Temporal changes in the clinical-epidemiological profile of patients with Chagas disease at a referral center in Brazil

• Published in: Revista da Sociedade Brasileira de Medicina Tropical
• Main Authors: Alejandro Marcel Hasslocher-Moreno, Roberto Magalhaes Saraiva, Pedro Emmanuel Alvarenga Americano do Brasil, Luiz Henrique Conde Sangenis, Sergio Salles Xavier, Andréa Silvestre de Sousa, Gilberto Marcelo Sperandio-da-Silva, Fernanda de Souza Nogueira Sardinha Mendes, Andréa Rodrigues da Costa, Marcelo Teixeira de Holanda, Henrique Horta Veloso, Flavia Mazzoli-Rocha, Fernanda Martins Carneiro, Luciana Fernandes Portela, Mauro Felippe Felix Mediano
• Format: Article in Journal/Newspaper
• Language: English
• Published: Sociedade Brasileira de Medicina Tropical (SBMT) 2021
• Subjects: Chagas disease; Epidemiologic studies; Cohort studies; Arctic medicine. Tropical medicine; RC955-962; Arctic
• Online Access: https://doi.org/10.1590/0037-8682-0040-2021; https://doaj.org/article/a7abb77f4e834745a1a813e2d5393d42

Abstract INTRODUCTION We aimed to describe the sociodemographic, epidemiological, and clinical characteristics of patients with chronic Chagas disease (CD) at an infectious disease referral center. Changes in patient profiles over time were also evaluated. METHODS This retrospective study included patients with CD from November 1986-December 2019. All patients underwent an evaluation protocol that included sociodemographic profile; epidemiological history; anamnesis; and physical, cardiologic, and digestive examinations. Trend differences for each 5-year period from 1986 to 2019 were tested using a nonparametric trend test for continuous and generalized linear models with binomial distribution for categorical variables. RESULTS A total of 2,168 patients (52.2% women) were included, with a mean age of 47.8 years old. White patients with low levels of education predominated. The reported transmission mode was vectorial in 90.2% of cases. The majority came from areas with a high prevalence (52.2%) and morbidity (67.8%) of CD. The most common clinical presentation was the indeterminate form (44.9%). The number of patients referred gradually decreased and the age at admission increased during the study period, as did the patients’ levels of education. CONCLUSIONS The clinical profile of CD is characterized by a predominance of the indeterminate form of the disease. Regarding the patients who were followed up at the referral center, there was a progressive increase in the mean age and a concomitant decrease in the number of new patients. This reflects the successful control of vector and transfusion transmission in Brazil as well as the aging population of patients with CD.