PREVALENCE OF CHAGAS DISEASE IN A RURAL AREA IN THE STATE OF CEARA, BRAZIL

SUMMARY Chagas disease is caused by Trypanosoma cruzi and affects about two to three million people in Brazil, still figuring as an important public health problem. A study was conducted in a rural area of the municipality of Limoeiro do Norte - CE, northeastern Brazil, aiming to determine the prevalence of T. cruzi infection. Of the inhabitants, 52% were examined, among whom 2.6% (4/154) were seropositive in at least two serological tests. All seropositive individuals were older than 50 years, farmers, with a low education and a family income of less than three minimum wages. Active surveillance may be an alternative for early detection of this disease

Ãndice de infestaÃÃo e infecÃÃo de triatomÃneos por Trypanosoma cruzi na regiÃo Sudeste do Estado do CearÃ

Chagas disease is one of the most important parasitic diseases in Latin America, transmitted by triatomine, has reached more than 10 million people. This illness is typical of rural environments and inadequate housing provides shelter to the vector the disease transmitter. The aim of this study was to investigate the presence of Trypanosoma cruzi in triatomines captured in intradomiciliary and surroundings in cities in the southeast region of CearÃin. This is a retrospective descriptive study, by consulting the archives of Control Program of Chagas Disease in Regional Laboratory of Endemic Diseases of Limoeiro do Norte â CE, which attends the cities that were studied from 2009 to 2011. During the study were captured a total of 18.408 specimens of insects, including nymphs and adults inside the home and outside homes. Of this total, 17.910 specimens were examined, representing 97,29%. The number of nymphs was taken about three times greater than the number of adults. The year of 2010 was the one with the highest number of captures, with a total of 8.548 triatomines, distributed among nymphs (6.115) and adults (2.433), and 637 inside of the houses and 7.911 around the houses. This year presented an infection rate of 1.30%, with 107 positive triatomines, being Quixerà the city with the highest infection rate in that year. The infection rate in adults triatomine (1.92%) was higher than in nymphs (1.21%). The species captured during the study period were Triatoma pseudomaculta, Triatoma brasiliensis, Panstrongylus megistus, Panstrongylus lutzi and Rhodnius nasutus. Of these species, T. pseudomaculta was the most captured throughout the study period, with 12.643 specimes. During this study, were 11 cities studied, and the most infested was Tabuleiro do Norte with 3.976 specimens, followed by Ãrere with 3.289. The city with the highest infection rate during the study period was Limoeiro do Norte (5,00%) with a total of 125 triatomines positive, followed by Quixerà (2.39%). At the end of the study, we can conclude that it is still necessary to intensify Control Program of Chagas disease, in order to avoid the maximum transmission of this disease. Finally we highlight the importance of conducting educational programs to the population in order to provide guidance to the public on disease prevention, such as towing houses, fix cracks and maintain clean environments at home and around the homes to prevent colonization of the approach and vectors.A doenÃa de Chagas à uma das doenÃas parasitÃrias mais importante da AmÃrica Latina, transmitida por triatomÃneos jà atingiu mais de 10 milhÃes de pessoas. Essa enfermidade à tÃpica de ambientes rurais e habitaÃÃes inadequadas que oferecem abrigo ao vector transmissor da doenÃa. O presente estudo tem como objetivo investigar a presenÃa de Trypanosoma cruzi em triatomÃneos capturados nos intra e peridomicÃlios, em municÃpios da regiÃo sudestedo estado do CearÃ. Trata-se de um estudo retrospectivo descritivo, de consulta aos arquivos do Programa de Controle da DoenÃa de Chagas do LaboratÃrio Regional de Endemias do Limoeiro do Norte â CE, que atende os municÃpios que foram estudados no perÃodo de 2009 a 2011. Durante o estudo foi capturado um total de 18.408 exemplares de triatomÃneos, entre ninfas e adultos no intradomicÃlio e peridomicÃlio. Desse total, 17.910 exemplares foram examinados, representando 97,29 % dos capturados. O nÃmero de ninfas capturadas foi cerca de trÃs vezes maior que o nÃmero de adultos. O ano de 2010 foi o ano com maior nÃmero de capturas, com um total de 8.548 triatomÃneos capturados, distribuÃdos entre ninfas (6.115) e adultos (2.433), sendo 637 no intradomicÃlio e 7.911 no peridomicÃlio. O Ãndice de infecÃÃo nesse ano foi de 1,30%, com 107 triatomÃneos positivos, sendo Quixerà o municÃpio com maior Ãndice de infecÃÃo. O Ãndice de infecÃÃo em adultos (1,92%) foi maior do que em ninfas (1,21%). As espÃcies capturadas durante o perÃodo de estudo foram Triatoma pseudomaculta, Triatoma brasiliensis, Panstrongylus megistus, Panstrongylus lutzi e Rhodnius nasutus. Dessas espÃcies, T. pseudomaculta foi a mais capturada durante todo o perÃodo de estudo, com 12.643 exemplares. Durante o perÃodo de estudo foram estudados 11 municÃpios, sendo o mais infestado Tabuleiro do Norte com 3.976 exemplares, seguido de Ãrere com 3.289 exemplares. O municÃpio que apresentou maior Ãndice de infecÃÃo durante o perÃodo de estudo foi Limoeiro do Norte (5,00%) com um total de 125 triatomÃneos positivos, seguido de Quixerà (2,39%). Ao fim do estudo, pode-se concluir que ainda faz-se necessÃria a intensificaÃÃo do Programa de Controle da DoenÃa de Chagas, para poder evitar ao mÃximo a transmissÃo da doenÃa. Finalmente destaca-se a importÃncia de realizar programas educativos à populaÃÃo com a finalidade de dar orientaÃÃes à populaÃÃo na prevenÃÃo da doenÃa, tais como rebocar as casas, corrigir frestas e manter limpos os ambientes no peridomicÃlio e no domicÃlio para evitar a aproximaÃÃo e colonizaÃÃo dos vetores

