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

Abstract: INTRODUCTION : This study evaluated the clinical forms and manifestation severities of Chagas disease among serologically reactive individuals from Western Rio Grande do Norte (Northeastern Brazil). METHODS : This cross-sectional study included 186 adults who were evaluated using electrocardiography, echocardiography, chest radiography, and contrast radiography of the esophagus and colon. A clinical-epidemiological questionnaire was also used. RESULTS : The indeterminate, cardiac, digestive, and cardiodigestive clinical forms of Chagas disease were diagnosed in 51.6% (96/186), 32.2% (60/186), 8.1% (15/186) and 8.1% (15/186) of the participants, respectively. Heart failure (functional classes I-IV) was detected in 7.5% (14/186) of the participants, and 36.4% (24/66), 30.3% (20/66), 15.2% (10/66), 13.6% (9/66), and 4.5% (3/66) of the patients were at stage A, B1, B2, C, and D, respectively. Dilated cardiomyopathy and electrocardiographic changes were detected in 10.2% (19/186) and 48.1% (91/186) of the participants, respectively. Apical aneurysm was diagnosed in 10.8% (20/186) of the participants, and other changes in the segmental myocardial contractility of the left ventricle were diagnosed in 33.9% (63/186) of the participants. Megaesophagus (groups I-IV) was observed in 7% (13/186) of the participants, megacolon (grades 1-3) was detected in12.9% (24/186) of the participants, and both organs were affected in 29.2% (7/24) of the megacolon cases. CONCLUSIONS : We detected various clinical forms of Chagas disease (including the digestive form). Our findings indicate that clinical symptoms alone may not be sufficient to exclude or confirm cardiac and/or digestive damage, and the number of patients with symptomatic clinical forms may be underestimated.

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Main Authors: Andrade,Cléber de Mesquita, Câmara,Antônia Cláudia Jácome da, Nunes,Daniela Ferreira, Guedes,Paulo Marcos da Matta, Pereira,Wogelsanger Oliveira, Chiari,Egler, Diniz,Rosiane Viana Zuza, Galvão,Lúcia Maria da Cunha
Format: Digital revista
Language:English
Published: Sociedade Brasileira de Medicina Tropical - SBMT 2015
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822015000600706
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spelling oai:scielo:S0037-868220150006007062015-12-08Chagas disease: morbidity profile in an endemic area of Northeastern BrazilAndrade,Cléber de MesquitaCâmara,Antônia Cláudia Jácome daNunes,Daniela FerreiraGuedes,Paulo Marcos da MattaPereira,Wogelsanger OliveiraChiari,EglerDiniz,Rosiane Viana ZuzaGalvão,Lúcia Maria da Cunha Trypanosoma cruzi Chagas disease Chagasic cardiomyopathy Megaesophagus. Megacolon. Abstract: INTRODUCTION : This study evaluated the clinical forms and manifestation severities of Chagas disease among serologically reactive individuals from Western Rio Grande do Norte (Northeastern Brazil). METHODS : This cross-sectional study included 186 adults who were evaluated using electrocardiography, echocardiography, chest radiography, and contrast radiography of the esophagus and colon. A clinical-epidemiological questionnaire was also used. RESULTS : The indeterminate, cardiac, digestive, and cardiodigestive clinical forms of Chagas disease were diagnosed in 51.6% (96/186), 32.2% (60/186), 8.1% (15/186) and 8.1% (15/186) of the participants, respectively. Heart failure (functional classes I-IV) was detected in 7.5% (14/186) of the participants, and 36.4% (24/66), 30.3% (20/66), 15.2% (10/66), 13.6% (9/66), and 4.5% (3/66) of the patients were at stage A, B1, B2, C, and D, respectively. Dilated cardiomyopathy and electrocardiographic changes were detected in 10.2% (19/186) and 48.1% (91/186) of the participants, respectively. Apical aneurysm was diagnosed in 10.8% (20/186) of the participants, and other changes in the segmental myocardial contractility of the left ventricle were diagnosed in 33.9% (63/186) of the participants. Megaesophagus (groups I-IV) was observed in 7% (13/186) of the participants, megacolon (grades 