Pharmaceutical care in the state of Ceará, Brazil: socioeconomic and demographic profile of patients with chagas disease attended in a referral center

The Pharmaceutical Care Service of the Chagas Disease Research Laboratory (LPDC), in the State of Ceará, Brazil, treats patients with Chagas disease (CD), characterized as a chronic, neglected disease that requires full patient follow-up. Objective: determine the socioeconomic and demographic profile of patients with CD treated at the LPDC. A descriptive cross-sectional study was carried out, in which 507 patients were treated from January 2007 to May 2016. The variables collected were gender, age, place of birth, schooling, family income, type of health care, occupation, living conditions and habits. The profile of Trypanosoma cruzi infected individuals consisted of 51.1% males; mean age of 50.4 years; 26.6% were small farmers; 48.7% had not finished elementary school; 36.9% had a family income of one minimum wage; 77.7% did not have private health insurance and most of them came from rural areas. Regarding habits, 66.5% were nonsmokers and 70.0% were sedentary. Additionally, an improvement was noted in housing conditions, with most patients moving from wattle and daub huts, which were their first homes, to brick houses. We conclude that the analysis of the socioeconomic and demographic profile of patients treated at the LPDC showed that most of them come from a low socioeconomic population, where the demand for treatment has been occurring at a later age, further reinforcing the importance of the follow-up provided by the LPDC.

Trypanosoma cruzi seroprevalence among solid organ donors in Ceará State, Brazil.

INTRODUCTION: The transmission of Chagas disease (CD) through blood transfusion, organ transplantation, and oral transmission has gained greater visibility as a result of intensified vector control activities in endemic regions and to control CD in non-endemic regions. In Brazil, Ceará is one of the states that perform the most organ transplants. Therefore, the objective of this study was to assess the prevalence of Trypanosoma cruzi infection in organ donor candidates. METHODS: A retrospective analysis was performed on data from potential organ donors at the Center of Transplantation of the State of Ceará from 2010 - 2015. RESULTS: Data from a total of 2,822 potential donors were obtained, of which 1,038 were effective donors and 1,784 were excluded, likely due to lack of family authorization or medical contraindication. The prevalence of T. cruzi infection among these potential donors was 1.3% (n = 29). The majority of infected donors were males aged 41 - 60 years, residing in the interior of the state. Interestingly, 72.4% (n = 21) had positive or inconclusive serology for additional infections, such as cytomegalovirus, hepatitis B and C, and toxoplasmosis. Probability analysis revealed that stroke was the most common cause of death among potential donors with CD. CONCLUSIONS: There was a high prevalence of CD and other coinfections among potential solid organ donors in Ceará, and statistical tests have shown that these individuals are at increased risk of stroke when compared to potential non-reactive donors. This work highlights the importance of screening DC infection in potential donors.

Trypanosoma cruzi seroprevalence among solid organ donors in Ceará State, Brazil

Abstract INTRODUCTION: The transmission of Chagas disease (CD) through blood transfusion, organ transplantation, and oral transmission has gained greater visibility as a result of intensified vector control activities in endemic regions and to control CD in non-endemic regions. In Brazil, Ceará is one of the states that perform the most organ transplants. Therefore, the objective of this study was to assess the prevalence of Trypanosoma cruzi infection in organ donor candidates. METHODS: A retrospective analysis was performed on data from potential organ donors at the Center of Transplantation of the State of Ceará from 2010 - 2015. RESULTS: Data from a total of 2,822 potential donors were obtained, of which 1,038 were effective donors and 1,784 were excluded, likely due to lack of family authorization or medical contraindication. The prevalence of T. cruzi infection among these potential donors was 1.3% (n = 29). The majority of infected donors were males aged 41 - 60 years, residing in the interior of the state. Interestingly, 72.4% (n = 21) had positive or inconclusive serology for additional infections, such as cytomegalovirus, hepatitis B and C, and toxoplasmosis. Probability analysis revealed that stroke was the most common cause of death among potential donors with CD. CONCLUSIONS: There was a high prevalence of CD and other coinfections among potential solid organ donors in Ceará, and statistical tests have shown that these individuals are at increased risk of stroke when compared to potential non-reactive donors. This work highlights the importance of screening DC infection in potential donors.

Insect vectors of Chagas disease (Trypanosoma cruzi) in Northeastern Brazil.

