Acute chagas’ disease in western Venezuela: A clinical, seroparasitologic, and epidemiologic study
Résumé
A clinical, parasitologic, and serologic study carried out between 1988 and 1996 on 59 acute-phase
patients in areas of western Venezuela where Chagas’ disease is endemic showed 19 symptomatic patterns or groups
of symptoms appearing in combination with different frequencies. The symptomatic pattern with the highest frequency
was that showing simultaneously fever, myalgia, headache, and Roman˜a’s sign, which was detected in 20% of the
acute-phase patients. Asymptomatic individuals and patients with fever as the only sign of the disease made up 15%
and 11.9% of the total acute cases, respectively. Statistical correlation analysis revealed that xenodiagnosis and
hemoculture were the most reliable and concordant of the five parasitologic methods used; these two methods also
showed the highest proportions in detecting any clinical symptomatic pattern in acute-phase patients. A similar high
reliability and concordance was obtained with a direct agglutination test, an indirect immunofluorescent antibody test,
and an ELISA as serologic tests, which also showed a higher proportion of positive detection of clinical patterns than
parasitologic methods (P , 0.001). It is recommended that individuals coming from endemic areas showing mild
and/or severe clinical manifestations should be suspected of being in contact or having been in contact with Trypanosoma
cruzi, be referred for parasitologic and serologic evaluations to confirm the presumptive clinical diagnosis of
acute Chagas’ disease, and start specific treatment. The epidemiologic implications of the present findings are discussed
and the use of similar methodology to evaluate other areas where Chagas’ disease is endemic is suggested.
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Información Adicional
Correo Electrónico | hugo@ula.ve gecr68@hotmail.com agustinarojas@yahoo.com borgesr@ula.ve nanes@ula.ve ngonzal@ula.ve |
Editor | The American Society of Tropical Medicine and Hygiene |
Colación | 215-222 |