Analysis of the seroprevalence of and factors associated with Chagas disease in an endemic area in Northeastern Brazil

ABSTRACT INTRODUCTION: Chagas disease (CD) is currently considered a neglected disease; hence, identifying the factors associated with its high prevalence is essential. This study aimed to identify the seroprevalence of and the possible factors associated with CD in inhabitants of the City of Limoeiro do Norte, Northeastern Brazil. METHODS: Between April and November 2013, blood collection was conducted and a semi-structured questionnaire was administered. Blood samples that showed positive or possible serology for anti-Trypanosoma cruzi antibodies based on indirect immunofluorescence, hemagglutination indirect, and an enzyme-linked immunosorbent assay were analyzed. Associations between CD positivity and the study variables were analyzed using prevalence ratios (PR) with 95% confidence intervals (CI). RESULTS: A total of 812 individuals were analyzed, of which T. cruzi seropositivity was determined in 4.2% (34 individuals). Sociodemographic variables showing a significant association with T. cruzi positivity included age >50 years (PR = 27.6; 95% CI = 6.66-114.4), elementary level education (PR = 5.15; 95% CI = 1.83-14.47), and retirement (PR = 7.25; 95% CI = 3.72-14.14). Positivity for T. cruzi was 6.17 times higher in those who had a history of living in rammed earth houses compared with those who did not (95% CI = 2.19-17.37). There was no evidence of vertical transmission in the individuals studied. Among the individuals infected with T. cruzi, the majority reported having a comorbidity (p < 0.01). CONCLUSIONS: This study demonstrated the seroprevalence of CD and identified factors associated with a high prevalence of CD

