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Ricardo-Caldera D, Espitia-Pérez L, Avilés-Vergara PA, Benítez ÁJ, Chacón-Pacheco J, Ballesteros-Correa J, Negrette-Oquendo A, Soto-De León S, Tovar-Acero C. Trypanosoma cruzi in domestic and wild mammals in the northeast region of Colombia. Int J Parasitol Parasites Wildl 2024; 24:100940. [PMID: 38708188 PMCID: PMC11067360 DOI: 10.1016/j.ijppaw.2024.100940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 04/23/2024] [Accepted: 04/24/2024] [Indexed: 05/07/2024]
Abstract
Trypanosoma cruzi hosts can serve as a source of infection for animals, vectors, and humans, contributing to the establishment of Chagas disease (CD) in a given area. Traditionally, the Department of Córdoba has not been considered a transmission area for CD; however, the report of several acute cases of Chagas disease highlights the importance of studying the dynamics of disease transmission in this region. This study aimed to detect T. cruzi in domestic and wild mammals in the department of Córdoba. In 2017, a cross-sectional descriptive study was conducted in six villages in two municipalities in the department of Córdoba. Blood samples from dogs living in the zones were collected in EDTA vacutainer tubes for domestic mammals. Wild mammals were collected using Sherman and Tomahawk traps and mist nets in crops and peridomiciles. T. cruzi DNA was detected using the kinetoplast DNA (kDNA) variable region and the tandem repeat satellite region of T. cruzi as molecular targets. We sampled 168 dogs and 146 wild mammals. The detected prevalence of T. cruzi was 6.37%; the TcI lineage was found in D. marsupialis, H. anomalus, and one canine. A specimen of D. marsupialis with TcI and TcII lineages was also identified. T. cruzi DNA was detected in domestic and wild animals in the study area, indicating the circulation of the parasite in peridomestic environments. D. marsupialis may represent an important host in maintaining this region's wild and domestic cycle.
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Affiliation(s)
- Dina Ricardo-Caldera
- Grupo de investigación en Enfermedades Tropicales y Resistencia Bacteriana, Facultad de Ciencias de la Salud, Universidad del Sinú, Montería, Colombia
| | - Lyda Espitia-Pérez
- Grupo de Investigación Biomédica y Biología Molecular, Facultad de Ciencias de la Salud, Universidad del Sinú, Montería, Colombia
| | - Paula A. Avilés-Vergara
- Grupo de investigación en Enfermedades Tropicales y Resistencia Bacteriana, Facultad de Ciencias de la Salud, Universidad del Sinú, Montería, Colombia
| | - Álvaro J. Benítez
- Grupo de investigación en Enfermedades Tropicales y Resistencia Bacteriana, Facultad de Ciencias de la Salud, Universidad del Sinú, Montería, Colombia
- Núcleo de Pesquisa em Ciências Biológicas & Departamento de Ciências Biológicas, Instituto de Ciências Exatas e Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, MG, Brazil
| | - Julio Chacón-Pacheco
- Grupo de Investigación Biodiversidad Unicórdoba, Universidad de Córdoba, Montería, Colombia
- Laboratorio de Ecología Funcional Unidad de Ecología y Sistemática (UNESIS), Laboratorio de Ecología Funcional, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | - Ana Negrette-Oquendo
- Grupo de investigación en Enfermedades Tropicales y Resistencia Bacteriana, Facultad de Ciencias de la Salud, Universidad del Sinú, Montería, Colombia
| | - Sara Soto-De León
- Grupo de investigación en Enfermedades Tropicales y Resistencia Bacteriana, Facultad de Ciencias de la Salud, Universidad del Sinú, Montería, Colombia
| | - Catalina Tovar-Acero
- Grupo de investigación en Enfermedades Tropicales y Resistencia Bacteriana, Facultad de Ciencias de la Salud, Universidad del Sinú, Montería, Colombia
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Jaramillo-Ramirez GI, Tacugue MC, Power GM, Qureshi R, Seelig F, Quintero J, Logan JG, Jones RT. A Qualitative Analysis of the Perceptions of Stakeholders Involved in Vector Control and Vector-Borne Disease Research and Surveillance in Orinoquia, Colombia. Trop Med Infect Dis 2024; 9:43. [PMID: 38393132 PMCID: PMC10892243 DOI: 10.3390/tropicalmed9020043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/16/2023] [Accepted: 12/20/2023] [Indexed: 02/25/2024] Open
Abstract
Colombia has a tropical climate and environmental conditions that favour the circulation of most of the known vector-borne diseases (VBDs). Protocols have been established and implemented to address the threats of these diseases, but they are for country-wide use and do not take into consideration the nuances of the different environments of the country. Almost the entire population is vulnerable to infection with one or more VBD. This study aims to characterise the perceptions and experiences of stakeholders involved in vector control and VBDs in the Orinoquia region in Colombia. Two panel discussions, and 12 semi-structured interviews, were conducted. Experts from the Colombian National Health Institute (INS), health secretaries from Meta, Guaviare and Vichada Departments, academic researchers, and individuals from private vector control companies participated. All sessions were recorded, transcribed, and translated, and then subject to thematic analysis. Three major themes emerged: involvement, limitations, and recommendations. Results showed that participants are engaged in vector surveillance activities, education, and vector control research. Participants focused on problems of disjointed efforts towards VBD control between health secretaries and the health ministry, as well as societal issues, such as socioeconomic, cultural, and political issues, which became the rationale for the lack of vector control resources. Responses in the panel discussions and interviews overlapped in opinions, and suggested that vector control could be improved through better communication between vector control bodies, strengthened engagement with vulnerable communities, more collaborative actions, and a more balanced distribution of resources.
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Affiliation(s)
| | - Maria Claudelle Tacugue
- Department of Disease Control, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Grace M Power
- Department of Disease Control, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 1QU, UK
| | - Rimsha Qureshi
- Department of Disease Control, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Frederik Seelig
- Department of Disease Control, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
- Global Vector Hub, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Juliana Quintero
- Department of Disease Control, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
- Division of Population Health and Internal Medicine, Fundación Santa Fe de Bogotá, Bogotá 110011, Colombia
| | - James G Logan
- Department of Disease Control, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Robert T Jones
- Department of Disease Control, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
- Global Vector Hub, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
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Santana Nogueira S, Cardoso Santos E, Oliveira Silva R, Vilela Gonçalves R, Lima GDA, Dias Novaes R. Monotherapy and combination chemotherapy for Chagas disease treatment: a systematic review of clinical efficacy and safety based on randomized controlled trials. Parasitology 2022; 149:1679-1694. [PMID: 35957576 PMCID: PMC11010555 DOI: 10.1017/s0031182022001081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 07/26/2022] [Accepted: 07/27/2022] [Indexed: 12/14/2022]
Abstract
From a systematic review framework, we analysed the clinical evidence on the effectiveness and safety of monotherapy and combination chemotherapy for Chagas disease (ChD) treatment. The research protocol was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and patient, intervention, comparison and outcome strategy. Only randomized controlled trials (RCT) were retrieved from Embase, Medline, Scopus and Web of Science databases. Diagnostic tools, treatment protocols, seroconversion rates and adverse events were investigated. Fifteen RCT mainly concentrated in endemic countries were identified. ChD diagnosis was mainly based on haemagglutination, immunofluorescence, enzyme-linked immunosorbent assay and polymerase chain reaction. Benznidazole (BNZ), nifurtimox, fosravuconazole, posaconazole, allopurinol and thioctic acid were the identified drugs. The best negative seroconversion results (100, 96, 94 and 91.3%) were, respectively, based on BNZ (5 mg kg day−1, 200 mg day−1, 150 mg day−1 and 2.5 mg kg−1) administration for 60 days. Negative seroconversion was not achieved with allopurinol (300 mg day−1 for 60 days). Adverse reactions ranged from 5 to 73% in patients receiving antiparasitic chemotherapy. Treatment discontinuation (1.5–57%) was mainly associated with gastrointestinal, cutaneous and neurological manifestations. Current RCT-based evidence indicates that BNZ is the most viable option for ChD treatment. However, new protocols need to be developed to mitigate side effects and increase patient adherence to antiparasitic chemotherapy. Therefore, shorter regimens, lower concentrations and treatments combining BNZ with posaconazole, fosravuconazole or ravuconazole may be viable to ensure comparable efficacy to BZN-based monotherapy, contributing to reduce dose- and time-dependent toxicity reactions.
