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1.
Braz. j. biol ; 81(4): 867-871, Oct.-Dec. 2021. tab
Article in English | LILACS | ID: biblio-1153428

ABSTRACT

Abstract Chagas disease (CD) is considered a typical low-income population sickness of the developing countries in Latin America. Given the historical relevance of CD in individuals in southern Rio Grande do Sul (RS) State, Brazil, the aim of this study was to identify the knowledge of the CD and its vectors by cardiac patients, and the prevalence of anti-T cruzi antibodies in these individuals in Pelotas, city located in Rio Grande do Sul (RS) state, Brazil. The subjects with cardiac disease were submitted to a semi-structured questionnaire as well as two serological tests in order to detect anti-T. cruzi IgG antibodies. Of the individuals that born in municipalities showing the highest triatomine infestation rates in recent decades, 81.8% were able to recognize the vector insect (p = 0.0042; OR = 5.9), and 83.3% reported either themselves or someone in their families to have CD (p = 0.043, OR = 5.2). Of the 54 patients submitted to serological analysis, only 01 patient (1.9%) was positive for anti-T. cruzi antibodies, a 55 year old man from the rural area of Canguçu county. This study provides support for the evaluation to be extended to other cardiology centers, given the importance of Chagas disease in Brazil.


Resumo A doença de Chagas (DC) é considerada uma doença típica da população de baixa renda dos países em desenvolvimento da América Latina. Dada a relevância histórica da DC em indivíduos do sul do Estado do Rio Grande do Sul (RS), o objetivo deste estudo foi identificar o conhecimento da doença de Chagas (DC) e seus vetores em pacientes cardíacos, e a prevalência de anticorpos anti-T cruzi nesses indivíduos, em Pelotas, cidade localizada no Rio Grande do Sul (RS), Brasil. Os pacientes cardiopatas foram submetidos a um questionário semiestruturado, e também a dois testes sorológicos para detecção de anticorpos anti-T. cruzi IgG. Dos indivíduos que nasceram em municípios com as maiores taxas de infestação por triatomíneos nas últimas décadas, 81,8% foram capazes de reconhecer o inseto vetor (p = 0,0042; OR = 5,9), e 83,3% relataram que eles próprios ou alguém em suas famílias tem DC (p = 0,043, OR = 5,2). Dos 54 pacientes submetidos à análise sorológica, apenas 01 paciente (1,9%) foi positivo para anticorpos anti-T.cruzi, um homem de 55 anos da área rural do município de Canguçu. Este estudo fornece subsídios para que a avaliação seja estendida a outros centros de cardiologia, devido à importância da doença de Chagas no Brasil.


Subject(s)
Humans , Animals , Middle Aged , Trypanosoma cruzi , Chagas Disease/epidemiology , Brazil/epidemiology , Seroepidemiologic Studies , Insect Vectors
3.
Braz. j. biol ; 81(3): 665-673, July-Sept. 2021. tab, graf
Article in English | LILACS | ID: biblio-1153396

ABSTRACT

Abstract Educational interventions may trigger actions that contribute to prevent parasitic diseases, such as Chagas disease (CD). This study aimed at investigating the impact of an instructional video named "Documentary on Chagas Disease" on knowledge about CD and its vectors displayed by a population that lives in an endemic area in Brazil, so as to validate it as an educational tool. The video was shown to 226 subjects, divided into two groups. Group 1 was composed of users of Basic Health Units (BHU) in Pelotas and Pinheiro Machado, cities located in Rio Grande do Sul (RS) state, Brazil, where CD is endemic. Group 2 consisted of students who attend three public schools located in the rural area in Pinheiro Machado, RS. Two questionnaires with questions about their knowledge about triatomines and CD were applied, before and after the documentary was shown. After the video was shown, there was significant increase in individuals' knowledge (in both groups) about "kissing bugs", their notification, the disease and its prevention. Besides, watchers considered that the quality of the material was satisfactory. Since the "Documentary on CD" can be easily accessed on the internet and was effective in teaching the population that lives in endemic areas, its use should be encouraged in places and meetings connected to health that aim at fighting against triatominae and at exposing an updated view of CD.


Resumo Intervenções educacionais podem desencadear ações que contribuam para a prevenção de doenças parasitárias, como a doença de Chagas (DC). Este estudo teve como objetivo investigar o impacto de um vídeo instrucional denominado "Documentário Doença de Chagas" no conhecimento sobre DC e seus vetores exibidos a uma população que vive em área endêmica no Brasil, para validá-lo como uma ferramenta educacional. O vídeo foi exibido para 226 indivíduos, divididos em dois grupos. O grupo 1 foi composto por usuários das Unidades Básicas de Saúde (UBS) de Pelotas e Pinheiro Machado, cidades do estado do Rio Grande do Sul (RS), Brasil, onde a DC é endêmica. O grupo 2 foi formado por estudantes que frequentam três escolas públicas localizadas na zona rural de Pinheiro Machado, RS. Dois questionários com perguntas sobre conhecimentos sobre triatomíneos e DC foram aplicados, antes e depois da exibição do documentário. Após a exibição do vídeo, houve um aumento significativo no conhecimento dos indivíduos (em ambos os grupos) sobre "triatomíneos", sua notificação, a doença e sua prevenção. Além disso, os observadores consideraram que a qualidade do material era satisfatória. Como o "Documentário DC" pode ser facilmente acessado na Internet e ser eficaz no ensino à população que vive em áreas endêmicas, seu uso deve ser incentivado em locais e reuniões relacionadas à saúde, que visam combater os triatomíneos e exibir uma informação atualizada sobre a DC.


