Oliveira Carlos Walmyr de Mattos, Sangenis Luiz Henrique Conde, Xavier Sergio Salles, Saraiva Roberto Magalhães, Mediano Mauro Felippe Felix, Sousa Andrea Silvestre de, Hasslocher-Moreno Alejandro Marcel
Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil.
Setor de Radiologia, Hospital do Câncer II, Instituto Nacional de Câncer, Rio de Janeiro, RJ, Brasil.
Rev Soc Bras Med Trop. 2025 Jun 16;58:e003012025. doi: 10.1590/0037-8682-0432-2024. eCollection 2025.
Chagas disease (CD) is associated with significant morbidity and mortality due to cardiac and/or gastrointestinal complications. CD transmission has diverse modes, and their potential relationship with the clinical forms of CD remains unexplored. This study evaluated the association between the transmission modes and chronic clinical forms of CD.
This retrospective study included patients with chronic CD referred to the outpatient clinic of INI/Fiocruz between November 1986 and August 2024. Clinical and epidemiological data were retrieved from medical records. Sociodemographic profiles, epidemiological history of CD, and clinical, cardiac, and digestive evaluations were assessed. Unadjusted and adjusted logistic regression models were fitted to assess the association between transmission modes and CD clinical forms.
The analysis included 2,162 patients (53.0% women; mean age 48.3 years). The CD transmission mode was evaluated as vectorial in 1962 (90.8%) patients, followed by blood transfusion in 123 (5.7%), congenital in 59 (2.7%), and oral in 18 (0.8%). Patients with congenital or oral transmission were younger, less likely to be women or self-reported as black, had lower rates of illiteracy, and a higher percentage were from non-endemic areas. No significant associations were observed between transmission modes and the cardiac or digestive forms of CD in unadjusted and adjusted analyses.
Vectorial transmission was the most common transmission mode in patients with chronic CD. No significant association was found between the transmission mode and CD clinical forms, indicating that other mechanisms associated with progression to chronic determinate forms should be investigated.
恰加斯病（CD）因心脏和/或胃肠道并发症而导致显著的发病率和死亡率。CD的传播方式多种多样，其与CD临床类型之间的潜在关系仍未得到探索。本研究评估了CD传播方式与慢性临床类型之间的关联。
这项回顾性研究纳入了1986年11月至2024年8月期间转诊至INI/Fiocruz门诊的慢性CD患者。从病历中检索临床和流行病学数据。评估社会人口统计学特征、CD的流行病学史以及临床、心脏和消化系统评估。采用未调整和调整后的逻辑回归模型来评估传播方式与CD临床类型之间的关联。
分析纳入了2162例患者（53.0%为女性；平均年龄48.3岁）。1962例（90.8%）患者的CD传播方式被评估为媒介传播，其次是输血传播123例（5.7%）、先天性传播59例（2.7%）和经口传播18例（0.8%）。先天性或经口传播的患者更年轻，女性或自我报告为黑人的可能性较小，文盲率较低，且来自非流行地区的比例更高。在未调整和调整后的分析中，未观察到传播方式与CD的心脏或消化系统类型之间存在显著关联。
媒介传播是慢性CD患者中最常见的传播方式。未发现传播方式与CD临床类型之间存在显著关联，这表明应研究与进展为慢性确定型相关的其他机制。
