Estudo clínico parasitológico de pacientes com Doença de Chagas, de Mambaí-GO, compreendendo um período de 30 anos
AUTOR(ES)
Joe Milton Cordova Bocanegra
DATA DE PUBLICAÇÃO
2008
RESUMO
The purpose of this research was to identify potencial relationships betwee the parasitaemia and the evolution of Chagass chronic disease. Patients with chronic Chagas infection were included from Mambaí Projec Research. They had been detected with six positive Chagas serologic test at 1975/76 One hundred and twenty-four patients had clinical, electrocardiographic and artifici xenodiagnosis evaluations at 2007; and also, they used esophagogram and dobl contrast enema of colon performed in previous periods. In 2007, the study of parasitaemia was based on a single artifici xenodiagnosis using 40 nymphs at first stage of D. Maximus. A group of five intestin contents of insects were considered a pool. According to the percentage of positive "pools", patients were classified wit absent, low (0.1-19.9%), medium (20 to 50%) and high (50.1-100%) parasitaemia. On hundred and five (84.7%), six (4.8%), 12 (9.7%) and one (0.8%) patients had absen low, medium and high parasitaemia, respectively. Also the parasitaemias trend was characterized. It was defined as: decrease when parasitaemia declined, constant when not change occurred and increased whe the parasitaemias level ascended, all in relation with 1976/78 parasitaemia testing. In those 124 patients, xenodiagnosiss positive level fell from 70.1% (87/124) i 1976/78 to 15.3% (19/124) at 2007. Among the 19 patients with positive xenodiagnosis seven remained at the same level, nine increased and three dropped their parasitaemia level. Sixty-seven (54%) patients had normal electrocardiograms. The most frequen electrocardiographic abnormalities were: alterations in ventricular repolarization (29.8% ventricular premature beats (17.7%), complete right bundle branch block (16.9%), le anterior fascicular block (9.7%) and first degree atrio-ventricular block (5.6%).Meanwhile, from the 124 patients with Chagas infection, there were 57 (45.9%) with cardiopathy form. Forty five had progressive evolution, 38 developed heart disease and seven worsen their 1975/76 pre-existing heart disease. Trend for heart disease increased throughout the years and those who developed heart disease, 78.9% did so to CI and C-II stages, considered mild to moderate disease. Once installed heart disease, it progress slowly. Evolution of the digestive form was evaluated through esophagograms made in 1975/76, 1988, and the double contrast enema of colon in 2002. Colon disease was considered if the patient related constipations symptom for six or more days. Digestive form was considered in 30 (24.2%) patients, 28 of them had progressive evolution. The research showed that the 19 patients with positive xenodiagnosis, in 2007, had similar clinical evolution percentage than the 105 patients with negative result. It also showed that patients with absent, medium and low parasitaemia tended to evolutes in similar way. There was a trend of higher evolution in those with parasitaemias decreased profile. In this research, xenodiagnosis, parasitaemias level and parasitaemias profile did not influence in the evolution of chronic Chagass disease.
ASSUNTO(S)
estudo clinico medicina parasitologico doença de chagas doença de chagas