INTRODUCTION: Chagas disease remains a public health problem in the rural and urban areas of 19 countries in the Americas. METHODS: The aim of the present study was to investigate the Trypanosoma cruzi infection rate of triatomines collected from both intra- and peridomiciliary areas in eleven municipalities of Southeastern Ceará, Brazil, from 2009 to 2015. RESULTS: A total of 32,364 triatomine specimens, including nymphs and adults, were collected, and 31,736 (98.06%) of these were examined. More nymphs were collected than adults, and the greatest number of triatomines (n = 8,548) was collected in 2010, for which the infection rate was 1.3%, with the highest rate of infections observed for specimens from Quixere. The species collected during the study were identified as Triatoma pseudomaculata, Triatoma brasiliensis, Panstrongylus megistus, Panstrongylus lutzi, and Rhodnius nasutus, with T. pseudomaculata being the most abundant (n = 19,962). CONCLUSIONS: These results verify the presence of triatomines in both intra- and peridomiciliary areas, thereby ensuring persistence of the pathogen and consequently, the disease, as the presence of infected vectors in households is an important risk factor. According to these findings, the Chagas Disease Control Program should intensify its efforts in order to prevent the spread of the disease.

[Satisfaction of Chagas disease patients attended at a pharmaceutical care service in the State of Ceará, Brazil]. / Satisfação dos pacientes com doença de Chagas atendidos por um serviço de atenção farmacêutica no estado do Ceará, Brasil.

In 2005, a pharmaceutical care service was created in the State of Ceará to provide pharmacotherapeutic follow-up for individuals infected with Trypanosoma cruzi (Chagas Disease). After 10 years of operation, an evaluation was conducted to assess the degree of satisfaction of patients treated under the service. This prospective study used a questionnaire comprising the following sections: socioeconomic data; infrastructure, facilities and operations; pharmaceutical care; and importance of the service. Seventy patients of both sexes and over 18 years of age were interviewed between August 2014 and May 2015. As for infrastructure, location and operation, the average grades show a high level of patient satisfaction. Regarding pharmaceutical care, most patients reported being satisfied and considered "being well treated" to be the most important aspect during treatment. In addition, all patients (100%) rated the service as very important and would recommend it to other individuals. Overall, the study showed a high level of patient satisfaction with the service. There is, however, still much to work to be done on this service in order to promote greater access and qualified care to fully achieve a humanized model focused on patient needs.

O Serviço de Atenção Farmacêutica ao paciente com doença de Chagas do estado do Ceará foi criando em 2005, com a finalidade de proporcionar seguimento farmacoterapêutico àqueles com esta morbidade. Decorridos 10 anos de atuação, objetivou-se avaliar a satisfação dos pacientes atendidos no serviço. Tratou-se de um estudo prospectivo, empregando um questionário subdividido nas seções: dados socioeconômicos; infraestrutura, localização e funcionamento; cuidado farmacêutico e importância do serviço. Foram entrevistados 70 pacientes de ambos os sexos e acima de 18 anos, entre agosto de 2014 e maio de 2015. Quanto à infraestrutura, localização e funcionamento, as notas obtidas mostraram que os pacientes estão satisfeitos com os parâmetros analisados. Com relação ao cuidado farmacêutico, a maioria dos pacientes mostrou-se satisfeita, tendo o "ser bem atendido" como aspecto mais importante durante o atendimento. Em relação à importância do serviço, 100% o considerou muito importante e o indicaria para outras pessoas. De modo geral, o estudo demonstrou um alto nível de satisfação com o serviço. Há muito a ser trabalhado neste serviço, como promover maior acesso e qualificação do atendimento, contribuindo para a concretização de um modelo humanizado, centrado nas necessidades do paciente.

Satisfação dos pacientes com doença de Chagas atendidos por um serviço de atenção farmacêutica no estado do Ceará, Brasil / Satisfaction of Chagas disease patients attended at a pharmaceutical care service in the State of Ceará, Brazil

