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Urban outbreak of acute Chagas disease in Amazon region of Brazil: four-year follow-up after treatment with benznidazole

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Date
2009
Author
Pinto, Ana Yecê das Neves
Ferreira Jr, Alberto Gomes
Valente, Vera da Costa
Harada, Geraldo Saburo
Valente, Sebastião Aldo da Silva
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Abstract
The objective of this report is to describe treatment outcomes over a four-year period of patients with acute Chagas disease in the Amazon region of Brazil. An outbreak of Chagas disease in a low-income district of urban Belém, in September 2000, affected 11 people simultaneously, indicating the likelihood of indirect, oral transmission of Trypanosoma cruzi. Prior to treatment, patients underwent physical and clinical tests; blood samples were processed with immunofluorescence assay (IFA) and quantitative buffy coat (QBC). Following treatment with benznidazole, parasitological and serologic tests (artificial xenodiagnosis and blood culture for T. cruzi), electrocardiogram, and echocardiogram were administered at intervals over a four-year period. Four years after treatment for acute Chagas disease, all patients presented with negative parasitological tests and persistent IgG anti-T. cruzi antibodies with lowered titers; three patients presented electrocardiogram abnormalities consistent with chronic Chagas disease or sequel of acute disease. The satisfactory response to treatment and relevance of serial parasitological examinations of patients with acute Chagas disease are discussed.(AU)
 
El objetivo de este informe es describir los resultados del tratamiento para la enfermedad aguda de Chagas durante un seguimiento de cuatro años en pacientes de la región amazónica de Brasil. Un brote de la enfermedad de Chagas en un distrito de bajos ingresos de la parte urbana de Belém afectó simultáneamente a 11 personas en septiembre de 2000; al parecer, la transmisión de Trypanosoma cruzi fue indirecta por vía oral. Antes del tratamiento, los pacientes se sometieron a un examen físico y pruebas clínicas; las muestras de sangre se estudiaron mediante inmunofluorescencia - indirecta y análisis cuantitativo de la capa leucocitaria (buffy coat). Después del - tratamiento con benznidazol se realizaron pruebas parasitológicas y serológicas (xenodiagnóstico artificial y hemocultivo de T. cruzi), electrocardiogramas y ecocardiogramas periódicos durante cuatro años. Cuatro años después del tratamiento por enfermedad aguda de Chagas, todos los pacientes eran negativos en los análisis parasitológicos y disminuyeron los títulos de anticuerpos IgM anti-T. cruzi persistentes; tres pacientes presentaron alteraciones electrocardiográficas indicadoras de enfermedad crónica de Chagas o de secuelas de la enfermedad aguda. Se discute la respuesta satisfactoria al tratamiento y la importancia de los análisis parasitológicos seriados de los pacientes con enfermedad aguda de Chagas.(AU)
 
Series
Rev Panam Salud Publica;25(1),ene. 2009
Subject
Benznidazole; Chagas Cardiomyopathy; Chagas Disease; Disease Outbreaks; Disease Transmission, Infectious; Immunologic Tests; Trypanosoma cruzi; Brazil; Cardiomiopatía chagásica; Enfermedad de Chagas; Brotes de Enfermedades; Transmisión de enfermedad; Pruebas Inmunológicas; Trypanosoma cruzi; Brasil; Doença de Chagas; Doença de Chagas; Surtos de Doenças; Nitroimidazóis; Tripanossomicidas; Brasil; Seguimentos; Fatores de Tempo; População Urbana; Adulto Jovem
URI
http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892009000100012
https://iris.paho.org/handle/10665.2/9885
Citation
Pinto, Ana Yecê das Neves,Ferreira Jr, Alberto Gomes,Valente, Vera da Costa,Harada, Geraldo Saburo,Valente, Sebastião Aldo da Silva (2009) Urban outbreak of acute Chagas disease in Amazon region of Brazil: four-year follow-up after treatment with benznidazole. Rev Panam Salud Publica;25(1) 77-83,jan. 2009. Retrieved from http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892009000100012
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