scholarly journals Evaluation of the performance of Loopamp™ Trypanosoma cruzi Detection Kit for the diagnosis of Chagas disease in a non-endemic area, Spain

2021 ◽  
Author(s):  
Maria D. Flores-Chavez ◽  
Alba Abras ◽  
Cristina Ballart ◽  
Ismael Ibáñez Perez ◽  
Pilar Perez-Gordillo ◽  
...  
Keyword(s):  
Trypanosoma Cruzi ◽  
Chagas Disease ◽  
Congenital Infection ◽  
Ease Of Use ◽  
Visual Examination ◽  
Positive Serology ◽  
Case Definitions ◽  
Standard Case ◽  
Sensitivity Specificity ◽  
Eiken Chemical

Background: In Spain, polymerase chain reaction (PCR) is the tool of choice for the diagnosis of congenital Chagas disease (CD) and serology for diagnosing chronic CD. A loop-mediated isothermal amplification test for Trypanosoma cruzi DNA detection showed a good analytical performance and ease of use. We aimed to evaluate the performance of the Loopamp™ Trypanosoma cruzi Detection Kit, Eiken Chemical Co. Ltd., Japan (Tcruzi-LAMP) for congenital and chronic CD diagnosis using well-characterized samples. Methods: We included samples from 39 congenital and 174 chronic CD cases, and from 48 uninfected children born to infected mothers and 34 non-chagasic individuals. Sensitivity, specificity and accuracy of Tcruzi-LAMP was estimated using standard case definitions for congenital CD (positive result by parasitological or PCR tests or serology after nine months of age) and chronic CD (positive serology by at least two tests). The Tcruzi-LAMP results were read by visual examination and a real-time fluorimeter. Results: For congenital CD, Tcruzi-LAMP sensitivity was 97% for both types of reading; specificity was 92% by visual examination and 94% by fluorimeter. For chronic CD, sensitivity was 47% and specificity 100%. The accuracy in congenital CD was >94% vs 56% in chronic CD. The agreement of Tcruzi-LAMP with PCR tests was better in congenital CD (kappa 0.86 to 0.91) than in chronic CD (kappa 0.67 to 0.83). Conclusions: The Loopamp™ Trypanosoma cruzi Detection Kit showed a good performance for the diagnosis of congenital CD. Tcruzi-LAMP, like PCR, can be useful for the screening and early diagnosis of congenital infection.

scholarly journals Triatomine Fauna and Recent Epidemiological Dynamics of Chagas Disease in an Endemic Area of Northeast Brazil

2018 ◽  
Vol 2018 ◽  
pp. 1-13 ◽  
Author(s):  
Cláudia M. Melo ◽  
Ana Carla F. G. Cruz ◽  
Antônio Fernando V. A. Lima ◽  
Luan R. Silva ◽  
Rubens R. Madi ◽  
...  
Keyword(s):  
Trypanosoma Cruzi ◽  
Disease Control ◽  
Chagas Disease ◽  
Control Program ◽  
The State ◽  
Positive Serology ◽  
Serological Tests ◽  
Systemic Analysis ◽  
South Central ◽  
Disease Control Program

Updated information of the dispersion dynamics of Chagas disease (CD) and a systemic analysis of these data will aid the early identification of areas that are vulnerable to transmission and enable efficient intervention. This work synthesized spatiotemporal information regarding triatomine fauna and analyzed this information in combination with the results from serological tests to elucidate the epidemiological panorama of CD in the state of Sergipe, Brazil. This is a retrospective analytical study that utilized information from the database of the National Chagas Disease Control Program. Between 2010 and 2016, 838 triatomines of eight species, namely, Panstrongylus geniculatus, which was first recorded in the state of Sergipe, Panstrongylus lutzi, P. megistus, Triatoma brasiliensis, T. pseudomaculata, T. tibiamaculata, T. melanocephala, and Rhodnius neglectus, were collected. Optical microscopy revealed that 13.2% of triatomines examined were infected by Trypanosoma cruzi-like flagellates. The distribution of triatomines exhibits an expanding south-central to northern dispersion, with a preference for semiarid and agreste areas and occasional observations in humid coastal areas due to anthropogenic actions reflected in the environment. Of the human cases analyzed from 2012 to 2016, 8.3% (191/2316) presented positive serology for Trypanosoma cruzi, and this proportion showed a gradual increase in the southern center of the state and new notifications in coastal regions. There is a need for intensification and continuity of the measures adopted by the Chagas Disease Control Program in Sergipe, identifying new priority areas for intervention and preferential ecotopes of the vectors, considering the occurrence of positive triatomines intradomicilliary and a source of new triatomines in the peridomiciles.

