title: Chagas disease: morbidity profile in an endemic area of Northeastern Brazil.
abstract: BACKGROUND
  This study evaluated the clinical forms and manifestation severities of Chagas disease among serologically reactive individuals from Western Rio Grande do Norte (Northeastern Brazil).
  
  
  METHODS
  This cross-sectional study included 186 adults who were evaluated using electrocardiography, echocardiography, chest radiography, and contrast radiography of the esophagus and colon. A clinical-epidemiological questionnaire was also used.
  
  
  RESULTS
  The indeterminate, cardiac, digestive, and cardiodigestive clinical forms of Chagas disease were diagnosed in 51.6% (96/186), 32.2% (60/186), 8.1% (15/186) and 8.1% (15/186) of the participants, respectively. Heart failure (functional classes I-IV) was detected in 7.5% (14/186) of the participants, and 36.4% (24/66), 30.3% (20/66), 15.2% (10/66), 13.6% (9/66), and 4.5% (3/66) of the patients were at stage A, B1, B2, C, and D, respectively. Dilated cardiomyopathy and electrocardiographic changes were detected in 10.2% (19/186) and 48.1% (91/186) of the participants, respectively. Apical aneurysm was diagnosed in 10.8% (20/186) of the participants, and other changes in the segmental myocardial contractility of the left ventricle were diagnosed in 33.9% (63/186) of the participants. Megaesophagus (groups I-IV) was observed in 7% (13/186) of the participants, megacolon (grades 1-3) was detected in 12.9% (24/186) of the participants, and both organs were affected in 29.2% (7/24) of the megacolon cases.
  
  
  CONCLUSIONS
  We detected various clinical forms of Chagas disease (including the digestive form). Our findings indicate that clinical symptoms alone may not be sufficient to exclude or confirm cardiac and/or digestive damage, and the number of patients with symptomatic clinical forms may be underestimated.
authors.affiliation: Programa de Pós-Graduação em Ciências da Saúde, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
authors.forename: Cléber de Mesquita
authors.initials: Cde M
authors.lastname: Andrade
authors.affiliation: Departamento de Análises Clínicas e Toxicológicas, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
authors.forename: Antônia Cláudia Jácome da
authors.initials: AC
authors.lastname: Câmara
authors.affiliation: Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Daniela Ferreira
authors.initials: DF
authors.lastname: Nunes
authors.affiliation: Departamento de Microbiologia e Parasitologia, Centro de Biociências, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
authors.forename: Paulo Marcos da Matta
authors.initials: PM
authors.lastname: Guedes
authors.affiliation: Faculdade de Ciências da Saúde, Universidade do Estado do Rio Grande do Norte, Mossoró, Rio Grande do Norte, Brazil.
authors.forename: Wogelsanger Oliveira
authors.initials: WO
authors.lastname: Pereira
authors.affiliation: Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Egler
authors.initials: E
authors.lastname: Chiari
authors.affiliation: Programa de Pós-Graduação em Ciências da Saúde, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
authors.forename: Rosiane Viana Zuza
authors.initials: RV
authors.lastname: Diniz
authors.affiliation: Programa de Pós-Graduação em Ciências da Saúde, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
authors.forename: Lúcia Maria da Cunha
authors.initials: LM
authors.lastname: Galvão
mesh_terms: D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D014355:Chagas Disease / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D019353:Endemic Diseases; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012959:Socioeconomic Factors; D055815:Young Adult