Longitudinal study, by xenodiagnosis, of parasitemia in patients with chronic Trypanosoma cruzi infection]

A 2-5 years follow-up of parasitemia, by the use of xenodiagnosis (XD) was carried out in nine patients with chronic T. cruzi infection who proceeded from chagasic endemic areas of Chile. The patients (mean age 55 years) were hospitalized in the chronic section of a psychiatry institution sited in a permanent triatomines free urban area. Clinical examination, X-rays images (cardiovascular, esophagus and colon) and electrocardiogram resulted normal in all the patients. Basic study unit of parasitemia was a XD box which contained 7 nymphs III of Triatoma infestans which was used in a serial XD consisting in the simultaneous application of a pair of boxes a day during three consecutive days, making a total of six boxes (42 nymphs). The minimal time of duration of infection (M.D.I.) for each patient was estimated that this was adquired close to hospitalization. The M.D.I. varied between 6 and 45 years. The global positivity of XD boxes ranged between 6.3 and 84.7%, being in three patients lower than 12% and in six patients higher than 52%. In considering the yield of XD it is important to stress that during all the study of the nine patients with chronic chagasic infection 1282 XD boxes were applied resulting positive 582 (45.4%). At the end of the follow-up all patients received specific treatment for chagasic infection with nifurtimox at the daily dose of 10 mg/kg of body weight during 60 days. According to the result, two main conclusions arise: 1.--Serial XD has a high efficiency for detecting, evaluate and evolve parasitemia in patients with chronic chagasic infection. 2.--Parasitemia may present low, medium or high levels in different individuals and has a variable and fluctuating character.