1-3) was detected in12.9% (24/186) of the participants, and both organs were affected in 29.2% (7/24) of the megacolon cases. CONCLUSIONS : We detected various clinical forms of Chagas disease (including the digestive form). Our findings indicate that clinical symptoms alone may not be sufficient to exclude or confirm cardiac and/or digestive damage, and the number of patients with symptomatic clinical forms may be underestimated.info:eu-repo/semantics/openAccessSociedade Brasileira de Medicina Tropical - SBMTRevista da Sociedade Brasileira de Medicina Tropical v.48 n.6 20152015-12-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822015000600706en10.1590/0037-8682-0235-2015
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language English
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author Andrade,Cléber de Mesquita
Câmara,Antônia Cláudia Jácome da
Nunes,Daniela Ferreira
Guedes,Paulo Marcos da Matta
Pereira,Wogelsanger Oliveira
Chiari,Egler
Diniz,Rosiane Viana Zuza
Galvão,Lúcia Maria da Cunha
spellingShingle Andrade,Cléber de Mesquita
Câmara,Antônia Cláudia Jácome da
Nunes,Daniela Ferreira
Guedes,Paulo Marcos da Matta
Pereira,Wogelsanger Oliveira
Chiari,Egler
Diniz,Rosiane Viana Zuza
Galvão,Lúcia Maria da Cunha
Chagas disease: morbidity profile in an endemic area of Northeastern Brazil
author_facet Andrade,Cléber de Mesquita
Câmara,Antônia Cláudia Jácome da
Nunes,Daniela Ferreira
Guedes,Paulo Marcos da Matta
Pereira,Wogelsanger Oliveira
Chiari,Egler
Diniz,Rosiane Viana Zuza
Galvão,Lúcia Maria da Cunha
author_sort Andrade,Cléber de Mesquita
title Chagas disease: morbidity profile in an endemic area of Northeastern Brazil
title_short Chagas disease: morbidity profile in an endemic area of Northeastern Brazil
title_full Chagas disease: morbidity profile in an endemic area of Northeastern Brazil
title_fullStr Chagas disease: morbidity profile in an endemic area of Northeastern Brazil
title_full_unstemmed Chagas disease: morbidity profile in an endemic area of Northeastern Brazil
title_sort chagas disease: morbidity profile in an endemic area of northeastern brazil
description Abstract: INTRODUCTION : This study evaluated the clinical forms and manifestation severities of Chagas disease among serologically reactive individuals from Western Rio Grande do Norte (Northeastern Brazil). METHODS : This cross-sectional study included 186 adults who were evaluated using electrocardiography, echocardiography, chest radiography, and contrast radiography of the esophagus and colon. A clinical-epidemiological questionnaire was also used. RESULTS : The indeterminate, cardiac, digestive, and cardiodigestive clinical forms of Chagas disease were diagnosed in 51.6% (96/186), 32.2% (60/186), 8.1% (15/186) and 8.1% (15/186) of the participants, respectively. Heart failure (functional classes I-IV) was detected in 7.5% (14/186) of the participants, and 36.4% (24/66), 30.3% (20/66), 15.2% (10/66), 13.6% (9/66), and 4.5% (3/66) of the patients were at stage A, B1, B2, C, and D, respectively. Dilated cardiomyopathy and electrocardiographic changes were detected in 10.2% (19/186) and 48.1% (91/186) of the participants, respectively. Apical aneurysm was diagnosed in 10.8% (20/186) of the participants, and other changes in the segmental myocardial contractility of the left ventricle were diagnosed in 33.9% (63/186) of the participants. Megaesophagus (groups I-IV) was observed in 7% (13/186) of the participants, megacolon (grades 1-3) was detected in12.9% (24/186) of the participants, and both organs were affected in 29.2% (7/24) of the megacolon cases. CONCLUSIONS : We detected various clinical forms of Chagas disease (including the digestive form). Our findings indicate that clinical symptoms alone may not be sufficient to exclude or confirm cardiac and/or digestive damage, and the number of patients with symptomatic clinical forms may be underestimated.
publisher Sociedade Brasileira de Medicina Tropical - SBMT
publishDate 2015
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822015000600706
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