RESUMO
UNLABELLED: Chagas disease is caused by the flagellate protozoan T: cruzi. Seroepidemiological surveys in Chiapas, Mexico have shown seropositive individuals, therefore, we searched for people affected by the chronic form of Chagas disease which involves the heart, causing a chronic, progressive and fatal disease called Chronic Chagasic Cardiopathy (CCC). MATERIAL AND METHODS: To establish the frequency of CCC we studied 28 patients seen at the Hospital General Regional "Dr. Rafael Pascacio Gamboa" during October 2002 through October 2003 in Tuxtla Gutierrez, Chiapas, the State capital city, with diagnosis of dilated cardiomyopathy (DC), a serological survey for antibodies against T. cruzi was done. This hospital cares for people from all parts of Chiapas, Mexico. Clinical diagnosis of DC was established there and blind serological studies were performed in Mexico City. RESULTS: Fifteen out of 28 DC patients (54%) had anti T. cruzi antibodies. All of them came from poor rural villages and they had heart failure and/or arrhythmia or heart blockade on EKG. CONCLUSIONS: This observation suggest that in Chiapas were Chagas disease is endemic, there are CCC patients. Any case with a clinical diagnosis of DC should be tested for antibodies against T. cruzi. The low socioeconomic status, culture and environment in this Mexican State favour the presence and transmission of this parasitic disease.
Assuntos
Anticorpos Antiprotozoários/sangue , Cardiomiopatia Dilatada/sangue , Trypanosoma cruzi/imunologia , Adulto , Idoso , Animais , Feminino , Humanos , Masculino , México , Pessoa de Meia-IdadeRESUMO
La enfermedad de Chagas es causada por el protozoario flagelado Trypanosoma cruzi. Encuestas seroepidemiológicas realizadas en Chiapas informan individuos seropositivos en comunidades rurales, y cabe la posibilidad de que la forma crónica de la enfermedad ocurra en el estado. La expresión clínica dominante en la enfermedad de Chagas crónica es cardíaca. Material y métodos: Con el objeto de conocer la frecuencia de cardiopatía chagásica crónica (CCC) se hizo una encuesta serológica a pacientes con miocardiopatía dilatada (MD) internados entre octubre de 2002 a octubre de 2003, en el Servicio de Cardiología del Hospital General Regional "Dr. Rafael Pascacio Gamboa" de Tuxtla Gutiérrez, Chiapas. El diagnóstico fue establecido en forma independiente y el estudio seroinmunológico fue ciego. Resultados: Quince (54%) de 28 sujetos con MD tenían anticuerpos a T. cruzi. Todos provenían de medio rural pobre, su cuadro clínico incluyó insuficiencia cardíaca y/o trastornos del ritmo o conducción. Conclusiones: Esta evidencia sugiere que en Chiapas, una zona endémica de enfermedad de Chagas, hay CCC. Dentro del estudio de la MD, la etiología chagásica, debe ser considerada, ya que las condiciones socioeconómicas, culturales y regionales favorecen su presencia.
Chagas disease is caused by the flagellate protozoan T. cruzi. Seroepidemiological surveys in Chiapas, Mexico have shown seropositive individuals, therefore, we searched for people affected by the chronic form of Chagas disease which involves the heart, causing a chronic, progressive and fatal disease called Chronic Chagasic Cardiopathy (CCC). Material and methods: To establish the frequency of CCC we studied 28 patients seen at the Hospital General Regional "Dr. Rafael Pascacio Gamboa" during October 2002 through October 2003 in Tuxtla Gutierrez, Chiapas, the State capital city, with diagnosis of dilated cardiomyopathy (DC), a serological survey for antibodies against T. cruzi was done. This hospital cares for people from all parts of Chiapas, Mexico. Clinical diagnosis of DC was established there and blind serological studies were performed in Mexico City. Results: Fifteen out of 28 DC patients (54%) had anti T. cruzi antibodies. All of them came from poor rural villages and they had heart failure and/or arrhythmia or heart blockade on EKG. Conclusions: This observation suggest that in Chiapas were Chagas disease is endemic, there are CCC patients. Any case with a clinical diagnosis of DC should be tested for antibodies against T. cruzi. The low socioeconomic status, culture and environment in this Mexican State favour the presence and transmission of this parasitic disease.
Assuntos
Adulto , Idoso , Animais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Anticorpos Antiprotozoários/sangue , Cardiomiopatia Dilatada/sangue , Trypanosoma cruzi/imunologia , MéxicoRESUMO
The phlebotomine sand fly Lutzomyia evansi is recorded in Mexico for the first time. This species is a suspected vector of Leishmania infantum in other parts of its geographical range and was captured in a focus of American visceral leishmaniasis where the principal vector, Lu. longipalpis sensu lato, was also found. The relative public health importance of the two species in the study area (Chiapas state, Southern Mexico) is discussed.
Assuntos
Insetos Vetores/classificação , Psychodidae/classificação , Animais , Feminino , Insetos Vetores/anatomia & histologia , Masculino , México , Psychodidae/anatomia & histologiaRESUMO
The phlebotomine sand fly Lutzomyia evansi is recorded in Mexico for the first time. This species is a suspected vector of Leishmania infantum in other parts of its geographical range and was captured in a focus of American visceral leishmaniasis where the principal vector, Lu. longipalpis sensu lato, was also found. The relative public health importance of the two species in the study area (Chiapas state, Southern Mexico) is discussed.
Assuntos
Animais , Feminino , Masculino , Insetos Vetores , Psychodidae , Insetos Vetores , México , PsychodidaeRESUMO
Reservoirs of T. cruzi were studied in the ecological reserve "El Zapotal", in the Tuxtla Gutiérrez municipality located in the state of Cchiapas. the parasite transmissión cycle exists in that area. A totral of 73 specimens of B different mammal species were trapped alive. Xenodiagnosis tests showed that 11% of them were positive for T. cruzi. Blood concentration exam, blood culture, serology (CIEP) and histological exam were carried out in 65 specimens fromthe total captured T. cruzi positive results in these tests were 1.5, 3.6 and 6.2% respectively. None of the 73 specimens were positive in the histological ewxams. Amastigote nests were found in cardiac tissue of mice, which were inoculated with triatomine bugs dejections collected from those specimens used from xenodiagnosis testing or by the inoculation of parasites grown in axenic blood cultures. These results indicated that there is a sylvan cycle which is maintained by mammal species, which are plundering this geographic area