Helena Rangel Esper, Vera Lúcia Teixeira de Freitas, João Guilherme Pontes Lima Assy, Olívia Campos Pinheiro Berreta, Alisson Dos Santos Brandão, Erika Yoshie Shimoda Nakanishi, Claudia de Abreu Fonseca, Francisco Oscar de Siqueira França, Marta Heloísa Lopes
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引用次数: 0
Abstract
Background: The experience of the USP Tropical Medicine Centre (NUMETROP) team in providing medical care during acute Chagas disease (ACD) outbreaks in Santarém, Pará, motivated this study.
Objectives: To study the epidemiological, clinical-laboratory, and socio-cultural aspects of confirmed cases of ACD in outbreaks in Santarém from March 2016 to March 2018.
Methods: Observational case series study of ACD outbreaks in two communities: Marimarituba in 2016 and Cachoeira do Aruã in 2017. Diagnostic characterisation included classification into discrete typing units (DTUs).
Findings: Eight cases were diagnosed as ACD TcIV in Marimarituba and seven cases were identified as ACD TcI in Cachoeira do Aruã. Women of childbearing age were numerous in both groups, and one miscarriage and two possible vertical transmissions were observed. Fever and rash were the most common findings in Marimarituba, with a fatality rate of 12.5%. In both outbreaks, serological surveillance was performed three to 21 months after treatment, with no confirmation of a "serological cure".
Main conclusions: We observed possible vertical transmission, diverse DTUs in the same municipality, and a lack of knowledge about patient outcomes. We highlight that, despite the importance of ACD in the Amazon region, there is no institutional follow-up of patients from diagnosis to cure.
背景：USP热带医学中心（NUMETROP）团队在帕尔桑塔姆姆的急性恰加斯病（ACD）暴发期间提供医疗服务的经验激发了这项研究。目的：研究2016年3月至2018年3月圣塔姆地区ACD确诊病例的流行病学、临床实验室和社会文化方面的情况。方法：对2016年marmarituba和2017年Cachoeira do Aruã两个社区的ACD暴发进行观察性病例系列研究。诊断特征包括分为离散型单元（dtu）。结果：marmararituba确诊为ACD TcIV 8例，Cachoeira do Aruã确诊为ACD tci7例。两组育龄妇女人数众多，观察到一例流产和两例可能的垂直传播。发热和皮疹是马里马里图巴最常见的症状，死亡率为12.5%。在这两次疫情中，在治疗后3至21个月进行了血清学监测，未确认“血清学治愈”。主要结论：我们观察到可能的垂直传播，同一城市的不同dtu，以及缺乏对患者预后的了解。我们强调，尽管ACD在亚马逊地区很重要，但没有对患者从诊断到治愈的机构随访。
期刊介绍：
Memórias do Instituto Oswaldo Cruz is a journal specialized in microbes & their vectors causing human infections. This means that we accept manuscripts covering multidisciplinary approaches and findings in the basic aspects of infectious diseases, e.g. basic in research in prokariotes, eukaryotes, and/or virus. Articles must clearly show what is the main question to be answered, the hypothesis raised, and the contribution given by the study.
Priority is given to manuscripts reporting novel mechanisms and general findings concerning the biology of human infectious prokariotes, eukariotes or virus. Papers reporting innovative methods for diagnostics or that advance the basic research with these infectious agents are also welcome.
It is important to mention what we do not publish: veterinary infectious agents research, taxonomic analysis and re-description of species, epidemiological studies or surveys or case reports and data re-analysis. Manuscripts that fall in these cases or that are considered of low priority by the journal editorial board, will be returned to the author(s) for submission to another journal.
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