Subject(s)
Humans , Animals , Triatoma , Triatominae , Chagas Disease/epidemiology , Brazil/epidemiology , Insect Vectors
5.
Medicina (B.Aires) ; 81(2): 154-158, June 2021. graf
Article in Spanish | LILACS | ID: biblio-1287265

ABSTRACT

Resumen La enfermedad de Chagas es endémica en América Latina y sigue siendo un problema regional a pesar de que su frecuencia ha disminuido gracias a importantes avances en salud ambiental. Para determinar su frecuencia en pacientes con enfermedades miocárdicas de El Salvador, se llevó a cabo una in vestigación observacional retrospectiva en nuestro hospital que es un centro de referencia de nivel nacional. Se revisó el registro del Laboratorio de Chagas en el período 2013-2015 para conocer cuántos individuos internados en la Unidad Cardiológica eran positivos por serología para infección chagásica y cuáles fueron sus diagnósticos. Se realizó un total de 1472 pruebas a pacientes individuales durante los 36 meses del período de estudio. De los 557 pacientes con serología positiva para Chagas, 97 (17.4%) fueron eventualmente hospitalizados en la Unidad Cardiológica. A su vez, estos 97 pacientes representaron el 33.7% de los 288 pacientes con cardiopatías. Entre los 97 con cardiopatía chagásica, 40 (41.2%) cumplieron criterios para colocación de marcapaso permanente, mientras que solo 13 de 191 (6.8%) enfermos con cardiopatías no chagásicas cumplieron esos criterios. La frecuencia de bloqueos auriculoventriculares asociados a infección por Trypanosoma cruzi resultó mucho mayor que las publicadas en estudios previos realizados en Sudamérica.


Abstract Chagas disease is endemic in Latin America and remains a regional problem despite improvements in en vironmental health conditions that have helped to control its transmission. To know more about its prevalence in heart disease patients, we carried out a survey in our national (El Salvador) reference hospital. We reviewed the Chagas Lab´s records 2013-2015 to find out how many of the patients admitted to the Hospital´s Heart Unit were serologically positives for Trypanosoma cruzi infection and which the associated diagnoses were. A total of 1472 patients were tested along the 36-month study period. Out of 557 (37.8%) patients with positive serology for Chagas infection, 97 (17.4%) were eventually admitted to the Heart Unit. Among these 97 Chagas infected patients with heart disease, 40 (41.2%) met the criteria for permanent pacemaker placement, while only 13 of 191 (6.8%) patients with non-chagasic heart disease met these criteria. The frequency of heart atrioventricular block associated with Trypanosoma cruzi infection was higher than frequencies reported in South American studies.


Subject(s)
Humans , Trypanosoma cruzi , Chagas Disease/diagnosis , Chagas Disease/epidemiology , Atrioventricular Block/etiology , Atrioventricular Block/epidemiology , El Salvador , Latin America
6.
Nursing (Säo Paulo) ; 24(275): 5514-5529, abr.-2021.
Article in Portuguese | LILACS, BDENF | ID: biblio-1224213

ABSTRACT

Objetivo: discutir sobre o impacto do déficit de investimentos para o tratamento da Doença de Chagas no Brasil. Método: trata-se de uma revisão narrativa da literatura realizada nas seguintes bases de dados: SCIELO, LILACS, BIREME e MEDLINE. A amostra final foi composta por 27 artigos científicos publicados entre o período de 2000 a 2020. Resultados: o Brasil é um dos países com maior prevalência de pacientes portadores da doença, porém pouco se avançou em pesquisas nessa área, de modo a repercutir em um baixo incentivo e investimento dos governantes e da indústria farmacêutica para a Doença de Chagas, tendo em vista a doença ser de progressão lenta e o diagnóstico e o tratamento serem tardios. Conclusão: fica evidente a falta de investimento e políticas públicas que possibilitem o diagnóstico e o tratamento precoce da doença tendo como conseqüência um déficit na qualidade de vida dos pacientes.(AU)


Objective: to discuss the impact of the investment deficit for the treatment of Chagas Disease in Brazil. Method: This is a narrative review of the literature conducted in the following databases: SCIELO, LILACS, BIREME and MEDLINE. The final sample consisted of 27 scientific articles published between 2000 and 2020. Results: Brazil is one of the countries with the highest prevalence of patients with the disease, but little progress has been made in research in this area, so as to have a low incentive and investment from governments and the pharmaceutical industry for Chagas Disease, in view of the disease being of slow progression and the diagnosis and treatment are late. Conclusion: it is evident the lack of investment and public policies that make possible the diagnosis and early treatment of the disease with the consequence of a deficit in the quality of life of the patients.(AU)


Objetivo: discutir el impacto del déficit de inversión para el tratamiento de la enfermedad de Chagas en Brasil. Método: se trata de una revisión narrativa de la literatura realizada en las siguientes bases de datos: SCIELO, LILACS, BIREME y MEDLINE. La muestra final consistió en 27 artículos científicos publicados entre 2000 y 2020. Resultados: el Brasil es uno de los países con mayor prevalencia de pacientes con la enfermedad, pero se ha avanzado poco en la investigación en esta área, para tener un bajo incentivo e inversión de los gobiernos y de la industria farmacéutica para la enfermedad de Chagas, considerando que la enfermedad es de progresión lenta y el diagnóstico y tratamiento son tardíos. Conclusión: es evidente la falta de inversión y de políticas públicas que permitan el diagnóstico y tratamiento precoz de la enfermedad con el consiguiente déficit en la calidad de vida de los pacientes.(AU)


