Epidemiology of Acute Chagas Disease in the Amazon: Association between the açaí production chain and case reports in Pará state, Brazil

BACKGROUND:

Acute Chagas Disease (ACD) in the Brazilian Amazon exhibits a unique epidemiological profile characterized primarily by oral transmission. The state of Pará, recognized as the world's largest producer of açaí, represents an epicenter of the disease. This study aimed to analyze the epidemiological patterns of ACD cases in Pará and investigate the relationship between its seasonality and the açaí production chain.

METHODS:

This epidemiological study used data on 2,762 ACD cases reported to the Notifiable Diseases Information System (SINAN) between 2013 and 2023. Sociodemographic and epidemiological variables were evaluated. Time series analysis was performed to determine seasonality and assess its correlation with variations in açaí prices.

RESULTS:

Oral transmission accounted for 87.44% of cases. The predominant demographic profiles were males (54.16%) and individuals with parda (mixed-race) skin color (85.41%). Temporal analysis revealed a significant seasonal trend (p < 0.001), with a peak incidence projected at the end of September, coinciding with the açaí harvest season. A moderate negative Spearman correlation was observed between ACD case numbers and açaí prices (r = -0.413; p < 0.001), suggesting that increased supply and consumption are associated with a heightened risk of infection.

CONCLUSIONS:

The epidemiology of ACD in Pará is closely linked to the açaí production cycle, confirming its role as the principal mode of oral transmission in the region. These results underscore the importance of public health policies focused on food safety and effective management practices throughout the entire açaí production chain to prevent new cases.