PREVALENCE OF CHAGAS DISEASE IN A RURAL AREA IN THE STATE OF CEARA, BRAZIL

A doença de Chagas é causada pelo Trypanosoma cruzi e atinge cerca de dois a três milhões de pessoas no Brasil, permanecendo como importante problema de saúde pública. Foi realizado um estudo em área rural do município de Limoeiro do Norte - CE, nordeste do Brasil, com o objetivo de conhecer a prevalência da infecção chagásica. Foram examinados 52% dos habitantes, dentre os quais 2,6% (4/154) apresentaram sorologia reagente em pelo menos dois testes sorológicos. Todos os positivos tinham idade superior a 50 anos, eram agricultores, com baixa escolaridade e renda familiar inferior a três salários mínimos. A busca ativa pode ser uma alternativa para o diagnóstico precoce dessa doença.Chagas disease is caused by Trypanosoma cruzi and affects about two to three million people in Brazil, still figuring as an important public health problem. A study was conducted in a rural area of the municipality of Limoeiro do Norte - CE, northeastern Brazil, aiming to determine the prevalence of T. cruzi infection. Of the inhabitants, 52% were examined, among whom 2.6% (4/154) were seropositive in at least two serological tests. All seropositive individuals were older than 50 years, farmers, with a low education and a family income of less than three minimum wages. Active surveillance may be an alternative for early detection of this disease

Insect vectors of Chagas disease (Trypanosoma cruzi) in Northeastern Brazil

Abstract INTRODUCTION: Chagas disease remains a public health problem in the rural and urban areas of 19 countries in the Americas. METHODS: The aim of the present study was to investigate the Trypanosoma cruzi infection rate of triatomines collected from both intra- and peridomiciliary areas in eleven municipalities of Southeastern Ceará, Brazil, from 2009 to 2015. RESULTS: A total of 32,364 triatomine specimens, including nymphs and adults, were collected, and 31,736 (98.06%) of these were examined. More nymphs were collected than adults, and the greatest number of triatomines (n = 8,548) was collected in 2010, for which the infection rate was 1.3%, with the highest rate of infections observed for specimens from Quixere. The species collected during the study were identified as Triatoma pseudomaculata, Triatoma brasiliensis, Panstrongylus megistus, Panstrongylus lutzi, and Rhodnius nasutus, with T. pseudomaculata being the most abundant (n = 19,962). CONCLUSIONS: These results verify the presence of triatomines in both intra- and peridomiciliary areas, thereby ensuring persistence of the pathogen and consequently, the disease, as the presence of infected vectors in households is an important risk factor. According to these findings, the Chagas Disease Control Program should intensify its efforts in order to prevent the spread of the disease

Trypanosoma cruzi seroprevalence among solid organ donors in Ceará State, Brazil

Abstract INTRODUCTION: The transmission of Chagas disease (CD) through blood transfusion, organ transplantation, and oral transmission has gained greater visibility as a result of intensified vector control activities in endemic regions and to control CD in non-endemic regions. In Brazil, Ceará is one of the states that perform the most organ transplants. Therefore, the objective of this study was to assess the prevalence of Trypanosoma cruzi infection in organ donor candidates. METHODS: A retrospective analysis was performed on data from potential organ donors at the Center of Transplantation of the State of Ceará from 2010 - 2015. RESULTS: Data from a total of 2,822 potential donors were obtained, of which 1,038 were effective donors and 1,784 were excluded, likely due to lack of family authorization or medical contraindication. The prevalence of T. cruzi infection among these potential donors was 1.3% (n = 29). The majority of infected donors were males aged 41 - 60 years, residing in the interior of the state. Interestingly, 72.4% (n = 21) had positive or inconclusive serology for additional infections, such as cytomegalovirus, hepatitis B and C, and toxoplasmosis. Probability analysis revealed that stroke was the most common cause of death among potential donors with CD. CONCLUSIONS: There was a high prevalence of CD and other coinfections among potential solid organ donors in Ceará, and statistical tests have shown that these individuals are at increased risk of stroke when compared to potential non-reactive donors. This work highlights the importance of screening DC infection in potential donors