Resumo O Serviço de Atenção Farmacêutica ao paciente com doença de Chagas do estado do Ceará foi criando em 2005, com a finalidade de proporcionar seguimento farmacoterapêutico àqueles com esta morbidade. Decorridos 10 anos de atuação, objetivou-se avaliar a satisfação dos pacientes atendidos no serviço. Tratou-se de um estudo prospectivo, empregando um questionário subdividido nas seções: dados socioeconômicos; infraestrutura, localização e funcionamento; cuidado farmacêutico e importância do serviço. Foram entrevistados 70 pacientes de ambos os sexos e acima de 18 anos, entre agosto de 2014 e maio de 2015. Quanto à infraestrutura, localização e funcionamento, as notas obtidas mostraram que os pacientes estão satisfeitos com os parâmetros analisados. Com relação ao cuidado farmacêutico, a maioria dos pacientes mostrou-se satisfeita, tendo o "ser bem atendido" como aspecto mais importante durante o atendimento. Em relação à importância do serviço, 100% o considerou muito importante e o indicaria para outras pessoas. De modo geral, o estudo demonstrou um alto nível de satisfação com o serviço. Há muito a ser trabalhado neste serviço, como promover maior acesso e qualificação do atendimento, contribuindo para a concretização de um modelo humanizado, centrado nas necessidades do paciente.

Abstract In 2005, a pharmaceutical care service was created in the State of Ceará to provide pharmacotherapeutic follow-up for individuals infected with Trypanosoma cruzi (Chagas Disease). After 10 years of operation, an evaluation was conducted to assess the degree of satisfaction of patients treated under the service. This prospective study used a questionnaire comprising the following sections: socioeconomic data; infrastructure, facilities and operations; pharmaceutical care; and importance of the service. Seventy patients of both sexes and over 18 years of age were interviewed between August 2014 and May 2015. As for infrastructure, location and operation, the average grades show a high level of patient satisfaction. Regarding pharmaceutical care, most patients reported being satisfied and considered "being well treated" to be the most important aspect during treatment. In addition, all patients (100%) rated the service as very important and would recommend it to other individuals. Overall, the study showed a high level of patient satisfaction with the service. There is, however, still much to work to be done on this service in order to promote greater access and qualified care to fully achieve a humanized model focused on patient needs.

Insect vectors of Chagas disease (Trypanosoma cruzi) in Northeastern Brazil

Abstract INTRODUCTION: Chagas disease remains a public health problem in the rural and urban areas of 19 countries in the Americas. METHODS: The aim of the present study was to investigate the Trypanosoma cruzi infection rate of triatomines collected from both intra- and peridomiciliary areas in eleven municipalities of Southeastern Ceará, Brazil, from 2009 to 2015. RESULTS: A total of 32,364 triatomine specimens, including nymphs and adults, were collected, and 31,736 (98.06%) of these were examined. More nymphs were collected than adults, and the greatest number of triatomines (n = 8,548) was collected in 2010, for which the infection rate was 1.3%, with the highest rate of infections observed for specimens from Quixere. The species collected during the study were identified as Triatoma pseudomaculata, Triatoma brasiliensis, Panstrongylus megistus, Panstrongylus lutzi, and Rhodnius nasutus, with T. pseudomaculata being the most abundant (n = 19,962). CONCLUSIONS: These results verify the presence of triatomines in both intra- and peridomiciliary areas, thereby ensuring persistence of the pathogen and consequently, the disease, as the presence of infected vectors in households is an important risk factor. According to these findings, the Chagas Disease Control Program should intensify its efforts in order to prevent the spread of the disease.

Perfil hematológico e bioquímico de pacientes com doença de Chagas atendidos por um serviço de atenção farmacêutica no estado do Ceará / Hematological and biochemical profile of patients with Chagas disease attended by a pharmaceutical care service in the state of Ceará

Introdução: A doença de Chagas (DC) é uma parasitose causada pelo agente infeccioso Trypanosoma cruzi. No Brasil, o tratamento específico da DC é realizado com o Benzonidazol (Bz), que devido à sua toxicidade pode levar ao aparecimento de várias reações adversas aos pacientes que fazem uso deste medicamento. Diante disso, existe uma preocupação em avaliar o paciente antes de iniciar a utilização do Bz, a fim de verificar possíveis alterações hematológicas e bioquímicas que eventualmente possam ser atribuídas à utilização deste medicamento. Objetivo: delinear o perfil dos parâmetros hematológicos e bioquímicos de pacientes com DC antes da farmacoterapia com Bz. Metodologia: Estudo retrospectivo que avaliou o perfil sociodemográfico e os parâmetros laboratoriais (eritrograma, leucograma, plaquetas, aspartato aminotransferase - TGO, alanina aminotransferase - TGP, ureia e creatinina) de 89 pacientes chagásicos crônicos atendidos no Serviço de Atenção Farmacêutica ao Paciente com doença de Chagas da Universidade Federal do Ceará no período de janeiro de 2010 a dezembro de 2015. Resultados: A população estudada se caracterizou feminina (52,8%), média de idade de 53,6 anos, de baixa renda e escolaridade, maioria aposentada, procedente do interior do estado do Ceará. No que se refere às análises hematológicas e bioquímicas, observa-se que todos os parâmetros se encontram dentro dos valores de referência. Na comparação entre gêneros, a análise estatística entre as médias demonstrou diferença significativa nos eritrócitos, no hematócrito, na hemoglobina, nas plaquetas e na contagem de linfócitos. Conclusão: Apesar da evidência de um perfil dentro dos valores normais de referência, o acompanhamento desses parâmetros laboratoriais é de suma importância no seguimento do paciente chagásico, visto que as reações adversas podem aparecer bem no início do tratamento com o Benzonidazol, levando muitas vezes à interrupção do medicamento. (AU)

