Frequency of Trypanosoma cruzi infection in patients with implanted pacemaker
Abstract
Introduction. In Colombia the impact of infections of Trypanosoma cruzi are known to produce chronic cardiopathy and expressed by bradycardia. In Colombia the extent and impact of these infections has not been examined.
Objective. The current study aimed to determine the prevalence of T. cruzi infection as measured by serology, in a population of patients with cardiopathy that required a permanent pacemaker as treatment for cardiac rhythm abnormalities and conduction blocking.
Materials and methods. A cross sectional study sampled 332 patients from the pacemaker clinic at the San Pedro Claver Hospital in Bogotá, Colombia, for one year (2004-2005). Epidemiological and clinical data were obtained through interviews and physical examination. Serological tests consisted of indirect inmunofluorescence assay and ELISA. Statistical analyses were accomplished with chi-square and Students' t tests.
Results. Of patients with pacemakers, 17.1% had anti-T. cruzi antibodies (seropositive). At the time when the pacemaker was implanted, chronic Chagas' disease patients were younger
(55±13 years) than those patients with cardiopathy (60±17 years) with no anti-T. cruzi antibodies (p<0.01). The seropositive group was aware of the Chagas' disease vector (83.6%) in contrast to the seronegative group (39.6%, p<0.001). In 60% of the patients of the seropositive group, no clinical signs of the disease were apparent. The geographical origin of the seropositive group were traced to regions in Colombia known to be endemic for Chagas´ disease transmission.
Conclusion. Chagas´ disease prevalence is high in Colombian patients who required a permanent cardiac pacemaker. Chronic Chagas' disease patients required pacemaker implant
at a younger age in contrast with patients with other cardiac pathologies. The clinical recognition of Chagas´ disease associated with cardiopathy is low despite the epidemiological data.
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References
1. World Health Organization. The World Health Report 1997. Geneva: OMS; 1997.
2. Ginks W, Leatham A, Siddons H. Prognosis of patients paced for chronic atrioventricular block. Br Heart J. 1979;41:633-6.
3. Organización Mundial de la Salud. Control de la enfermedad de Chagas, informe de un comité de expertos. Serie de informes técnicos. Ginebra: OMS; 1991. p.3-29.
4. Dias E, Laranja FS, Miranda A, Nobrega G. Chagas' disease: a clinical, epidemiologic, and pathologic study. Circulation. 1956;14:1035-60.
5. Panamerican Health Organization. Status of Chagas' disease in the region of the Americas. Epidemiologic bulletin. Washington, D.C.: OPS; 1984. p.5-9.
6. Pinto Dias JC. Natural history of Chagas disease. Arq Bras Cardiol. 1995;65:359-66.
7. Chagas C. A forma cardiaca da trypanossomiase americana. Arch Brasil Med. 1928;18:46-5.Hagar JM, Rahimtoola SH. Chagas' heart disease. Curr Probl Cardiol. 1995;20:825-924.
9. Dias JC, Kloetzel K. The prognostic value of the electro-
cardiographic features of chronic Chagas' disease. Rev
Inst Med Trop Sao Paulo. 1968;10:158-62.
10. Forichon E. Contribution aux estimations de morbidité
et de mortalité dans la maladie de Chagas. Rev Pat Trop. 1975;4:55-78.
11. Schijman AG, Vigliano CA, Viotti RJ, Burgos JM, Brandariz S, Lococo BE, et al. Trypanosoma cruzi DNA in cardiac lesions of Argentinean patients with end-stage chronic Chagas heart disease. Am J Trop Med Hyg. 2004;70:210-20.
12. Ouaissi A, Da Silva AC, Guevara AG, Borges M, Guilvard E. Trypanosoma cruzi-induced host immune system dysfunction: a rationale for parasite immunosuppressive factor(s) encoding gene targeting. J Biomed Biotechnol. 2001;1:11-7.
13. Tanowitz HB, Kaul DK, Chen B, Morris SA, Factor SM, Weiss LM, et al. Compromised microcirculation in acute murine Trypanosoma cruzi infection. J Parasitol. 1996;82:124-30.
14. López MC, Duque S, Orozco LC, Camargo D, Gualdrón LE, Cáceres E, et al. Inmunodiagnóstico de la infección chagásica por Elisa. Biomédica. 1999;19:159-63.
15. Albhom A, Norell S. Introduction to modern epidemiology. 2nd edition. Chestnut Hill: Epidemiology Resources Inc.; 1990. p.25.
16. World Health Organization. Weekly Epidemiological Record. Geneva: WHO; 2000. p.10-2.
17. World Health Organization. Weekly Epidemiological Record. Geneva: WHO; 2000. p.153-5.
18. Briceño-León R. Rural housing for control of Chagas disease in Venezuela. Parasitol Today. 1987;3:384-7.
19. Guhl F, Restrepo M, Angulo VM, Antunes CM, Campbell-Lendrum D, Davies CR. Lessons from a national survey of Chagas disease transmission risk in Colombia. Trends Parasitol. 2005;21:259-62.
20. Rincon LG, Rocha MO, Pires MT, Oliveira BG, Barros Vda C, Barros MV, et al. Clinical profile of Chagas and non-Chagas' disease patients with cardiac pacemaker. Rev Soc Bras Med Trop. 2006:39:245-9.
21. Dias JC. Epidemiological surveillance of Chagas disease. Cad Saude Publica. 2000;16(Suppl.2):43-59.
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