Epidemiological indicators of Chagas disease in the metropolitan region of Salvador, Bahia, Brazil

Lanza, Fernanda Cardoso; Ribeiro-Jr, Gilmar; Miranda, Diego Lopes Paim; Santos, Fred Luciano Neves; Carvalho, Cristiane Medeiros Moraes de; Cunha, Gabriel Muricy; Carneiro, Ianei de Oliveira; Reis, Renato Barbosa; Cunha, José Maurício Albuquerque; Cardoso, Cristiane Wanderley; Soares, Jorgana Fernanda de Souza; Araújo, Fernando Luiz Vieira de; Reis, Mitermayer Galvão

doi:10.1590/0037-8682-0185-2022

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Revista da Sociedade Brasileira de Medicina Tropical

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Major Article • Rev. Soc. Bras. Med. Trop. 56 • 2023 • https://doi.org/10.1590/0037-8682-0185-2022 copy

Epidemiological indicators of Chagas disease in the metropolitan region of Salvador, Bahia, Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Background:

Chagas disease (CD) is caused by Trypanosoma cruzi and transmitted by triatomines. Historical information from the 20^th century demonstrates T. cruzi records in the metropolitan region of Salvador (MRS), the third largest urban agglomeration in the Brazilian Northeast and the eighth largest in Brazil, an area with intense migratory activity from CD-endemic regions. Therefore, this study aimed to evaluate CD indicators (prevalence and mortality) in the MRS.

Methods:

A mixed ecological and descriptive study was conducted using secondary data. We analyzed data from 2008 to 2015: deaths due to CD, self-reported cases of CD, and blood donors that were non-negative for T. cruzi infection.

Results:

São Francisco do Conde was one of the municipalities with the highest mortality rates due to CD. The seroprevalence rates varied by year and municipality; those with the highest values were 2008: Vera Cruz, 2009: Mata de São João, 2010: Dias D'Ávila, 2011 and 2015: São Francisco do Conde, 2012: São Sebastião do Passé, and 2013 and 2014: Pojuca. Spatial correlations between the municipalities were not detected.

Conclusions:

We conclude that CD is present in the MRS. The indicators analyzed in the MRS are below-state-level data. Given the importance of indicator analysis for the surveillance and control of CD at the state and national levels, it is important to strengthen the surveillance program at the municipal level, including the regions classified as low risk for T. cruzi vector transmission.

Keywords:
Trypanosoma cruzi; Public health; Epidemiological surveillance

	Year
Municipality Residence RMS	2008			2009			2010			2011			2012			2013			2014			2015
	Cases	Population	CSMR	Cases	Population	CSMR	Cases	Population	CSMR	Cases	Population	CSMR	Cases	Population	CSMR	Cases	Population	CSMR	Cases	Population	CSMR	Cases	Population	CSMR
Camaçari	12	220,495	5.4	11	227,955	4.8	18	234,558	7.7	18	242,970	7.4	11	249,206	4.4	15	255,238	5.9	11	275,575	4.0	10	281,413	3.6
Candeias	13	78,618	16.5	8	81,306	9.8	13	81,699	15.9	14	83,158	16.8	12	83,647	14.3	16	84,121	19.0	8	89,419	8.9	9	88,308	10.2
Dias d'Ávila	8	53,821	14.9	3	56,600	5.3	2	57,708	3.5	4	66,440	6.0	2	68,060	2.9	4	69,628	5.7	4	75,103	5.3	4	76,624	5.2
Itaparica	0	19,897	0.0	0	20,641	0.0	1	20,796	4.8	1	20,725	4.8	3	20,862	14.4	3	20,994	14.3	2	22,329	9.0	2	22,476	8.9
Lauro de Freitas	8	144,492	5.5	13	153,016	8.5	8	156,936	5.1	17	163,449	10.4	12	167,308	7.2	12	171,042	7.0	10	184,383	5.4	9	188,013	4.8
Madre de Deus	0	15,432	0.0	2	16,354	12.2	0	16,783	0.0	0	17,376	0.0	2	17,786	11.2	2	18,183	11.0	1	19,600	5.1	2	19,985	10.0
Mata de São João	7	37,201	18.8	4	38,962	10.3	5	39,585	12.6	7	40,183	17.4	4	40,866	9.8	4	41,527	9.6	4	44,538	9.0	3	45,194	6.6
Pojuca	0	30,221	0.0	2	31,687	6.3	6	32,225	18.6	4	33,066	12.1	1	33,595	3.0	1	34,106	2.9	3	36,551	8.2	2	37,061	5.4
Salvador	132	2,892,625	4.6	108	2,948,733	3.7	129	2,998,056	4.3	125	2,675,656	4.7	125	2,693,605	4.6	113	2,710,968	4.2	132	2,883,682	4.6	133	2,902,927	4.6
São Francisco do Conde	7	29,829	23.5	5	31,219	16.0	5	31,699	15.8	3	33,183	9.0	3	33,713	8.9	6	34,226	17.5	3	36,677	8.2	4	38,838	10.3
São Sebastião do Passé	3	40,321	7.4	3	41,624	7.2	4	41,758	9.6	4	42,153	9.5	1	42,321	2.4	5	42,485	11.8	4	45,090	8.9	5	45,292	11.0
Simões Filho	7	109,269	6.4	8	114,649	7.0	5	116,662	4.3	2	118,047	1.7	6	119,759	5.0	1	121,416	0.8	8	129,964	6.2	3	131,630	2.3
Vera Cruz	2	35,060	5.7	2	36,843	5.4	2	37,539	5.3	4	37,567	10.6	1	38,167	2.6	1	38,748	2.6	3	41,524	7.2	3	42,103	7.1

