{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T10:27:26Z","timestamp":1774348046533,"version":"3.50.1"},"reference-count":41,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,4]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>The prevalence and characteristics of chronic Chagas disease (CCD) in the Amazon Region remain underexplored. This study aimed to describe the challenges encountered during a serological survey and follow-up of CCD, while also highlighting potential risk factors in the Amazon Region. The serological survey involved residents of periurban and rural areas of Manaus in the Brazilian Amazon. All participants were invited to complete a clinical, epidemiological, and demographic questionnaire and provide a blood sample for anti-<jats:italic>Trypanosoma cruzi<\/jats:italic> (<jats:italic>T. cruzi<\/jats:italic>) IgG tests. A total of 1,845 participants were included, of whom 43 were identified as having presumed CCD, based on having at least two positive serological tests. Only 35 underwent complementary tests, and five had cardiac alterations not consistent with CCD. The main risk factors associated with CCD were age \u226520 years, living in periurban areas, reporting the presence of the insect vector inside the household, entering the forest, consumption of bushmeat, and having undergone blood transfusion. In the Amazon, the population is exposed to the sylvatic <jats:italic>T. cruzi<\/jats:italic> life cycle and is unaware of the associated risk factors. The divergent serology results raise doubts about the reliability of the commercial serological tests used for CCD screening in the region. Surveillance for CCD is important in the Amazon.<\/jats:p>","DOI":"10.4269\/ajtmh.24-0549","type":"journal-article","created":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T14:58:20Z","timestamp":1742914700000},"page":"1220-1228","source":"Crossref","is-referenced-by-count":3,"title":["Chronic Chagas Disease in the Brazilian Amazon: Serological Survey, Clinical Follow-Up, and Associated Risk Factors"],"prefix":"10.4269","volume":"112","author":[{"given":"Susan","family":"Smith-Doria","sequence":"first","affiliation":[{"name":"Programa de P\u00f3s-gradua\u00e7\u00e3o em Medicina Tropical, Universidade do Estado do Amazonas, Funda\u00e7\u00e3o de Medicina Tropical - Doutor Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil;"}]},{"given":"Laise Kelma Costa","family":"Magalh\u00e3es","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-gradua\u00e7\u00e3o em Medicina Tropical, Universidade do Estado do Amazonas, Funda\u00e7\u00e3o de Medicina Tropical - Doutor Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil;"}]},{"given":"Laylah Kelre Costa","family":"Magalh\u00e3es","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-gradua\u00e7\u00e3o em Medicina Tropical, Universidade do Estado do Amazonas, Funda\u00e7\u00e3o de Medicina Tropical - Doutor Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil;"}]},{"given":"Suzane Ribeiro","family":"Prestes","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-gradua\u00e7\u00e3o em Medicina Tropical, Universidade do Estado do Amazonas, Funda\u00e7\u00e3o de Medicina Tropical - Doutor Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil;"}]},{"given":"Alba Regina Jorge","family":"Brand\u00e3o","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-gradua\u00e7\u00e3o em Medicina Tropical, Universidade do Estado do Amazonas, Funda\u00e7\u00e3o de Medicina Tropical - Doutor Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil;"}]},{"given":"Emily de Sousa","family":"Moura","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-gradua\u00e7\u00e3o em Medicina Tropical, Universidade do Estado do Amazonas, Funda\u00e7\u00e3o de Medicina Tropical - Doutor Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil;"}]},{"given":"Elsa Isela","family":"Guevara Moctezuma","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-gradua\u00e7\u00e3o em Medicina Tropical, Universidade do Estado do Amazonas, Funda\u00e7\u00e3o de Medicina Tropical - Doutor Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil;"}]},{"given":"Monica Regina","family":"Hosanahh da Silva e Silva","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-gradua\u00e7\u00e3o em Medicina Tropical, Universidade do Estado do Amazonas, Funda\u00e7\u00e3o de Medicina Tropical - Doutor Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil;"}]},{"given":"Katia","family":"do Nascimento Couceiro","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-gradua\u00e7\u00e3o em Medicina Tropical, Universidade do Estado do Amazonas, Funda\u00e7\u00e3o de Medicina Tropical - Doutor Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil;"}]},{"given":"Yuliana","family":"Padr\u00f3n-Antonio","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-gradua\u00e7\u00e3o em biotecnologia e Recursos Naturais, Escola Superior de Ci\u00eancias da Sa\u00fade, Universidade do Estado do Amazonas (UEA), Manaus, Brazil;"}]},{"given":"Victor","family":"Irungu Mwangi","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-gradua\u00e7\u00e3o em Medicina Tropical, Universidade do Estado do Amazonas, Funda\u00e7\u00e3o de Medicina Tropical - Doutor Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil;"}]},{"given":"Jessica Vanina","family":"Ortiz","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-gradua\u00e7\u00e3o em Medicina Tropical, Universidade do Estado do Amazonas, Funda\u00e7\u00e3o de Medicina Tropical - Doutor Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil;"}]},{"given":"Le\u00edla Ines Aguiar Raposo","family":"C\u00e2mara Coelho","sequence":"additional","affiliation":[{"name":"Universidade Federal do Amazonas (UFAM), Manaus, Brazil;"}]},{"given":"Adriano","family":"Gomes-Silva","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Pesquisa Cl\u00ednica em Micobacterioses, Instituto Nacional de Infectologia Evandro Chagas, INI-FIOCRUZ, Rio de Janeiro, Brazil;"},{"name":"Laborat\u00f3rio Interdisciplinar de Pesquisas M\u00e9dicas, Instituto Oswaldo Cruz, IOC-FIOCRUZ, Rio de Janeiro, Brazil;"}]},{"given":"Henrique","family":"Silveira","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-gradua\u00e7\u00e3o em Medicina Tropical, Universidade do Estado do Amazonas, Funda\u00e7\u00e3o de Medicina Tropical - Doutor Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil;"},{"name":"Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal;"}]},{"given":"Jo\u00e3o Marcos Bemfica Barbosa","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-gradua\u00e7\u00e3o em Medicina Tropical, Universidade do Estado do Amazonas, Funda\u00e7\u00e3o de Medicina Tropical - Doutor Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil;"}]},{"given":"Jorge Augusto de Oliveira","family":"Guerra","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-gradua\u00e7\u00e3o em Medicina Tropical, Universidade do Estado do Amazonas, Funda\u00e7\u00e3o de Medicina Tropical - Doutor Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil;"}]},{"given":"Maria das Gra\u00e7as Vale Barbosa","family":"Guerra","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-gradua\u00e7\u00e3o em Medicina Tropical, Universidade do Estado do Amazonas, Funda\u00e7\u00e3o de Medicina Tropical - Doutor Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil;"},{"name":"Programa de P\u00f3s-gradua\u00e7\u00e3o em biotecnologia e Recursos Naturais, Escola Superior de Ci\u00eancias da Sa\u00fade, Universidade do Estado do Amazonas (UEA), Manaus, Brazil;"},{"name":"Funda\u00e7\u00e3o Hospitalar Alfredo da Matta, Amazonas, Brazil"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Lancet","first-page":"82","article-title":"Chagas disease","volume":"391","author":"P\u00e9rez-Molina","year":"2018"},{"key":"b2","series-title":"Eurosurveillance","first-page":"19968","article-title":"Chagas disease in European countries: The challenge of a surveillance system","volume":"16","author":"Basile","year":"2011"},{"key":"b3","article-title":"Integrating Neglected Tropical Diseases into Global Health and Development. 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