Avaliação da morbidade e letalidade da doença de Chagas em indivíduos atendidos por um serviço de atenção farmacêutica no estado do Ceará

Abstract

Chagas' disease (DC) is transmitted by a flagellate protozoan called Trypanosoma cruzi. It is classified as a neglected disease by the World Health Organization (WHO) due to its direct relation to the socioeconomic status of patients, leading to a high burden of morbidity and mortality for patients in endemic countries, including Brazil.It is estimatedthat approximately 6 to 7 million people are infected worldwide, with 2 million in Brazil. This was a retrospective descriptive study on the morbidity and mortality of patients with Chagas' disease treated at the Chagas Disease Research Laboratory (LPDC) in the period 2005 to 2017.To assess the morbidity, the records of the patients in the LPDC were used and for the mortality, death certificates through the mortality information system (SIM) and the cause of death through the Notification of Injury Information System (SINAN) were used. All patients attended by the service (n=520) were analyzed. Regarding the gender variable, the majority were male (51%) and the mean age found was 50.38 years. As for the place of birth, the most prominent municipalities were: Limoeiro do Norte (14.42%), Russas (14.23%), Quixeré (11.53%) and Jaguaruana (10%); the most prominent was the municipality of Fortaleza (21.2%), Limoeiro do Norte (13.26%) and Quixeré (13.46%). As to the frequency of clinical forms of CD found in the study period, the undetermined form was the most prevalent (48.65%), followed by the cardiac form (46.73%), mixed form (3.46%) and digestive form (1,15%). In the cardiac form, the ECG changes most observed were right bundle branch block (37.36%), followed by divisional left bundle branch block (25.27%) and diffuse left bundle branch repolarization (14.28%). In the digestive form, it was observed,chagasic megacolon (66.66%) and chagasic megaesophagus (33.3%) and in the mixed form, right bundle branch block (77.77%), chagasic megacolon (44.44%) and anteromedial divisional block (38.88%). In relation to mortality, the majority were male (72.2%), coming from Fortaleza (16.6%), Jaguaruana (16.6%) and Crateús (11.11%). Most of these had as the basic cause, cardiac impairment (66.66%) and as the associated cause, pulmonary edema (16.6%) and respiratory failure (11.1%). This study demonstrated the impact that Chagas disease can have on the quality of life of patients treated by the LPDC and serves as a warning for greater visibility and investment in research focusing on neglected diseases.