Introduction: Chagas' disease (DC) is a parasite caused by the infectious agent Trypanosoma cruzi. In Brazil, the specific treatment of CD is performed with Benzonidazole (Bz), which due to its toxicity, can lead to the appearance of several adverse reactions to patients who use it. Therefore, there is a certain concern in evaluating the patient before starting the use of Bz, in order to verify possible hematological and biochemical alterations that may be attributed to the use of benzonidazole. Objective: to delineate the profile of the hematological and biochemical parameters of patients with CD before the pharmacotherapy with Bz. Methodology: Retrospective study of sociodemographic and laboratory parameters (erythrogram, leukogram, platelets, aspartate aminotransferase- TGO, alanine aminotransferase - TGP, urea and creatinine) from 89 chronic Chagas' patients treated at the Pharmaceutical Care Service of Federal University of Ceará, the January 2010 to December 2015. Results: The population studied was female (52.8%), mean age 53.6 years, low income and education, retired majority, from the interior of the state of Ceará. As far as hematological and biochemical analysis are concerned, it is observed that all parameters are within the reference values. In the comparison between genders, statistical analysis between means showed a significant difference in erythrocytes, hematocrit, hemoglobin, platelets and lymphocyte counts. Conclusion: Despite the evidence of a profile within the normal reference values, the follow-up of these laboratory parameters is of paramount importance in the follow-up of the chagasic patient, since adverse reactions may appear well at the beginning of Benzonidazole treatment, often leading to medication interruption. (AU)

Evolução eletrocardiográfica e sorológica de pacientes com doença de Chagas crônica acompanhados por seis anos após o tratamento com benzonidazol / Electrocardiographic and serological evolution of patients with chronic Chagas disease followed-up for six years after treatment with benzonidazole

Introdução: O tratamento com benzonidazol na fase crônica da doença de Chagas ainda permanece controverso. O presente estudo objetiva avaliar a efetividade da quimioterapia com benzonidazol em pacientes chagásicos crônicos por meio de análises sorológica e eletrocardiográfica. Método: Estudo prospectivo histórico, com acompanhamento eletrocardiográfico e sorológico pelos métodos imunoenzimático (ELISA) e de imunofluorescência indireta uma vez por ano, antes e após o tratamento, entre 2005 e 2011. No perfil sociodemográfico dos 30 pacientes acompanhados o predomínio era do sexo masculino, faixa etária entre 25-64 anos, com primeiro grau incompleto e em sua maioria agricultores. Resultados: A análise sorológica por ELISA demonstrou queda significativa da densidade óptica das amostras coletadas antes (2005) e após o tratamento com benzonidazol (2011). Em relação à imunofluorescência indireta, os pacientes se mantiveram inalterados durante o acompanhamento (variação de no máximo uma diluição entre as amostras basal e final). Na avaliação eletrocardiográfica, 76,2% (16/21) dos pacientes apresentaram manutenção dos laudos eletrocardiográficos ao longo do estudo. Conclusão: Foram observadas regressões nas análises sorológicas dos pacientes tratados com benzonidazol, acompanhados por 6 anos, além da manutenção dos padrões eletrocardiográficos iniciais na maioria dos casos, o que pode sugerir um efeito benéfico do fármaco no tratamento desses pacientes na fase crônica da doença de Chagas.