scholarly journals The indeterminate form of human chronic Chagas' disease: a clinical epidemological review

1989 ◽  
Vol 22 (3) ◽  
pp. 147-156 ◽  
Author(s):  
João Carlos Pinto Dias
Keyword(s):  
Natural History ◽  
Trypanosoma Cruzi ◽  
Chagas Disease ◽  
Clinical Findings ◽  
X Rays ◽  
Classical Concept ◽  
Positive Serology ◽  
Indeterminate Form ◽  
History Of ◽  
Chronic Chagas Disease

Data on the epidemiology and the natural history of the indeterminate form of human chronic Chagas' disease (IFCCD) are discussed, revealing its great importance in endemic areas of Brazil. The work shows that IFCCD presents a gradual and very slow course, causing a benign picture in the studied patients. Evolution patterns, prognostic and anatomopathological features are also discussed. For practical purposes, the classical concept of IFCCD proved to be simple, operational and consistent, It is defined by the absence of symptoms and clinical findings in chronic infected patients with positive serology and/or parasitological examinations for Trypanosoma cruzi coupled with normal electrocardiographic and radiological exams (heart, oesophagus and colon X-Rays). If a patient is submitted to more rigorous and sophisticated tests, these can reveal some alterations, generally small ones and unable to interfere with the prognosis of the infection. It is suggested that research lines specially related to the evolution ary factors and immunological involvement during this phase be adopted.

scholarly journals Mixed infections by different Trypanosoma cruzi discrete typing units among Chagas disease patients in an endemic community in Panama

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241921
Author(s):  
Alexa Prescilla Ledezma ◽  
Roberto Blandon ◽  
Alejandro G. Schijman ◽  
Alejandro Benatar ◽  
Azael Saldaña ◽  
...  
Keyword(s):  
Trypanosoma Cruzi ◽  
Chagas Disease ◽  
Control Sample ◽  
Rapid Test ◽  
Control Group ◽  
Mixed Infections ◽  
Eastern Region ◽  
Positive Serology ◽  
Serological Tests ◽  
Epidemiological Characteristics

Background Trypanosoma cruzi, the hemoparasite that causes Chagas disease, is divided into six Discrete Typing Units or DTUs: TcI-TcVI plus Tcbat. This genetic diversity is based on ecobiological and clinical characteristics associated with particular populations of the parasite. The main objective of this study was the identification of DTUs in patients with chronic chagasic infections from a mountainous rural community in the eastern region of Panama. Methods A total of 106 patients were tested for Chagas disease with three serological tests (ELISA, rapid test, and Western blot). Molecular diagnosis and DTU typing were carried out by conventional PCRs and qPCR targeting different genomic markers, respectively. As a control sample for the typing, 28 patients suspected to be chagasic from the metropolitan area of Panama City were included. Results Results showed a positivity in the evaluated patients of 42.3% (33/78); high compared to other endemic regions in the country. In the control group, 20/28 (71.43%) patients presented positive serology. The typing of samples from rural patients showed that 78.78% (26/33) corresponded to TcI, while 9.09% (3/33) were mixed infections (TcI plus TcII/V/VI). Seventy-five percent (15/20) of the patients in the control group presented TcI, and in five samples it was not possible to typify the T. cruzi genotype involved. Conclusions These results confirm that TcI is the main DTU of T. cruzi present in chronic chagasic patients from Panama. However, the circulation of other genotypes (TcII/V/VI) in this country is described for the first time. The eco-epidemiological characteristics that condition the circulation of TcII/V/VI, as well as the immune and clinical impact of mixed infections in this remote mountainous region should be investigated, which will help local action programs in the surveillance, prevention, and management of Chagas disease.

