Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/11703
Title: Clinical Follow-Up of Responses to Treatment with Benznidazol in Amazon: A Cohort Study of Acute Chagas Disease
Authors: Pinto, Ana Yecê das Neves
Valente, Vera da Costa
Coura, José Rodrigues
Valente, Sebastião Aldo da Silva
Junqueira, Ana Cristina Veríssimo
Santos, Laura Cristina
Ferreira Jr., Alberto Gomes
Macedo, Roberto Cavalleiro de
Affilliation: Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Departamento de Clínica Epidemiológica. Belém, PA, Brasil.
Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Departamento de Parasitologia. Belém, PA, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.
Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Departamento de Parasitologia. Belém, PA, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.
Fundação Luis D`Écourt. Belém, PA, Brasil.
Santa Casa Hospital. Belém, Pará, Brasil.
Abstract: A total of 179 individuals with acute Chagas disease mainly transmitted by oral source, from Para´ and Amapa´ State, Amazonian, Brazil were included during the period from 1988 to 2005. Blood samples were used to survey peripheral blood for T. cruzi hemoparasites by quantitative buffy coat (QBC), indirect xenodiagnosis, blood culture and serology to detection of total IgM and anti-T. cruzi IgG antibodies by indirect immunofluorescence assay (IFA) and indirect hemagglutination assay (HA). All assays were performed pre-treatment (0 days) and repeated 35 (67) and 68 (66) days after the initiation of treatment with benznidazol and every 6 months while remained seropositive. The endpoint of collection was performed in 2005. Total medium period of follow-up per person was 5.6 years. Also, a blood sample was collected from 72 randomly chosen treated patients to perform polimerase chain reaction (PCR) method. Proportions of subjects with negative or positive serology according to the number of years after treatment were compared. In the endpoint of follow-up we found 47 patients (26.7%) serologically negative, therefore considered cured and 5 (2.7%) exhibited mild cardiac Chagas disease. Other 132 patients had persistent positive serologic tests. The PCR carried out in 72 individuals was positive in 9.8%. Added, there was evidence of therapeutic failure immediately following treatment, as demonstrated by xenodiagnosis and blood culture methods in 2.3% and 3.5% of cases, respectively. There was a strong evidence of antibody clearing in the fourth year after treatment and continuous decrease of antibody titers. Authors suggest that control programs should apply operational researches with new drug interventions four years after the acute phase for those treated patients with persistently positive serology.
Keywords: Chagas Disease
Amazon
Benznidazol
Treatment
Reação em Cadeia da Polimerase
Parasitemia
keywords: Amazônia
Tratamento
DeCS: Doença de Chagas
Benznidazol
Reação em Cadeia da Polimerase
Issue Date: 2013
Publisher: Plos One
Citation: PINTO, Ana Yecê das Neves. Clinical Follow-Up of Responses to Treatment with Benznidazol in Amazon: A Cohort Study of Acute Chagas Disease. Plos One, v.8, n.5, 9p.,May 2013.
DOI: 10.1371/journal.pone.0064450
Copyright: open access
Appears in Collections:IOC - Artigos de Periódicos

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