title: Benznidazole Use among Patients with Chronic Chagas' Cardiomyopathy in an Endemic Region of Brazil.
abstract: Chagas disease (CD) is a neglected tropical disease that affects individuals in almost every country in Latin America. There are two available drugs with antiparasitic profiles; however, only benznidazole (BZN) has been approved for commercialization in Brazil. The usefulness of prescribing BZN for patients with chronic Chagas cardiomyopathy (CCC) is controversial. There are no studies in the literature describing the extent of BZN use at this stage or the profile of patients using this drug. The present study aimed to determine the prevalence and factors associated with previous BZN use among individuals with CCC. This cross-sectional study was conducted with 1,812 individuals with CCC from 21 Brazilian cities endemic for CD. The dependent variable was "prior use of BZN" (no vs. yes). The independent variables were grouped into socioeconomic, lifestyle and medical history aspects. Binary logistic regression (α ≥ 0.05) was used. Among the evaluated individuals, 27.2% reported previous use of BZN. The likelihood of prior use of BZN was higher among younger individuals (OR = 2.7), individuals with a higher education (OR = 2.7), individuals with a lower monthly per capita income (OR = 1.3), individuals who practiced physical exercise (OR = 1.5), individuals who had prior knowledge of the CD diagnosis (OR = 2.5), individuals without hypertension (OR = 1.3) and individuals with a longer time to the CD diagnosis (OR = 6.1). The present study revealed a small proportion of therapeutic BZN use among Brazilian CCC patients. This finding suggests a late diagnosis and undertreatment of the disease. BZN use was higher among individuals with better clinical and demographic conditions but with a lower income and a longer time to the CD diagnosis. Knowledge of the BZN usage profile may help reduce the current state of neglect of this disease and pave the way for future studies.
authors.affiliation: Graduate Program in Health Sciences, State University of Montes Claros (Universidade Estadual de Montes Claros), Montes Claros, Minas Gerais, Brazil.
authors.forename: Ariela Mota
authors.initials: AM
authors.lastname: Ferreira
authors.affiliation: Institute of the University of São Paulo, University of São Paulo (Universidade de São Paulo), São Paulo, São Paulo, Brazil.
authors.forename: Ester Cerdeira
authors.initials: EC
authors.lastname: Sabino
authors.affiliation: Medical Investigation Laboratories-03 Clinics Hospital, Medical School, University of São Paulo (Universidade de São Paulo), São Paulo, São Paulo, Brazil.
authors.forename: Lea Campos
authors.initials: LC
authors.lastname: de Oliveira
authors.affiliation: Federal University of São João del-Rey, Research Group in Epidemiology and New Technologies in Health-campus CCO, São João del-Rei, Brazil.
authors.forename: Cláudia Di Lorenzo
authors.initials: CD
authors.lastname: Oliveira
authors.affiliation: Federal University of São João del-Rey, Research Group in Epidemiology and New Technologies in Health-campus CCO, São João del-Rei, Brazil.
authors.forename: Clareci Silva
authors.initials: CS
authors.lastname: Cardoso
authors.affiliation: Department of Internal Medicine, Federal University of Minas Gerais (Universidade Federal de Minas Gerais), Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Antônio Luiz Pinho
authors.initials: AL
authors.lastname: Ribeiro
authors.affiliation: Graduate Program in Health Sciences, State University of Montes Claros (Universidade Estadual de Montes Claros), Montes Claros, Minas Gerais, Brazil.
authors.forename: Desirée Sant'Ana
authors.identifier: http://orcid.org/0000-0002-0331-0747
authors.initials: DS
authors.lastname: Haikal
mesh_terms: D000368:Aged; D001938:Brazil / Q000453:epidemiology; D002598:Chagas Cardiomyopathy / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D002908:Chronic Disease; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009593:Nitroimidazoles / Q000627:therapeutic use*; D012959:Socioeconomic Factors; D014344:Trypanocidal Agents / Q000627:therapeutic use
chemical_list: D009593:Nitroimidazoles; D014344:Trypanocidal Agents; C009999:benzonidazole