Perfil epidemiológico da doença de chagas nos Estados do Norte, Nordeste e Centro-Oeste no período de 2010 a 2020

Abstract

Aim: To analyze the epidemiological profile of Chagas Disease (CD) in the states of the North, Northeast and Midwest regions from 2010 to 2020. Methods: This is a cross-sectional study. Data from hospitalizations in public hospitals registered to the Department of Informatics of the Unified Health System (DATASUS) for the period from 2010 to 2020 were selected. Hospital admission rates for Chagas Disease and its complications were constructed (ICD10 B57: Chagas disease, B57.0: acute form of Chagas disease with cardiac involvement, B57.1: acute form without cardiac involvement, B57.2: chronic Chagas disease with cardiac involvement, B57.3: chronic Chagas disease with digestive system involvement, B57.4: chronic Chagas disease with involvement of the nervous system, B57.5: chronic Chagas disease with involvement of other organs, I43.0: heart disease in infectious and parasitic diseases classified elsewhere, I42.0: dilated cardiomyopathy, K23.1: Chagas disease megaesophagus and K93.1: Chagas disease megacolon) by states, regions, age groups, sex and year of occurrence. Univariate and multiple logistic regression models were constructed to investigate factors associated with hospitalizations for the outcomes of interest. Results: Of the total number of hospitalizations for CD, 72,583 (57.8%) were male. In relation to individuals affected by CD, almost 90% were of mixed race/color. Dilated cardiomyopathy was the CD complication with the highest percentage of occurrence (93.2%). The states of Ceará (23.3/10,000 rate) and Pernambuco (22.5/10,000) had the highest CD rates. Among the years studied, 2015 had the highest rate of hospitalizations (12.3/10,000), while 2020 had the lowest rate (6.5/10,000). The most affected age group was people over 60 years old (rate of 43.1/10,000 hospitalizations), with the municipalities of Canto do Buriti (583/10,000 hospitalizations) and Barbalha (572/10,000) having the highest rates of study. In the analysis of associated factors, it was observed that being female (OR=1.03; 95%CI 1.01-1.04) and mixed race/color (OR=2.04; 95%CI 1.97- 2.11) or black (OR=1.60; 95%CI 1.50-1.71) were shown to be factors associated with hospitalizations for CD. The same occurred with age groups, in which being 60 years of age or older proved to be a factor strongly associated with CD (OR=12.06; 95%CI 10.79-13.48). The other age groups, except those under 10 years of age, were also associated. Among the states studied, it was observed that the states of Ceará (OR=1.58; 95%CI 1.45-1.72) and Pernambuco (OR=1.59; 95%CI 1.46-1.73) were associated when compared to the state of Acre. Conclusion: Non-modifiable demographic characteristics and place of residence proved to be factors associated with the occurrence of hospitalizations for CD, demonstrating the need to prioritize groups with these characteristics for better control of the disease in the country.