Doença de chagas crônica e fatores associados à morbimortalidade: possibilidades de atuação da atenção primária

Abstract

Chagas disease is a neglected anthropozoonosis that still has high prevalence and significant morbidity and mortality. It has a great biopsychosocial impact on sufferers, from the asymptomatic forms to those with major complications. It generates high costs in public health due to the frequency with which patients seek more complex health services and the early labor disability that these people manifest in symptomatic forms of the disease, bringing burden to social security. This study proposes an analysis of secondary data from medical records of patients with chronic Chagas' disease followed at the Hospital de Clínicas of the Universidade Federal de Uberlândia between March 2018 and March 2020, using current criteria from the literature for the classification of cases and correlating them with the role of Primary Health Care in the management and monitoring of this pathology.A total of 534 medical records of patients with chronic Chagas disease were acquired. These were assisted in the Outpatient Clinics, Infirmaries and the Institution's Emergency Room. Of these, 101 were promptly excluded from patients in the indeterminate clinical forms and those with the digestive forms. Thus, 433 medical records of patients with cardiomyopathy were selected, a clinical form that has the most impact on the health of the patient and society as a whole. This study shows that patients with chronic Chagas cardiomyopathy in its most severe forms were associated with a greater number of hospitalizations and days in the hospital. Cases with a higher risk of death were associated with a greater number of hospitalizations, days in the hospital, visits to the outpatient service and visits to the emergency room. Male patients were also associated with a higher risk of death. In the final assessment of the medical records, 56.6% of which are classified as advanced forms of chronic Chagas cardiomyopathy. When analyzing the medical records in two moments, 72.9% of the cases remained in the stages in which they were recovered, 16.6% improved and 10.5% worsened the stage. This study concluded that chagasic patients in advanced stages of the clinical cardiac form and at higher risk of death have a major impact on more complex healthcare services. All cases, especially stable and less severe ones, should be followed up longitudinally in PHC, providing better quality of life for patients and stabilization, delay or even improvement in the evolution of the disease.