scholarly journals International meeting: new diagnostic tests are urgently needed to treat patients with Chagas disease

2008 ◽  
Vol 41 (3) ◽  
pp. 315-319 ◽  
Keyword(s):  
Chagas Disease ◽  
Diagnostic Tests ◽  
Clinical Manifestations ◽  
Specific Treatment ◽  
Treatment Access ◽  
Limited Effectiveness ◽  
Technical Report ◽  
Blood Banks ◽  
Chronic Chagas Disease ◽  
Cruzi Infection

Trypanosoma cruzi infection is often not detected early on or actively diagnosed, partly because most infected individuals are either asymptomatic or oligosymptomatic. Moreover, in most places, neither blood banks nor healthcare units offer diagnostic confirmation or treatment access. By the time patients present clinical manifestations of advanced chronic Chagas disease, specific treatment with current drugs usually has limited effectiveness. Better-quality serological assays are urgently needed, especially rapid diagnostic tests for diagnosis patients in both acute and chronic phases, as well as for confirming that a parasitological cure has been achieved. Some new antigen combinations look promising and it is important to assess which ones are potentially the best, together with their requirements in terms of investigation and development. In August 2007, a group of specialized researchers and healthcare professionals met to discuss the state of Chagas infection diagnosis and to build a consensus for a plan of action to develop efficient, affordable, accessible and easy-to-use diagnostic tests for Chagas disease. This technical report presents the conclusions from that meeting.

scholarly journals Comparison of seven diagnostic tests to detect Trypanosoma cruzi infection in patients in chronic phase of Chagas disease

2014 ◽  
pp. 61-66 ◽  
Author(s):  
Luisa Fernanda Duarte ◽  
Oscar Roberto Flórez ◽  
Giovanna Rincón ◽  
Clara Isabel González
Keyword(s):  
Comparative Analysis ◽  
Trypanosoma Cruzi ◽  
Chagas Disease ◽  
Diagnostic Tests ◽  
Nuclear Dna ◽  
Quality Analysis ◽  
Control Group ◽  
Predictive Values ◽  
Chronic Chagas Disease ◽  
Cruzi Infection

Objective: To compare the diagnostic performance of seven methods to determine Trypanosoma cruzi infection in patients with chronic Chagas disease. Methods: Analytical study, using the case-control design, which included 205 people (patients with Chagasic cardiomyopathy, n= 100; control group, n= 105). Three enzyme linked immunosorbent assays, one indirect hemagglutination assay and one immunochromatographic test were assessed. Additionally, DNA amplification was performed via the PCR method using kinetoplast and nuclear DNA as target sequences. For the comparative analysis of diagnostic tests, the parameters used were sensitivity, specificity, positive and negative predictive values, Receiver Operator Characteristic (ROC), positive and negative likelihood ratio, as well as κ quality analysis. Results: The commercial Bioelisa Chagas test showed the highest sensitivity (98%), specificity (100%), and positive and negative predictive values; additionally it had the highest discriminatory power. Otherwise, the amplification of T. cruzi DNA in blood samples showed low values of sensitivity (kinetoplast DNA= 51%, nuclear DNA= 22%), but high values of specificity (100%), and moderate to low discriminatory ability. Conclusion: The comparative analysis among the different methods suggests that the diagnostic strategy of T. cruzi infection in patients with chronic Chagas disease can be performed using ELISA assays based on recombinant proteins and/or synthetic peptides, which show higher diagnosis performance and can confirm and exclude the diagnosis of T. cruzi infection. The molecular methods show poor performance when used in the diagnosis of patients with chronic Chagas disease.

scholarly journals Clinical manifestations of peripheral nervous system involvement in human chronic chagas disease

1996 ◽  
Vol 54 (2) ◽  
pp. 190-196 ◽  
Author(s):  
Osvaldo Genovese ◽  
Carlos Ballario ◽  
Ruben Storino ◽  
Elsa Segura ◽  
Roberto E. R. Sica
Keyword(s):  
Nervous System ◽  
Peripheral Nervous System ◽  
Chagas Disease ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Sensory Impairment ◽  
System Involvement ◽  
Conduction Velocities ◽  
Sensory Action ◽  
Chronic Chagas Disease