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Affiliation(s)
- Silas Santana Nogueira
- Programa de Pós-Graduação em Biociências Aplicadas à Saúde, Instituto de Ciências Biomédicas, Universidade Federal de Alfenas, Alfenas, 37130-000, Minas Gerais, Brazil
- Instituto Federal do Sul de Minas Gerais, Pouso Alegre, Minas Gerais, Brazil
| | - Eliziária Cardoso Santos
- Faculdade de Medicina, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
| | - Roberta Oliveira Silva
- Programa de Pós-Graduação em Biociências Aplicadas à Saúde, Instituto de Ciências Biomédicas, Universidade Federal de Alfenas, Alfenas, 37130-000, Minas Gerais, Brazil
| | - Reggiani Vilela Gonçalves
- Departamento de Biologia Animal, Universidade Federal de Viçosa, Viçosa, 36570-900, Minas Gerais, Brazil
| | - Graziela Domingues Almeida Lima
- Programa de Pós-Graduação em Biociências Aplicadas à Saúde, Instituto de Ciências Biomédicas, Universidade Federal de Alfenas, Alfenas, 37130-000, Minas Gerais, Brazil
| | - Rômulo Dias Novaes
- Programa de Pós-Graduação em Biociências Aplicadas à Saúde, Instituto de Ciências Biomédicas, Universidade Federal de Alfenas, Alfenas, 37130-000, Minas Gerais, Brazil
- Departamento de Biologia Estrutural, Instituto de Ciências Biomédicas, Universidade Federal de Alfenas, Alfenas, 37130-000, Minas Gerais, Brazil
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Herrera L, Morocoima A, Lozano-Arias D, García-Alzate R, Viettri M, Lares M, Ferrer E. Infections and Coinfections by Trypanosomatid Parasites in a Rural Community of Venezuela. Acta Parasitol 2022; 67:1015-1023. [PMID: 35013940 DOI: 10.1007/s11686-021-00505-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 11/29/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Trypanosoma cruzi, Trypanosoma rangeli and Leishmania spp. are parasites that coexist in several endemic areas. The identification of these parasites in hosts is important for the control programs. METHODS 216 samples from human blood (101), blood of other mammals (45) and triatomine intestinal content and hemolymph (70), from an endemic area of Venezuela, were analysed. The samples were evaluated by; serology (only humans) and PCR for T. cruzi in human, other mammals and triatomines, PCR for T. rangeli in mammals-including human and triatomines and PCR for Leishmania in mammals-including human. RESULTS The 9.9% of the human samples were positive for T. cruzi by serology, 11.9% by PCR, 4% for T. rangeli PCR and none for Leishmania spp. PCR. 60% of the samples of other mammals showed DNA amplification for T. cruzi, 42.2% for T. rangeli and 4.4% for Leishmania spp. 61.4% of the triatomine samples showed DNA amplification for T. cruzi and 10% for T. rangeli. CONCLUSIONS High T. cruzi infection was detected in mammals and triatomines compared with T. rangeli. Low leishmanial infection was detected in other mammals. It is the first time that T. cruzi/T. rangeli coinfection, in humans, Canis familiaris (dog), and Bos Taurus (cow), were reported world-wide, and that this coinfection was described in Tamandua tetradactyla (anteater) from Venezuela. The coinfection T. cruzi/T. rangeli in mammals-including humans and triatomines, and coinfection T. cruzi/Leishmania spp. in non-human mammals, show the risk for trypanosomic zoonoses in this endemic area.
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Affiliation(s)
- Leidi Herrera
- Instituto de Zoología y Ecología Tropical (IZET), Facultad de Ciencias, Universidad Central de Venezuela (UCV), Caracas, Venezuela
| | - Antonio Morocoima
- Centro de Medicina Tropical de Oriente, Universidad de Oriente (UDO), Núcleo Anzoátegui, Barcelona, Estado Anzoátegui, Venezuela
| | - Daisy Lozano-Arias
- Instituto de Zoología y Ecología Tropical (IZET), Facultad de Ciencias, Universidad Central de Venezuela (UCV), Caracas, Venezuela
- Fundación Universitaría San Martín, Sede Puerto Colombia, Barranquilla, Colombia
| | - Roberto García-Alzate
- Instituto de Zoología y Ecología Tropical (IZET), Facultad de Ciencias, Universidad Central de Venezuela (UCV), Caracas, Venezuela
- Grupo de Investigación en Biodiversidad, Universidad del Atlantico, Barranquilla, Atlántico, Colombia
| | - Mercedes Viettri
- Instituto de Investigaciones Biomédicas "Dr. Francisco J. Triana Alonso" (BIOMED), Facultad de Ciencias de la Salud Sede Aragua, Universidad de Carabobo, Maracay, Estado Aragua, Venezuela
| | - María Lares
- Instituto de Investigaciones Biomédicas "Dr. Francisco J. Triana Alonso" (BIOMED), Facultad de Ciencias de la Salud Sede Aragua, Universidad de Carabobo, Maracay, Estado Aragua, Venezuela
| | - Elizabeth Ferrer
- Instituto de Investigaciones Biomédicas "Dr. Francisco J. Triana Alonso" (BIOMED), Facultad de Ciencias de la Salud Sede Aragua, Universidad de Carabobo, Maracay, Estado Aragua, Venezuela.
- Departamento de Parasitología, Facultad de Ciencias de la Salud Sede Aragua, Universidad de Carabobo, Maracay, Estado Aragua, Venezuela.
