Elsa Isela Guevara Moctezuma

: The prevalence and characteristics of chronic Chagas disease (CCD) in the Amazon Region remain underexplored. This study aimed to describe the challenges encountered during a serological survey and follow-up of CCD, while also highlighting potential risk factors in the Amazon Region. The serological survey involved residents of periurban and rural areas of Manaus in the Brazilian Amazon. All participants were invited to complete a clinical, epidemiological, and demographic questionnaire and provide a blood sample for anti-Trypanosoma cruzi (T. cruzi) IgG tests. A total of 1,845 participants were included, of whom 43 were identified as having presumed CCD, based on having at least two positive serological tests. Only 35 underwent complementary tests, and five had cardiac alterations not consistent with CCD. The main risk factors associated with CCD were age ≥20 years, living in periurban areas, reporting the presence of the insect vector inside the household, entering the forest, consumption of bushmeat, and having undergone blood transfusion. In the Amazon, the population is exposed to the sylvatic T. cruzi life cycle and is unaware of the associated risk factors. The divergent serology results raise doubts about the reliability of the commercial serological tests used for CCD screening in the region. Surveillance for CCD is important in the Amazon.

Objectives: This study aims to provide a comprehensive analysis of clinical and epidemiological data related to Chronic Chagas Cardiomyopathy (CCC) in the Amazon region of Brazil.Methods: A review of observational, retrospective, and cross-sectional studies related to Chagas Disease in the Amazon region of Brazil was conducted, and a case series addressing CCC in patients treated at the FMT-HVD outpatient clinic, a reference center for Chagas disease in Brazil, was carried out.Results: Clinical characteristics of 55 patients from the Amazon region with CCC were described. The most common electrocardiographic alteration observed was abnormal ventricular repolarization (AVR), present in 40% of cases. The most common echocardiographic finding was left ventricular systolic dysfunction (49%), followed by akinesia or hypokinesia of the inferior and/or inferolateral walls (38.1%) and the presence of an apical aneurysm (32.7%).Conclusions: Overall, this study demonstrates that CCC in the Amazon region presents clinical characteristics and severity that are similar to those observed in other regions. However, certain peculiarities, such as the frequency of right bundle branch block (RBBB) and anterior and septal involvement during the acute phase, require additional investigation to better comprehend the disease in the region. Overall, the study provides crucial clinical insights for the diagnosis and treatment of CCC in the Amazon region.