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A Three-Year Follow-Up Study of Infection with Trypanosoma Cruzi and Electrocardiographic Abnormalities in a Rural Community in Northeast Brazil^*

James H. Maguire, Kenneth E. Mott, Rodney Hoff, Armenio Guimarães, José T. Franca, José Antonio Almeida de Souza, Nilson Borges Ramos AND Italo A. Sherlock

Department of Tropical Public Health, Harvard School of Public Health, Boston, Massachusetts 02115
Department of Cardiology, Hospital Professor Edgard Santos, Federal University of Bahia, Salvador, Bahia, Brazil, and Nucleo de Pesquisas
Fundação Oswaldo Cruz (F.O.C.), Salvador, Bahia, Brazil

The relationship between parasitemia, seroreactivity to Trypanosoma cruzi, and electrocardiographic abnormalities was studied in 115 individuals from a rural community in northeast Brazil where Chagas' disease is endemic. Vector control measures were introduced, and after 3 years 106 of the original participants were located and re-examined. Serum antibodies to T. cruzi were measured by complement fixation and indirect fluorescent antibody tests and parasitemia by xenodiagnosis and blood cultures. On both examinations more seropositive children than seropositive adults showed parasitemia, and parasitemia was more likely to persist over the 3-year period in younger individuals. Electrocardiographic (ECG) abnormalities were seen more frequently in seropositive individuals without parasitemia. However, ECG abnormalities, as expected, were more prevalent in older individuals and therefore no specific inverse relationship between ECG findings and parasitemia could be shown. The decreased prevalence of infection noted in younger individuals following the introduction of vector control measures indicates that this approach limited transmission.

Accepted for publication May 25, 1981.

^* The Harvard component, under the direction of Dr. Thomas H. Weller, is supported by a grant from the Wellcome Trust and NIH grant No. AI305-02, and its collaborative activities in Brazil are under the aegis of the Pan American Health Organization. Field activities were subsidized by the Industria e Comércio de Mineracão S. A. (ICOMI).

This work was presented in preliminary form at the International Congress on Chagas' Disease, Rio de Janeiro, July 1979, and an abstract was published in the Annals of the Congress.

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