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Gual-Gonzalez L, Arango-Ferreira C, Lopera-Restrepo LC, Cantillo-Barraza O, Marín DV, Bustamante NR, Triana-Chavez O, Nolan MS. Acute Pediatric Chagas Disease in Antioquia, Colombia: A Geographic Location of Suspected Oral Transmission. Microorganisms 2021; 10:8. [PMID: 35056459 PMCID: PMC8781947 DOI: 10.3390/microorganisms10010008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/17/2021] [Accepted: 12/18/2021] [Indexed: 11/16/2022] Open
Abstract
Chagas disease, Trypanosoma cruzi infection, is an insidious cause of heart failure in Latin America. Early diagnosis and treatment are critical to prevent irreversible myocardial damage that progressively accumulates over decades. Several structural barriers account for the less than 1% of cases in Colombia being treated, including poor physician knowledge, especially considering that some regions are considered non-endemic. The two cases reported here represent an emerging epidemiologic scenario associated with pediatric Chagas disease. Both cases are suspected oral transmitted parasitic infection in a geographic region of Colombia (Andean region of Antioquia) where no previous oral transmission of Chagas disease had been reported. Their clinical histories and course of disease are presented here to increase physician awareness of the epidemiologic risk factors and clinical manifestations associated with pediatric oral Chagas disease in Antioquia department, Colombia.
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Affiliation(s)
- Lídia Gual-Gonzalez
- Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Catalina Arango-Ferreira
- Departamento de Pediatría Hospital San Vicente Fundación, Medellin 050010, Colombia;
- Departamento de Pediatría, Facultad de Medicina, Universidad de Antioquia, MMedellin 050010, Colombia; (D.V.M.); (N.R.B.)
| | | | - Omar Cantillo-Barraza
- Grupo Biología y Control de Enfermedades Infecciosas, Universidad de Antioquia, Medellin 050010, Colombia; (O.C.-B.); (O.T.-C.)
| | - Daniela Velásquez Marín
- Departamento de Pediatría, Facultad de Medicina, Universidad de Antioquia, MMedellin 050010, Colombia; (D.V.M.); (N.R.B.)
| | - Natalia Restrepo Bustamante
- Departamento de Pediatría, Facultad de Medicina, Universidad de Antioquia, MMedellin 050010, Colombia; (D.V.M.); (N.R.B.)
| | - Omar Triana-Chavez
- Grupo Biología y Control de Enfermedades Infecciosas, Universidad de Antioquia, Medellin 050010, Colombia; (O.C.-B.); (O.T.-C.)
| | - Melissa S. Nolan
- Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
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Austen JM, Barbosa AD. Diversity and Epidemiology of Bat Trypanosomes: A One Health Perspective. Pathogens 2021; 10:pathogens10091148. [PMID: 34578180 PMCID: PMC8465530 DOI: 10.3390/pathogens10091148] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 08/30/2021] [Accepted: 09/01/2021] [Indexed: 11/17/2022] Open
Abstract
Bats (order Chiroptera) have been increasingly recognised as important reservoir hosts for human and animal pathogens worldwide. In this context, molecular and microscopy-based investigations to date have revealed remarkably high diversity of Trypanosoma spp. harboured by bats, including species of recognised medical and veterinary importance such as Trypanosoma cruzi and Trypanosoma evansi (aetiological agents of Chagas disease and Surra, respectively). This review synthesises current knowledge on the diversity, taxonomy, evolution and epidemiology of bat trypanosomes based on both molecular studies and morphological records. In addition, we use a One Health approach to discuss the significance of bats as reservoirs (and putative vectors) of T. cruzi, with a focus on the complex associations between intra-specific genetic diversity and eco-epidemiology of T. cruzi in sylvatic and domestic ecosystems. This article also highlights current knowledge gaps on the biological implications of trypanosome co-infections in a single host, as well as the prevalence, vectors, life-cycle, host-range and clinical impact of most bat trypanosomes recorded to date. Continuous research efforts involving molecular surveillance of bat trypanosomes are required for improved disease prevention and control, mitigation of biosecurity risks and potential spill-over events, ultimately ensuring the health of humans, domestic animals and wildlife globally.
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Affiliation(s)
- Jill M. Austen
- Centre for Biosecurity and One Health, Harry Butler Institute, Murdoch University, Murdoch, WA 6150, Australia
- Correspondence: (J.M.A.); (A.D.B.)
| | - Amanda D. Barbosa
- Centre for Biosecurity and One Health, Harry Butler Institute, Murdoch University, Murdoch, WA 6150, Australia
- CAPES Foundation, Ministry of Education of Brazil, Brasilia 70040-020, DF, Brazil
- Correspondence: (J.M.A.); (A.D.B.)
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Joselín DV, Ignacio M, Ángel RM, Gabriel GG, Rodrigo Isaias LV, Víctor SC, Jorge FN, Jose ÁC, Bertha E. Multiple Discrete Typing Units of Trypanosoma cruzi Infect Sylvatic Triatoma dimidiata and Panstrongylus rufotuberculatus in Southeast Mexico. Am J Trop Med Hyg 2021; 105:1042-1049. [PMID: 34398820 PMCID: PMC8592174 DOI: 10.4269/ajtmh.20-1574] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 05/11/2021] [Indexed: 11/07/2022] Open
Abstract
Chagas disease or American trypanosomiasis is an infection caused by the parasite Trypanosoma cruzi. According to its genetic characteristics, this parasite is divided into six groups (TcI-TcVI) called discrete typing units (DTUs). Trypanosoma cruzi is transmitted to humans by insects of the Triatominae family. In Mexico, despite having a great variety of triatomine species, little is known about vector sylvatic populations and the DTUs associated with them. In this work, molecular markers such as minicircle, miniexon, 18S, and 24S ribosomal genes and restriction fragment length polymorphism (RFLP) analysis of the hsp70 gene were used to determine the DTUs present in vectors from rural communities and sylvatic areas inside the Biosphere Reserve Los Tuxtlas, Veracruz, in southeast Mexico. One hundred triatomines were collected and two species were identified: Triatoma dimidiata and Panstrongylus rufotuberculatus. The infection with T. cruzi was determined in 29% of analyzed vectors from the domestic area and TcI was the predominant DTU. Furthermore, 71% of vectors from the sylvatic environment were infected and TcI, TcII, TcIV, and TcVI were identified. One female and one male of P. rufotuberculatus were infected only with TcI. This is the first report of TcVI in T. dimidiata from the sylvatic area in México and the first report of P. rufotuberculatus infected with T. cruzi in Mexico.
