[Study of the factors determining an unexpected occurrecne of Chagas cardiomyopathy in Sucre, Bolivia].
The purpose of this case-control study carried out between February 1, 1994 and December 22, 1994 at the "Instituto de Gastroenterologia Boliviano-Japonés" in Sucre, Bolivia was to determine risk factors for chronic Chagas cardiomyopathy in adult patients with positive serological tests for Trypanosoma cruzi. A total of 196 subjects were included. Inclusion criteria were positive serological tests for Trypanosoma cruzi, residence in the city of Sucre, Bolivia for at least 3 months, and age over 14 years. There were 62 cases presenting electrocardiographic findings consistent with Chagas cardiomyopathy and 134 controls presenting normal electrocardiographic findings. Both cases and controls underwent a standardized protocol including physical examination and laboratory tests. Interviews were set up to evaluate personal and familial history of Chagas disease, socioeconomic status, and presence of Triatoma infestans in the home. Bivariate analysis of data indicated that Chagas cardiomyopathy was associated with the following risk factors: heart rate (p < 0.05), fecaloma (p < 0.05), occupation requiring strenuous physical exertion (p < 0.001), proximity with domestic animals (p < 0.005), especially pigs (p < 0.005), dwelling features including outbuildings, more than 2 bedrooms, and inside ceilings (p < 0.001). Multivariate analysis revealed the following risk factors: occupation requiring strenuous physical exertion (p < 0.005), a yard around the house (p < 0.05), and inside ceilings (p < 0.05). The results of this study show that prevention of chronic Chagas cardiomyopathy in Sucre, Bolivia will depend on improvement of living conditions.
De Muynck
A
A
Département de Recherche Clinique, Institut de Médecine Tropicale, Anvers, Belgique. lmaniran@itg.be
Muñoz
R
R
Manirankunda
L
L
Pizzaro
J C
JC
Gutierrez
J
J
D000293:Adolescent; D000328:Adult; D000818:Animals; D001838:Bolivia; D016022:Case-Control Studies; D002598:Chagas Cardiomyopathy / Q000175:diagnosis*; D002908:Chronic Disease; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D014349:Trypanosoma cruzi / Q000302:isolation & purification