Temporal trend of Acute Chagas Disease in the state of Pará, 2008–2024
DOI:
https://doi.org/10.5327/prmj.1016Keywords:
Chagas disease, time factors, epidemiological monitoring, incidence, Amazon RegionAbstract
Purpose: To analyze the temporal trend in the incidence of acute Chagas disease in the state of Pará from 2008 to 2024, and to assess possible structural changes associated with the year 2020. Methods: An ecological time-series study was conducted using confirmed cases of acute Chagas disease in Pará from 2008 to 2024, obtained from the Notifiable Diseases Information System (SINAN). Annual incidence rates per 100,000 inhabitants were calculated based on population estimates from the Brazilian Institute of Geography and Statistics (IBGE). Trends were analyzed using Prais-Winsten regression, with calculation of the annual percent change (APC). Interrupted time series analysis was also performed, considering 2020 as the intervention point. Results: A significant increasing trend was observed over the entire period (β=0.07741; p<0.001), with an APC of 8.05% (95%CI 4.42–11.80). In the pre-2020 period, the trend was already upward (β=0.10159; p<0.001). In 2020, an abrupt reduction in the level of the series was identified (β=-0.92968; p=0.0047), possibly related to indirect impacts of the COVID-19 pandemic on epidemiological surveillance. In the subsequent period, an acceleration in the trend was observed (β=0.18023; p=0.0308), suggesting intensification of the growth pattern. These findings are consistent with the epidemiological profile of the Amazon region, characterized by the relevance of oral transmission and the persistence of structural determinants associated with the fresh food production chain. Conclusion: Acute Chagas disease showed consistent growth in Pará, with a structural change in 2020 followed by further intensification, reinforcing the need for continuous strengthening of surveillance and control strategies.
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References
1. Rodrigues ADPS. Doença de Chagas aguda: o impacto da transmissão oral no Estado do Pará [trabalho de conclusão de curso]. Belém: Faculdade de Nutrição, Instituto de Ciências da Saúde, Universidade Federal do Pará; 2021.
2. Ferreira HE, Costa AM, Brito FD, Duarte GD, Gemaque HE, Kosmiscky ID, et al. Incidência da Doença de Chagas Aguda no estado do Pará-Brasil, entre os anos de 2010 e 2020. Res Soc Dev. 2022;11(10):e569111032475. https://doi.org/10.33448/rsd-v11i10.32475
3. Coura JR, Junqueira ACV. Doença de Chagas: da descoberta aos desafios atuais. Rio de Janeiro: Editora FIOCRUZ; 2020.
4. Leitão VR, Teles JR, Gonzaga YC, De Araújo CM, Gomes AC, de Oliveira JV, et al. Análise epidemiológica da doença de chagas aguda no brasil (2013-2023): padrões temporais, sazonais e por sexo em adultos de 20 a 59 anos. Braz J Implantol Health Sci. 2025;7(11):1789-803. https://doi.org/10.36557/2674-8169.2025v7n11p1789-1803
5. Mazzardo V, Bailo DW, Abbud Neto CA, Lima Junior PD, Bochio ALA, Gabriel BB, et al. Doença de Chagas: Avanços no Controle e Mudanças na Epidemiologia Brasileira (2012-2022). Braz J Implantol Sci. 2024;6(8):2512-25. https://doi.org/10.36557/2674-8169.2024v6n8p2512-2525
6. Rodrigues AA, Souza CL, Magalhães DL. Aspectos clínicos, socioambientais e nutricionais da doença de Chagas na atualidade. Rev Saude Com. 2023;19(4):3570-85. https://doi.org/10.22481/rsc.v19i4.12311
7. Santos TBL, Silva LMC, Reis FVF, Nascimento FCA. Doença de Chagas aguda no município de Belém/Pará. Rev Aracê. 2024;6(3):8673-86. https://doi.org/10.56238/arev6n3-256
8. Vasconcelos AC, Cartágenes SC, Silva TF. Açaí e a transmissão da doença de Chagas: uma revisão. Res Soc Dev. 2022;11(16):e532111638638. https://doi.org/10.33448/rsd-v11i16.38638
9. Barbosa SB, Nascimento FA, Silva LMC. Doença de Chagas aguda nas regiões de saúde do estado do Pará: uma série histórica. Rev Aracê. 2025;7(7):38831-46. https://doi.org/10.56238/arev7n7-210
10. Lopes NC, Porto YCM, Alves JE. Descrição do perfil epidemiológico da doença de Chagas no Amazonas. RECIMA21. 2024;5(12): e5125980. https://doi.org/10.47820/recima21.v5i12.5980
11. Lopez Bernal J, Cummins S, Gasparrini A. Interrupted time series regression for the evaluation of public health interventions: a tutorial. Int J Epidemiol. 2016;46(1). https://doi.org/10.1093/ije/dyw098
12. Santos VR, Meis JD, Savino W, Andrade JA, Vieira JR, Coura JR, et al. Acute Chagas disease in the state of Pará, Amazon Region: is it increasing? Mem Inst Oswaldo Cruz. 2018.;113(5). https://doi.org/10.1590/0074-02760170298
13. Zambrano S, Montoya K, Avalos A, Gutiérrez B, San Francisco J, Vega JL, et al. Oral Route Infection by Trypanosoma cruzi: From the Beginning to the Present Day. Pathogens. 2026;15(1):47. https://doi.org/10.3390/pathogens15010047
14. Sousa DR, Oliveira Guerra JA, Ortiz JV, Nascimento Couceiro K, Silva e Silva MR, Jorge Brandão AR, et al. Acute Chagas disease associated with ingestion of contaminated food in Brazilian western Amazon. Trop Med Amp Int Health. 2023;28(7):541-50. https://doi.org/10.1111/tmi.13899
15. Sallas J, Elidio GA, Costacurta GF, Frank CHM, Rohlfs DB, Pacheco FC, et al. Decréscimo nas notificações compulsórias registradas pela Rede Nacional de Vigilância Epidemiológica Hospitalar do Brasil durante a pandemia da COVID-19: um estudo descritivo, 2017-2020. Epidemiol Serv Saude. 2022;31(1). https://doi.org/10.1590/S1679-49742022000100011
16. Miranda CD, Souza BC, Filgueiras TC, Melo Neto JS, Silva AS, Silva HP, et al. Epidemiological Scenario of American Trypanosomiasis and Its Socioeconomic and Environmental Relations, Pará, Eastern Brazilian Amazon. Trop Med Infect Dis. 2025;10(4):88. https://doi.org/10.3390/tropicalmed10040088
17. Ferreira RT, Cabral ML, Martins RS, Araujo PF, Silva SA, Britto C, et al. Detection and genotyping of Trypanosoma cruzi from açai products commercialized in Rio de Janeiro and Pará, Brazil. Parasites Amp Vectors. 2018;11(233). https://doi.org/10.1186/s13071-018-2699-6
18. Brasil. Ministério da Saúde. Doença de Chagas [Internet]. MS [acessado em 13 abr. 2026]. Disponível em: https://www.gov.br/saude/pt-br/assuntos/saude-de-a-a-z/d/doenca-de-chagas.
