Memorias do Instituto Oswaldo Cruz · 2025
Acute Chagas disease in Amazonia, western Pará: perspectives from medical assistance to genetic elucidation.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Esper Helena Rangel, de Freitas Vera Lúcia Teixeira, Assy João Guilherme Pontes Lima, Berreta Olívia Campos Pinheiro, Brandão Alisson Dos Santos, Nakanishi Erika Yoshie Shimoda, Fonseca Claudia de Abreu, França Francisco Oscar de Siqueira, Lopes Marta Heloísa
Аннотация
BACKGROUND: The experience of the USP Tropical Medicine Centre (NUMETROP) team in providing medical care during acute Chagas disease (ACD) outbreaks in Santarém, Pará, motivated this study.
OBJECTIVES: To study the epidemiological, clinical-laboratory, and socio-cultural aspects of confirmed cases of ACD in outbreaks in Santarém from March 2016 to March 2018.
METHODS: Observational case series study of ACD outbreaks in two communities: Marimarituba in 2016 and Cachoeira do Aruã in 2017. Diagnostic characterisation included classification into discrete typing units (DTUs).
FINDINGS: Eight cases were diagnosed as ACD TcIV in Marimarituba and seven cases were identified as ACD TcI in Cachoeira do Aruã. Women of childbearing age were numerous in both groups, and one miscarriage and two possible vertical transmissions were observed. Fever and rash were the most common findings in Marimarituba, with a fatality rate of 12.5%. In both outbreaks, serological surveillance was performed three to 21 months after treatment, with no confirmation of a "serological cure".
MAIN CONCLUSIONS: We observed possible vertical transmission, diverse DTUs in the same municipality, and a lack of knowledge about patient outcomes. We highlight that, despite the importance of ACD in the Amazon region, there is no institutional follow-up of patients from diagnosis to cure.
OBJECTIVES: To study the epidemiological, clinical-laboratory, and socio-cultural aspects of confirmed cases of ACD in outbreaks in Santarém from March 2016 to March 2018.
METHODS: Observational case series study of ACD outbreaks in two communities: Marimarituba in 2016 and Cachoeira do Aruã in 2017. Diagnostic characterisation included classification into discrete typing units (DTUs).
FINDINGS: Eight cases were diagnosed as ACD TcIV in Marimarituba and seven cases were identified as ACD TcI in Cachoeira do Aruã. Women of childbearing age were numerous in both groups, and one miscarriage and two possible vertical transmissions were observed. Fever and rash were the most common findings in Marimarituba, with a fatality rate of 12.5%. In both outbreaks, serological surveillance was performed three to 21 months after treatment, with no confirmation of a "serological cure".
MAIN CONCLUSIONS: We observed possible vertical transmission, diverse DTUs in the same municipality, and a lack of knowledge about patient outcomes. We highlight that, despite the importance of ACD in the Amazon region, there is no institutional follow-up of patients from diagnosis to cure.