Chagas Disease in northern Minas Gerais: Clinical and epidemiological features of patients at a pioneering specialized outpatient service

Abstract

INTRODUCTION: Chagas Disease (CD) remains a persistent public health problem in Brazil, particularly in historically hyperendemic regions such as northern Minas Gerais. Despite the sustained burden of transmission and chronic disease, access to specialized care for CD continues to be limited. This study aimed to describe the clinical and epidemiological profile of patients attending a newly established specialized CD outpatient clinic and to contextualize its role within the regional hyperendemic scenario. METHODS: A descriptive cross-sectional assessment was conducted using routinely collected clinical information from medical records of patients who attended the service between October 2022 and September 2024. Data extraction combined review of paper and electronic records with verification through on-site clinical documentation. RESULTS: Over the two-year period, the clinic experienced a substantial increase in demand. In the first year, 274 patients received care, whereas in the second year this number rose to 657-an increase of 239.7%. Overall, 931 patients attended the service. The majority of patients were female, with a mean age of 58 (± 11.1) years, and had the indeterminate form of CD (47.2%). A total of 630 patients (68.5%) underwent etiological treatment for the disease. Among these, 309 received prescriptions directly from the outpatient clinic, and 208 out of them (67.3%) experienced adverse drug reactions. The clinic provides care for the northern macro-region of Minas Gerais, encompassing 86 municipalities: 45 (52%) of these referred patients during the study period. Referral patterns highlighted contrasting municipal profiles: Montes Claros was the largest source of patients. CONCLUSION: The findings demonstrate the growing demand for specialized CD care and underscore the importance of dedicated services in regions where primary care lacks structured clinical pathways for CD management. The clinic offers not only access to etiological treatment and longitudinal follow-up but also a reproducible model for expanding equitable care for neglected diseases in other endemic settings.