Doença de chagas cardíaca crônica na atenção primária à saúde: entraves e possibilidades de intervenção

Abstract

Chagas disease, caused by the protozoan Trypanosoma cruzi, is an infectious disease that can occur in acute or chronic forms. Its transmission occurs in different ways and around 30% of patients affected by chronic Chagas disease progress to the cardiac form. Brazil represents an important endemic area for this disease in the world. The Ministry of Health included chronic Chagas disease on the National Compulsory Notification List in 2020, characterizing the importance of surveillance actions. In this sense, PHC is configured as the point in the health network capable of promoting longitudinal and timely care, being the ideal space to expand epidemiological investigation actions and effective case management. Standardizing a flow of care is necessary for comprehensive patient monitoring. This is a non- randomized intervention study with the objective of evaluating the profile of a group of people affected by Chagas disease in a chronic state. It is also part of the scope of this research to prepare a technical report containing the insights obtained and the flowchart for managing patients with chronic cardiac Chagas disease within the scope of Primary Care in the city of Patos de Minas-MG. For this purpose, 33 cases of the disease, obtained through a community search, were monitored in relation to notification, diagnosis, classification and management of cases. In the sample evaluated, a predominant percentage of women was obtained (19; 57.6%). Patients had a mean age of 68.9 years and a mean time of residence in rural areas of 22.42 ± 17.96 and in urban areas of 44.15 ± 17.66. Most of the cases evaluated were classified as low risk of death, according to the score of Rassi et al. (2007) (16; 66.6%) (and Rassi et al. (2006) (19; 86.4%) and classified in stage A of the disease (21; 77.8%). Only 16 (48.5%) individuals attended for blood collection for serological testing. There are major obstacles and challenges in the diagnosis and management of patients with chronic cardiac Chagas disease in PHC. The integration of health surveillance services with primary care, as well as raising awareness among the population through popular health education, can greatly improve surveillance and care for the population affected by the disease.

Keywords: Chagas disease. Chagas cardiomyopathy. Primary health care. Intervention studies