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Prevalence of Chagas heart disease in a region endemic for Trypanosoma cruzi: evidence from a central Bolivian community

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dc.contributor.author Yager, Jessica E.
dc.contributor.author Lozano Beltran, Daniel F.
dc.contributor.author Torrico, Faustino
dc.contributor.author Gilman, Robert Hugh
dc.contributor.author Bern, Caryn
dc.date.accessioned 2019-02-06T14:52:34Z
dc.date.available 2019-02-06T14:52:34Z
dc.date.issued 2015
dc.identifier.uri https://hdl.handle.net/20.500.12866/5315
dc.description.abstract BACKGROUND: Though the incidence of new Trypanosoma cruzi infections has decreased significantly in endemic regions in the Americas, medical professionals continue to encounter a high burden of resulting Chagas disease among infected adults. The current prevalence of Chagas heart disease in a community setting is not known; nor is it known how recent insecticide vector control measures may have impacted the progression of cardiac disease in an infected population. OBJECTIVES: We sought to determine the current prevalence of T. cruzi infection and associated Chagas heart disease in a Bolivian community endemic for T. cruzi. METHODS: Nested within a community serosurvey in rural and periurban communities in central Bolivia, we performed a cross-sectional cardiac substudy to evaluate adults for historical, clinical, and electrocardiographic evidence of cardiac disease. All adults between the ages of 20 and 60 years old with T. cruzi infection and those with a clinical history, physical exam, or electrocardiogram consistent with cardiac abnormalities were also scheduled for echocardiography. RESULTS: Of the 604 cardiac substudy participants with definitive serology results, 183 were seropositive for infection with T. cruzi (30.3%). Participants who were seropositive for T. cruzi infection were more likely to have conduction system defects (1.6% vs. 0% for complete right bundle branch block and 10.4% vs. 1.9% for any bundle branch block; p = 0.008 and p < 0.001, respectively). However, there was no statistically significant difference in the prevalence of bradycardia among seropositive versus seronegative participants. Echocardiogram findings were not consistent with a high burden of Chagas cardiomyopathy: valvulopathies were the most common abnormality, and few participants were found to have low ejection fraction or left ventricular dilatation. No participants had significant heart failure. CONCLUSIONS: Though almost one-third of adults in the community were seropositive for T. cruzi infection, few had evidence of Chagas heart disease. en_US
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartofseries Global Heart
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Adult en_US
dc.subject Female en_US
dc.subject Humans en_US
dc.subject Male en_US
dc.subject Young Adult en_US
dc.subject Enzyme-Linked Immunosorbent Assay en_US
dc.subject Cross-Sectional Studies en_US
dc.subject Middle Aged en_US
dc.subject Prevalence en_US
dc.subject Endemic Diseases en_US
dc.subject Chromatography, Affinity en_US
dc.subject Bolivia/epidemiology en_US
dc.subject Bradycardia/epidemiology en_US
dc.subject Bundle-Branch Block/epidemiology en_US
dc.subject Chagas Cardiomyopathy/epidemiology en_US
dc.subject Chagas Disease/epidemiology/immunology en_US
dc.subject Echocardiography en_US
dc.subject Electrocardiography en_US
dc.subject Heart Failure/epidemiology en_US
dc.subject Hemagglutination Tests en_US
dc.subject Seroepidemiologic Studies en_US
dc.subject Trypanosoma cruzi/immunology en_US
dc.title Prevalence of Chagas heart disease in a region endemic for Trypanosoma cruzi: evidence from a central Bolivian community en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1016/j.gheart.2015.07.002
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.04
dc.relation.issn 2211-8179


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