Avaliação do panorama epidemiológico da Doença de Chagas aguda e seu mecanismo de transmissão oral no município de Itaituba, Pará, Amazônia brasileira

Abstract

The Brazilian Amazon region presents a singularity in its health-disease process, concentrating most cases of infectious and parasitic diseases, among them Chagas Acute Disease (ACD), caused by the protozoan Trypanosoma cruzi, which is a relevant problem. Brazilian public health. From 2000 to 2010, 1,087 cases were registered in Brazil, of which about 70% corresponded to notifications by oral transmission and 7% by vector transmission, with Pará being the second largest causative state of the disease and first in the production ranking. pulp and / or acai juice. In this sense, the present study aimed to describe the epidemiology and transmission mechanism of Acute Chagas Disease in Itaituba-PA, where the epidemiological data contained in the National System of Diseases and Notification (SINAN) were used as collection instruments. and individual notification forms (FNI) of the disease, stored in the SUS DATA-SUS database, as well as a semi-structured questionnaire and observational form, applied in 09 points of sale and handling of açaí pulp (beaters) in central Itaituba area. This is a cross-sectional field survey by retrospective survey with qualitative, quantitative, descriptive and exploratory methodological approaches. Thus, the research is divided into four chapters, the first of which discusses published literature on the oral transmission of Chagas disease, through discussions of works related to the theme, through a state of the art of the last decade (2007 to 2017). The second describes the epidemiology of Chagas Acuda disease in the state of Pará. The third chapter deals with the epidemiology of Chagas Aguda disease in the municipality of Itaituba-PA in the 10 years of study. The fourth and last chapter evaluates the risk of oral transmission by the consumption of acai in the municipality, and each chapter sought to respond to a specific objective pre-established in this study. The results showed 92 publications on the subject, addressing specific characteristics of the disease with emphasis on its heterogeneous dynamics, regarding its transmission pathways. Regarding the epidemiological profile in the state of Pará, the occurrence of 1693 cases has been demonstrated, also characterizing the heterogeneity of the disease, prevalent in male humans, between 19 and 59 years old, predominant in the urban area, especially the pathway. oral transmission, probable place of contamination at home and state average of 169.3 / 100,000 inhabitants. In the municipality of Itaituba-PA there were only 22 cases of the disease, demonstrating singularities, compared to other studies developed in the Amazon, highlighting a predominance in males, in the age group going to 60 years, in individuals of brown race, farmers and / or truck drivers, residents of rural areas, also highlighting the oral route of infection and municipal average of 2.2/100,000 inhabitants. Regarding the risk of transmission, Itaituba was characterized by simplicity in the physical structure of its points of sale, as well as the artisanal form of production, but with satisfactory conditions of hygiene, safety and individual protection, thus presenting low risk for transmission. sore throat. It is emphasized that the prevention of endemic diseases in the Amazon region requires strategies aimed at collecting as much information as possible, as well as training of ESF, PACS, clinics and hospitals teams, in order to detect and properly fill out the individual notification form.