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Affiliation(s)
- Díaz-Valdez Joselín
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Martínez Ignacio
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Rodríguez-Moreno Ángel
- Instituto de Biología, Universidad Nacional Autónoma de México, Ciudad de México, México
| | | | | | - Sánchez-Cordero Víctor
- Instituto de Biología, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Fraga-Nodarse Jorge
- Departamento de Parasitología, Instituto de Medicina Tropical Pedro Kouri, La Habana, Cuba
| | - Ángeles-Chimal Jose
- Facultad de Medicina, Universidad Autónoma del Estado de Morelos, Cuernavaca, Morelos, México
| | - Espinoza Bertha
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de México, México
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Diversity and interactions among triatomine bugs, their blood feeding sources, gut microbiota and Trypanosoma cruzi in the Sierra Nevada de Santa Marta in Colombia. Sci Rep 2021; 11:12306. [PMID: 34112903 PMCID: PMC8192545 DOI: 10.1038/s41598-021-91783-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 05/25/2021] [Indexed: 12/14/2022] Open
Abstract
Chagas disease remains a major neglected disease in Colombia. We aimed to characterize Trypanosoma cruzi transmission networks in the Sierra Nevada de Santa Marta (SNSM) region, to shed light on disease ecology and help optimize control strategies. Triatomines were collected in rural communities and analyzed for blood feeding sources, parasite diversity and gut microbiota composition through a metagenomic and deep sequencing approach. Triatoma dimidiata predominated, followed by Rhodnius prolixus, Triatoma maculata, Rhodnius pallescens, Panstrongylus geniculatus and Eratyrus cuspidatus. Twenty-two species were identified as blood sources, resulting in an integrated transmission network with extensive connectivity among sylvatic and domestic host species. Only TcI parasites were detected, predominantly from TcIb but TcIa was also reported. The close relatedness of T. cruzi strains further supported the lack of separate transmission cycles according to habitats or triatomine species. Triatomine microbiota varied according to species, developmental stage and T. cruzi infection. Bacterial families correlated with the presence/absence of T. cruzi were identified. In conclusion, we identified a domestic transmission cycle encompassing multiple vector species and tightly connected with sylvatic hosts in the SNSM region, rather than an isolated domestic transmission cycle. Therefore, integrated interventions targeting all vector species and their contact with humans should be considered.
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Suescún-Carrero SH, Salamanca-Cardozo LP, Pinazo MJ, Armadans-Gil L. Sensitivity and Specificity of two rapid tests for the diagnosis of infection by Trypanosoma cruzi in a Colombian population. PLoS Negl Trop Dis 2021; 15:e0009483. [PMID: 34077424 PMCID: PMC8202949 DOI: 10.1371/journal.pntd.0009483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 06/14/2021] [Accepted: 05/17/2021] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE To evaluate diagnostic precision of two rapid diagnostic tests (RDT's) on patients with chronic Chagas disease. METHODOLOGY Prospective study with the following inclusion criteria: subjects older than 3 years, signed informed consent. Exclusion criterion: subjects could not have previously received treatment for infection with T. cruzi. The study population were participants in a screening process undertaken in rural and urban zones of the department Boyacá, Colombia. Two RDT's were performed to all participants: the Chagas Detect Plus InBios (CDP) and the Chagas Stat-Pak (CSP) and as a reference standard the ELISA Chagas III GrupoBios and the Chagas ELISA IgG+IgM I Vircell tests were used. In the case of discordant results between the two ELISA tests, an indirect immunofluorescence was done. RESULTS Three hundred-five (305) subjects were included in the study (38 patients with leishmaniasis), of which 215 tested negative for T cruzi and 90 tested positive according to the reference standard. The sensitivity of the RDT's were 100% (CI 95% 95.9-100), and the specificity of the CDP was 99.1% (CI 95% 96.6-99.8) and for CSP was 100% (CI 95% 98.3-100). The agreement of CDP was 99.5% and for CSP was 100% with Kappa values of (k = 99.1; CI 95% 92.6-99.8%) and (k = 100; CI 95% 94.3-100), respectively. RDT's did not present cross-reactions with samples from patients who were positive for leishmaniasis. CONCLUSIONS The findings demonstrate excellent results from the RDT's in terms of validity, safety, and reproducibility. The results obtained provide evidence for the recommendation for using these tests in a Colombian epidemiological context principally in endemic areas in which laboratory installations necessary to perform conventional tests are not available, or they are scarce and to help in diagnosing chronic Chagas disease in order to provide access to treatment as soon as possible.
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Affiliation(s)
- Sandra Helena Suescún-Carrero
- Grupo de Investigación del Laboratorio de Salud Pública de Boyacá, Secretaria de Salud de Boyacá, Tunja, Colombia, Doctorado en Metodología de la Investigación Biomédica y Salud Pública, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lyda Pilar Salamanca-Cardozo
- Grupo de Investigación del Laboratorio de Salud Pública de Boyacá, Secretaria de Salud de Boyacá, Tunja, Colombia
| | - María-Jesus Pinazo
- Barcelona Institute for Global Health (ISGlobal), Hospital Clinic—University of Barcelona, Barcelona, Spain
| | - Lluis Armadans-Gil
- Servicio de Medicina Preventiva y Epidemiología, Hospital Universitari Vall d’Hebron—Universitat Autònoma de Barcelona, Barcelona, Spain
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Cantillo-Barraza O, Medina M, Zuluaga S, Valverde C, Motta C, Ladino A, Osorio MI, Jaimes-Dueñez J, Triana-Chávez O. Eco-epidemiological study reveals the importance of Triatoma dimidiata in the Trypanosoma cruzi transmission, in a municipality certified without transmission by Rhodnius prolixus in Colombia. Acta Trop 2020; 209:105550. [PMID: 32473116 DOI: 10.1016/j.actatropica.2020.105550] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 05/19/2020] [Accepted: 05/20/2020] [Indexed: 02/08/2023]
Abstract
Boyaca department is an endemic area for Chagas disease in Colombia, where 24 of its municipalities have been certified by the PAHO with interruption of Trypanosoma cruzi transmission by R. prolixus. However, the presence of secondary vectors, represent a risk of parasite transmission for citizens and a challenge for the health care institutions. The aim of this work was to investigate eco-epidemiological features of Chagas disease in the municipality of Socota (Boyaca), in order to improve control and surveillance strategies. To understand the transmission dynamics of T. cruzi in this area, we designed a comprehensive, multi-faceted study including: (i) entomological survey in five villages (La Vega, Comaita, Chusvita, Guaquira and Pueblo Nuevo), (ii) blood meal source determination, (iii) T. cruzi infection rate in collected triatomines, (iv) identification of circulating T. cruzi genotypes, (v) serological determination of T. cruzi infection in domestic dogs; and (vi) evaluation of infection in synanthropic mammals. A total of 90 T. dimidiata were collected, of which 73.3% (66/90) and 24.4% (22/90) were collected inside dwellings and peridomestic areas, respectively, while the rest (2/90) in Chusvita Elementary School. T. cruzi infection was evidenced in 40% (36/90) of triatomine bugs using PCR analyses, in which only DTU I was found, and TcI Dom was the most distributed. Blood-meal analysis showed that T. dimidiata only fed of humans. Seroprevalence in domestic dogs was 4.6% (3/66), while that two Didelphis marsupialis captured showed no infection. In conclusion, the high dispersion and colonization of T. dimidiata shown in this municipality, along the high rate of T. cruzi (TcI) infection and its anthropophilic behavior constitute a risk situation for Chagas disease transmission in this municipality certified without R. prolixus. The epidemiological implications of these findings are herein discussed.
