Prevalence and morbidity of chagasic infection in a rural population of Santiago del Estero Province, Republic Argentina

SOSA-ESTANI S

REVISTA DA SOCIEDADE BRASILEIRA DE MEDICINA TROPICAL

Año: 1994 vol. 27 p. 109 - 110

0037-8682

A study was carried out in a rural community with 3,021 inhabitants located in Termas de Rio Hondo, Santiago del Estero, Argentina, in order to find out the distribution of Chagas' Disease and observese the association of some factors (alcohol, reinfection and overwork) that might contribue to the development of cardiopathy.       The above area is considered as a highly endemic area for the disease.       In 1985, Chagas' Disease transmission began to be controlled in the area and a prevalence of T. cruzi infection of 28,47% in 2,200 individuals over 6 month of age was found. Among them, men in productive age and illiterate individuals show a higher risk of beign infected.       In 1988, electrocardiographic examination performed in 1,039 individuals over 9 years of age showed an overall prevalence of 24% alterations. Such prevalence was higher in reactive than in non-reactive individuals with p<0.05.       Changes compatible with Chagas' Disease cardiopathy were less frequent than those prevously reported from other areas by other authors. Nevertheless, the Proportion Attributable to Chagas' Disease was higher in relation to other changes, thereby evidencing that cardiopathy in this area is attributed to T. cruzi. The sex especific analysis shows that in men the major caese of cardiopathy is T. cruzi infection, unlikely in women       Factors that might contribute to the development of cardiopathy in infected individuals were investigated in a subsample of 473 individuals between 15 and 54 years of age. The low frecuency of compatible changes, as well as the classification of Chagas' Disease evolution being Grade 3, would probably indicate l low virulence of circulating T. cruzi strain in the area.       Regarding the above mentioned factors, we see that men are generally more exposed both to alcohol intake and overwork, while women are more exposed to scarce migration (higher probability of reinfection) and high blood pressure. None of them, in terms of statistical significance, proved to be a risk factors for developing cardiopathy in both infected and exposed individuals. Even so, alcohol intake, occupational background and blood pressure showed increasing risk estimates whenever the degree of exposure increased.       The multivariate analysis show that, according to sex, men are more likely to become infected and women have a higher risk of high blood pressure. In addition, the serological response, among other factors, showed that men have a higher risk of developing cardiopathy, unlikely women. Overwork associated to high blood pressure are probably the major cause of cardiopathy in the latter.