	Year
Municipality Residence RMS	2008			2009			2010			2011			2012			2013			2014			2015
	Cases	Population	PC	Cases	Population	PC	Cases	Population	PC	Cases	Population	PC	Cases	Population	PC	Cases	Population	PC	Cases	Population	PC	Cases	Population	PC
Camaçari	63	164,550	38.3	73	136,350	53.5	88	196,650	44.7	107	184,650	57.9	109	169,200	64.4	112	195,300	57.3	112	214,800	52.1	112	198,900	56.3
Candeias	137	45,240	302.8	145	42,540	340.9	142	54,150	262.2	139	53,340	260.6	134	57,780	231.9	131	56,730	230.9	132	58,380	226.1	0	54,480	0.0
Dias d'Ávila	43	42,000	102.4	41	34,500	118.8	48	34,500	139.1	38	26,490	143.5	40	30,150	132.7	38	51,750	73.4	38	56,850	66.8	0	54,750	0.0
Itaparica	14	17,250	81.2	14	20,641	67.8	16	20,700	77.3	16	20,700	77.3	16	20,862	76.7	15	20,700	72.5	15	22,329	67.2	0	22,476	0.0
Lauro de Freitas	98	100,830	97.2	102	84,840	120.2	96	78,390	122.5	86	93,210	92.3	90	117,960	76.3	86	123,750	69.5	86	137,490	62.6	86	125,100	68.7
Madre de Deus	7	15,432	45.4	6	16,354	36.7	5	16,783	29.8	5	17,250	29.0	4	17,250	23.2	3	17,250	17.4	3	17,250	17.4	3	17,250	17.4
Mata de São João	48	37,201	129.0	50	35,280	141.7	53	39,585	133.9	55	40,183	136.9	55	40,866	134.6	52	41,527	125.2	51	44,538	114.5	56	45,194	123.9
Pojuca	23	30,221	76.1	24	31,687	75.7	31	32,225	96.2	33	33,066	99.8	32	33,595	95.3	30	34,106	88.0	29	36,551	79.3	29	37,061	78.2
Salvador	1214	796,590	152.4	1187	815,400	145.6	1213	942,930	128.6	1096	834,000	131.4	1078	711,390	151.5	1021	973,680	104.9	945	1,026,630	92.0	962	1,074,180	89.6
São Francisco do Conde	50	29,829	167.6	49	31,219	157.0	42	31,699	132.5	70	33,183	211.0	82	33,713	243.2	88	24,150	364.4	76	34,500	220.3	77	38,838	198.3
São Sebastião do Passé	51	40,321	126.5	42	41,624	100.9	38	41,758	91.0	41	41,400	99.0	39	41,400	94.2	41	42,485	96.5	42	45,090	93.1	0	44,400	0.0
Simões Filho	109	52,950	205.9	105	59,490	176.5	93	50,250	185.1	99	55,650	177.9	56	65,100	86.0	87	68,100	127.8	79	53,100	148.8	35	53,100	65.9
Vera Cruz	35	34,500	101.4	35	36,843	95.0	35	37,539	93.2	35	27,600	126.8	35	38,167	91.7	35	38,748	90.3	35	41,400	84.5	35	37,950	92.2

	Year
Municipality Residence RMS	2008			2009			2010			2011			2012			2013			2014			2015
	Cases	Population	SC	Cases	Population	SC	Cases	Population	SC	Cases	Population	SC	Cases	Population	SC	Cases	Population	SC	Cases	Population	SC	Cases	Population	SC
Dias d'Ávila	1	174	574.7	1	310	322.6	1	169	591.7	1	330	303.0	0	264	0.0	1	366	273.2	1	380	263.2	0	369	0.0
Itaparica	0	32	0.0	1	64	1,562.5	0	61	0.0	0	70	0.0	0	60	0.0	0	83	0.0	0	64	0.0	0	68	0.0
Lauro de Freitas	5	1,188	420.9	1	1,268	78.9	0	1,354	0.0	1	1,616	61.9	4	1,519	263.3	7	1,422	492.3	5	1,715	291.5	7	1,919	364.8
Madre de Deus	0	122	0.0	0	82	0.0	0	133	0.0	0	135	0.0	2	194	1,030.9	0	254	0.0	0	175	0.0	1	351	284.9
Mata de São João	0	80	0.0	2	79	2,531.6	0	75	0.0	1	112	892.9	0	171	0.0	1	183	546.4	0	149	0.0	1	208	480.8
Pojuca	1	100	1,000.0	2	85	2,352.9	0	76	0.0	0	98	0.0	0	179	0.0	1	120	833.3	1	142	704.2	0	144	0.0
Salvador	121	25,671	471.3	47	29,378	160.0	56	30,087	186.1	71	30,785	230.6	160	32,510	492.2	95	30,419	312.3	143	30,484	469.1	124	32,971	376.1
São Francisco do Conde	1	87	1,149.4	0	95	0.0	0	200	0.0	1	78	1,282.1	1	118	847.5	1	133	751.9	0	119	0.0	3	121	2,479.3
São Sebastião do Passé	1	229	436.7	0	130	0.0	0	116	0.0	0	95	0.0	2	191	1,047.1	0	202	0.0	0	161	0.0	0	169	0.0
Simões Filho	4	950	421.1	3	917	327.2	4	1,067	374.9	2	1,140	175.4	7	1,181	592.7	4	975	410.3	4	924	432.9	4	1,111	360.0
Vera Cruz	3	66	4,545.5	0	89	0.0	0	103	0.0	0	118	0.0	0	170	0.0	0	125	0.0	0	110	0.0	1	136	735.3

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[1] Corresponding author: Dr. Mitermayer Galvão dos Reis. e-mail:mitermayer.reis@fiocruz.br