Morbidity of Chagas heart disease in the microregion of Rio
Negro,Amazonian Brazil: a case-control study |
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Authors: | José Rodrigues Coura Pedro Albajar Vi?as Lucia Maria Brum-Soares Andréa Silvestre de Sousa Sérgio Salles Xavier |
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Institution: | 1.Laboratório de Doenças Parasitárias, Instituto Oswaldo Cruz;2.Department of Neglected Tropical Disease, World Health Organization, Geneva, Switzerland;3.Médicos sem Fronteiras, Brasil;4.Instituto de Pesquisa Clínica-Fiocruz, Rio de Janeiro, RJ, Brasil |
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Abstract: | A case-control study on the morbidity of Chagas heart disease was carried out in the
municipality of Barcelos in the microregion of the Rio Negro, state of Amazonas. One
hundred and six individuals, who were serologically positive for Trypanosoma
cruzi infection, as confirmed by at least two techniques with different
principles, were matched according to age and sex with an equal number of
seronegative individuals. The cases and controls were evaluated using an
epidemiological questionnaire and clinical, electrocardiograph and echocardiograph
examinations. In the seroepidemiological evaluation, 62% of the interviewees
recognised triatomines and most of them confirmed that they had seen these insects in
the piassava plantations of the riverside communities of the Negro River tributaries.
Of the seropositive patients, 25.8% affirmed that they had been stung by the
triatomines and 11.7% denied having been stung. The principal clinical manifestations
of the seropositive individuals were palpitations, chest pain and dyspnoea upon
effort. Cardiac auscultation revealed extrasystoles, bradycardia and systolic
murmurs. The electrocardiographic alterations were ventricular extrasystoles, left
and right bundle branch block, atrioventricular block and primary T wave alterations.
The echocardiogram was altered in 22.6% of the seropositive individuals and in 8.5%
of the seronegative individuals. |
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Keywords: | Chagas heart disease morbidity case control study Amazon Region |
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