title: Profile of Trypanosoma cruzi infection in a tropical medicine reference center, Northern Italy.
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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Centre for Tropical Diseases (CTD), Sacro Cuore Hospital, Negrar, Verona, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Gobbi
authors.affiliation: Centre for Tropical Diseases (CTD), Sacro Cuore Hospital, Negrar, Verona, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Angheben
authors.affiliation: Centre for Tropical Diseases (CTD), Sacro Cuore Hospital, Negrar, Verona, Italy; Centre for Community Epidemiology and Tropical Medicine (CECOMET), Esmeraldas, Ecuador.
authors.forename: Mariella
authors.initials: M
authors.lastname: Anselmi
authors.affiliation: Prevention Department, ULSS 20, Verona, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Postiglione
authors.affiliation: Operational Center Bruxelles, Médecins Sans Frontières, Bruxelles, Belgium.
authors.forename: Ernestina
authors.initials: E
authors.lastname: Repetto
authors.affiliation: Centre for Tropical Diseases (CTD), Sacro Cuore Hospital, Negrar, Verona, Italy.
authors.forename: Dora
authors.initials: D
authors.lastname: Buonfrate
authors.affiliation: Centre for Tropical Diseases (CTD), Sacro Cuore Hospital, Negrar, Verona, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Marocco
authors.affiliation: Centre for Tropical Diseases (CTD), Sacro Cuore Hospital, Negrar, Verona, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Tais
authors.affiliation: Cardiology Unit, Sacro Cuore Hospital, Negrar, Verona, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Chiampan
authors.affiliation: Radiology Unit, Sacro Cuore Hospital, Negrar, Verona, Italy.
authors.forename: Paride
authors.initials: P
authors.lastname: Mainardi
authors.affiliation: Centre for Tropical Diseases (CTD), Sacro Cuore Hospital, Negrar, Verona, Italy.
authors.forename: Zeno
authors.initials: Z
authors.lastname: Bisoffi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D014355:Chagas Disease / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D002648:Child; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009547:Nifurtimox / Q000627:therapeutic use; D009593:Nitroimidazoles / Q000627:therapeutic use; D011247:Pregnancy; D012189:Retrospective Studies; D014330:Tropical Medicine; D014481:United States
chemical_list: D009593:Nitroimidazoles; D009547:Nifurtimox; C009999:benzonidazole