Subject(s)
Humans , Prevalence , Chagas Disease/therapy , Chagas Disease/epidemiology , Health Policy , Investments , Therapeutics/economics , Health Policy
7.
J. Hum. Growth Dev. (Impr.) ; 31(1): 84-92, Jan.-Apr. 2021. map, tab
Article in English | LILACS, INDEXPSI | ID: biblio-1250156

ABSTRACT

INTRODUCTION: Chagas disease (CD) is a disease caused by the protozoan flagellates of the Kinetoplastid order Trypanosoma cruzi. Approximately 8,000,000 people are infected worldwide, mainly in Latin America, causing disabilities and more than 10,000 deaths per year OBJECTIVE: This study aimed to describe the epidemiological panorama of CD in the Western Brazilian Amazon from 2007 to 2018. METHODS: In this ecological study, secondary data regarding the confirmed cases of T. cruzi infection in the states of Acre, Amazonas, Rondônia, and Roraima were collected from the Single Health System Notification Information System of the Department of Informatics of the Single Health System and were analyzed. The data were used to characterize the epidemiological profile of T. cruzi infection and to determine the frequency of infection in Western Amazonia. RESULTS: A total of 184 cases of CD were reported in Western Amazonia, and the highest number of cases was reported in the states of Amazonas and Acre. CONCLUSION: The epidemiological panorama of the Western Brazilian Amazon from 2007 to 2018 includes a greater number of cases of T. cruzi infection in men aged 20-39 years and those living in rural areas. Oral transmission was prevalent in the region during the study, and the highest number of cases was reported in the months of April and December. Epidemiological data are an important resource for understanding the dynamics of CD and the main aspects related to the health-disease process.


INTRODUÇÃO: A doença de Chagas (DC) é uma enfermidade causada pelo protozoário flagelado da ordem Kinetoplastida denominado Trypanosoma cruzi. Estima-se que oito milhões de pessoas estejam infectadas em todo o mundo, principalmente na América Latina, causando incapacidades e mais de dez mil mortes por ano. OBJETIVO: Descrever o panorama epidemiológico da doença de Chagas na Amazônia Ocidental brasileira no período de 2007 a 2018. MÉTODO: Trata-se de um estudo ecológico e com coleta e análise de dados referentes aos casos confirmados de infecção por T. cruzi nos estados do Acre, Amazonas, Rondônia e Roraima, por meio de fontes secundárias oriundos do Sistema de Informação de Agravos de Notificação do Sistema Único de Saúde (SINAN) do Departamento de Informática do Sistema Único de Saúde (DATASUS). Os dados foram utilizados para caracterizar o perfil epidemiológico dos infectados por T. cruzi e determinar a frequência da infecção na Amazônia Ocidental RESULTADOS: Houve a notificação de 184 casos de doença de Chagas na Amazônia Ocidental com mais registros nos estados do Amazonas e Acre. CONCLUSÃO: O panorama epidemiológico da Amazônia Ocidental Brasileira no período de 2007 a 2018, compreende uma maior quantidade de casos em indivíduos do sexo masculino, na faixa etária dos 20-39 anos, e provenientes de zona rural. A forma de contágio prevalente na região durante o estudo foi a oral e a maior sazonalidade compreendeu os meses de abril e dezembro. Dados epidemiológicos são um importante recurso para a compreensão da dinâmica da DC e os principais aspectos relacionados no processo saúde-doença.


Subject(s)
Health Profile , Morbidity , Chagas Disease , Chagas Disease/epidemiology , Information Systems
9.
Cad. Saúde Pública (Online) ; 37(6): e00175920, 2021. tab, graf
Article in Portuguese | LILACS | ID: biblio-1278621

ABSTRACT

Para o reconhecimento da magnitude da doença de Chagas crônica no Brasil, é necessário rearticular as ações de vigilância em saúde, buscando o desenvolvimento de uma ampla rede hierarquizada de serviços distribuída geograficamente, para prover atendimento aos milhares de cidadãos acometidos pela infecção por Trypanosoma cruzi. O objetivo do trabalho foi elaborar um modelo de priorização de municípios para a vigilância da doença de Chagas crônica, a fim de ofertar cuidado integral às pessoas afetadas pela enfermidade. Para isso, foi realizada uma análise multicritério utilizando o algoritmo PROMETHEÉ II implementado no software Pradin. Os critérios de avaliação do modelo foram compostos de três índices construídos a partir de indicadores (a) epidemiológicos diretamente relacionados à doença de Chagas crônica, (b) decorrentes da evolução da doença de Chagas crônica, e (c) relacionados ao acesso aos serviços de saúde. A Escala Fundamental de Saaty foi utilizada para definição dos pesos dos indicadores, com maior importância aos diretamente relacionados à doença de Chagas crônica e àqueles com maior confiabilidade e respectiva qualidade de informação. A avaliação da consistência dos modelos se deu em comparação com dados disponíveis das áreas historicamente endêmicas, com a distribuição de casos agudos, e outras análises de sensibilidade. O modelo mais adequado foi definido por 1.345 municípios de média prioridade, 1.003 de alta e 601 como muito alta prioridade para doença de Chagas crônica, com maiores proporções nas regiões Sudeste e Nordeste. A priorização permite à gestão racionalizar e direcionar recursos, sendo essencial para identificar os territórios onde as pessoas infectadas estão vivendo, a fim de promover a assistência integral e melhorar a qualidade de vida.


