Chagas disease in the new york city metropolitan area

Crystal Zheng, Orlando Quintero, Elizabeth K. Revere, Michael B. Oey, Fabiola Espinoza, Yoram A. Puius, Diana Ramirez-Baron, Carlos R. Salama, Luis F. Hidalgo, Fabiana S. Machado, Omar Saeed, Jooyoung Shin, Snehal R. Patel, Christina M. Coyle, Herbert B. Tanowitz

Research output: Contribution to journalArticlepeer-review

Abstract

Background. Chagas disease, caused by the parasite Trypanosoma cruzi, once considered a disease confined to Mexico, Central America, and South America, is now an emerging global public health problem. An estimated 300 000 immigrants in the United States are chronically infected with T. cruzi. However, awareness of Chagas disease among the medical community in the United States is poor. Methods. We review our experience managing 60 patients with Chagas disease in hospitals throughout the New York City metropolitan area and describe screening, clinical manifestations, EKG findings, imaging, and treatment. Results. The most common country of origin of our patients was El Salvador (n = 24, 40%), and the most common detection method was by routine blood donor screening (n = 21, 35%). Nearly half of the patients were asymptomatic (n = 29, 48%). Twentyseven patients were treated with either benznidazole or nifurtimox, of whom 7 did not complete therapy due to side effects or were lost to follow-up. Ten patients had advanced heart failure requiring device implantation or organ transplantation. Conclusions. Based on our experience, we recommend that targeted screening be used to identify at-risk, asymptomatic patients before progression to clinical disease. Evaluation should include an electrocardiogram, echocardiogram, and chest x-ray, as well as gastrointestinal imaging if relevant symptoms are present. Patients should be treated if appropriate, but providers should be aware of adverse effects that may prevent patients from completing treatment.

Original languageEnglish (US)
Article numberofaa156
JournalOpen Forum Infectious Diseases
Volume7
Issue number5
DOIs
StatePublished - 2020

Keywords

  • Chagas disease
  • Heart transplant
  • New York City
  • Nonendemic countries
  • Trypanosoma cruzi

ASJC Scopus subject areas

  • Oncology
  • Clinical Neurology

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