Aspectos epidemiológicos e clínicos de mulheres portadoras de doença de Chagas em Campo Grande - MS

Abstract

Chagas infection represents one of the most serious problems of Public Health because of its high prevalence and risks of placental, oral and transfusion transmission. Objective: to characterize epidemiologic and clinic aspects of women carrying Chagas´ disease in Campo Grande, Mato Grosso do Sul, from March 2007 to April 2008. Material and methods: A descriptive cross sectional study was carried out with 32 female patients selected by the Program of Protection to Pregnant Women of the Institute for Research and Diagnosis of Associação de Pais e Amigos dos Excepcionais, who were then referred to be assisted at Center of Infect-Parasitic Diseases in the city. Inclusion criteria: women diagnosed with infection by Trypanosoma cruzi and referred by the Program. Exclusion criteria: women without Trypanosoma cruzi infection. The project was approved by protocol nº. 883 (March 20, 2007, Document 196/96 - Conselho Nacional de Saúde. “Software” SPSS, version 13.0 and Pearson linear correlation have been used in statistical analyses. The ocurrance was 0,7 (1000 pregnant). Results showed predominance of low education; only 3,1% had higher degree. As for profession, 62,5% were housewives; and, in relation to race, 87,5% where Caucasian, 9,4% were dark-skinned and 3,1% others. The survey abut the patients´ origin showed that 81,2% of them did not come from Campo Grande: 56,2% were born in the interior of the state; 18,8% came from Bahia, Minas Gerais, Pernambuco, Paraná or Rio Grande do Sul; and 6,2% came from Bolivia. Data about rural and urban origin indicated, respectively, 56,3% and 43,8%. Among all participants, 74,2% used to live in endemic areas and 25,8%, in non- endemic areas. The proportion of abortion in relation to birth was of 36% and the average rate of abortion was 0,53±0,84. Among those who presented co-morbidities, 70,0% presented hypertension. As for symptoms, 84,4% did not present gastrointestinal disorders and 78,1% did not present cardiac issues. ECG proved to be altered in 42,3% of the patients and included disorders in the right branch conduction in 37,5%, diffuse alteration of ventricular repolarization in 25,0%; the remaining 25,0% presented complete block of the right branch and one patient presented sinus bradycardia, isolated supraventricular extrasystole and left antero-superior divisional block. The fraction of mean ejection was 0,71±0,05, whereas the mean cardiothoracic index was 0,45±0,07. A significant and negative linear correlation was seen. In conclusion, the patients were either born or lived during a period in wood or wattle houses in the rural area, and there was a direct correlation between low education and Chagas´ disease. In reaction to current house, 93,5% live in urban non-endemic zone. The transmission through vectors was evident. Alterations of ECG echocardiogram and chest X-ray play an important role in the initial evaluation, even in asymptomatic patients.