The identification of the magnitude of chronic Chagas disease in Brazil requires linking activities in health surveillance, seeking to develop a wide, hierarchically organized and geographically distributed network of services to provide care to thousands of individuals with Trypanosoma cruzi infection. The study aimed to elaborate a model for prioritization of municipalities for chronic Chagas disease, to offer comprehensive care for persons with the disease. A multicriteria analysis was thus performed using the PROMETHEÉ II algorithm, implemented in the Pradin software. The criteria for assessing the model consisted of three indices built from the following indicators: (a) epidemiological, directly related to chronic Chagas disease, (b) related to the evolution in chronic Chagas disease, and (c) related to access to health services. Saaty's Fundamental Scale was used to define the indicators' weights, with greater importance assigned to those directly related to chronic Chagas disease and to those with greater reliability and respective quality of information. Assessment of the models' consistency was based on comparison of the available data in historically endemic areas with the distribution of acute cases, besides other sensitivity analyses. The best model was defined by 1,345 municipalities with medium priority, 1,003 high priority, and 601 with very high priority for chronic Chagas disease, with the highest proportions in the Southeast and Northeast regions. Prioritization allows the administration to rationalize and channel resources, and it is essential to identify the territories where persons with chronic Chagas disease are living, to promote comprehensive care and improve quality of life.


Para el reconocimiento de la magnitud de la enfermedad de Chagas crónica en Brasil, es necesario rearticular las acciones de vigilancia en salud, buscando el desarrollo de una amplia red jerarquizada de servicios distribuida geográficamente, para proveer atención a los millares de ciudadanos afectados por la infección por Trypanosoma cruzi. El objetivo del trabajo fue elaborar un modelo de priorización de municipios para la vigilancia de la enfermedad de Chagas crónica, con el fin de ofertar cuidado integral a las personas afectadas por la enfermedad. Para eso, se realizó un análisis multicriterio, utilizando el algoritmo PROMETHEÉ II, implementado en el software Pradin. Los criterios de evaluación del modelo estuvieron compuestos por tres índices construidos a partir de indicadores (a) epidemiológicos directamente relacionados con la enfermedad de Chagas crónica, (b) derivados de la evolución de la enfermedad de Chagas crónica y, (c) relacionados con el acceso a los servicios de salud. La Escala Fundamental de Saaty se utilizó para la definición de los pesos de los indicadores, con mayor importancia a los directamente relacionados con la enfermedad de Chagas crónica y aquellos con mayor confiabilidad, así como su respectiva calidad de información. La evaluación de la consistencia de los modelos se consiguió en comparación con los datos disponibles de las áreas históricamente endémicas, con la distribución de casos agudos, y otros análisis de sensibilidad. El modelo más adecuado se definió por 1.345 municipios de media prioridad, 1.003 de alta y 601 como mucho alta prioridad para enfermedad de Chagas crónica, con mayores proporciones en las regiones Sudeste y Nordeste. La priorización permite a las áreas de gestión racionalizar y dirigir recursos, y es esencial para identificar los territorios donde estas personas están viviendo, con el fin de promover la asistencia integral y mejorar la calidad de vida.


Subject(s)
Humans , Trypanosoma cruzi , Chagas Disease/epidemiology , Quality of Life , Brazil/epidemiology , Reproducibility of Results
10.
Mem. Inst. Oswaldo Cruz ; 116: e210015, 2021. tab, graf
Article in English | LILACS | ID: biblio-1250359

ABSTRACT

Chagas disease persists as one of the most important, and yet most neglected, diseases in the world, and several changes in its epidemiological aspects have been recorded since its discovery. Currently, some of the most relevant changes are related to: (i) the reduction in the incidence of the endemic due to the control of the most important vectors, Triatoma infestans and Rhodnius prolixus, in many countries; (ii) the migration of human populations spreading cases of the disease throughout the world, from endemic to non-endemic areas, transforming Chagas disease into a global threat; and (iii) new acute cases and deaths caused by oral transmission, especially in the north of Brazil. Despite the reduction in the number of cases, new challenges need to be responded to, including monitoring and control activities aiming to prevent house infestation by the secondary vectors from occurring. In 1979, Lent & Wygodzinsky(1) published the most complete review of the subfamily Triatominae, encompassing 111 recognised species in the taxon. Forty-two years later, 46 new species and one subspecies have been described or revalidated. Here we summarise the new species and contextualise them regarding their ecology, epidemiologic importance, and the obstacles they pose to the control of Chagas disease around the world.


Subject(s)
Humans , Animals , Triatoma , Trypanosoma cruzi , Triatominae , Chagas Disease/prevention & control , Chagas Disease/epidemiology , Brazil/epidemiology , Insect Vectors
11.
Rev. Soc. Bras. Med. Trop ; 54: e00402021, 2021. tab
Article in English | LILACS | ID: biblio-1250818

ABSTRACT

Abstract INTRODUCTION We aimed to describe the sociodemographic, epidemiological, and clinical characteristics of patients with chronic Chagas disease (CD) at an infectious disease referral center. Changes in patient profiles over time were also evaluated. METHODS This retrospective study included patients with CD from November 1986-December 2019. All patients underwent an evaluation protocol that included sociodemographic profile; epidemiological history; anamnesis; and physical, cardiologic, and digestive examinations. Trend differences for each 5-year period from 1986 to 2019 were tested using a nonparametric trend test for continuous and generalized linear models with binomial distribution for categorical variables. RESULTS A total of 2,168 patients (52.2% women) were included, with a mean age of 47.8 years old. White patients with low levels of education predominated. The reported transmission mode was vectorial in 90.2% of cases. The majority came from areas with a high prevalence (52.2%) and morbidity (67.8%) of CD. The most common clinical presentation was the indeterminate form (44.9%). The number of patients referred gradually decreased and the age at admission increased during the study period, as did the patients' levels of education. CONCLUSIONS The clinical profile of CD is characterized by a predominance of the indeterminate form of the disease. Regarding the patients who were followed up at the referral center, there was a progressive increase in the mean age and a concomitant decrease in the number of new patients. This reflects the successful control of vector and transfusion transmission in Brazil as well as the aging population of patients with CD.