We conducted a clinical and electromyographical study in patients with Chagas' disease in the indeterminate or chronic stages of the illness. Altogether 841 patients were examined. Only 511 were admitted within the protocol; the remainder patients were rejected because they showed other causes able to damage the nervous system. Fifty two (10.17%) out of the 511 patients showed signs and symptoms of peripheral nervous system involvement in the form of sensory impairment and diminished tendon jerks suggesting the presence of neuropathy. Forty five of them were submitted to a conventional electromyographical examination. Fifteen of mem showed normal results, while the remainder 30 disclosed a reduced interference pattern, being most of the remaining motor unit potentials fragmented or poliphasic, reduced sensory and motor conduction velocities and diminished amplitude of the sensory action potential. The findings suggest that some chagasic patients in the indeterminate or chronic stages of the disease may develop a clinical mild sensory-motor peripheral neuropathy.

scholarly journals New evidence of spontaneous cure in human Chagas' disease

2003 ◽  
Vol 36 (1) ◽  
pp. 103-107 ◽  
Author(s):  
Sonia S. Francolino ◽  
Antonio Fernandez Antunes ◽  
Rodolfo Talice ◽  
Rachel Rosa ◽  
Joel Selanikio ◽  
...  
Keyword(s):  
Flow Cytometry ◽  
Trypanosoma Cruzi ◽  
Chagas Disease ◽  
Acute Phase ◽  
Clinical Data ◽  
Specific Treatment ◽  
Serological Tests ◽  
Spontaneous Cure ◽  
New Evidence ◽  
Cruzi Infection

A new case of spontaneous cure of human Chagas' disease is described in Uruguay. An 87-year-old man who had a typical acute phase of Trypanosoma cruzi infection in 1947 and never received specific treatment against the disease, when examined in 1998 revealed several completely negative parasitological and serological tests, including traditional serology, PCR and flow cytometry. As a whole, such findings fulfill the current criteria to define the cure of Chagas' disease. Clinical data suggest the possibility of a benign evolution of Chagas' disease in this case, but the basic findings (slight cardiac and esophageal impairment) could also be due to the advanced age of the patient.

scholarly journals Chagas Disease in People with HIV: A Narrative Review

2021 ◽  
Vol 6 (4) ◽  
pp. 198
Author(s):  
Eva H. Clark ◽  
Caryn Bern
Keyword(s):  
At Risk ◽  
Chagas Disease ◽  
South American ◽  
Appropriate Use ◽  
Hiv Diagnosis ◽  
Cd4 Counts ◽  
Virologic Control ◽  
Fatal Form ◽  
Chronic Chagas Disease ◽  
Cruzi Infection

Many questions remain unanswered regarding the epidemiology, pathophysiology, diagnosis, treatment, and monitoring of Trypanosoma cruzi infection in people with HIV (PWH). The reported prevalence of T. cruzi infection in PWH living in endemic countries ranges from 1–28% and is likely similar in at-risk US populations. While classic cardiac and gastrointestinal presentations of chronic Chagas disease occur in PWH, PWH are additionally at risk for a severe and often fatal form of T. cruzi-mediated disease called reactivation disease. T. cruzi reactivation typically occurs in PWH with low CD4 counts and poor virologic control. National HIV guidelines in several endemic South American countries recommend that all PWH be screened for T. cruzi infection at the time of HIV diagnosis; however, this recommendation is not widely implemented. The early detection of T. cruzi infection in PWH is critical as the sequelae of Chagas disease, including T. cruzi reactivation, may be preventable through the restoration of robust cellular immunity via the initiation of antiretroviral therapy and the appropriate use of antitrypanosomal therapy.

Notes on rapid diagnostic tests for chronic Chagas disease

2017 ◽  
Vol 110 (1) ◽  
pp. 9-12 ◽  
Author(s):  
A. Angheben ◽  
F. Gobbi ◽  
D. Buonfrate ◽  
S. Tais ◽  
M. Degani ◽  
...  
Keyword(s):  
Chagas Disease ◽  
Diagnostic Tests ◽  
Rapid Diagnostic Tests ◽  
Chronic Chagas Disease

scholarly journals Polymorphic Sites at the Immunoregulatory CTLA-4 Gene Are Associated with Chronic Chagas Disease and Its Clinical Manifestations

PLoS ONE ◽  
2013 ◽  
Vol 8 (10) ◽  
pp. e78367 ◽  
Author(s):  
Fabrício C. Dias ◽  
Tiago da S. Medina ◽  
Celso T. Mendes-Junior ◽  
Roberto O. Dantas ◽  
Cristina W. Pissetti ◽  
...  
Keyword(s):  
Chagas Disease ◽  
Clinical Manifestations ◽  
Chronic Chagas Disease
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