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Erazo D, González C, Guhl F, Umaña JD, Morales-Betancourt JA, Cordovez J. Rhodnius prolixus Colonization and Trypanosoma cruzi Transmission in Oil Palm ( Elaeis guineensis) Plantations in the Orinoco Basin, Colombia. Am J Trop Med Hyg 2020; 103:428-436. [PMID: 32458775 PMCID: PMC7356441 DOI: 10.4269/ajtmh.19-0331] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Trypanosoma cruzi is the etiological agent of Chagas disease that infects more than seven million people in Latin America. The parasite is transmitted by triatomine insects, of which some species are often associated with palms. The establishment of oil palm plantations (Elaeis guineensis) in the Orinoco region (Colombia) has been rapidly growing, possibly constituting a new environment for the establishment and increase in triatomine populations. In this study, the potential of Rhodnius prolixus to colonize E. guineensis plantations and maintain T. cruzi transmission was assessed. Fieldwork was conducted in two areas located in the department of Casanare for sampling E. guineensis and Attalea butyracea palms, sampling for triatomines to determine their abundance and prevalence of T. cruzi infection. To assess T. cruzi transmission potential in the area, sylvatic and domestic mammals were sampled. Results showed that palm infestation with triatomines was higher in A. butyracea than in E. guineensis palms and T. cruzi infection in triatomines varied between habitats for one study area, but was constant in the other site. Trypanosoma cruzi–infected mammals in the E. guineensis plantations were mainly generalist rodents, suggesting that these mammals could have an important role in T. cruzi transmission in plantations. In conclusion, E. guineensis plantations in the Orinoco region are suitable habitats for R. prolixus and T. cruzi transmission.
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Affiliation(s)
- Diana Erazo
- Grupo de Investigación en Biología Matemática y Computacional (BIOMAC), Universidad de los Andes, Bogotá, Colombia
| | - Camila González
- Centro de Investigaciones en Microbiología y Parasitología Tropical (CIMPAT), Facultad de Ciencias, Universidad de los Andes, Bogotá, Colombia
| | - Felipe Guhl
- Centro de Investigaciones en Microbiología y Parasitología Tropical (CIMPAT), Facultad de Ciencias, Universidad de los Andes, Bogotá, Colombia
| | - Juan Daniel Umaña
- Grupo de Investigación en Biología Matemática y Computacional (BIOMAC), Universidad de los Andes, Bogotá, Colombia
| | - Juan Alejandro Morales-Betancourt
- Centro de Investigaciones en Microbiología y Parasitología Tropical (CIMPAT), Facultad de Ciencias, Universidad de los Andes, Bogotá, Colombia
| | - Juan Cordovez
- Grupo de Investigación en Biología Matemática y Computacional (BIOMAC), Universidad de los Andes, Bogotá, Colombia
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Kann S, Kunz M, Hansen J, Sievertsen J, Crespo JJ, Loperena A, Arriens S, Dandekar T. Chagas Disease: Detection of Trypanosoma cruzi by a New, High-Specific Real Time PCR. J Clin Med 2020; 9:jcm9051517. [PMID: 32443464 PMCID: PMC7291166 DOI: 10.3390/jcm9051517] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 05/11/2020] [Accepted: 05/14/2020] [Indexed: 11/24/2022] Open
Abstract
Background: Chagas disease (CD) is a major burden in Latin America, expanding also to non-endemic countries. A gold standard to detect the CD causing pathogen Trypanosoma cruzi is currently not available. Existing real time polymerase chain reactions (RT-PCRs) lack sensitivity and/or specificity. We present a new, highly specific RT-PCR for the diagnosis and monitoring of CD. Material and Methods: We analyzed 352 serum samples from Indigenous people living in high endemic CD areas of Colombia using three leading RT-PCRs (k-DNA-, TCZ-, 18S rRNA-PCR), the newly developed one (NDO-PCR), a Rapid Test/enzyme-linked immuno sorbent assay (ELISA), and immunofluorescence. Eighty-seven PCR-products were verified by sequence analysis after plasmid vector preparation. Results: The NDO-PCR showed the highest sensitivity (92.3%), specificity (100%), and accuracy (94.3%) for T. cruzi detection in the 87 sequenced samples. Sensitivities and specificities of the kDNA-PCR were 89.2%/22.7%, 20.5%/100% for TCZ-PCR, and 1.5%/100% for the 18S rRNA-PCR. The kDNA-PCR revealed a 77.3% false positive rate, mostly due to cross-reactions with T. rangeli (NDO-PCR 0%). TCZ- and 18S rRNA-PCR showed a false negative rate of 79.5% and 98.5% (NDO-PCR 7.7%), respectively. Conclusions: The NDO-PCR demonstrated the highest specificity, sensitivity, and accuracy compared to leading PCRs. Together with serologic tests, it can be considered as a reliable tool for CD detection and can improve CD management significantly.
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Affiliation(s)
- Simone Kann
- Department Research and Development, Bernhard-Nocht-Institute for Tropical Medicine (BNITM), 20359 Hamburg, Germany; (J.H.); (J.S.); (S.A.)
- Actually Medical Mission Institute, 97074 Wuerzburg, Germany
- Correspondence:
| | - Meik Kunz
- Chair of Medical Informatics, Friedrich-Alexander University of Erlangen-Nürnberg, 91054 Erlangen, Germany;
| | - Jessica Hansen
- Department Research and Development, Bernhard-Nocht-Institute for Tropical Medicine (BNITM), 20359 Hamburg, Germany; (J.H.); (J.S.); (S.A.)
| | - Jürgen Sievertsen
- Department Research and Development, Bernhard-Nocht-Institute for Tropical Medicine (BNITM), 20359 Hamburg, Germany; (J.H.); (J.S.); (S.A.)
| | - Jose J. Crespo
- Department Health Advocacy, Organization Wiwa Yugumaiun Bunkuanarrua Tayrona (OWYBT), Valledupar 200001, Colombia; (J.J.C.); (A.L.)
| | - Aristides Loperena
- Department Health Advocacy, Organization Wiwa Yugumaiun Bunkuanarrua Tayrona (OWYBT), Valledupar 200001, Colombia; (J.J.C.); (A.L.)
| | - Sandra Arriens
- Department Research and Development, Bernhard-Nocht-Institute for Tropical Medicine (BNITM), 20359 Hamburg, Germany; (J.H.); (J.S.); (S.A.)
| | - Thomas Dandekar
- Department of Bioinformatics, Biocenter, Functional Genomics and Systems Biology Group, Julius-Maximilians University, 97070 Wuerzburg, Germany;
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Kruse CS, Guerra DA, Gelillo-Smith R, Vargas A, Krishnan L, Stigler-Granados P. Leveraging Technology to Manage Chagas Disease by Tracking Domestic and Sylvatic Animal Hosts as Sentinels: A Systematic Review. Am J Trop Med Hyg 2020; 101:1126-1134. [PMID: 31549619 PMCID: PMC6838565 DOI: 10.4269/ajtmh.19-0050] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Surveillance of Chagas in the United States show more is known about prevalence in animals and vectors than in humans. Leveraging health information technology (HIT) may augment surveillance efforts for Chagas disease (CD), given its ability to disseminate information through health information exchanges (HIE) and geographical information systems (GISs). This systematic review seeks to determine whether technological tracking of Trypanosoma cruzi–infected domestic and/or sylvatic animals as sentinels can serve as a potential surveillance resource to manage CD in the southern United States. A Boolean search string was used in PubMed and the Cumulative Index to Nursing and Allied Health Literature (CINAHL). Relevance of results was established and analysis of articles was performed by multiple reviewers. The overall Cohen statistic was 0.73, demonstrating moderate agreement among the study team. Four major themes were derived for this systematic review (n = 41): animals act as reservoir hosts to perpetuate CD, transmission to humans could be dependent on cohabitation proximity, variations in T. cruzi genotypes could lead to different clinical manifestations, and leveraging technology to track T. cruzi in domestic animals could reveal prevalent areas or “danger zones.” Overall, our systematic review identified that HIT can serve as a surveillance tool to manage CD. Health information technology can serve as a surveillance tool to manage CD. This can be accomplished by tracking domestic and/or sylvatic animals as sentinels within a GIS. Information can be disseminated through HIE for use by clinicians and public health officials to reach at-risk populations.