Subject(s)
Humans , Animals , Male , Aged , Chagas Disease/diagnosis , Chagas Disease/epidemiology , Referral and Consultation , Brazil/epidemiology , Prevalence , Retrospective Studies , Middle Aged
12.
Rev. Soc. Bras. Med. Trop ; 54: e0247-2020, 2021. tab, graf
Article in English | LILACS | ID: biblio-1155527

ABSTRACT

Abstract INTRODUCTION: This study estimated the seroprevalence and risk factors of Chagas disease (CD) in a population of the Quixeré municipality, Ceará. METHODS: We conducted serological methods to detect the Trypanosoma cruzi infection. The other variables were evaluated by a standardized questionnaire. RESULTS: The estimated prevalence of CD was 3.7%. Male sex, age >40 years, being farmers, low education level, origin from rural areas, and being born in Quixeré were significantly associated with infection. CONCLUSION: CD persists in this rural population of Northeast Brazil. Poverty, low education, and limited information regarding CD are critical issues that need to be addressed.


Subject(s)
Humans , Male , Adult , Trypanosoma cruzi , Chagas Disease/epidemiology , Rural Population , Brazil/epidemiology , Seroepidemiologic Studies , Prevalence , Risk Factors
13.
Rev. Soc. Bras. Med. Trop ; 54: e00842020, 2021. tab, graf
Article in English | ColecionaSUS, LILACS, ColecionaSUS, SES-SP | ID: biblio-1143885

ABSTRACT

Abstract INTRODUCTION: Panstrongylus megistus is the main triatomine involved in the human transmission of Trypanosoma cruzi in Minas Gerais, Brazil. We analyzed the occurrence of triatomines in the Itaúna micro-regions for healthcare. METHODS: Data were collected as part of routine entomological surveillance activities, including the species identity, capture site, developmental stage, and trypanosome infection. RESULTS: In total, 503 specimens from five species were captured (495 P. megistus). Adults were mainly captured by residents inside their homes, whereas nymphs were mostly captured by public health professionals outside. CONCLUSIONS: The epidemiologically important triatomine, P. megistus, continues to persist in our study region.


Subject(s)
Humans , Animals , Panstrongylus , Trypanosoma cruzi , Chagas Disease/epidemiology , Brazil/epidemiology , Insect Vectors
14.
Epidemiol. serv. saúde ; 30(2): e2020877, 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1279004

ABSTRACT

Objetivo: Avaliar a qualidade da identificação de triatomíneos na rede de laboratórios do estado de Pernambuco, Brasil. Métodos: Os nove laboratórios participantes receberam material de apoio com as chaves dicotômicas e um painel composto por sete insetos triatomíneos conhecidos no estado, para identificação da situação do espécime no recebimento (estrutura completa ou danificada), espécie e sexo. Resultados: Nove laboratórios de 12 aderiram ao estudo. A proporção de acerto para identificação do sexo foi de 56/63, e para espécie, 45/63, não apresentando relação direta com a ocorrência de danos nas estruturas morfológicas durante o transporte dos insetos. Para Panstrongylus megistus, houve acerto em todos os espécimes (9/9), enquanto para espécies do gênero Rhodnius a proporção foi menor (3/9). Conclusão: Apesar do bom desempenho na identificação entomológica, as fragilidades observadas poderão orientar ações para melhoria na rede de laboratórios e serão essenciais para os programas de controle vetorial da doença de Chagas.


Objetivo: Evaluar la calidad de la identificación de triatominos en la red de laboratorios del estado de Pernambuco, Brasil. Métodos: Los nueve laboratorios participantes recibieron material de apoyo con claves dicotómicas y un panel conformado por siete insectos triatominos conocidas en el estado, para identificar la situación del espécimen al recibirlo (estructura completa o dañada), especie y sexo. Resultados: La adherencia al laboratorio fue del 9/12. La proporción de aciertos para la identificación del sexo fue del 56/63, y para las especies 45/63, no mostraron relación directa con la ocurrencia de daños en las estructuras morfológicas durante el transporte de insectos. Solo Panstrongylus megistus logró el 9/9 de precisión, mientras que para las especies del género Rhodnius fue el más pequeño (3/9). Conclusión: A pesar del buen desempeño en identificación entomológica, la evaluación indicó debilidades que permitirán implementar acciones correctivas para mejorar la red de laboratorios, esenciales para los programas de control vectorial de la enfermedad de Chagas.


Objective: To assess the quality of triatomine identification in the laboratory network of the state of Pernambuco, Brazil. Methods: The participating laboratories received support material with dichotomous keys and a panel made up of seven triatomine insects known in the Pernambuco, in order to identify specimen status on receipt (intact or damaged structure), as well as species and sex. Results: Nine out of 12 laboratories took part of the study. The proportion of correct answers was 56/63 for sex identification, and 45/63, for species. The answers did not present a direct relationship with occurrence of damage to morphological structures during insect transportation. Panstrongylus megistus identification was correct for all specimens (9/9 laboratories), while correct identification of species of the Rhodnius genus was the lowest (3/9 laboratories). Conclusion: Despite the good performance in entomological identification, the weaknesses observed may guide improvements in the laboratory network and will be essential for Chagas disease vector control programs.


