Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
Parasit Vectors. 2018 Jun 19;11(1):354. doi: 10.1186/s13071-018-2929-y.
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. 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.
This 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.
We 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.
在拉丁美洲，恰加斯病控制规划降低了该病的流行率。随着向城市地区迁移和预期寿命的延长，巴西出现了一种恰加斯病的新态势，目前大多数患者为居住在城市地区的老年人群。然而，由于森林媒介的传播以及受污染食物的口服传播，仍会发生急性恰加斯病病例。因此，我们对在巴西里约热内卢的埃万德罗·查加斯国家传染病研究所接受治疗的患者的临床和流行病学特征进行了描述。我们旨在确定患者的临床类型、相关合并症以及来自年轻患者的地理区域。这将有助于确定当前可能面临的潜在挑战。
这是一项横断面研究。2013 年 3 月至 2016 年 4 月间，我们招募了患有慢性恰加斯病的成年患者。从电子病历和访谈中获得了临床和流行病学数据。根据巴西恰加斯病共识，确定了患者的恰加斯病临床类型。共有 619 名患者（平均年龄 60 ± 12 岁；56.9%为女性）纳入本研究。患者的临床类型如下：不确定型 29.1%；心脏型 55.4%；消化系统型 5.5%；混合型 10.0%。65 岁以上的患者占人口的 38%。347 名（56%）患者患有高血压，261 名（42%）患者患有血脂异常，185 名（30%）患者患有糖尿病。不同临床类型的患者在性别、种族、合并症频率或起源地方面无差异。老年人群主要来自巴伊亚州、米纳斯吉拉斯州和伯南布哥州，而年轻患者主要来自塞阿拉州、帕拉伊巴州和里约热内卢州。
我们描述了巴西恰加斯病患者中构成比例较大的老年人群，具有较高的合并症发生率。我们还发现，年轻患者的起源地模式发生了变化。
