Doença de Chagas nas mulheres em idade fértil da Comunidade Hispana Armênia em São Paulo / Chagas disease in women of childbearing age from the Armenian Hispana Community in São Paulo

INTRODUÇÃO: Programas de controle da transmissão vetorial e transfusional da doença de Chagas alcançaram sucesso no Brasil, Chile e Uruguai, porém, a transmissão congênita vem demonstrando importância crescente e pode ocorrer em 71% dos recém-nascidos de mães com infecção aguda durante a gravidez e em 1,6% na fase crônica de doença. A migração de mulheres em idade fértil de outros países da América Latina para o Brasil pode aumentar a incidência da transmissão vertical no País, justificando a necessidade de acompanhamento médico adequado em mulheres grávidas e tratamento imediato de crianças com infecção congênita, já que são altas as taxas de cura. Os objetivos do estudo foram estimar a prevalência da doença em mulheres com idade fértil da Comunidade Hispana Armênia, informar e esclarecer dúvidas a respeito da doença. MÉTODO: Depois de realizada a coleta de 5 ml de sangue, em tubo ativador de coágulo com gel separador, de cada voluntária, o diagnóstico da doença de Chagas foi estabelecido por dois testes sorológicos de imunofluorescência indireta e um teste imunoenzimático - ELISA indireto. RESULTADOS: Das 84 coletas realizadas, quatro resultados foram excluídos, por serem de mulheres menopausadas. De 80 amostras analisadas, duas apresentaram resultado positivo para doença de Chagas. CONCLUSÃO: Conclui-se que na comunidade estudada, a preocupação com a transmissão vertical da doença de Chagas é baixa, o que não exclui a necessidade de implementar programas de saúde pública que contemplem orientação, esclarecimentos contínuos, a triagem de rotina em gestantes e recém-nascidos, assegurando assim, a detecção e tratamento de casos agudos e crônicos. (AU)

Evaluation of in vitro anti-Trypanosoma cruzi activity of medications benznidazole, amiodarone hydrochloride, and their combination.

INTRODUCTION: Approximately seven to eight million people worldwide have Chagas disease. In Brazil, benznidazole is the most commonly used active drug against Trypanosoma cruzi; however, its efficacy is limited, and side effects are frequent. Recent studies suggest that amiodarone may be beneficial in the treatment of this disease, by exerting anti-T. cruzi action. This study evaluated changes in T. cruzi cell count in in vitro cultures subjected to different doses of benznidazole, amiodarone, and their combination. METHODS: T. cruzi (Y strain) cultures containing approximately 100,000 cells were treated with either 100mg, 50mg, 25mg, 12.5mg, or 10mg of benznidazole, amiodarone, or their combination. On the 4th day, cell count was compared to the baseline data. RESULTS: On the 4th day, no parasites were observed in any of the treated cultures. CONCLUSIONS: Benznidazole and amiodarone were equally effective in eliminating T. cruzi in culture. The combination of the two drugs was also equally effective, but our data cannot demonstrate synergism, as similar results were obtained when the drugs were tested individually or in combination. It is suggested that this study be repeated with other T. cruzi strains to determine whether similar results can be obtained again.

Evaluation of in vitro anti-Trypanosoma cruzi activity of medications benznidazole, amiodarone hydrochloride, and their combination

Abstract INTRODUCTION: Approximately seven to eight million people worldwide have Chagas disease. In Brazil, benznidazole is the most commonly used active drug against Trypanosoma cruzi; however, its efficacy is limited, and side effects are frequent. Recent studies suggest that amiodarone may be beneficial in the treatment of this disease, by exerting anti-T. cruzi action. This study evaluated changes in T. cruzi cell count in in vitro cultures subjected to different doses of benznidazole, amiodarone, and their combination. METHODS: T. cruzi (Y strain) cultures containing approximately 100,000 cells were treated with either 100mg, 50mg, 25mg, 12.5mg, or 10mg of benznidazole, amiodarone, or their combination. On the 4th day, cell count was compared to the baseline data. RESULTS: On the 4th day, no parasites were observed in any of the treated cultures. CONCLUSIONS: Benznidazole and amiodarone were equally effective in eliminating T. cruzi in culture. The combination of the two drugs was also equally effective, but our data cannot demonstrate synergism, as similar results were obtained when the drugs were tested individually or in combination. It is suggested that this study be repeated with other T. cruzi strains to determine whether similar results can be obtained again.

Evaluation of Parasiticide Treatment with Benznidazol in the Electrocardiographic, Clinical, and Serological Evolution of Chagas Disease.

INTRODUCTION: Chagas disease is one of the most important endemic parasitic diseases in Latin America. In its chronic phase, progression to cardiomyopathy has high morbidity and mortality. The persistence of a normal electrocardiogram (ECG) provides a similar prognosis to that of a non-diseased population. Benznidazole (BNZ) is the only drug with trypanocidal action available in Brazil. MATERIALS/METHODS/RESULTS: A group of 310 patients with chronic Chagas disease who had normal ECGs at the first medical visit performed before 2002 were included. There were 263 patients treated with BNZ and 47 untreated. The follow-up period was 19.59 years. Univariate analyses showed that those treated were younger and predominantly male. As many as 79.08% of those treated and 46.81% of those untreated continued with normal electrocardiograms (p <0.0001). The occurrence of electrocardiographic abnormalities and relevant clinical events (heart failure, stroke, total mortality, and cardiovascular death) was less prevalent in treated patients (p <0.001, p: 0.022, p: 0.047 respectively). In multivariate analyses, the parasiticide treatment was an independent variable for persistence of a normal ECG pattern, which was an independent variable in the prevention of significant clinical events. The immunofluorescence titers decreased with the parasitological treatment. However, the small number of tests in untreated patients did not allow the correlation of the decrease of these titers with electrocardiographic alterations. CONCLUSION: These data suggest that treatment with benznidazole prevents the occurrence of electrocardiographic alterations. On the other hand, patients who develop ECG abnormalities present with more significant clinical events.

Evaluation of parasiticide treatment with benznidazol in the electrocardiographic, clinical, and serological evolution of Chagas Disease

Chagas disease is one of the most important endemic parasitic diseases in Latin America. In its chronic phase, progression to cardiomyopathy has high morbidity and mortality. The persistence of a normal electrocardiogram (ECG) provides a similar prognosis to that of a non-diseased population. Benznidazole (BNZ) is the only drug with trypanocidal action available in Brazil. MATERIALS/METHODS/RESULTS: A group of 310 patients with chronic Chagas disease who had normal ECGs at the first medical visit performed before 2002 were included. There were 263 patients treated with BNZ and 47 untreated. The follow-up period was 19.59 years. Univariate analyses showed that those treated were younger and predominantly male. As many as 79.08% of those treated and 46.81% of those untreated continued with normal electrocardiograms (p <0.0001)...