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Observational Study
. 2025 Apr 25:120:e240108.
doi: 10.1590/0074-02760240108. eCollection 2025.

Acute Chagas disease in Amazonia, western Pará: perspectives from medical assistance to genetic elucidation

Helena Rangel Esper  1   2   3 , Vera Lúcia Teixeira de Freitas  2 , João Guilherme Pontes Lima Assy  1   3 , Olívia Campos Pinheiro Berreta  1   3 , Alisson Dos Santos Brandão  1   3 , Erika Yoshie Shimoda Nakanishi  4 , Claudia de Abreu Fonseca  4 , Francisco Oscar de Siqueira França  1   2   4 , Marta Heloísa Lopes  2   4
Affiliations
Observational Study

Acute Chagas disease in Amazonia, western Pará: perspectives from medical assistance to genetic elucidation

Helena Rangel Esper et al. Mem Inst Oswaldo Cruz. .

Abstract

Background: The experience of the USP Tropical Medicine Centre (NUMETROP) team in providing medical care during acute Chagas disease (ACD) outbreaks in Santarém, Pará, motivated this study.

Objectives: To study the epidemiological, clinical-laboratory, and socio-cultural aspects of confirmed cases of ACD in outbreaks in Santarém from March 2016 to March 2018.

Methods: Observational case series study of ACD outbreaks in two communities: Marimarituba in 2016 and Cachoeira do Aruã in 2017. Diagnostic characterisation included classification into discrete typing units (DTUs).

Findings: Eight cases were diagnosed as ACD TcIV in Marimarituba and seven cases were identified as ACD TcI in Cachoeira do Aruã. Women of childbearing age were numerous in both groups, and one miscarriage and two possible vertical transmissions were observed. Fever and rash were the most common findings in Marimarituba, with a fatality rate of 12.5%. In both outbreaks, serological surveillance was performed three to 21 months after treatment, with no confirmation of a "serological cure".

Main conclusions: We observed possible vertical transmission, diverse DTUs in the same municipality, and a lack of knowledge about patient outcomes. We highlight that, despite the importance of ACD in the Amazon region, there is no institutional follow-up of patients from diagnosis to cure.

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Conflict of interest statement

All authors reviewed and approved the final manuscript as submitted and agreed to be accountable for all aspects of the study

Figures

None
Follow-up of a pregnant patient from Marimarituba with acute Chagas disease (ACD) after consumption of bacaba wine.
See this image and copyright information in PMC

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