A doença de Chagas no município de Irecê, Bahia, Brasil

Abstract

INTRODUCTION: The etiological agent of Chagas disease (CD) is the flagellated protozoan Trypanosoma cruzi, and its vectors are hematophagous insects called triatomines. The World Health Organization estimates that 6-7 million people are infected with T. cruzi worldwide, with regional differences in its prevalence due to negligence, little knowledge on the part of health professionals and the fact that few studies have been carried out in endemic areas. The state of Bahia is endemic for CD, and the municipality of Irecê is classified as high risk for vector transmission of T. cruzi. OBJECTIVE: To identify the risk of CD in the municipality of Irecê. METHODOLOGY: A cross-sectional, descriptive study. Seroepidemiological and entomological surveys were carried out in the rural area of Irecê between January and November 2024. A structured interview was carried out with the participants and a serological test and active search for triatomines in the home environment and direct parasitological examination to estimate the prevalence of T. cruzi infection in the specimens located. The knowledge of primary health care professionals was assessed using structured interviews. RESULTS: We visited 156 households in rural areas and 273 people took part in the study. The seroprevalence of anti-T. cruzi was 2.5%. A total of 268 triatomines were collected, 93.6% were found in the peridomicile, 60.1% were nymphs, 10.8% were Triatoma sordida and 4.5% had flagellated forms detected in the direct parasitological examination. With regard to health professionals, 257 took part in the study and 87.9% recognized the etiological agent, identified the forms of vector transmission (100%), blood transfusion (55.3%) and oral transmission (61.9%); the main organs identified as affected were the heart (99.2%) and spleen (58.4%); the signs/symptoms identified in the acute phase were fever (76.6%), edema (85.2%), splenomegaly (68.0%) and hepatomegaly (65.2%); in chronic cases, it was recognized that it can occur asymptomatically, but may have electrocardiographic alterations (99.2%), megacolon (64.6%), megaesophagus (59.1%), congestive heart failure (99.2%), thromboembolic phenomena (58.4%) and respiratory discomfort (80.9%); 72.0% recognized the existence of etiological treatment, but 47.5% were unable to say which drug it was; and for 73.5% of the participants, the disease is incurable; the advice to be given in the event of an insect bite in humans was to carry out serological tests (91.8%). CONCLUSION: In view of the results presented, there is a risk of CD due to the existence of carriers, triatomines in the home and the incipient knowledge of health professionals, which limits their actions in primary prevention, early diagnosis and proper management of those affected by CD.