Álvarez-Hernández Diego-Abelardo, García-Rodríguez-Arana Rodolfo, Ortiz-Hernández Alejandro, Álvarez-Sánchez Mariana, Wu Meng, Mejia Rojelio, Martínez-Juárez Luis-Alberto, Montoya Alejandra, Gallardo-Rincon Héctor, Vázquez-López Rosalino, Fernández-Presas Ana-María
Faculty of Health Sciences, Anahuac University Mexico - North Campus, Huixquilucan, Mexico State 52786, Mexico.
Faculty of Health Sciences, Anahuac University Mexico - North Campus, Huixquilucan, Mexico State, Mexico.
Ther Adv Infect Dis. 2021 Aug 4;8:20499361211033715. doi: 10.1177/20499361211033715. eCollection 2021 Jan-Dec.
Chagas disease (CD) is caused by . When acquired, the disease develops in stages. For diagnosis, laboratory confirmation is required, and an extensive assessment of the patient's health should be performed. Treatment consists of the administration of trypanocidal drugs, which may cause severe adverse effects. The objective of our systematic review was to analyze data contained in the CD published case reports to understand the challenges that patients and clinicians face worldwide.
We performed a systematic review following the PRISMA guidance. PubMed database was explored using the terms 'American trypanosomiasis' or 'Chagas disease'. Results were limited to human case reports written in English or Spanish. A total of 258 reports (322 patients) were included in the analysis. Metadata was obtained from each article. Following this, it was analyzed to obtain descriptive measures.
From the sample, 56.2% were males and 43.8% were females. Most cases were from endemic countries (85.4%). The most common clinical manifestations were fever during the acute stage (70.0%), dyspnea during the chronic stage in its cardiac form (53.7%), and constipation during the chronic stage in its digestive form (73.7%). Most patients were diagnosed in the chronic stage (72.0%). Treatment was administered in 56.2% of cases. The mortality rate for the acute stage cases was 24.4%, while for the chronic stage this was 28.4%.
CD is a parasitic disease endemic to Latin America, with increasing importance due to human and vector migration. In this review, we report reasons for delays in diagnosis and treatment, and trends in medical practices. Community awareness must be increased to improve CD's diagnoses; health professionals should be appropriately trained to detect and treat infected individuals. Furthermore, public health policies are needed to increase the availability of screening and diagnostic tools, trypanocidal drugs, and, eventually, vaccines.
恰加斯病（CD）由……引起。感染该疾病后，病情会分阶段发展。对于诊断，需要实验室确认，并且应对患者的健康状况进行全面评估。治疗包括使用杀锥虫药物，这些药物可能会引起严重的不良反应。我们系统评价的目的是分析恰加斯病已发表病例报告中包含的数据，以了解全球患者和临床医生面临的挑战。
我们按照PRISMA指南进行了系统评价。使用“美洲锥虫病”或“恰加斯病”等术语在PubMed数据库中进行检索。结果仅限于用英文或西班牙文撰写的人类病例报告。共有258篇报告（322例患者）纳入分析。从每篇文章中获取元数据。随后，对其进行分析以获得描述性指标。
在样本中，男性占56.2%，女性占43.8%。大多数病例来自流行国家（85.4%）。最常见的临床表现为急性期发热（70.0%）、慢性期心脏型呼吸困难（53.7%）以及慢性期消化型便秘（73.7%）。大多数患者在慢性期被诊断出来（72.0%）。56.2%的病例接受了治疗。急性期病例的死亡率为24.4%，而慢性期为28.4%。
恰加斯病是拉丁美洲特有的寄生虫病，由于人类和病媒的迁移，其重要性日益增加。在本综述中，我们报告了诊断和治疗延迟的原因以及医疗实践的趋势。必须提高社区意识以改善恰加斯病的诊断；卫生专业人员应接受适当培训，以检测和治疗感染者。此外还需要公共卫生政策，以增加筛查和诊断工具、杀锥虫药物以及最终疫苗的可及性。