Subject(s)
Humans , Animals , Triatominae/parasitology , Entomology , Insect Vectors/parasitology , Trypanosoma cruzi/parasitology , Brazil/epidemiology , Chagas Disease/epidemiology , Laboratories/statistics & numerical data
15.
Arq. bras. cardiol ; 115(6): 1082-1091, dez. 2020. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1152955

ABSTRACT

Resumo Fundamento A doença de Chagas (DC) é considerada um problema de saúde pública na América Latina. A região nordeste, principalmente o estado do Ceará, ainda representa grande preocupação em termos de risco de transmissão da doença. Objetivo Estimar a prevalência de T. cruzi em doadores de sangue do estado do Ceará. Métodos Trata-se um de estudo retrospectivo descritivo realizado no período de 2010 a 2015, a partir de dados registrados no sistema informatizado do Centro de Hematologia e Hemoterapia do Ceará (HEMOCE). Resultados Dos 763.731 potenciais doadores de sangue, 14.159 foram considerados impedidos de fazer a doação devido à sorologia, sendo que 1.982 (0,33%) o foram devido à positividade/inconclusão para doença de Chagas. Compareceram à Hemorrede para a repetição 425 indivíduos, sendo confirmados 28,2% (120/425) como impedidos de doar devido a DC. Conclusão Não houve redução significativa das sorologias positivas/inconclusivas no período entre 2010-2015, porém foi observada redução em relação a 1996/1997 no estado. A determinação da prevalência da doença de Chagas em bancos de sangue pode ser relevante como indicador do risco de transmissão transfusional em determinada região. Novos testes sorológicos para triagem com melhor acurácia são necessários, reduzindo o descarte desnecessário de bolsas de sangue, os custos para o Sistema Único de Saúde e a insegurança para os pacientes e familiares. (Arq Bras Cardiol. 2020; 115(6):1082-1091)


Abstract Background Chagas disease (CD) is considered a public health problem in Latin America. The northeastern region, especially the state of Ceará, still represents a major concern in terms of the risk of transmission of CD. Objective To estimate the prevalence of T. cruzi in blood donors from the state of Ceará. Methods This is a retrospective descriptive study that was performed in the period from 2010 to 2015 from data recorded in the computerized system of the Hematology and Hemotherapy Center of Ceará (HEMOCE in Portuguese). Results Of the 763,731 potential blood donors, 14,159 were serologically ineligible; 1,982 (0.33%) were serologically ineligible due to positive / inconclusive diagnosis for CD. A total of 425 individuals came to the HEMOCE to repeat the test, with 28.2% (120/425) declared ineligible for donations due to CD. Conclusion No significant reduction of positive / inconclusive serology was observed in the period between 2010 and 2015, but a reduction was observed when compared to 1996/1997 in the state. The determination of the prevalence of CD in blood banks may be relevant as an indicator of the risk of CD transmission through blood transfusions in a given region. New serological tests for triage with better accuracy in screening are needed, in an attempt to reduce the unnecessary disposal of blood bags, reduce costs for the Brazilian Unified Health System, and diminish insecurity for the patient and family members. (Arq Bras Cardiol. 2020; 115(6):1082-1091)


Subject(s)
Humans , Trypanosoma cruzi , Chagas Disease/diagnosis , Chagas Disease/epidemiology , Blood Donors , Brazil/epidemiology , Antibodies, Protozoan , Prevalence , Retrospective Studies , Latin America
16.
Arq. bras. cardiol ; 115(6): 1051-1060, dez. 2020. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1152934

ABSTRACT

Resumo Fundamento Em regiões endêmicas da doença de Chagas, por muitos anos, existe uma observação empírica recorrente de que a doença arterial coronariana (DAC) é incomum em pacientes com doença de Chagas. Estudos anteriores baseados em análise patológica ou angiografia coronária invasiva apresentam resultados controversos. Objetivo Investigar se a DAC é menos prevalente e menos grave em pacientes com doença de Chagas crônica em comparação a uma população pareada controle, com perfil de risco para DAC similar. Métodos Um total de 86 participantes, 43 pacientes com doença de Chagas crônica consecutivos e 43 indivíduos assintomáticos, sem qualquer história prévia de doença cardíaca ou doença DAC conhecida (grupo controle), foram incluídos no estudo. Pacientes e controles foram pareados quanto sexo, idade e escore de risco de Framingham. Todos os pacientes foram analisados quanto ao escore de cálcio coronário (ECC) e submetidos à angiotomografia coronária usando um tomógrafo de 320 detectores. O nível de significância estatística adotado foi de p < 0,05. Resultados O ECC foi significativamente mais baixo em pacientes com doença de Chagas em comparação aos controles (p<0,05). A presença de placas ateroscleróticas coronárias foi significativamente menos frequente em pacientes com doença de Chagas que nos controles (20,9% versus 41,9%, p=0,037). Após ajuste quanto ao escore de Framingham, o odds ratio para a presença de qualquer calcificação coronária foi de 0,26 (IC95%: 0,07-0,99, p=0,048). O padrão é similar para escore de cálcio coronário (ECC) > 10 (OR: 0,11, IC95%: 0,01-0,87, p=0,04), e para a presença de estenose (OR: 0,06, IC95%: 0,01-0,47, p=0,001). O pareamento por escore de propensão também mostrou um efeito da doença de Chagas no ECC (-21,6 pontos no escore absoluto e 25% menos pacientes com ECC > 10; p=0,015). Conclusões A prevalência e a gravidade da DAC são mais baixas nos pacientes com doença de Chagas crônica em comparação a uma população pareada e perfil de risco para DAC similar. (Arq Bras Cardiol. 2020; 115(6):1051-1060)


