Epidemiologia de la enfermedad de Chagas en una poblacion de Oaxaca, México / Epidemiologic study of Chagas' disease in a town in Oaxaca, México

RESUMO

A survey was made of residents and hospital patients in Miahuatlan, Oaxaca, México, for cases of Chagas'disease. This survey focused primarily upon 85 patients attending the local hospital who had clinical pictures suggesting the disease, 14 with possible acute cases and 71 with possible chronic cases. In addition, sera from 14 Miahuatlan blood donors were examined; seroepidemiologic testing was performed with 52 sera from schoolchildren at another community nearby, and triatomine bugs were collected from Miahuatlan residences. Each of the 85 patients provided a complete clinical history and blood specimen, and each was given an ECG and a series of heart X-rays or chest teleradiography. In some cases biopsy or necropsy speciments were obtained. A variety of parasitologic and serologic test performed with these specimens indicated chagasic infections in four of the 14 subjects with possible acute cases and eight of the 71 subjects with possible chronic cases. One of these latter subjects had the first case of Chagas'disease involving a megasigmoid that had ever been reported in México. A high proportion (78 percent of the sera from Miahuatlan blood donors tested positive for Trypanosoma cruzi antibodies by complement fixation, as did 88 percent of the sera from the 52 schoolchildren. A total of 57 triatomid vector insects were captured alive and tested for T. cruzi. Most (92 percent) were