Perfil epidemiológico da infecção por Trypanosoma cruzi em regiões de vulnerabilidade do Brasil

• Ano de defesa: 2023
• Autor(a) principal: Sampaio, George Harisson Felinto
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal do Rio Grande do Norte; Brasil; UFRN; PROGRAMA DE PÓS-GRADUAÇÃO EM CIÊNCIAS DA SAÚDE
• Palavras-chave em Português: Trypanosoma cruzi; Triatomíneos; Saúde pública; Doença de Chagas; CNPQ::CIENCIAS DA SAUDE
• Link de acesso: https://repositorio.ufrn.br/handle/123456789/54539

Introduction: The spread of T. cruzi infection is directly related to its mode of transmission, and the primary control actions are those that prevent or hinder the contact of the parasite with humans and domestic animals. Therefore, it is essential to understand the socio-epidemiological characteristics of each region, so that specific control measures are established for each parasite transmission cycle. Objective: To determine the epidemiological profile of individuals with suspected acute Chagas disease in Northern Brazil and to evaluate the entomological control of T. cruzi vectors in an endemic area of the Rio Grande do Norte state. Methods: The epidemiological profile of individuals with suspected acute Chagas disease was evaluated in the municipality of Breves, state of Pará (PA), Brazil. The data obtained by the municipal Health Department were used in the period from 2007 to 2017 and were analyzed using simple descriptive statistics. The active search for triatomines in the domiciliary units (DU) and the chemical control of vectors were evaluated in infested DU. Quantitative analysis of surveyed households on entomological indicators was performed using the random effects linear regression test (p<0.05). Results: A total of 265 individuals were notified as suspected cases of acute Chagas disease, of which 64.1% (170/265) had laboratory confirmation of Chagas infection. The analysis of the epidemiological profile of these individuals showed that most of them were male (54.7%-145/265), aged between 1 and 39 years (71.3%-189/265), low level of education (74.4%-197/265) and residents in rural (58.9%- 156/265) and urban areas (37.7%- 100/265). The main route of transmission of T. cruzi was oral (98.1% - 260/265), probably through the consumption of açaí contaminated with viable forms of the parasite. Contamination occurred mainly in the domicile (96.2%-255/265) with a higher incidence between the months of August and December. In the rural mesoregion of RN, 92,156 DUs were investigated and the presence of triatomines was recorded in 4,639 (5%). Only 53.1% (2,463/4,639) of infested DU were submitted to chemical control. In addition, there was a decrease in the total number of DU surveyed over the period, associated with an increase in the rate of indoor colonization (p = 0.004). Of the total of 4,653 specimens of triatomine captured the registered species were Triatoma pseudomaculata (n = 1,775), Triatoma brasiliensis (n = 1,569), Rhodnius nasutus (n = 741) and Panstrongylus lutzi (n = 568), with index overall T. cruzi infection of 2.2% (90/4,104). Conclusions: The results showed that the oral transmission of T. cruzi has become increasingly high in the northern region of Brazil, highlighting the need to implement actions aimed at health education as strategies to ensure the improvement of food handling practices in nature. In addition, it was found that entomological surveillance in areas of the RN has been discontinued, and the data point to the need for more effective and continuous public policies, mainly related to the chemical control of vectors, avoiding the exposure of humans and domestic animals to the risk of acquiring T. cruzi infection.