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Heterogeneity of Trypanosoma cruzi infection rates in vectors and animal reservoirs in Colombia: a systematic review and meta-analysis. Parasit Vectors 2019; 12:308. [PMID: 31221188 PMCID: PMC6585012 DOI: 10.1186/s13071-019-3541-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 05/29/2019] [Indexed: 11/11/2022] Open
Abstract
Background The heterogeneity of Trypanosoma cruzi infection rates among triatomines insects and animal reservoirs has been studied in independent studies, but little information has been systematised to allow pooled and comparative estimates. Unravelling the main patterns of this heterogeneity could contribute to a further understanding of T. cruzi transmission in Colombia. Methods A systematic search was conducted in PubMed, Medline, LILACS, Embase, Web of Knowledge, Google Scholar and secondary sources with no filters of language or time and until April 2018. Based on selection criteria, all relevant studies reporting T. cruzi infection rates in reservoirs or triatomines were chosen. For pooled analyses, a random effects model for binomial distribution was used. Heterogeneity among studies is reported as I2. Subgroup analyses included: taxonomic classification, ecotope and diagnostic methods. Publication bias and sensitivity analyses were performed. Results Overall, 39 studies reporting infection rates in Colombia were found (22 for potential reservoirs and 28 for triatomine insects) for a total sample of 22,838 potential animals and 11,307 triatomines evaluated for T. cruzi infection. We have found evidence of 38/71 different animal species as potential T. cruzi reservoirs and 14/18 species as triatomine vectors for T. cruzi. Among animals, the species with the highest pooled prevalence were opossum (Didelphis marsupialis) with 48.0% (95% CI: 26–71%; I2 = 88%, τ2 = 0.07, P < 0.01) and domestic dog (Canis lupus familiaris) with 22.0% (95% CI: 4–48%; I2 = 96%, τ2 = 0.01, P < 0.01). Among triatomines, the highest prevalence was found for Triatoma maculata in the peridomestic ecotope (68.0%, 95% CI: 62–74%; I2 = 0%, τ2 = 0, P < 0.0001), followed by Rhodnius prolixus (62.0%, 95% CI: 38–84%; I2 = 95%, τ2 = 0.05, P < 0.01) and Rhodnius pallescens (54.0%, 95% CI: 37–71%; I2 = 86%, τ2 = 0.035, P < 0.01) in the sylvatic ecotope. Conclusions To our knowledge, this is the first systematic and quantitative analyses of triatomine insects and potential animal reservoirs for T. cruzi infection in Colombia. The results highlight a marked heterogeneity between species and provide initial estimates of infection rates heterogeneity. Electronic supplementary material The online version of this article (10.1186/s13071-019-3541-5) contains supplementary material, which is available to authorized users.
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Llau AF, Tejada CE, Ahmed NU. Chagas Disease Prevalence in Colombia: A Meta-Analysis and Systematic Review. Vector Borne Zoonotic Dis 2019; 19:81-89. [DOI: 10.1089/vbz.2018.2308] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Anthoni F. Llau
- Global Health Consortium, Florida International University, Robert Stempel College of Public Health and Social Work, Miami, Florida
| | - Carlos Espinal Tejada
- Global Health Consortium, Florida International University, Robert Stempel College of Public Health and Social Work, Miami, Florida
| | - Nasar U. Ahmed
- Department of Epidemiology, Florida International University, Robert Stempel College of Public Health and Social Work, Miami, Florida
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Ihle-Soto C, Costoya E, Correa JP, Bacigalupo A, Cornejo-Villar B, Estadella V, Solari A, Ortiz S, Hernández HJ, Botto-Mahan C, Gorla DE, Cattan PE. Spatio-temporal characterization of Trypanosoma cruzi infection and discrete typing units infecting hosts and vectors from non-domestic foci of Chile. PLoS Negl Trop Dis 2019; 13:e0007170. [PMID: 30768613 PMCID: PMC6395009 DOI: 10.1371/journal.pntd.0007170] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 02/28/2019] [Accepted: 01/17/2019] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Trypanosoma cruzi is a protozoan parasite that is transmitted by triatomine vectors to mammals. It is classified in six discrete typing units (DTUs). In Chile, domestic vectorial transmission has been interrupted; however, the parasite is maintained in non-domestic foci. The aim of this study was to describe T. cruzi infection and DTU composition in mammals and triatomines from several non-domestic populations of North-Central Chile and to evaluate their spatio-temporal variations. METHODOLOGY/PRINCIPAL FINDINGS A total of 710 small mammals and 1140 triatomines captured in six localities during two study periods (summer/winter) of the same year were analyzed by conventional PCR to detect kDNA of T. cruzi. Positive samples were DNA blotted and hybridized with specific probes for detection of DTUs TcI, TcII, TcV, and TcVI. Infection status was modeled, and cluster analysis was performed in each locality. We detected 30.1% of overall infection in small mammals and 34.1% in triatomines, with higher rates in synanthropic mammals and in M. spinolai. We identified infecting DTUs in 45 mammals and 110 triatomines, present more commonly as single infections; the most frequent DTU detected was TcI. Differences in infection rates among species, localities and study periods were detected in small mammals, and between triatomine species; temporally, infection presented opposite patterns between mammals and triatomines. Infection clustering was frequent in vectors, and one locality exhibited half of the 21 clusters found. CONCLUSIONS/SIGNIFICANCE We determined T. cruzi infection in natural host and vector populations simultaneously in a spatially widespread manner during two study periods. All captured species presented T. cruzi infection, showing spatial and temporal variations. Trypanosoma cruzi distribution can be clustered in space and time. These clusters may represent different spatial and temporal risks of transmission.
