Serological survey for Chagas disease in the rural areas of Manaus, Coari, and Tefé in the Western Brazilian Amazon
Serological survey for Chagas disease in the rural areas of Manaus, Coari, and Tefé in the Western Brazilian Amazon
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DOI：
10.1590/s0037-86822011000600009
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发表时间：
2011-12-01
影响因子：
2
通讯作者：
Barbosa, Maria das Graças Vale
中科院分区：
文献类型：
--
作者：
Magalhães, Belisa Maria Lopes;Coelho, Leíla Ines Aguiar Raposo Câmara;Barbosa, Maria das Graças Vale
简介：砍伐森林、不受控制的森林、人口从流行地区迁移以及大量自然感染克氏锥虫的宿主和野生病媒，都促使南美锥虫病在亚马逊地区流行。研究方法：我们对1，263人进行了初步血清学调查（ELISA），其中1，095人（86.7%）为亚马孙州本地人，666人（52.7%）为男性，948人（75.1%）年龄在20岁以上。对间接免疫荧光（IFI）检测呈反应性、不确定性或不确定性的血清样品或IFA检测呈低滴度阳性的血清样品进行Western blot（WB）检测。血清学证实的患者（WB）进行了评价流行病学，临床，心电图，超声心动图的特点。结果：15例患者血清学确诊为T。cruzi感染，其中12人是土生土长的亚马逊州，总血清阳性率为1.2%和0.9%的亚马逊州。15例中5例为男性，平均年龄47岁，多为文化程度低的农民。1例非本地患者，来自阿拉戈斯，显示右束支分支传导阻滞、束支分支传导阻滞和前上左心室收缩功能障碍，射血分数为54%。结论：本研究的结果证实了监测亚马逊地区CD病例的重要性，特别是在亚马逊州。
Introduction: Deforestation, uncontrolled forest, human population migration from endemic areas, and the large number of reservoirs and wild vectors naturally infected by Trypanosoma cruzi promote the endemicity of Chagas disease in the Amazon region. Methods: We conducted an initial serological survey (ELISA) in a sample of 1,263 persons; 1,095 (86.7%) were natives of the state of Amazonas, 666 (52.7%) were male, and 948 (75.1%) were over 20 years old. Serum samples that were found to be reactive, indeterminate, or inconclusive by indirect immunofluorescence (IFI) or positive with low titer by IFA were tested by Western blot (WB). Serologically confirmed patients (WB) were evaluated in terms of epidemiological, clinical, ECG, and echocardiography characteristics. Results: Fifteen patients had serologically confirmed T. cruzi infection, and 12 of them were autochthonous to the state of Amazonas, for an overall seroprevalence of 1.2% and 0.9% for the state of Amazonas. Five of the 15 cases were males, and the average age was 47 years old; most were farmers with low education. One patient who was not autochthonous, having originated from Alagoas, showed right bundle branch block, bundle branch block, and anterosuperior left ventricular systolic dysfunction with an ejection fraction of 54%. Conclusions: The results of this study ratify the importance of monitoring CD cases in Amazonia, particularly in the state of Amazonas.