Revista da Sociedade Brasileira de Medicina Tropical (Apr 1996)

Perfil clínico-epidemiológico de chagásicos atendidos em ambulatório de referência e proposição de modelo de atenção ao chagásico na perspectiva do SUS

  • Eliane Dias Gontijo,
  • Manoel Otávio C. Rocha,
  • Ulrika Torquato de Oliveira

Journal volume & issue
Vol. 29, no. 2
pp. 101 – 108

Abstract

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Estudo caso-controle, para análise de características clínicas e epidemiológicas foi conduzido em 842 indivíduos atendidos em Ambulatório de Referência de Doença de Chagas, em Belo Horizonte, no período de 1985/92. Verificou-se que os chagásicos apresentaram média de idade mais elevada (37,78 anos); menor escolaridade, independente da cor, e desempenhavam atividades de maior esforço (pA case-control study to analyse clinical and epidemiological data of 842 patientes seen in an out­patient ward reference center for chagas disease in Belo Horizonte, Brazil,from 1985 to 1992. It was verified that these patients were in a average age of 37.78 years; lower literacy regardless of race, and, performed activities that demanded greater muscle effort (p <0.05). The main mechanism for disease transmission proved to be the vectorial route. Disease-especific complaints prevailed in the above mentioned patients (p<0.05). The most important abnormalities found in clinical examination were with cardiac sounds (OR:2.96 95%CI:1.29-4.09) and the presence of extrasystole (OR:7.16 95%Cl:1. 59-45.07). lmunofluorescence Test was more sensitive (94 %) and specific (96 %). It also had a PPV of 99% and e NPV of 83%. ELISA lest carried out in 43 patientes did not yield false results. Indeterminate chronic phase (56 %) or early stages of the disease prevailed. The findings of normal EKGs and abnormalities in 30%, of the Hotter tests, 41% of the exercise tests, 33% of the ECO tests and, 48% of normal chestx-ray with abnormal ECO, high lights the importance of caring out more detailed exams in specific situations. We hereby propose a care model for the Chagas disease patient, integrated to our State Health Plan stressing serologic tests, and training capable human resources committed to the development of integrated health care and the optimization of our referral and counter-referral system, thus issuing total care to the Chagas disease patient.

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