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Affiliation(s)
- Camila Ihle-Soto
- Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago, Región Metropolitana, Chile
| | - Eduardo Costoya
- Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago, Región Metropolitana, Chile
| | - Juana P. Correa
- Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago, Región Metropolitana, Chile
- Facultad de Ciencias, Universidad de Chile, Santiago, Región Metropolitana, Chile
| | - Antonella Bacigalupo
- Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago, Región Metropolitana, Chile
| | - Berenice Cornejo-Villar
- Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago, Región Metropolitana, Chile
| | - Viviana Estadella
- Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago, Región Metropolitana, Chile
| | - Aldo Solari
- Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Región Metropolitana, Chile
| | - Sylvia Ortiz
- Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Región Metropolitana, Chile
| | - Héctor J. Hernández
- Facultad de Ciencias Forestales y de la Conservación de la Naturaleza, Universidad de Chile, Santiago, Región Metropolitana, Chile
| | - Carezza Botto-Mahan
- Facultad de Ciencias, Universidad de Chile, Santiago, Región Metropolitana, Chile
| | - David E. Gorla
- Instituto de Diversidad y Ecología Animal, CONICET, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Pedro E. Cattan
- Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago, Región Metropolitana, Chile
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Olivera MJ, Fory JA, Porras JF, Buitrago G. Prevalence of Chagas disease in Colombia: A systematic review and meta-analysis. PLoS One 2019; 14:e0210156. [PMID: 30615644 PMCID: PMC6322748 DOI: 10.1371/journal.pone.0210156] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 12/18/2018] [Indexed: 12/20/2022] Open
Abstract
Background Despite the adoption of campaigns to interrupt the main vector and to detect Trypanosoma cruzi in blood banks, millions of people are still chronically infected; however, the prevalence data are limited, and the epidemiology of Chagas disease has not been systematically evaluated. This study aimed to estimate the prevalence of Chagas disease in Colombia. Methods A systematic literature review and meta-analysis was conducted to select all observational studies reporting the prevalence of Chagas disease in Colombia, based on serological diagnosis in participants of any age and published between January 2007 and November 2017. Pooled estimates and 95% confidence intervals (95% CIs) were calculated using random-effects models. In addition, the I2 statistic was calculated. Results The literature search yielded a total of 1,510 studies; sixteen articles with relevant prevalence data were included in the systematic review. Of these, only 12 articles were included for entry in the meta-analysis. The pooled prevalence of Chagas disease across studies was 2.0% (95% CI: 1.0–4.0). A high degree of heterogeneity was found among studies (I2 > 75%; p < 0.001). The publication bias was not statistically significant (Egger’s test, p = 0.078). The highest pooled prevalences were found in the adult population (3.0%, 95% CI: 1.0–4.0), pregnant women (3.0%, 95% CI: 3.0–4.0) and the Orinoco region (7.0%, 95% CI: 2.2–12.6). Conclusions The results indicate that the T. cruzi-infected population is aging, the adult population, pregnant women and that the Orinoco region (department of Casanare) have the highest prevalences. These results highlight the need to maintain screening and surveillance programs to identify people with chronic T. cruzi infections.
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Affiliation(s)
- Mario J Olivera
- Grupo de Parasitología, Instituto Nacional de Salud, Bogotá, D.C., Colombia.,Programme in Health Economics, Pontificia Universidad Javeriana, Bogotá, D.C., Colombia
| | - Johana A Fory
- Facultad de Medicina, Universidad Militar Nueva Granada, Bogotá, D.C., Colombia
| | - Julián F Porras
- Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia
| | - Giancarlo Buitrago
- Departamento de Epidemiología y Bioestadística, Pontificia Universidad Javeriana, Bogotá, D.C., Colombia
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Tovar Acero C, Negrete Peñata J, González C, León C, Ortiz M, Chacón Pacheco J, Monterrosa E, Luna A, Ricardo Caldera D, Espitia-Pérez L. New Scenarios of Chagas Disease Transmission in Northern Colombia. J Parasitol Res 2017; 2017:3943215. [PMID: 29082037 PMCID: PMC5634585 DOI: 10.1155/2017/3943215] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 08/12/2017] [Accepted: 08/20/2017] [Indexed: 11/18/2022] Open
Abstract
Chagas disease (CD) is a systemic parasitic infection caused by the flagellated form of Trypanosoma cruzi. Córdoba department, located in the Colombian Caribbean Coast, was not considered as a region at risk of T. cruzi transmission. In this article, we describe the first acute CD case in Salitral village in Sahagún, Córdoba, confirmed by microscopy and serological tests. Our results draw attention to a new scenario of transmission of acute CD in nonendemic areas of Colombia and highlight the need to include CD in the differential diagnosis of febrile syndromes in this region.
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Affiliation(s)
- Catalina Tovar Acero
- Grupo de Investigación en Enfermedades Tropicales y Resistencia Bacteriana, Facultad de Ciencias de la Salud, Universidad del Sinú, Montería, Colombia
| | - Jorge Negrete Peñata
- Laboratorio de Investigaciones Biomédicas, Universidad del Sinú, Montería, Colombia
| | - Camila González
- Departamento de Ciencias Biológicas, Centro de Investigaciones en Microbiología y Parasitología Tropical (CIMPAT), Universidad de los Andes, Bogotá, Colombia
| | - Cielo León
- Departamento de Ciencias Biológicas, Centro de Investigaciones en Microbiología y Parasitología Tropical (CIMPAT), Universidad de los Andes, Bogotá, Colombia
| | - Mario Ortiz
- Departamento de Ciencias Biológicas, Centro de Investigaciones en Microbiología y Parasitología Tropical (CIMPAT), Universidad de los Andes, Bogotá, Colombia
| | - Julio Chacón Pacheco
- Fundación Colombia Mia, Montería, Colombia
- Grupo de Investigación Biodiversidad Unicordoba, Universidad de Córdoba, Montería, Colombia
| | - Elkin Monterrosa
- Área de Entomología, Laboratorio de Salud Pública de Córdoba, Montería, Colombia
| | | | - Dina Ricardo Caldera
- Grupo de Investigación en Enfermedades Tropicales y Resistencia Bacteriana, Facultad de Ciencias de la Salud, Universidad del Sinú, Montería, Colombia
| | - Lyda Espitia-Pérez
- Grupo de Investigación Biomédica y Biología Molecular, Facultad de Ciencias de la Salud, Universidad del Sinú, Montería, Colombia
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Tomasini N, Ragone PG, Gourbière S, Aparicio JP, Diosque P. Epidemiological modeling of Trypanosoma cruzi: Low stercorarian transmission and failure of host adaptive immunity explain the frequency of mixed infections in humans. PLoS Comput Biol 2017; 13:e1005532. [PMID: 28481887 PMCID: PMC5440054 DOI: 10.1371/journal.pcbi.1005532] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 05/22/2017] [Accepted: 04/24/2017] [Indexed: 01/27/2023] Open
Abstract
People living in areas with active vector-borne transmission of Chagas disease have multiple contacts with its causative agent, Trypanosoma cruzi. Reinfections by T. cruzi are possible at least in animal models leading to lower or even hardly detectable parasitaemia. In humans, although reinfections are thought to have major public health implications by increasing the risk of chronic manifestations of the disease, there is little quantitative knowledge about their frequency and the timing of parasite re-inoculation in the course of the disease. Here, we implemented stochastic agent-based models i) to estimate the rate of re-inoculation in humans and ii) to assess how frequent are reinfections during the acute and chronic stages of the disease according to alternative hypotheses on the adaptive immune response following a primary infection. By using a hybrid genetic algorithm, the models were fitted to epidemiological data of Argentinean rural villages where mixed infections by different genotypes of T. cruzi reach 56% in humans. To explain this percentage, the best model predicted 0.032 (0.008-0.042) annual reinfections per individual with 98.4% of them occurring in the chronic phase. In addition, the parasite escapes to the adaptive immune response mounted after the primary infection in at least 20% of the events of re-inoculation. With these low annual rates, the risks of reinfection during the typically long chronic stage of the disease stand around 14% (4%-18%) and 60% (21%-70%) after 5 and 30 years, with most individuals being re-infected 1-3 times overall. These low rates are better explained by the weak efficiency of the stercorarian mode of transmission than a highly efficient adaptive immune response. Those estimates are of particular interest for vaccine development and for our understanding of the higher risk of chronic disease manifestations suffered by infected people living in endemic areas.
