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Cardiac and digestive forms of chronic Chagas disease in Brazilian social welfare, 2004-2016
Jean Ezequiel Limongi1, Izabela Lima Perissato1, Antônio Marcos Machado de Oliveira1
1Curso de Saúde Coletiva, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil.
Insights
Chagas disease impacts Brazilian social welfare, primarily due to chronic Chagas cardiomyopathy. This condition disproportionately affects working-age men in rural Southeastern Brazil, leading to disability.
Area of Science:
- Public Health
- Epidemiology
- Tropical Medicine
Background:
- Chagas disease is a neglected tropical disease causing chronic illness, morbidity, and mortality.
- Despite reduced incidence in Brazil, existing cases significantly burden the social welfare system.
Purpose of the Study:
- To analyze sociodemographic factors of Brazilian social welfare beneficiaries with chronic Chagas disease (cardiac and digestive forms).
- To examine data from 2004 to 2016.
Main Methods:
- Cross-sectional study utilizing data from the Brazilian Ministry of Labor and Social Security.
- Logistic regression was employed to estimate crude and adjusted odds ratios.
Main Results:
- 25,085 individuals received benefits, predominantly men (63%) with the cardiac form (81.4%) in urban areas (64%).
- Higher benefit frequency was observed in the Midwest macroregion.
- Male sex, age 30-49, rural residence, and the Southeast macroregion showed significant associations with the cardiac form.
Conclusions:
- Chronic Chagas cardiomyopathy is the primary driver of Chagas disease's impact on Brazilian social welfare.
- The condition is strongly associated with working-age men residing in rural areas of Southeastern Brazil.
Introduction:
Chagas disease is a neglected tropical disease with a chronic clinical course and high rates of morbidity and mortality. Despite a drastic reduction in the disease's incidence in Brazil in recent decades, older cases still impact the national social welfare system.
Objectives:
To analyze the sociodemographic characteristics of Brazilian social welfare beneficiaries affected by the cardiac and digestive forms of chronic Chagas disease between 2004 and 2016.
Methods:
This cross-sectional study was based on data from the Brazilian Ministry of Labor and Social Security. Crude and adjusted odds ratios were estimated using logistic regression.
Results:
Benefits were granted to 25,085 affected individuals, mostly men (15,812; 63%) with the cardiac form (20,424; 81.4%) who resided in urban areas (16,051; 64%). The highest relative frequency of benefits were granted in the Midwest macroregion (31.1/100,000 inhabitants). Male sex (odds ratios = 1.2; 95% CI 1.1-1.2), age 30-49 years (odds ratios = 1.8; 95% CI 1.4-2.1), residence in rural areas (odds ratios = 1.6; 95% CI 1.5-1.7) or the Southeast macroregion (odds ratios = 2.9; 95% CI 2.4-3.4) had the highest association with the cardiac form. Individuals with the cardiac form had a higher median age at disease onset (45 years; p < 0.001) but a lower age at work disability onset (50 years; p = 0.01).
Conclusions:
The impact of Chagas disease on Brazilian social welfare is mainly due to chronic Chagas cardiomyopathy, which was mainly associated with men in their productive years who live in rural areas in Southeastern Brazil.
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