Echalar Jhean-Carla, Veliz David, Urquizo Omar N, Niemeyer Hermann M, Pinto Carlos F
Universidad Mayor Real Y Pontificia de San Francisco Xavier de Chuquisaca, Junin esq. Estudiantes # 692, Sucre, Bolivia.
Universidad de Chile, Facultad de Ciencias, Departamento de Ciencias Ecológicas, Santiago, Chile.
Parasite Epidemiol Control. 2021 Feb 3;13:e00204. doi: 10.1016/j.parepi.2021.e00204. eCollection 2021 May.
Chagas disease currently affects some 6 million people around the world. At the chronic stage, cardiomyopathy occurs in about 20-30% of infested people. Most prevalence studies have focused on young to adult people due to the drastic consequences of acquiring the pathogen and the possibility to cure the disease at this age; the prevalence of this disease, the effect of patients' sex and the consequences to senescent people have been largely neglected. This study looks to characterize the seroprevalence of Chagas disease and its relation with occurrence of electrocardiographic anomalies associated with sex and age, and to compare rural and urban populations in Bolivia.
Seroprevalence of Chagas disease was determined in blood samples and electrocardiograms were performed on seropositive individuals.
The rural population showed higher seroprevalence than the urban population (92% and 40%, respectively). The proportion of Chagasic cardiac anomalies in seropositive persons was highest in patients of the 50-59 age group (36%) as compared with the 40-49 (8%) and the ≥60 (17%) age groups.
Higher seroprevalence in rural population was attributable to a higher probability to encounter the vector in rural areas. Increased exposure to infection and to development of the disease symptoms together with increased lethality of the disease as patients age explains the age-related Chagasic electrocardiographic anomalies. Since rural and urban populations showed different reactions under Chagas disease and the rural population was mainly of guaraní stock, the genetic and environmental determinants of the results should be further explored.
恰加斯病目前影响着全球约600万人。在慢性阶段，约20%-30%的感染者会出现心肌病。由于感染病原体的严重后果以及该年龄段治愈疾病的可能性，大多数患病率研究都集中在年轻人至成年人身上；这种疾病的患病率、患者性别的影响以及对老年人的影响在很大程度上被忽视了。本研究旨在描述恰加斯病的血清阳性率及其与性别和年龄相关的心电图异常发生情况的关系，并比较玻利维亚农村和城市人口。
通过血液样本测定恰加斯病的血清阳性率，并对血清阳性个体进行心电图检查。
农村人口的血清阳性率高于城市人口（分别为92%和40%）。血清阳性者中恰加斯性心脏异常的比例在50-59岁年龄组患者中最高（36%），而40-49岁年龄组（8%）和≥60岁年龄组（17%）相对较低。
农村人口较高的血清阳性率归因于在农村地区接触病媒的可能性更高。随着患者年龄增长，感染暴露增加、疾病症状发展以及疾病致死率上升，解释了与年龄相关的恰加斯性心电图异常。由于农村和城市人口在恰加斯病方面表现出不同反应，且农村人口主要为瓜拉尼族裔，因此应进一步探索这些结果的遗传和环境决定因素。
