Epidemiological, clinical and etiological treatment aspects in the Chagas clinic of the municipality of Comapa - Jutiapa, Guatemala

Abstract

Chagas disease (CD) is a major public health problem in Guatemala, where an estimated 166,000 people are infected with Trypanosoma cruzi and 1.4 million are at risk of infection. The municipality of Comapa (department of Jutiapa) is in a “hot spot” for CD control in Central America. To improve access to CD healthcare, the Departmental Directorate of Integrated Health Services Networks of Jutiapa, with support from the Drugs for Neglected Diseases initiative Latin America, set up a Chagas clinic in Comapa; This study describes epidemiological and clinical aspects of the population attended in the clinic. Using a descriptive observational study design, based on the review of a database with 590 care records between 2019 and 2024. The mean age was 44.1 years; 61.9 % were women and 7.1 % were pregnant women. 32 % exhibited the cardiac form of chronic CD. Trypanocidal treatment was started in 77.5 %, and of these, 7.6 % did not complete the prescribed regimen. All patients were treated with nifurtimox. 71.5 % of those treated reported adverse reactions (ADR). The most frequent ADRs were neuropsychiatric (67.6 %), followed by digestive (47.1 %); in 59 % of cases, between two and four ADRs occurred simultaneously. This characterization is one of the few descriptions of the Guatemalan population with T. cruzi infection/ CD. In general, the clinical data are similar to those reported in other publications. The Comapa Chagas Clinic provides a new model which can facilitate access at the primary health care level for people with CD.