Abstract Background In Chagas' disease endemic regions, there has been for many years a recurrent empirical observation that coronary artery disease (CAD) is uncommon in patients with Chagas' disease. Previous pathological and invasive coronary angiography studies led to controversial results. Objective We sought to investigate whether CAD is less prevalent and less severe in patients with chronic Chagas' disease when compared with a matched population with a similar CAD risk profile. Methods A total of 86 participants, 43 consecutive patients with chronic Chagas' disease and 43 asymptomatic individuals, without any prior history of cardiac disease or known CAD (control group), were included. Patients and controls were matched according to gender, age, and Framingham risk score. All participants underwent coronary calcium scoring and coronary computed tomography angiography on a 320-row detector scanner. Statistical significance level adopted was p < 0.05. Results The coronary artery calcium score (CACS) was significantly lower in patients with Chagas' disease than in controls (p<0.05). The presence of coronary atherosclerotic plaques was significantly less frequent in patients with Chagas' disease than in controls (20.9% versus 41.9%, p=0.037). After adjustment for the Framingham score, the odds ratio for the presence of any coronary artery calcium (CAC) in Chagas patients was 0.26 (95%CI: 0.07-0.99, p=0.048). The pattern is similar for CACS > 10 (OR: 0.11, 95%CI: 0.01-0.87, p=0.04) and for the presence of any stenosis (OR: 0.06, 95%CI: 0.01-0.47, p=0.001). Propensity score matching also indicated an effect of Chagas disease on the CACS (-21.6 points in the absolute score and 25% less of patients with CACS >10, p=0.015). Conclusions CAD is less prevalent and less severe in patients with chronic Chagas' disease when compared with a matched population with a similar CAD risk profile. (Arq Bras Cardiol. 2020; 115(6):1051-1060)


Subject(s)
Humans , Coronary Artery Disease/etiology , Coronary Artery Disease/epidemiology , Coronary Artery Disease/diagnostic imaging , Chagas Disease/complications , Chagas Disease/epidemiology , Chagas Disease/diagnostic imaging , Prevalence , Predictive Value of Tests , Risk Factors , Coronary Angiography , Computed Tomography Angiography
17.
Rev. chil. infectol ; 37(4): 402-412, ago. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1138565

ABSTRACT

Resumen Introducción: La enfermedad de Chagas en Chile ha aumentado en pesquisa, especialmente en mujeres gestantes y donantes en general, pero sigue desatendida en Latinoamérica. La epidemiología ambiental del vector señala a la Región de Coquimbo de mayor riesgo. Objetivo: Analizar la serie temporal de mortalidad y tasa de incidencia por enfermedad de Chagas a nivel nacional, regional, comunal y según edad. Método: Estudio de base poblacional, serie de tiempo de mortalidad (1997 al 2017) y tasa de incidencia (2011 al 2017), país, región y 15 comunas. Uso de tasas brutas y ajustadas, calculando χ2, T test, ANOVA, valor p < 0,05. Resultados: Mortalidad; El 49,37% (668) de las muertes nacionales (1.353) tenían residencia en la Región de Coquimbo, mayoritariamente hombres y mayores de 60 años con complicaciones cardiacas y digestivas, residentes en Salamanca, Combarbalá e Illapel. Incidencia; De 6.173 casos acumulados, 6% son menores de 20 años, mayor en mujeres (61,4%) con edad promedio 50 años versus 56 años hombres (T test = 29,19 valor p = 0,000), residentes de; Ovalle, Andacollo, Monte Patria e Illapel. Conclusiones: La mitad de las muertes por enfermedad de Chagas residen en la Región de Coquimbo, los casos nuevos son 6% en personas bajo 20 años de edad.


Abstract Background: Chagas disease in Chile has increased in research, especially in pregnant women and donors in general, but remains neglected in Latin America. The environmental epidemiology of the vector points out the Coquimbo region is a greatest risk area. Aim: To analyze the time series of mortality and incidence rate Chagas disease national; regional and communal according to age. Method: Population-based study, time series of mortality (1997 to 2017) and incidence rate (2011 to 2017), country, region and 15 communes. Use of gross and adjusted rates, calculating ch2, T test, ANOVA, p value < 0.05. Results: Mortality; 49.37% (668) of the National deaths (1353) were Coquimbo region's residents, mainly male patients and over 60 years old people with cardiac and digestive complications, residents from Salamanca, Combarbalá and Illapel. Incidence: Of 6.173 accumulated cases, 6% are under 20 years old, higher incidence of women (61.4%) with an average age of 50 years old versus 56 years old men (T test = 29.19 p-value = 0.000), residents from Ovalle, Andacollo, Monte Patria and Illapel. Conclusions: Half of Chagas' disease deaths reside in the Coquimbo region, new cases, under 20 years old, are 6%.


