Chagas Disease in Northern California: Observed Prevalence, Clinical Characteristics, and Outcomes Within an Integrated Health Care Delivery System.

Q2 Social Sciences

The Permanente journal Pub Date : 2025-06-26 DOI:10.7812/TPP/25.041

Salvador Hernandez, Kishan K Srikanth, Akshay Bommireddi, Thomas K Leong, David A Miller, Andrew P Ambrosy, Jonathan Zaroff

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引用次数: 0

Abstract

Introduction: Chagas disease (CD) is caused by the protozoan parasite Trypanosoma cruzi and can remain clinically silent for decades. The objectives of this study were to quantify the prevalence of CD within the membership of Kaiser Permanente Northern California, to describe the demographic and clinical characteristics of patients with CD, and to report their adverse cardiovascular outcomes.

Methods: In this cohort study from 2006 to 2022, the authors identified patients with CD by screening the electronic medical record for International Classification of Diseases, 9th Revision and 10th Revision codes. The authors obtained demographic, medical history, electrocardiographic, echocardiographic, and pharmacy data. Adverse outcomes, including all-cause mortality, heart failure hospitalization, and heart transplantation, were identified by database programming and confirmed by manual chart review.

Results: There were 53 cases of CD in total, and 75% of patients self-identified as Hispanic. The mean age was 49 years old, and 45% were female. Dyslipidemia (45%) and hypertension (32%) were common comorbidities. A total of 7 patients (13%) had a left ventricular ejection fraction < 45%. During the follow-up period, adverse outcomes included 4 cardiovascular deaths, 5 heart failure hospitalizations, and 4 heart transplantations. The prevalence of diagnosed CD in the Kaiser Permanente Northern California population has risen from 0.22 per 100,000 persons from 2006 to 2010 to 0.70 per 100,000 persons from 2018 to 2022.

Discussion: The prevalence of diagnosed CD in Kaiser Permanente Northern California increased during the study period, and patients with CD frequently had poor cardiovascular outcomes, likely due to the patients presenting with advanced disease.

Conclusion: Systematic screening and awareness are likely to facilitate early diagnosis and improve treatment to avoid chronic complications of CD.

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加州北部的恰加斯病：观察到的流行、临床特征和综合医疗服务系统的结果。

简介：恰加斯病（CD）是由克氏锥虫引起的原生动物寄生虫，可在临床上保持沉默数十年。本研究的目的是量化Kaiser Permanente北加州会员的乳糜泻患病率，描述乳糜泻患者的人口统计学和临床特征，并报告他们的不良心血管结果。方法：在2006年至2022年的队列研究中，作者通过筛选国际疾病分类第9版和第10版代码的电子病历来识别CD患者。作者获得了人口统计、病史、心电图、超声心动图和药学数据。不良结果，包括全因死亡率、心力衰竭住院和心脏移植，通过数据库编程确定，并通过手工图表审查确认。结果：共有53例CD， 75%的患者自认为是西班牙裔。平均年龄49岁，女性占45%。血脂异常（45%）和高血压（32%）是常见的合并症。7例患者（13%）左心室射血分数< 45%。在随访期间，不良结果包括4例心血管死亡、5例心力衰竭住院和4例心脏移植。Kaiser Permanente北加州人口中诊断为乳糜泻的患病率从2006年至2010年的每10万人0.22人上升到2018年至2022年的每10万人0.70人。讨论：在Kaiser Permanente北加州，诊断为乳糜泻的患病率在研究期间有所增加，乳糜泻患者通常有较差的心血管预后，可能是由于患者表现为疾病晚期。结论：系统的筛查和认识有助于CD的早期诊断和改善治疗，避免慢性并发症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

The Permanente journal Medicine-Medicine (all)

CiteScore

2.20

自引率

0.00%

发文量