Trypanosoma cruzi infection in Latin American pregnant women living outside endemic countries and frequency of congenital transmission: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Valeria Colombo ◽  
Andrea Giacomelli ◽  
Giovanni Casazza ◽  
Laura Galimberti ◽  
Cecilia Bonazzetti ◽  
...  
Keyword(s):  
Trypanosoma Cruzi ◽  
Pregnant Women ◽  
Chagas Disease ◽  
Latin American ◽  
Transmission Rate ◽  
Congenital Infection ◽  
Health Concern ◽  
Congenital Transmission ◽  
Global Rate ◽  
Cruzi Infection

Abstract Background Chagas disease, as a consequence of globalization and immigration, is no more restricted to Central and Latin America. Therefore, congenital transmission represents a growing public health concern in non-endemic countries. Methods The aim of this study was to assess the prevalence of Trypanosoma cruzi infection in pregnant Latin American (LA) women living outside endemic countries and the rate of congenital transmission. Data were extracted from studies indexed in PubMed, Scopus, Embase, Lilacs and SciELO databases without language restriction. Two investigators independently collected data on study characteristics, diagnosis, prevalence of infection in pregnant women and congenital infection rate. The data were pooled using a random effects model. Results The search identified 1078 articles of which 29 were eligible regarding prevalence of T. cruzi infection among pregnant women and 1795 articles of which 32 were eligible regarding the congenital transmission rate. The estimated pooled prevalence of T. cruzi infection in LA pregnant women was 4.2% [95% confidence interval (CI): 3.0–5.5]. The prevalence of T. cruzi infection in pregnant women from Bolivia was 15.5% (95% CI: 11.7–19.7) and 0.5% (95% CI: 0.2–0.89) for those coming from all other LA countries. The estimated global rate of congenital transmission was 3.5% (95% CI: 2.5–4.5); excluding poor-quality studies, the rate of congenital transmission was 3.8% (95% CI: 2.4–5.1). Conclusions Prevalence of Chagas disease among LA pregnant women living outside endemic countries is high, particularly in Bolivian women. The rate of vertical transmission of T. cruzi infection is similar to the rate reported in South and Central American countries.

scholarly journals HIV and Chagas Disease: An Evaluation of the Use of Real-Time Quantitative Polymerase Chain Reaction to Measure Levels of Trypanosoma cruzi Parasitemia in HIV Patients in Cochabamba, Bolivia

2021 ◽  
Author(s):  
Melissa J. Reimer-McAtee ◽  
Carolina Mejia ◽  
Taryn Clark ◽  
Jules Terle ◽  
Monica J. Pajuelo ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Trypanosoma Cruzi ◽  
Real Time ◽  
Chagas Disease ◽  
Blood Clot ◽  
Quantitative Polymerase Chain Reaction ◽  
Chain Reaction ◽  
Positive Serology ◽  
Polymerase Chain ◽  
Chronic Chagas Disease

This cross-sectional study evaluated epidemiologic characteristics of persons living with HIV (PWH) coinfected with Trypanosoma cruzi in Cochabamba, Bolivia, and estimated T. cruzi parasitemia by real-time quantitative polymerase chain reaction (qPCR) in patients with and without evidence of reactivation by direct microscopy. Thirty-two of the 116 HIV patients evaluated had positive serology for T. cruzi indicative of chronic Chagas disease (27.6%). Sixteen of the 32 (50%) patients with positive serology were positive by quantitative polymerase chain reaction (qPCR), and four of the 32 (12.5%) were positive by direct microscopy. The median parasite load by qPCR in those with CD4+ < 200 was 168 parasites/mL (73-9951) compared with 28.5 parasites/mL (15–1,528) in those with CD4+ ≥ 200 (P = 0.89). There was a significant inverse relationship between the degree of parasitemia estimated by qPCR from blood clot and CD4+ count on the logarithmic scale (rsBC= –0.70, P = 0.007). The correlation between T. cruzi estimated by qPCR+ blood clot and HIV viral load was statistically significant with rsBC = 0.61, P = 0.047. Given the significant mortality of PWH and Chagas reactivation and that 57% of our patients with CD4+ counts < 200 cells/mm3 showed evidence of reactivation, we propose that screening for chronic Chagas disease be considered in PWH in regions endemic for Chagas disease and in the immigrant populations in nonendemic regions. Additionally, our study showed that PWH with advancing immunosuppression have higher levels of estimated parasitemia measured by qPCR and suggests a role for active surveillance for Chagas reactivation with consideration of treatment with antitrypanosomal therapy until immune reconstitution can be achieved.