Subject(s)
Humans , Male , Female , Pregnancy , Adult , Middle Aged , Young Adult , Chagas Disease/epidemiology , Chile/epidemiology , Incidence , Latin America
18.
Rev. cuba. med. trop ; 72(2): e461, mayo.-ago. 2020. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1149913

ABSTRACT

RESUMEN Introducción: La enfermedad de Chagas es de alta endemia en Colombia y es considerada un problema de salud pública por la morbilidad y mortalidad que ocasiona. Conocer la percepción de las comunidades frente a esta enfermedad es relevante en cuanto a las estrategias oportunas que se pueden establecer para su prevención. Objetivo: Evaluar la fiabilidad y validez de un instrumento que permita medir los conocimientos, actitudes y prácticas frente a la enfermedad de Chagas en comunidades endémicas. Métodos: Se desarrolló un estudio de corte transversal para la validación del contenido de un instrumento, diseñado con base en la literatura, el cual se sometió a la valoración por un panel de expertos que determinaron la eficiencia, relevancia, claridad y coherencia de cada uno de los ítems. Se determinó el índice Kappa de Randolph para evaluar concordancia. Luego se aplicó a 135 personas de áreas endémicas y se estableció el alfa de Cronbach para determinar consistencia interna. Resultados: El instrumento estudiado demostró concordancia según el índice de Randolph con una Kappa entre 0,7-0,8 para los ítems evaluados, con un alfa de Cronbach de 0,855 lo cual denota una consistencia adecuada. El cuestionario finalmente se estructuró con un total de 27 ítems que abordan: factores epidemiológicos y conocimientos de la enfermedad junto con actitudes y prácticas frente a esta. Conclusiones: El instrumento tiene un nivel adecuado de consistencia interna y concordancia, que permitiría su aplicación en áreas endémicas con poblaciones en riesgo a adquirir la enfermedad de Chagas.


ABSTRACT Introduction: Chagas disease is highly endemic in Colombia and considered to be a public health problem due to its morbidity and mortality. Learning about community perception of this disease is relevant to devise timely strategies for its prevention. Objective: Evaluate the reliability and validity of an instrument to measure knowledge, attitudes and practices in response to Chagas disease in endemic communities. Methods: A cross-sectional study was conducted to validate the content of a tool based on the literature and assessed by an expert panel to determine the efficiency, relevance, clarity, and coherence of each of its items. Determination was made of Randolph's kappa index to evaluate agreement. Then it was applied to 135 people from endemic areas and Cronbach's alpha was established to determine internal consistency. Results: The tool studied showed agreement by Randolph's index with a kappa between 0.7 and 0.8 for the items evaluated and a Cronbach's alpha of 0.855, denoting appropriate consistency. The questionnaire was finally structured with a total 27 items addressing epidemiological factors and knowledge about the disease as well as attitudes and practices in response to it. Conclusions: The tool has an adequate level of internal consistency and agreement, which makes its application advisable in endemic areas with populations at risk of acquiring Chagas disease.


Subject(s)
Humans , Epidemiologic Factors , Health Knowledge, Attitudes, Practice , Chagas Disease/epidemiology , Endemic Diseases/prevention & control , Epidemiology, Descriptive , Cross-Sectional Studies , Reproducibility of Results , Colombia , Validation Study , Evaluation of Research Programs and Tools
19.
An. Fac. Cienc. Méd. (Asunción) ; 53(1): 81-92, 20200401.
Article in Spanish | LILACS | ID: biblio-1095724

ABSTRACT

La tripanosomiasis americana o enfermedad de Chagas, producida por el protozoo hemoflagelado Trypanosoma cruzi. En Paraguay el principal vector Triatoma infestans ("vinchuca" o "chichã guasu") es considerado, en términos sociales y económicos, una de las enfermedades parasitarias más importantes que pueden desencadenar complicaciones graves cardiológicas. Durante el Periodo 2014 al 2017 en el Departamento de San Pedro se registraron 302 casos de Enfermedad de Chagas detectados por serología. El objetivo del estudio estuvo dirigido a investigar el nivel de conocimiento de la población que, por su forma de vida, presentan factores de riesgo. Se realizó una investigación cualitativa exploratoria, con enfoque hermenéutico. La población de estudio estuvo conformada por 41 familias que residen en comunidades del Departamento de San Pedro, que se encuentran entre 15 km a 40 km de zonas urbanas, a quienes se le realizo una entrevista semi-estructurada en profundidad. Entre los resultados obtenidos se evidenció que: La mayoría de los pobladores de la zona conocen al triatoma y lo pudieron observar cuando eran niños y algunos afirman haber sido picados, pudiendo así describir la morfología y otras características del vector; la mayoría desconoce la sintomatología producida por el T. cruzi, pero tienen un conocimiento básico relacionado a la enfermedad.


The american trypanosomiasis, also known as Chagas disease, is caused by an hemophlagelated protozoo called Trypanosoma cruzi. In Paraguay, the most relevant vector is Triatoma infestans (vinchuca or "chichã guasu") is considered, in social and economic terms, one of the most important parasitic diseases which may cause severe cardiological complications. Since 2014 till 2017, in San Pedro´s department, have been registered 302 cases of Chagas disease, all detected by serology. The objective of this study was directed to investigate the degree of knowledge of the population that, because of their lifestyles, presents risk factors. It has been made a qualitative-exploratory investigation, with hermeneutic focus. The population studied was made up for 41 families which reside in communities of San Pedro´s department, that are located around 15/40 km of urban zones. They all had a deep semi-structured interview. The results showed that: most of the settlers know triatoma and could observe it when they were children and also some of them affirm have been chopped, being able to describe the morphology and other characteristics of the vector. Most of the interviewed unknown the symptomatology produced by T. cruzi, but have the basic knowledge related with this disease.


Subject(s)
Chagas Disease/epidemiology
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