title: [Clinico-epidemiologic profile of Chagas disease patients attending an ambulatory referral center and proposal of a model of care for the Chagas patient under the perspective of a comprehensive health care].
abstract: A case-control study to analyse clinical and epidemiological data of 842 patientes seen in an outpatient ward reference center for chagas disease in Belo Horizonte, Brazil, from 1985 to 1992. It was verified that these patients were in a average age of 37.78 years; lower literacy regardless of race, and, performed activities that demanded greater muscle effort (p < 0.05). The main mechanism for disease transmission proved to be the vectorial route. Disease-especific complaints prevailed in the above mentioned patients (p < 0.05). The most important abnormalities found in clinical examination were with cardiac sounds (OR: 2.96 95% CI: 1.29-4.09) and the presence of extrasystole (OR: 7.16 95% CI: 1.59-45.07). Imunofluorescence Test was more sensitive (94%) and specific (96%). It also had a PPV of 99% and e NPV of 83%. ELISA test carried out in 43 patientes did not yield false results. Indeterminate chronic phase (56%) or early stages of the disease prevailed. The findings of normal EKGs and abnormalities in 30% of the Holter tests, 41% of the exercise tests, 33% of the ECO tests and, 48% of normal chest x-ray with abnormal ECO, high lights the importance of caring out more detailed exams in specific situations. We hereby propose a care model for the Chagas disease patient, integrated to our State Health Plan stressing serologic tests, and training capable human resources committed to the development of integrated health care and the optimization of our referral and counter-referral system, thus issuing total care to the Chagas disease patient.
authors.affiliation: Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte.
authors.forename: E D
authors.initials: ED
authors.lastname: Gontijo
authors.forename: M O
authors.initials: MO
authors.lastname: Rocha
authors.forename: U
authors.initials: U
authors.lastname: Torquato de Oliveira
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D000704:Analysis of Variance; D001938:Brazil / Q000453:epidemiology; D016022:Case-Control Studies; D014355:Chagas Disease / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D003191:Comprehensive Health Care; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D012017:Referral and Consultation; D012959:Socioeconomic Factors
vernacular_title: Perfil clínico-epidemiológico de chagásicos atendidos em ambulatório de referência e proposição de modelo de atenção ao chagásico na perspectiva do sus.