Chagas cardiomyopathy and serologic testing in a small rural hospital in Chiapas, Mexico.

OBJECTIVES: To conduct a study in a small rural hospital located in the state of Chiapas, Mexico, to: (1) examine the prevalence of chagasic cardiomyopathy among patients with the diagnosis of congestive heart failure and (2) assess the prevalence of positive serologic results in blood donors in the hospital, in an attempt to ascertain whether Chagas' disease remains an important cause of heart failure at least in some areas of Mexico. METHODS: The study of patients with cardiomyopathy was conducted by retrospective chart review of patients with the diagnosis of congestive heart failure treated at the hospital during the years 2000-2002. With the blood donors, the results of their serologic screening were reviewed for a six-month period beginning in April 2002. Serologic testing was done in both groups with either indirect hemagglutination (IHA) or enzyme-linked immunosorbent assay (ELISA), or with both. RESULTS: Of 67 patients with heart failure and no risk factors for other causes of heart failure, 40 of them had serologic tests performed. Thirty-three of these 40 (82.5%) were positive by ELISA, IHA, or both. With 97 blood donors, one or both serologic tests were positive in 17 of them (17.5%). CONCLUSIONS: This research adds to the evidence that Chagas' disease continues to be a major cause of heart failure in some areas of Mexico and that there continues to be a risk of transmission by blood transfusion if donated blood is not consistently screened.

Chagas cardiomyopathy and serologic testing in a small rural hospital in Chiapas, Mexico / Miocardiopatía chagásica y pruebas serológicas de enfermedad de Chagas en un hospital rural pequeño de Chiapas, México

OBJETIVO: Llevar a cabo un estudio en un hospital rural pequeño del Estado de Chiapas, México, con el fin de: 1) examinar la prevalencia de miocardiopatía chagásica en pacientes con un diagnóstico de insuficiencia cardíaca congestiva y 2) estimar la prevalencia de positividad serológica en donantes de sangre del hospital, con objeto de determinar si la enfermedad de Chagas sigue siendo una causa importante de insuficiencia cardíaca en algunas partes de México. MÉTODOS: El estudio de los pacientes con miocardiopatía se llevó a cabo mediante la inspección retrospectiva de las fichas de pacientes con un diagnóstico de insuficiencia cardíaca congestiva tratados en el hospital durante el período de 2000­2002. En el caso de los donantes de sangre, los resultados de sus pruebas serológicas fueron revisados durante un período de seis meses que comenzó en abril de 2002. Los pruebas serológicas se efectuaron en ambos grupos mediante hemaglutinación indirecta (HAI) o ensayo de inmunoadsorción enzimática (ELISA), o ambos métodos. RESULTADOS: De 67 pacientes con insuficiencia cardíaca que no tenían factores de riesgo de sufrir otras causas de este trastorno, 40 fueron sometidos a pruebas serológicas. De estos cuarenta, 33 (82,5%) tuvieron resultados positivos en el ELISA, la HAI, o ambos. Del total de 97 donantes de sangre, 17 (17,5%) tuvieron una o dos pruebas con resultados positivos. CONCLUSIONES: Este estudio se suma a las pruebas ya existentes de que la enfermedad de Chagas sigue siendo una de las principales causas de insuficiencia cardíaca en algunas partes de México y de que sigue habiendo un riesgo de transmisión por transfusión de sangre si la sangre donada no se somete a tamizaje con regularidad

Objectives. To conduct a study in a small rural hospital located in the state of Chiapas, Mexico, to: (1) examine the prevalence of chagasic cardiomyopathy among patients with the diagnosis of congestive heart failure and (2) assess the prevalence of positive serologic results in blood donors in the hospital, in an attempt to ascertain whether Chagas' disease remains an important cause of heart failure at least in some areas of Mexico. Methods. The study of patients with cardiomyopathy was conducted by retrospective chart review of patients with the diagnosis of congestive heart failure treated at the hospital during the years 2000­2002. With the blood donors, the results of their serologic screening were reviewed for a six-month period beginning in April 2002. Serologic testing was done in both groups with either indirect hemagglutination (IHA) or enzyme-linked immunosorbent assay (ELISA), or with both. Results. Of 67 patients with heart failure and no risk factors for other causes of heart failure, 40 of them had serologic tests performed. Thirty-three of these 40 (82.5%) were positive by ELISA, IHA, or both. With 97 blood donors, one or both serologic tests were positive in 17 of them (17.5%). Conclusions. This research adds to the evidence that Chagas' disease continues to be a major cause of heart failure in some areas of Mexico and that there continues to be a risk of transmission by blood transfusion if donated blood is not consistently screened