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Megaesophagus and Seroreactivity to Trypanosoma Cruzi in a Rural Community in Northeast Brazil^*

Eduardo Mota, Charles W. Todd, James H. Maguire, Dorival Portugal^||, Oto Santana^||, Raimundo Ribeiro Filho^|| AND Italo A. Sherlock^**

Department of Preventive Medicine, Medical School, Federal University of Bahia, Salvador, Bahia, Brazil
Department of Tropical Public Health, Harvard School of Public Health, Boston, Massachusetts 02115
Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts 02115
^|| Hospital Professor Edgard Santos, Federal University of Bahia, Salvador, Bahia, Brazil
^** Nucleo de Pesquisas, Fundação Oswaldo Cruz (F.O.C.), Salvador, Bahia, Brazil

The relationship of symptoms and radiographic abnormalities suggestive of esophageal motility disorders with electrocardiographic (ECG) alterations and seroreactivity to Trypanosoma cruzi was studied in a defined population in a rural area endemic for Chagas' disease in Bahia, Brazil. Between January and June 1981, 680 individuals 5 years of age or older were examined with serologic tests, ECGs and questionnaires for esophageal motility disorder. Of these, 39.9% were seropositive for Chagas' disease. Symptoms of dysphagia occurred 2.5 times more frequently among seropositive individuals than among seronegative individuals. Radiographic esophageal abnormalities were 3.6 times more frequent among seropositive individuals than among seronegative individuals in the symptomatic group. Symptoms and radiographic abnormalities were more common in men than in women although this was not statistically significant. Among seropositive individuals the percentage with symptoms of dysphagia increased with age, with a peak prevalence rate of 23.9% in the 45- to 64-year-old age group. Also, in the seropositive group, 41.7% with X-ray abnormalities of the esophagus and 26.3% with symptoms of dysphagia presented an abnormal ECG.

Accepted for publication March 16, 1984.

^* This work was presented at the XIX Congresso da Sociedade Brasileira de Medicina Tropical, Rio de Janeiro, RJ, Brazil, 20–25 February 1983.

The Harvard component, under the direction of Dr. Thomas H. Weller, is supported by a grant from the Wellcome Trust and NIH grant No. AI 16305-04, and its collaborative activities in Brazil are under the aegis of the Pan American Health Organization.

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