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[帕拉伊巴州塞托和皮奥伊州卡廷加地区恰加斯病的发病率]

[Morbidity of Chagas disease in areas of Sertão da Paraiba and Caatinga do Piauí].

作者信息

Coura J R, Borges-Pereira J, Alves Filho F I, de Castro J A, da Cunha R V, Costa W, Junqueira A C

机构信息

Departamento de Medicina Tropical do Instituto Oswaldo Cruz (FIOCRUZ), Rio de Janeiro.

出版信息

Rev Soc Bras Med Trop. 1996 Mar-Apr;29(2):197-205. doi: 10.1590/s0037-86821996000200012.

Abstract

A clinical and electrocardiographic case control study was carried out with 186 pairs of persons with positive and negative serology for T. cruzi infection from the Sertão Paraíba and in 200 seropositive cases from the region of Caatinga in the State of Piauí, North-eastern Brazil. The predominant clinical manifestations in seropositive cases in both areas were: palpitations, dyspnea on effort, precordial pain, dysphagia, odynophagia, pyrosis and intestinal constipation. The EKG abnormalities rates suggestive of chronic chagasic cardiopathy were respectively in Paraíba and Piauí: AV block 3.8% and 2%, RBBB III 6.4% and 7%, RBBB III+ LAB 10.7% and 10.5%, and multifocal extrasystoles 2.7% and 3%. Xenodiagnosis in a sample of 54 seropositive individuals in the Sert-ao of Para-iba and in 120 in the Caatinga of Piauí was revealed 13% and 34% positive; PCR tests in a sample of 47 seropositives in Paraíba and 101 in Piauí revealed positives in 44.6% and 59.5% respectively. Blood culture in LIT media of 101 seropositive cases from the Caatinga of Piauí was positive for T. cruzi in 25.7%. A triatomine survey carried out in a sample of 132 domiciles and peridomiciles in the Sertão of Paraíba and in a sample of 159 in the Caatinga of Piauí showed the following results: In Paraíba, 16 specimens of T. brasiliensis, not infected with T. cruzi, were captured. In Piauí, 750 triatomines were captured, of these 625 were examined: 49 were T. pseudomaculata, not infected with T. cruzi (19 in peridomiciles and 30 in the domiciles), and 576 were T. brasiliensis (371 in the domiciles and 205 in the peridomiciles) and of this latter specie 32 (5.5%) were infected with T. cruzi (31 in the domiciles and one in the peridomicile).

摘要

对巴西东北部皮奥伊州卡廷加地区200例血清阳性病例以及帕拉伊巴 sertão地区186对克氏锥虫感染血清学阳性和阴性的个体进行了临床和心电图病例对照研究。两个地区血清阳性病例的主要临床表现为:心悸、劳力性呼吸困难、心前区疼痛、吞咽困难、吞咽痛、烧心和肠道便秘。提示慢性恰加斯病性心脏病的心电图异常率在帕拉伊巴和皮奥伊分别为:房室传导阻滞3.8%和2%,完全性右束支传导阻滞6.4%和7%,完全性右束支传导阻滞伴左前分支阻滞10.7%和10.5%,多源性期前收缩2.7%和3%。对帕拉伊巴 sertão地区54例血清阳性个体和皮奥伊卡廷加地区120例血清阳性个体进行异种诊断,阳性率分别为13%和34%;对帕拉伊巴47例血清阳性样本和皮奥伊101例血清阳性样本进行PCR检测,阳性率分别为44.6%和59.5%。对皮奥伊卡廷加地区101例血清阳性病例的Lit培养基血培养中,克氏锥虫阳性率为25.7%。对帕拉伊巴 sertão地区132个住所和住宅周围环境样本以及皮奥伊卡廷加地区159个样本进行的锥蝽调查结果如下:在帕拉伊巴,捕获了16只未感染克氏锥虫的巴西锥蝽标本。在皮奥伊,捕获了750只锥蝽,其中625只接受检查:49只为未感染克氏锥虫的伪黄斑锥蝽(住宅周围环境中有19只,住所中有30只),576只为巴西锥蝽(住所中有371只,住宅周围环境中有205只),其中32只(5.5%)感染了克氏锥虫(住所中有31只,住宅周围环境中有1只)。

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