Clinical Characteristics and Outcomes of Chagas Disease in the United States: A Multicenter Retrospective Analysis

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Title: Clinical Characteristics and Outcomes of Chagas Disease in the United States: A Multicenter Retrospective Analysis
Authors: Henao-Martinez, Andres F. | Olivo-Freites, Christian | Agudelo-Higuita, Nelson | Ferraz, Carolina | Franco-Paredes, Carlos | Tuells, José | Woc-Colburn, Laila | Villalpando-Carrión, Salvador | Chastain, Daniel B. | Rassi Jr., Anis
Research Group/s: Salud Comunitaria (SALUD)
Center, Department or Service: Universidad de Alicante. Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia
Keywords: Chagas disease | United States | Clinical characteristics and outcomes
Issue Date: 11-Sep-2023
Publisher: American Society of Tropical Medicine and Hygiene
Citation: American Journal of Tropical Medicine and Hygiene. 2023, 109(5): 1006-1011.
Abstract: Chagas disease affects approximately 300,000 patients in the United States. We evaluated a multicenter U.S.-based network to obtain clinical characteristics and outcomes of chronic Chagas disease by disease forms. This was a U.S.-based, multicenter, population-based, retrospective cohort study. We queried TriNetX, a global research network, to identify patients with dual-positive IgG serology for Trypanosoma cruzi. We captured outcomes of interest for up to 5 years. We found 429 patients with evidence of dual-positive T. cruzi IgG out of 19,831 patients with an available test result from 31 U.S. medical centers. The positive proportion for those tested was 2.2%, up to 4.6% among Hispanics. We found a prevalence of a positive Chagas serology of 0.02% among Hispanics. Cardiomyopathy risk reached an annual rate of 1.3% during the initial 5 years of follow-up among patients with the indeterminate form. We found no new events for pulmonary embolism, sudden death, or left ventricular aneurysms at 5 years. Annual risks for arrhythmias and stroke for chronic Chagas cardiomyopathy (CCC) were 1.6% and 0.8%, respectively. The yearly mortality and hospitalization rates for CCC were 2.7% and 17.1%, respectively. Only 13 patients had a documented antitrypanosomal therapy course within 6 months after diagnosis. Of those receiving treatment, 10 patients received benznidazole and three nifurtimox. Chagas disease screening in patients from endemic areas living in the United States remains crucial. Chronic Chagas cardiomyopathy carries a considerable disease burden, translating into increased morbidity and mortality and an enlarging medical health service utilization.
ISSN: 0002-9637 (Print) | 1476-1645 (Online)
DOI: 10.4269/ajtmh.23-0361
Language: eng
Type: info:eu-repo/semantics/article
Rights: © 2023 American Society of Tropical Medicine and Hygiene
Peer Review: si
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Appears in Collections:INV - SALUD - Artículos de Revistas

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