Cardiac and digestive forms of chronic Chagas disease in Brazilian social welfare, 2004-2016.

INTRODUCTION

Chagas disease is a neglected tropical disease with a chronic clinical course and high rates of morbidity and mortality. Despite a drastic reduction in the disease's incidence in Brazil in recent decades, older cases still impact the national social welfare system.

OBJECTIVES

To analyze the sociodemographic characteristics of Brazilian social welfare beneficiaries affected by the cardiac and digestive forms of chronic Chagas disease between 2004 and 2016.

METHODS

This cross-sectional study was based on data from the Brazilian Ministry of Labor and Social Security. Crude and adjusted odds ratios were estimated using logistic regression.

RESULTS

Benefits were granted to 25,085 affected individuals, mostly men (15,812; 63%) with the cardiac form (20,424; 81.4%) who resided in urban areas (16,051; 64%). The highest relative frequency of benefits were granted in the Midwest macroregion (31.1/100,000 inhabitants). Male sex (odds ratios = 1.2; 95% CI 1.1-1.2), age 30-49 years (odds ratios = 1.8; 95% CI 1.4-2.1), residence in rural areas (odds ratios = 1.6; 95% CI 1.5-1.7) or the Southeast macroregion (odds ratios = 2.9; 95% CI 2.4-3.4) had the highest association with the cardiac form. Individuals with the cardiac form had a higher median age at disease onset (45 years; p < 0.001) but a lower age at work disability onset (50 years; p = 0.01).

CONCLUSIONS

The impact of Chagas disease on Brazilian social welfare is mainly due to chronic Chagas cardiomyopathy, which was mainly associated with men in their productive years who live in rural areas in Southeastern Brazil.