Abstract
BackgroundChagas disease control programmes have decreased the prevalence of Chagas disease in Latin America. Together with migration to urban areas and increase in life expectancy, a new scenario for Chagas disease has emerged in Brazil with most patients currently elderly individuals living in urban areas. However, acute Chagas disease cases still occur due to vector transmission by sylvatic vectors and oral transmission by contaminated food. Therefore, we characterized the clinical and epidemiological profile of the patients followed at Evandro Chagas National Institute of Infectious Diseases in Rio de Janeiro, Brazil. We aimed to identify the clinical forms, associated co-morbidities, and geographical areas where younger patients originate from. This will aid in the identification of potential challenges to be currently faced.ResultsThis is a cross-sectional study. Adult patients with chronic Chagas disease were recruited between March 2013 and April 2016. Clinical and epidemiological data were obtained from electronic medical records and interviews. The clinical form of the Chagas disease presented by the patients was determined following the Brazilian Consensus on Chagas disease. Six hundred and nineteen patients (mean age 60 ± 12 years; 56.9% women) were included in this study. Patients’ clinical forms were classified as follows: indeterminate 29.1%; cardiac 55.4%; digestive 5.5%; and mixed 10.0%. Patients aged over 65 years comprised 38% of the population. Hypertension was present in 347 (56%) patients, dyslipidemia in 261 patients (42%) and diabetes mellitus in 185 patients (30%). There were no differences regarding gender, race, comorbidities frequency or place of origin across Chagas disease clinical forms. Most of the elderly population originated from Bahia, Minas Gerais and Pernambuco states, while most of the younger patients were born in Ceará, Paraíba and Rio de Janeiro states.ConclusionsWe described a great proportion of elderly patients in the composition of an urban Brazilian Chagas disease patient cohort with a high prevalence of comorbidities. We also identified a change in the pattern of the place of origin among younger patients.
Highlights
Chagas disease control programmes have decreased the prevalence of Chagas disease in Latin America
An estimated 5–6 million people live with Chagas disease (CD) in Latin American countries [1] and CD is responsible for approximately 12,000 deaths per year [2]
The following data were obtained from electronic medical records filed at Infectious Disease (INI): gender, age, place of origin, comorbidities and symptoms related to CD, CD classification and left ventricular ejection fraction (LVEF)
Summary
Chagas disease control programmes have decreased the prevalence of Chagas disease in Latin America. Together with migration to urban areas and increase in life expectancy, a new scenario for Chagas disease has emerged in Brazil with most patients currently elderly individuals living in urban areas. We aimed to identify the clinical forms, associated co-morbidities, and geographical areas where younger patients originate from. This will aid in the identification of potential challenges to be currently faced. Chagas disease (CD) or American trypanosomiasis is a potentially life-threatening illness caused by the parasite Trypanosoma cruzi. An estimated 5–6 million people live with CD in Latin American countries [1] and CD is responsible for approximately 12,000 deaths per year [2]. The economic burden is high in Brazil which has the highest annual health-care costs in Latin America (mean $129,211,209) [8]
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