Mapping the morbidity and mortality of Chagas disease in an endemic area in Brazil

Abstract

Chagas disease is among the 21 neglected diseases according to the World Health Organization. This study aimed to investigate the morbidity and mortality distribution of Chagas disease for identifying areas with greater prevalences and deaths of the disease in Northeast Brazil. A population-based ecological study was performed from 2016 to 2018 using data on acute Chagas disease patients from the Disease Notification Information System, chronic cases from the Chagas Disease and the referral Heart Failure Outpatient Clinic in Pernambuco, and Chagas disease-related mortality from the Mortality Information System. The unit of analysis were Pernambuco State mesoregions. The indicators were spatialized into thematic maps on the occurrence and mortality of the disease per 100,000 inhabitants. No cases of acute disease were reported in the period analyzed. Data on 801 chronic Chagas disease patients were analyzed. The population showed an average age of 62 years, with female predominance. The most prevalent comorbidity was systemic arterial hypertension and cardiologic involvement without ventricular dysfunction. The average chronic disease occurrence rate was 3.2/ 100,000 people/ year. As for deaths in the mortality system; in total, 350 deaths were recorded, showing male predominance, age ≥ 60 years, and chronic disease with cardiac involvement as the main mortality cause. The annual average mortality proportion was 1.6/100,000 people. The chronic case distribution showed spatial heterogeneity, with the highest rates of chronic disease and deaths observed in two mesoregions, with the main cause of death being heart-related. This highlights the need for more specialized services in areas with higher burden of the disease to avoid delay in the patients' care.

A relação entre a doença de Chagas e a hipertensão arterial sistêmica: revisão integrativa

“…Dessa forma, a presença prévia de uma pressão arterial mais elevada, tornaria um indivíduo que habita uma zona de risco para contrair a doença de Chagas mais predisposto a manifestar suas complicações cardiovasculares, e a evoluir com uma cardiomiopatia crônica de pior prognóstico (da da Silva Brito, 2019;Finocchi, & Sassos, 2017). Isso ocorre, pois a fisiopatologia que envolve a miocardiopatia hipertensiva e a chagásica são semelhantes, ambas contribuindo para um quadro clínico de inflamação sistêmica, com acometimento tissular extenso, e destruição das fibras miocárdicas, ocasionando a dilatação do ventrículo e a insuficiência cardíaca Medeiros et al, 2022). Pacientes característicos desta condição clínica, geralmente irão cursar com dispneia, fadiga e edema de membros inferiores (Mesquita, et al, 2019).…”

Implications of Chagas Disease on the Quality of Life of the Brazilian Population: A Bibliographic Review

“…disease or American trypanosomiasis is a generalized, essentially chronic infection caused by the protozoan Trypanosoma cruzi, transmitted mainly by hematophagous triatomine vectors, popularly known as "barbeiros". The species Triatoma brasiliensis and Triatoma pseudomaculata are the main vectors of Chagas disease in Northeast Brazil (MEDEIROS, 2022).…”

“…Chagas disease is also characterized by having an acute phase, predominantly asymptomatic, but with an evolution of death of 5% to 10% in symptomatic patients. In addition, there is a chronic phase that can progress to cardiac, digestive and neurological impairment, occurring in about 30% to 40% of infected people in the first to third decade after the acute phase is manifested (MEDEIROS, 2022;VELASCO, 2020).…”

Prevalence of the Transmission Type of Chagas Disease in the Brazilian Amazon

“…Chagas disease (CD) is by definition a parasitic disease caused by the transmission of the protozoan Trypanosoma cruzi. It is estimated that 6 to 7 million people worldwide are infected, and the disease is found mainly in endemic areas of continental Latin American countries (MEDEIROS, 2022). Although triatomine insects are the primary vectors of CD transmission, the oral route through contaminated food was considered the main means of transmission in the Brazilian Amazon (ORTIZ, 2021).…”