Revista da Sociedade Brasileira de Medicina Tropical (Dec 2011)

Serological survey for Chagas disease in the rural areas of Manaus, Coari, and Tefé in the Western Brazilian Amazon

  • Belisa Maria Lopes Magalhães,
  • Leíla Ines Aguiar Raposo Câmara Coelho,
  • Marcel Gonçalves Maciel,
  • João Marcos Benfica Barbosa Ferreira,
  • Eufrozina Setsu Umezawa,
  • José Rodrigues Coura,
  • Jorge Augusto de Oliveira Guerra,
  • Maria das Graças Vale Barbosa

DOI
https://doi.org/10.1590/S0037-86822011000600009
Journal volume & issue
Vol. 44, no. 6
pp. 697 – 702

Abstract

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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.

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