Clinical features of Chagas disease progression and severity

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES Lancet Regional Health-Americas Pub Date : 2024-09-01 DOI:10.1016/j.lana.2024.100832
Maria Carmo P. Nunes , Caryn Bern , Eva H. Clark , Antonio L. Teixeira , Israel Molina
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Abstract

Chagas disease, the most common form of nonischaemic cardiomyopathy globally, is one of the leading causes of morbidity and mortality in Latin America. Chagas cardiomyopathy has a wide clinical spectrum and prognosis, which is primarily determined by the severity of left ventricular dysfunction. Chagas disease also affects the brain, particularly manifesting as cardioembolic strokes and cognitive impairments. Disease progression is influenced by various factors such as anti-parasite treatments, host–parasite interactions, and other determinants.

This review explores Chagas disease, covering clinical presentations, the range of severity of Chagas cardiomyopathy, and neurological manifestations. We investigate factors that influence the progression of cardiomyopathy, including anti-parasitic treatments, interactions between hosts and parasites, and the influence of social determinants on the course of the disease. This review analyses key prognostic factors associated with the progression and mortality of Chagas cardiomyopathy, offering insights into this potentially fatal illness.

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南美锥虫病进展和严重程度的临床特征
南美锥虫病是全球最常见的非缺血性心肌病,也是拉丁美洲发病和死亡的主要原因之一。南美锥虫病心肌病的临床表现和预后广泛,主要取决于左心室功能障碍的严重程度。恰加斯病还会影响大脑,尤其表现为心肌栓塞性中风和认知障碍。本综述探讨南美锥虫病,涵盖临床表现、南美锥虫心肌病的严重程度范围以及神经系统表现。我们研究了影响心肌病进展的因素,包括抗寄生虫治疗、宿主与寄生虫之间的相互作用以及社会决定因素对病程的影响。这篇综述分析了与南美锥虫病心肌病进展和死亡率相关的主要预后因素,为人们深入了解这种可能致命的疾病提供了参考。
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期刊介绍: The Lancet Regional Health – Americas, an open-access journal, contributes to The Lancet's global initiative by focusing on health-care quality and access in the Americas. It aims to advance clinical practice and health policy in the region, promoting better health outcomes. The journal publishes high-quality original research advocating change or shedding light on clinical practice and health policy. It welcomes submissions on various regional health topics, including infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, emergency care, health policy, and health equity.
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