Epidemiology of oral transmission of Chagas disease and socioeconomic conditions in Pará, Brazil.

ABSTRACT                                                                                 OBJECTIVE: Verify relationships between the prevalence of CD, Human Development Index (HDI), the production and consumption of acai in Para, Brazil. METHODS: Cross-sectional study with secondary data on CD prevalence collected on the platform of the Department of Informatics of the Unified Health System (DATASUS), notified in the period from 2007 to 2018. Data on HDI, local production and consumption of acai, were obtained from the website and the Agricultural Census of the Brazilian Institute of Geography and Statistics (IBGE), respectively. Comparisons of the number of cases, HDI and local acai consumption were performed using Spearman's correlation, while the evolution of annual production was verified by analysis of variance. Correlations with a p-value <0.05 were considered significant. RESULTS: There was no significant correlation between the number of cases of Chagas disease among the municipalities according to the HDI (p = 0.2000). However, there was an increase in the annual production of acai (X2 = 40.25; p = 0.0001) and a significant correlation between local consumption of acai and the prevalence of chagas disease (p = 0.003), although without statistical significance in the correlation between acai production and oral transmission (p = 0.087). CONCLUSION: The prevalence of CD was associated with local consumption of acai, but not by oral transmission or influenced by the HDI, in a non-causal way. The increase in annual production concerns about the increase in the prevalence of CD in the state of Para. DESCRIPTORS: Chagas disease, Epidemiology, Cross-sectional studies, Disease transmission infectious, Euterpe. RESUMO OBEJTIVO: Verificar relacoes entre a prevalencia da DC, Indice de Desenvolvimento Humano (IDH), a producao e consumo de acai no Para, Brasil. METODOS: Estudo transversal com dados secundarios de prevalencias de DC obtidos na plataforma do Departamento de informatica do Sistema Unico de Saude (DATASUS), notificados no periodo de 2007 a 2018. Os dados sobre IDH, producao e consumo local de acai, foram obtidos no website e no Censo Agricola do Instituto Brasileiro de Geografia e Estatistica (IBGE), respectivamente. As comparacoes do numero de casos, IDH e consumo local de acai foram realizadas pela correlacao de Spearman, enquanto a evolucao da producao anual foi verificada pela analise de variância. As correlacoes com valor de p<0,05 foram consideradas significativas. RESULTADOS: Nao houve correlacao significativa entre o numero de casos de doenca de chagas entre os municipios de acordo com o IDH (p=0,2000). Porem, houve aumento da producao anual de acai (X2= 40,25; p=0,0001) e correlacao significativa entre o consumo local de acai e a prevalencia da doenca de chagas (p=0,003), embora sem significância estatistica na correlacao entre a producao de acai e transmissao oral (p=0,087).  CONCLUSAO: A prevalencia de DC associou-se ao consumo local de acai, mas nao pela transmissao oral ou influenciada pelo IDH, de forma nao causal. O aumento da producao anual preocupa sobre o aumento da prevalencia de DC no estado do Para. DESCRITORES: Doenca de Chagas, Epidemiologia, Estudos transversais, Transmissao de doenca infecciosa.