Abstract
Following Latin American migration, Chagas disease has inevitably appeared in non-endemic countries in Europe and elsewhere. New policies are necessary to prevent transmission in those countries but the long, often undetected chronic period of the early stages of the disease also renders epidemiological studies important. The main objective of our study was to determine the presence of clinical, electrocardiogram (ECG) and echocardiographic abnormalities in a population of Latin American migrants infected with Trypanosoma cruzi at the moment of diagnosis. We performed a hospital-based observational study of 100 adult patients with newly diagnosed Chagas infection between January 2005 and December 2009. Thirty-seven patients were classified within the Brazilian Consensus on Chagas cardiomyopathy early cardiac stages (A or B1) and 49 presented pathological findings (stage B2) according to the Panamerican Health Organization Classification. Overall, 49 patients showed ECG and/or echocardiographic alterations. The presence of ECG and ecocardiographic alterations were significantly associated (p=0.038). The most frequent ECG and echocardiographic findings were right bundle branch block (12 cases) and impaired left ventricular wall relaxation (24 cases), respectively. In conclusion, ECG and echocardiographic alterations coherent with Chagas cardiomyopathy were found in a large proportion of newly diagnosed Latin American migrants infected with T. cruzi. In the mid-term, Chagas disease might become an important cause of chronic cadiomyopathy in our attendance area.
Highlights
Chagas disease is a zoonosis caused by the parasite Trypanosoma cruzi, a flagellated protozoa mainly transmitted to humans by the faeces of blood-sucking triatomine bugs (Triatoma infestans and others)
Between January 2005 and December 2009, we studied all consecutive adult patients newly diagnosed with Chagas infection at the Unitat de Salut Internacional Metropolitana Nord
Echocardiographic changes were seen in 31 patients, and allowed the diagnosis of Chagas cardiomyopathy in eight individuals with a normal ECG (Table 2)
Summary
Chagas disease is a zoonosis caused by the parasite Trypanosoma cruzi, a flagellated protozoa mainly transmitted to humans by the faeces of blood-sucking triatomine bugs (Triatoma infestans and others). A hundred years from its description, Chagas disease remains a neglected tropical disease and is as such recognised by the World Health Organization [1]. Until the late twentieth century, Chagas had a geographical distribution that was confined to that of its vector, namely in Central and South America. The disease is no longer confined to Central and South America. Non-endemic countries in Europe and elsewhere have seen the emergence of Chagas disease following migration of chronically infected individuals from endemic areas. In Europe, for example, there are an estimated 2,300,000 Latin American migrants, both documented or undocumented [2,3] and non-endemic countries need to consider implementing preventive policies concerning blood transfusion, organ transplantation and vertical transmission [4,5]
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