Dynamics of T Cells Repertoire During Trypanosoma cruzi Infection and its Post-Treatment Modulation

2019 ◽  
Vol 26 (36) ◽  
pp. 6519-6543 ◽  
Author(s):  
Adriana Egui ◽  
Paola Lasso ◽  
Elena Pérez-Antón ◽  
M. Carmen Thomas ◽  
Manuel Carlos López
Keyword(s):  
Immune Response ◽  
Trypanosoma Cruzi ◽  
Chagas Disease ◽  
Cardiac Tissue ◽  
Acute Infection ◽  
Clinical Status ◽  
Chronic Phase ◽  
Parasite Load ◽  
Chronic Patients ◽  
Cruzi Infection

Chagas disease courses with different clinical phases and has a variable clinical presentation and progression. The acute infection phase mostly exhibits a non-specific symptomatology. In the absence of treatment, the acute phase is followed by a chronic phase, which is initially asymptomatic. This chronic asymptomatic phase of the disease is characterized by a fragile balance between the host’s immune response and the parasite replication. The loss of this balance is crucial for the progression of the sickness. The virulence and tropism of the T. cruzi infecting strain together to the inflammation processes in the cardiac tissue are the main factors for the establishment and severity of the cardiomyopathy. The efficacy of treatment in chronic Chagas disease patients is controversial. However, several studies carried out in chronic patients demonstrated that antiparasitic treatment reduces parasite load in the bloodstream and leads to an improvement in the immune response against the Trypanosoma cruzi parasite. The present review is mainly focused on the cellular patterns associated to the clinical status and the evolution of the disease in chronic patients, as well as the effectiveness of the treatment related to T. cruzi infection control. Therefore, an emphasis is placed on the dynamics of specific-antigens T cell subpopulations, their memory and activation phenotypes, their functionality and their contribution to pathogenesis or disease control, as well as their association with risk of congenital transmission of the parasite.

The Prevalence of Trypanosoma cruzi, the Causal Agent of Chagas Disease, in Texas Rodent Populations

EcoHealth ◽  
2017 ◽  
Vol 14 (1) ◽  
pp. 130-143 ◽  
Author(s):  
Adriana Aleman ◽  
Trina Guerra ◽  
Troy J. Maikis ◽  
Matthew T. Milholland ◽  
Ivan Castro-Arellano ◽  
...  
Keyword(s):  
Trypanosoma Cruzi ◽  
Chagas Disease ◽  
Causal Agent ◽  
Rodent Populations

scholarly journals Absence of Bim sensitizes mice to experimental Trypanosoma cruzi infection

2021 ◽  
Vol 12 (7) ◽  
Author(s):  
Marcela Hernández-Torres ◽  
Rogério Silva do Nascimento ◽  
Monica Cardozo Rebouças ◽  
Alexandra Cassado ◽  
Kely Catarine Matteucci ◽  
...  
Keyword(s):  
T Cells ◽  
Trypanosoma Cruzi ◽  
Chagas Disease ◽  
Parasite Load ◽  
Peritoneal Macrophages ◽  
T Cell Response ◽  
No Production ◽  
Similar Reduction ◽  
Ifn Γ

AbstractChagas disease is a life-threatening disorder caused by the protozoan parasite Trypanosoma cruzi. Parasite-specific antibodies, CD8+ T cells, as well as IFN-γ and nitric oxide (NO) are key elements of the adaptive and innate immunity against the extracellular and intracellular forms of the parasite. Bim is a potent pro-apoptotic member of the Bcl-2 family implicated in different aspects of the immune regulation, such as negative selection of self-reactive thymocytes and elimination of antigen-specific T cells at the end of an immune response. Interestingly, the role of Bim during infections remains largely unidentified. To explore the role of Bim in Chagas disease, we infected WT, Bim+/−, Bim−/− mice with trypomastigotes forms of the Y strain of T. cruzi. Strikingly, our data revealed that Bim−/− mice exhibit a delay in the development of parasitemia followed by a deficiency in the control of parasite load in the bloodstream and a decreased survival compared to WT and Bim+/− mice. At the peak of parasitemia, peritoneal macrophages of Bim−/− mice exhibit decreased NO production, which correlated with a decrease in the pro-inflammatory Small Peritoneal Macrophage (SPM) subset. A similar reduction in NO secretion, as well as in the pro-inflammatory cytokines IFN-γ and IL-6, was also observed in Bim−/− splenocytes. Moreover, an impaired anti-T. cruzi CD8+ T-cell response was found in Bim−/− mice at this time point. Taken together, our results suggest that these alterations may contribute to the establishment of a delayed yet enlarged parasitic load observed at day 9 after infection of Bim−/− mice and place Bim as an important protein in the control of T. cruzi infections.

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