a1 Robert Koch-Institute, Fachgebiet Klinische Parasitologie. Nordufer 20.1000 Berlin 65, West Germany.
a2 Klinikum Charlottenburg der FU Berlin, Abteilung für innere Medizin mit Schwerpunkt Infektionskrankheiten, Spandauer Damm 130, 1000 Berlin 19, West Germany.
The prevalence of cardiac morbidity due to Change' disease was assessed in a rural community in Central Bolivia. Sixty-nine of 104 persons (66%) were seropositive to Trypanosoma cruzi by two serological methods. Two of 35 (6%) seronegative individuals presented with modest ECG alterations (left anterior hemiblock), but 21 of 69 (30%) seropositives showed modest and severe abnormalities (6 complete right bundle branch block. 2 polyfocal or frequent extrasystoles, 9 ischaemic ST alterations). A high percentage (56%) of domiciliary Triatoma infestans was infected with T. cruzi. There was a significant association between seropositivity and substandard housing. Priority preventive measures should thus include house improvement (to reduce bug infestation) and health education.