Evidence map›Paper›PMID 39292716›Full record

ArticlePLoS neglected tropical diseases2024

Oral Chagas disease outbreak by bacaba juice ingestion: A century after Carlos Chagas' discovery, the disease is still hard to manage.

Eudes Alves Simões-Neto, Daniel Wagner de Castro Lima Santos, Maria Rosa Quaresma Bomfim, Jackson Maurício Lopes Costa, Amanda Ferreira Simões, Lucas Dias Vasconcelos, Domingos Carvalho Sodré, Ana Cleide Mineu Costa, Samuel Vieira Rodrigues Dumont, Bruna de Oliveira de Melo and 1 more

Abstract read
In one paragraph

Article in PLoS neglected tropical diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Oral Route Infection byPathogens (Basel, Switzerland) · 2026
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Eudes Alves Simões-NetoHealth Sciences Graduate Program, Federal University of Maranhão, São Luís, Brazil.ORCID 0000-0001-5449-5908
Daniel Wagner de Castro Lima SantosPresidente Dutra University Hospital (HU-UPD), Brazilian Company of Hospital Services (EBSERH), Federal University of Maranhão (UFMA), São Luís, Brazil.
Maria Rosa Quaresma BomfimCeuma University (UNICEUMA), São Luís, Brazil.
Jackson Maurício Lopes CostaState Health Department of Maranhão (SES/MA), São Luís, Brazil.
Amanda Ferreira SimõesBrasília University Hospital (HUB), Brazilian Company of Hospital Services (EBSERH), Brasília University (UnB), Brasília, Brazil.
Lucas Dias VasconcelosHealth Sciences Graduate Program, Federal University of Maranhão, São Luís, Brazil.
Domingos Carvalho SodréState Health Department of Maranhão (SES/MA), São Luís, Brazil.
Ana Cleide Mineu CostaState Health Department of Maranhão (SES/MA), São Luís, Brazil.
Samuel Vieira Rodrigues DumontState Health Department of Maranhão (SES/MA), São Luís, Brazil.
Bruna de Oliveira de MeloCeuma University (UNICEUMA), São Luís, Brazil.
Conceição de Maria Pedrozo E Silva de AzevedoHealth Sciences Graduate Program, Federal University of Maranhão, São Luís, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOrally transmitted acute Chagas disease (ACD) primarily affects low-visibility and low-income individuals in tropical and subtropical zones. Managing ACD remains challenging even after more than 100 years of its discovery. Its spread to non-endemic areas has made it a global health issue. The aim of this work is to demonstrate the difficulties encountered in handling a real-life situation. METHODOLOGY AND

findingsThis report examines an outbreak of 39 cases of ACD due to oral transmission by bacaba juice ingestion that occurred in Pedro do Rosário, Maranhão, Brazil. A clinical and epidemiological investigation, including an entomological search, was conducted. Diagnosis criteria included positive peripheral blood smear (PBS), seroconversion of IgG, and a two-fold increase in IgG titer (laboratory criteria); and clinical findings, epidemiological exposure, and at least one positive IgG test (clinical-epidemiological criteria). In-house conventional polymerase chain reaction (PCR) was performed on 33 samples. All patients were treated with benznidazole. After 4.5 years, IgG levels were reassessed in 26 individuals. The mean age was 33.6 years, with no gender difference. The mean incubation period was 13.8 days, and the mean between symptom onset and treatment was 16.6 days. The most common symptoms were fever and lymphadenopathy (90%). Diagnostic success rates were 66.6% (laboratory criteria), 23% (clinical-epidemiological criteria), and 10.2% (high clinical suspicion despite negative tests). Test positivity rates were 69.7% (PBS), 91.4% (serology), and 100% (PCR). There were no deaths. Serological cure was achieved in 34.6% of cases, and IgG titers decreased in 15.3%. CONCLUSIONS AND SIGNIFICANCE: We encountered several barriers in managing ACD, including population vulnerability, reliance on outdated diagnostic techniques, lack of standardized molecular biology methods, and limited therapeutic options. This report underscores the importance of rapid surveillance and early treatment to prevent fatalities. We recommend the standardization of conventional PCR in diagnostic routines.

Indexed as

Chagas DiseaseDisease OutbreaksTrypanosoma cruziAdolescentAdultAgedAnimalsAntibodies, ProtozoanBrazilChildFemaleFruit and Vegetable JuicesHumansImmunoglobulin GMaleMiddle AgedAntibodies, ProtozoanbenzonidazoleImmunoglobulin GNitroimidazolesTrypanocidal Agents

Identifiers

PMID39292716
PMCPMC11441692

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.