Background: Treatment with benzonidazole in the chronic phase of Chagas disease remains controversial. This study is aimed at evaluating the effectiveness of chemotherapy with benzonidazole in chronic Chagas disease using serological and electrocardiographic analysis. Method: Historical prospective study with electrocardiographic and serological monitoring by enzyme immunoassay (ELISA) and indirect immunofluorescence once a year, before and after the treatment, from 2005 to 2011. In the socio-demographic profile of the 30 patients followed-up, there was a prevalence of males, ages ranged between 25-64 years, incomplete school education and most of them farmers. Results: ELISA serology showed a significant decrease in the optical density of the samples collected before (2005) and after treatment with benzonidazole (2011). Indirect immunofluorescence demonstrated patients remained unchanged during follow-up (maximum variation of one dilution between the baseline sample and 2011). In the electrocardiographic assessment, 76.2% (16/21) of the patients maintained their electrocardiographic reports throughout the study. Conclusion: Patients treated with benzonidazole and followed-up for 6 years presented a regression in serological analysis and maintenance of their baseline ECG patterns in most cases, which may suggest a beneficial effect of the drug in the chronic treatment of Chagas disease.

PREVALENCE OF CHAGAS DISEASE IN A RURAL AREA IN THE STATE OF CEARA, BRAZIL.

Chagas disease is caused by Trypanosoma cruzi and affects about two to three million people in Brazil, still figuring as an important public health problem. A study was conducted in a rural area of the municipality of Limoeiro do Norte - CE, northeastern Brazil, aiming to determine the prevalence of T. cruzi infection. Of the inhabitants, 52% were examined, among whom 2.6% (4/154) were seropositive in at least two serological tests. All seropositive individuals were older than 50 years, farmers, with a low education and a family income of less than three minimum wages. Active surveillance may be an alternative for early detection of this disease.

Clinical and epidemiological profile of elderly patients with Chagas disease followed between 2005-2013 by pharmaceutical care service in Ceará State, Northeastern Brazil.

By controlling the transmission of Chagas disease, the challenge of providing assistance to millions of infected patients that reach old age arises. In this study, the socioeconomic, demographic and comorbidity records of all elderly chagasic patients followed at the Pharmaceutical Care Service of the Chagas Disease Research Laboratory were assessed. The information related to the clinical form of the disease was obtained from medical records provided by the Walter Cantídio University Hospital. The profile of the studied population was: women (50.5%); mean age of 67 years; retired (54.6%); married (51.6 %); high illiteracy rate (40.2%); and family income equal to the minimum wage (51.5%). The predominant clinical forms of Chagas disease were cardiac (65.3%) and indeterminate (14.7%). The main electrocardiographic changes were the right bundle branch block (41.0%), associated or not with the anterosuperior left bundle branch block (27.4%). The average number of comorbidities per patient was 2.23 ± 1.54, with systemic arterial hypertension being the main one found (67.0%). It was found that the elderly comprise a vulnerable group of patients that associate aging with cardiac and/or digestive disorders resulting from the evolution of Chagas disease and other comorbidities, which requires special attention from health services to ensure more appropriate medical and social care.

Clinical and epddemiological profile of elderlypatients with chagas disease foollowed between 2005-2013 by pharmaceutical care service in ceará state, northeasternBrrazil / Perfil clínico e epidemiológico de pacientes idosos com doença de Chagas atendidos entre 2005-2013 por um serviço de atenção farmacêutica no estado do Ceará, nordeste do Brasil

By controlling the transmission of Chagas disease, the challenge of providing assistance to millions of infected patients that reach old age arises. In this study, the socioeconomic, demographic and comorbidity records of all elderly chagasic patients followed at the Pharmaceutical Care Service of the Chagas Disease Research Laboratory were assessed. The information related to the clinical form of the disease was obtained from medical records provided by the Walter Cantídio University Hospital. The profile of the studied population was: women (50.5%); mean age of 67 years; retired (54.6%); married (51.6 %); high illiteracy rate (40.2%); and family income equal to the minimum wage (51.5%). The predominant clinical forms of Chagas disease were cardiac (65.3%) and indeterminate (14.7%). The main electrocardiographic changes were the right bundle branch block (41.0%), associated or not with the anterosuperior left bundle branch block (27.4%). The average number of comorbidities per patient was 2.23 ± 1.54, with systemic arterial hypertension being the main one found (67.0%). It was found that the elderly comprise a vulnerable group of patients that associate aging with cardiac and/or digestive disorders resulting from the evolution of Chagas disease and other comorbidities, which requires special attention from health services to ensure more appropriate medical and social care.

