and laboratory parameters (erythrogram, leukogram, platelets, aspartate aminotransferase- TGO, alanine aminotransferase - TGP, urea and creatinine) from 89 chronic Chagas’ patients treated at the Pharmaceutical Care Service of Federal University of Ceará, the January 2010 to December 2015. Results: The population studied was female (52.8%), mean age 53.6 years, low income and education, retired majority, from the interior of the state of Ceará. As far as hematological and biochemical analysis are concerned, it is observed that all parameters are within the reference values. In the comparison between genders, statistical analysis between means showed a significant difference in erythrocytes, hematocrit, hemoglobin, platelets and lymphocyte counts. Conclusion: Despite the evidence of a profile within the normal reference values, the follow-up of these laboratory parameters is of paramount importance in the follow-up of the chagasic patient, since adverse reactions may appear well at the beginning of Benzonidazole treatment, often leading to medication interruption. Introdução: A doença de Chagas (DC) é uma parasitose causada pelo agente infeccioso Trypanosoma cruzi. No Brasil, o tratamento específico da DC é realizado com o Benzonidazol (Bz), que devido à sua toxicidade pode levar ao aparecimento de várias reações adversas aos pacientes que fazem uso deste medicamento. Diante disso, existe uma preocupação em avaliar o paciente antes de iniciar a utilização do Bz, a fim de verificar possíveis alterações hematológicas e bioquímicas que eventualmente possam ser atribuídas à utilização deste medicamento. Objetivo: delinear o perfil dos parâmetros hematológicos e bioquímicos de pacientes com DC antes da farmacoterapia com Bz. Metodologia: Estudo retrospectivo que avaliou o perfil sociodemográfico e os parâmetros laboratoriais (eritrograma, leucograma, plaquetas, aspartato aminotransferase - TGO, alanina aminotransferase - TGP, ureia e creatinina) de 89 pacientes chagásicos crônicos atendidos no Serviço de Atenção Farmacêutica ao Paciente com doença de Chagas da Universidade Federal do Ceará no período de janeiro de 2010 a dezembro de 2015. Resultados: A população estudada se caracterizou feminina (52,8%), média de idade de 53,6 anos, de baixa renda e escolaridade, maioria aposentada, procedente do interior do estado do Ceará. No que se refere às análises hematológicas e bioquímicas, observa-se que todos os parâmetros se encontram dentro dos valores de referência. Na comparação entre gêneros, a análise estatística entre as médias demonstrou diferença significativa nos eritrócitos, no hematócrito, na hemoglobina, nas plaquetas e na contagem de linfócitos. Conclusão: Apesar da evidência de um perfil dentro dos valores normais de referência, o acompanhamento desses parâmetros laboratoriais é de suma importância no seguimento do paciente chagásico, visto que as reações adversas podem aparecer bem no início do tratamento com o Benzonidazol, levando muitas vezes à interrupção do medicamento.

In Brazil, among the endemic vector-borne diseases, Chagas disease has been considered one of the most important public health problems. The present study aimed at estimating the prevalence of triatomines infected with Trypanosoma cruzi in the city of Limoeiro do Norte, CE, Brazil. This investigation was conducted by consulting the archives of the Chagas disease control program of the Health District of Limoeiro do Norte for the period from 2006 to 2009. The study included dead or alive, adults and nymphs triatomines, which where captured during the investigated period. During the four-year study, 2,863 specimens of nymphs and adults insects were captured from the domestic and peridomestic areas; 2,756 were examined, representing 96.3 % of collected specimens. The insect infection rate was 7.9 % in four-year study. The number of captured nymphs was nearly three times higher than the number of adults; however the number of nymphs infected with the flagellate (5.30 %) was lower than the number of adults form (15.85 %). Limoeiro do Norte showed a high risk for Chagas disease transmission, suggesting that the control actions should be intensified in this city to prevent the disease transmission and the vector spread.

INTRODUCTION: Chagas disease remains a public health problem in the rural and urban areas of 19 countries in the Americas. METHODS: The aim of the present study was to investigate the Trypanosoma cruzi infection rate of triatomines collected from both intra- and peridomiciliary areas in eleven municipalities of Southeastern Ceará, Brazil, from 2009 to 2015. RESULTS: A total of 32,364 triatomine specimens, including nymphs and adults, were collected, and 31,736 (98.06%) of these were examined. More nymphs were collected than adults, and the greatest number of triatomines (n = 8,548) was collected in 2010, for which the infection rate was 1.3%, with the highest rate of infections observed for specimens from Quixere. The species collected during the study were identified as Triatoma pseudomaculata, Triatoma brasiliensis, Panstrongylus megistus, Panstrongylus lutzi, and Rhodnius nasutus, with T. pseudomaculata being the most abundant (n = 19,962). CONCLUSIONS: These results verify the presence of triatomines in both intra- and peridomiciliary areas, thereby ensuring persistence of the pathogen and consequently, the disease, as the presence of infected vectors in households is an important risk factor. According to these findings, the Chagas Disease Control Program should intensify its efforts in order to prevent the spread of the disease.

INTRODUCTION: The transmission of Chagas disease (CD) through blood transfusion, organ transplantation, and oral transmission has gained greater visibility as a result of intensified vector control activities in endemic regions and to control CD in non-endemic regions. In Brazil, Ceará is one of the states that perform the most organ transplants. Therefore, the objective of this study was to assess the prevalence of Trypanosoma cruzi infection in organ donor candidates. METHODS: A retrospective analysis was performed on data from potential organ donors at the Center of Transplantation of the State of Ceará from 2010 - 2015. RESULTS: Data from a total of 2,822 potential donors were obtained, of which 1,038 were effective donors and 1,784 were excluded, likely due to lack of family authorization or medical contraindication. The prevalence of T. cruzi infection among these potential donors was 1.3% (n = 29). The majority of infected donors were males aged 41 - 60 years, residing in the interior of the state. Interestingly, 72.4% (n = 21) had positive or inconclusive serology for additional infections, such as cytomegalovirus, hepatitis B and C, and toxoplasmosis. Probability analysis revealed that stroke was the most common cause of death among potential donors with CD. CONCLUSIONS: There was a high prevalence of CD and other coinfections among potential solid organ donors in Ceará, and statistical tests have shown that these individuals are at increased risk of stroke when compared to potential non-reactive donors. This work highlights the importance of screening DC infection in potential donors.