Berganza Elsa, Herazo Rafael, García Esdras, Marchiol Andrea, Menes Marianela, Alvarado Estuardo, Trampe Ranferí, Pinazo María Jesús
Dirección Departamental de Redes Integradas de Servicios de Salud de Jutiapa, Departamento de Epidemiología y Gestión del Riesgo, Jutiapa 22001, Guatemala.
Drugs for Neglected Diseases initiative Latin America, Chagas Program, Rio de Janeiro 20010-903, Brazil.
Acta Trop. 2025 Jun;266:107648. doi: 10.1016/j.actatropica.2025.107648. Epub 2025 May 9.
Chagas disease (CD) is a major public health problem in Guatemala, where an estimated 166,000 people are infected with Trypanosoma cruzi and 1.4 million are at risk of infection. The municipality of Comapa (department of Jutiapa) is in a "hot spot" for CD control in Central America. To improve access to CD healthcare, the Departmental Directorate of Integrated Health Services Networks of Jutiapa, with support from the Drugs for Neglected Diseases initiative Latin America, set up a Chagas clinic in Comapa; This study describes epidemiological and clinical aspects of the population attended in the clinic. Using a descriptive observational study design, based on the review of a database with 590 care records between 2019 and 2024. The mean age was 44.1 years; 61.9 % were women and 7.1 % were pregnant women. 32 % exhibited the cardiac form of chronic CD. Trypanocidal treatment was started in 77.5 %, and of these, 7.6 % did not complete the prescribed regimen. All patients were treated with nifurtimox. 71.5 % of those treated reported adverse reactions (ADR). The most frequent ADRs were neuropsychiatric (67.6 %), followed by digestive (47.1 %); in 59 % of cases, between two and four ADRs occurred simultaneously. This characterization is one of the few descriptions of the Guatemalan population with T. cruzi infection/ CD. In general, the clinical data are similar to those reported in other publications. The Comapa Chagas Clinic provides a new model which can facilitate access at the primary health care level for people with CD.
恰加斯病(CD)是危地马拉的一个重大公共卫生问题,据估计,该国16.6万人感染了克氏锥虫,140万人有感染风险。科马帕市(朱蒂亚帕省)位于中美洲恰加斯病防控的“热点地区”。为了改善恰加斯病的医疗服务可及性,朱蒂亚帕省综合卫生服务网络部门在被忽视疾病药物研发倡议拉丁美洲项目的支持下,在科马帕市设立了一家恰加斯病诊所;本研究描述了该诊所就诊人群的流行病学和临床特征。采用描述性观察研究设计,基于对2019年至2024年期间590份护理记录数据库的回顾。平均年龄为44.1岁;61.9%为女性,7.1%为孕妇。32%表现为慢性恰加斯病的心脏型。77.5%的患者开始接受抗锥虫治疗,其中7.6%未完成规定疗程。所有患者均接受硝呋莫司治疗。71.5%接受治疗的患者报告有不良反应(ADR)。最常见的不良反应是神经精神方面的(67.6%),其次是消化系统的(47.1%);59%的病例同时出现两到四种不良反应。这一特征描述是对危地马拉克氏锥虫感染/恰加斯病患者群体为数不多的描述之一。总体而言,临床数据与其他出版物报道的数据相似。科马帕恰加斯病诊所提供了一种新的模式,可促进恰加斯病患者在初级卫生保健层面获得医疗服务。