Controlando-se a transmissão da doença de Chagas, surge o desafio de prestar assistência a milhões de pacientes infectados que chegam à velhice. Neste estudo, foram avaliados os registros socioeconômicos, demográficos e de comorbidades de todos os pacientes chagásicos idosos acompanhados no Serviço de Atenção Farmacêutica do Laboratório de Pesquisa em Doença de Chagas. As informações relacionadas à forma clínica da doença foram obtidas a partir de registros médicos disponibilizados pelo Hospital Universitário Walter Cantídio. O perfil da população estudada foi de: mulheres (50,5%); idade média de 67 anos; aposentados (54,6%); casados (51,6%); alta taxa de analfabetismo (40,2%); e renda familiar de um salário mínimo (51,5%). As formas clínicas predominantes da doença de Chagas foram a cardíaca (65,3%) e a indeterminada (14,7%). As principais alterações eletrocardiográficas foram o bloqueio de ramo direito (41,0%), associado ou não ao bloqueio ântero superior esquerdo (27,4%). O número médio de comorbidades por paciente foi de 2,23 ± 1,54, sendo a hipertensão arterial sistêmica a principal encontrada (67,0%). Verificou-se que os idosos constituem grupo vulnerável de pacientes que associam o envelhecimento com as alterações cardíacas e/ou digestivas resultantes da evolução da doença de Chagas e outras comorbidades, o que exige atenção especial dos serviços de saúde para um atendimento médico e social mais adequado.

Clinical and serological evolution in chronic Chagas disease patients in a 4-year pharmacotherapy follow-up: a preliminary study.

INTRODUCTION: The role of trypanocidal therapy in the chronic phase of Chagas disease remains controversial. METHODS: A total of 13 patients with chronic Chagas disease were treated with benznidazole (5mg/kg/day/60 days) and surveyed via antibody measurement and conventional electrocardiogram over the course of 4 years. RESULTS: The antibody titers were significantly reduced after 4 years (p<0.05). Most of the patients showed maintenance of the initial clinical picture (electrocardiographic), with the exception of 4 cases. CONCLUSIONS: Although trypanocidal therapy in the chronic phase of Chagas disease was of limited effectiveness, we believe that it is beneficial in treating these patients.

Doença de Chagas: situação vetorial no município de Limoeiro do Norte – CE, no período de 2006 a 2009 / Chagas Disease: vector status in the city of Limoeiro do Norte – CE, during the period from 2006 to 2009

Entre as doenças transmitidas por vetores no Brasil, a doença de Chagas é uma das mais importantes como problemas de saúde pública. Neste estudo foi estimada a prevalência de triatomíneos infectados por Trypanosoma cruzi no município de Limoeiro do Norte-CE, por meio de consulta aos arquivos do Programa de Controle da Doença de Chagas deste Distrito Sanitário no período de 2006 a 2009. Na análise foram incluídos os triatomíneos adultos e ninfas, mortos ou vivos, capturados durante o período investigado. Durante os quatro anos de estudo foram capturados 2.863 exemplares de triatomíneos, ninfase adultos distribuídos no intradomicílio e peridomicílio; e examinados 2.756 (96,3 %) exemplares. O índice de infecção dos triatomíneos foi de 7,9 % nos quatros anos de estudo. O número de ninfas capturadas foi cerca de três vezes maior que o número de adultos; no entanto, o número de ninfas infectadas pelo flagelado (5,30 %) foi inferior aos adultos (15,85 %). O distrito de Limoeiro do Norte apresenta alto risco de transmissão para doença de Chagas e, portanto, sugere-se que as ações de controle sejam intensificadas neste município para evitar a ocorrência de transmissão da doença e dispersão do vetor.

In Brazil, among the endemic vector-borne diseases, Chagas disease has been considered one of the mostimportant public health problems. The present study aimed at estimating the prevalence of triatominesinfected with Trypanosoma cruzi in the city of Limoeiro do Norte, CE, Brazil. This investigation was conductedby consulting the archives of the Chagas disease control program of the Health District of Limoeiro do Nortefor the period from 2006 to 2009. The study included dead or alive, adults and nymphs triatomines, whichwhere captured during the investigated period. During the four-year study, 2,863 specimens of nymphs andadults insects were captured from the domestic and peridomestic areas; 2,756 were examined, representing96.3 % of collected specimens. The insect infection rate was 7.9 % in four-year study. The number of capturednymphs was nearly three times higher than the number of adults; however the number of nymphs infectedwith the flagellate (5.30 %) was lower than the number of adults form (15.85 %). Limoeiro do Norte showeda high risk for Chagas disease transmission, suggesting that the control actions should be intensified in thiscity to prevent the disease transmission and the vector spread.