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Profile of Trypanosoma cruzi infection in a tropical medicine reference center, Northern Italy.
- Source :
-
PLoS neglected tropical diseases [PLoS Negl Trop Dis] 2014 Dec 11; Vol. 8 (12), pp. e3361. Date of Electronic Publication: 2014 Dec 11 (Print Publication: 2014). - Publication Year :
- 2014
-
Abstract
- Background: Chagas disease (CD) is endemic in Central and South America, Mexico and even in some areas of the United States. However, cases have been increasingly recorded also in non-endemic countries. The estimated number of infected people in Europe is in a wide range of 14000 to 181000 subjects, mostly resident in Spain, Italy and the United Kingdom.<br />Methodology/principal Findings: Retrospective, observational study describing the characteristics of patients with CD who attended the Centre for Tropical Diseases (Negrar, Verona, Italy) between 2005 and 2013. All the patients affected by CD underwent chest X-ray, ECG, echocardiography, barium X-ray of the oesophagus and colonic enema. They were classified in the indeterminate, cardiac, digestive or mixed category according to the results of the screening tests. Treatment with benznidazole (or nifurtimox in case of intolerance to the first line therapy) was offered to all patients, excluding the ones with advanced cardiomiopathy, pregnant and lactating women. Patients included were 332 (73.9% women). We classified 68.1% of patients as having Indeterminate Chagas, 11.1% Cardiac Chagas, 18.7% as Digestive Chagas and 2.1% as Mixed Form. Three hundred and twenty-one patients (96.7%) were treated with benznidazole, and most of them (83.2%) completed the treatment. At least one adverse effect was reported by 27.7% of patients, but they were mostly mild. Only a couple of patients received nifurtimox as second line treatment.<br />Conclusions/significance: Our case series represents the largest cohort of T. cruzi infected patients diagnosed and treated in Italy. An improvement of the access to diagnosis and cure is still needed, considering that about 9200 infected people are estimated to live in Italy. In general, there is an urgent need of common guidelines to better classify and manage patients with CD in non-endemic countries.
- Subjects :
- Adolescent
Adult
Aged
Chagas Disease classification
Chagas Disease diagnosis
Chagas Disease drug therapy
Child
Echocardiography
Electrocardiography
Female
Humans
Italy epidemiology
Male
Middle Aged
Nifurtimox therapeutic use
Nitroimidazoles therapeutic use
Pregnancy
Retrospective Studies
Tropical Medicine
United States
Chagas Disease epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1935-2735
- Volume :
- 8
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- PLoS neglected tropical diseases
- Publication Type :
- Academic Journal
- Accession number :
- 25502927
- Full Text :
- https://doi.org/10.1371/journal.pntd.0003361