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Affiliation(s)
- Nicolás Tomasini
- Instituto de Patología Experimental, Facultad de Ciencias de la Salud, CONICET, Universidad Nacional de Salta, Salta, Argentina
| | - Paula Gabriela Ragone
- Instituto de Patología Experimental, Facultad de Ciencias de la Salud, CONICET, Universidad Nacional de Salta, Salta, Argentina
| | - Sébastien Gourbière
- UMR 228 ESPACE-DEV-IMAGES, ‘Institut de Modélisation et d'Analyses en Géo-Environnement et Santé’, Université de Perpignan Via Domitia, Perpignan, France
| | - Juan Pablo Aparicio
- Instituto de Investigaciones en Energía no Convencional, CONICET, Universidad Nacional de Salta, Salta, Argentina
| | - Patricio Diosque
- Instituto de Patología Experimental, Facultad de Ciencias de la Salud, CONICET, Universidad Nacional de Salta, Salta, Argentina
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Ortiz S, Ceballos MJ, González CR, Reyes C, Gómez V, García A, Solari A. Trypanosoma cruzi diversity in infected dogs from areas of the north coast of Chile. VETERINARY PARASITOLOGY- REGIONAL STUDIES AND REPORTS 2016; 5:42-47. [PMID: 31014537 DOI: 10.1016/j.vprsr.2016.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 09/13/2016] [Accepted: 09/19/2016] [Indexed: 01/10/2023]
Abstract
As part of a multi-site research program on the eco-epidemiology and control of Chagas disease in northern Chile, we sought to identify the Trypanosoma cruzi discrete typing units (DTUs) infecting rural and peridomestic dogs, using direct methods without grown of the parasite in the laboratory and thus to assess the use of this species as a sentinel of the disease in well-defined endemic areas of T. cruzi in Chile. Infected dogs (35) from three villages were included in the study. The studied villages were Caleta Río Seco and Caleta San Marcos, both in the Tarapacá Region, and La Serena in the Coquimbo Region. These villages were selected based on previous evidence of Mepraia infection reports of the Chilean Ministry of Health. Amplicons from nested-PCR positive samples were used as targets to determine the infective T. cruzi DTUs circulating in blood using PCR-DNA blotting and hybridization assays with five specific DNA probes (TcI, TcII, TcIII, TcV and TcVI). Results of hybridization with dog samples from Caleta Rio Seco showed single infections in 2 out of 16 and mixed infections in 14 out of 16. TcVI was the most frequent DTU found in this area. A highlight is that for the first time the presence of TcIII is reported in this area. Samples from Caleta San Marcos showed single infections in 5 out of 9 and mixed infections in 4 out of 9. TcVI was the most frequent DTU found in this area. Samples from La Serena showed single infections in 5 out of 10 and mixed infections in 2 out of 10; we were unable to genotype the other 3 samples. Our results indicate that infection by T. cruzi DTUs in dogs is not homogeneously distributed but rather specific to each region of our country, as demonstrated by the differences in the T. cruzi DTU distribution in some localities.
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Affiliation(s)
- S Ortiz
- Programa de Biología Celular y Molecular, ICBM, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - M J Ceballos
- Escuela de Medicina Veterinaria, Facultad de Ciencias Agropecuarias, Universidad Pedro de Valdivia, La Serena, Chile
| | - C R González
- Instituto de Entomología, Facultad de Ciencias Básicas, Universidad, Metropolitana de Ciencias de la Educación, Santiago, Chile; Laboratorio de Entomología Médica, Sección Parasitología, Instituto de Salud, Pública de, Chile
| | - C Reyes
- Laboratorio de Entomología Médica, Sección Parasitología, Instituto de Salud, Pública de, Chile
| | - V Gómez
- Facultad de Medicina, Universidad Pedro de Valdivia, La Serena, Chile
| | - A García
- Facultad de Medicina, Universidad Pedro de Valdivia, La Serena, Chile
| | - A Solari
- Programa de Biología Celular y Molecular, ICBM, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
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Saavedra M, Zulantay I, Apt W, Castillo J, Araya E, Martínez G, Rodríguez J. Quantification by real-time PCR of Trypanosoma cruzi DNA in samples of Triatoma infestans used in xenodiagnosis of chronic Chagas disease patients. Parasit Vectors 2016; 9:382. [PMID: 27377063 PMCID: PMC4932745 DOI: 10.1186/s13071-016-1664-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 06/23/2016] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Trypanosoma cruzi multiplies and differentiates in the digestive tract of triatomine insects. Xenodiagnosis (XD) is a parasitological tool in which the insect vectors acts as a biological culture medium to amplify and detect T. cruzi infection in mammals. The sensitivity of XD has been overcome by the application of PCR in fecal samples (FS) of XD (PCR-XD). In this study, T. cruzi amplified in Triatoma infestans fed by XD on individuals with chronic Chagas disease (CChD) is quantified by real-time PCR (qPCR-XD). FINDINGS Under informed consent, 100 individuals were evaluated. In 21 of them XD, PCR-XD and qPCR-XD were positive. For the contrary, 79 were negative XD. In 58 (73.4 %) and 66 cases (83.5 %) of them, PCR-XD (Fisher's exact test P = 0.005) and qPCR-XD (Fisher's exact test: P = 0.037) respectively, were positive. In cases with positive XD, qPCR-XD allowed to establish that in 9/21 cases (42.9 %) the parasite burden fluctuated between 100 and 1,000 par. eq./ml. Otherwise, in 32/79 (40.5 %) cases with negative XD, a parasite burden between 1 and 10 par. eq./ml was determined. All samples showed amplification of exogenous internal control (X12, Ct average: 31.8), so problems in the DNA extraction (excess or loss of genetic material), unspecific amplification and/or inhibition in qPCR-XD reactions were ruled out. Additionally, in all the patients qPCR in blood (qPCR-B) was performed. In the cases with positive XD, the concordance between the positivity of qPCR-XD and qPCR-B was 100 %, nevertheless, the parasite burden in blood was lower and different than XD (Chi-square test: χ (2) = 91.82, df = 5, P = 0.0001). In the cases with negative XD the ranges of qPCR-XD and qPCR-B were similar (Chi-square test: χ (2) = 6.71, df = 5, P = 0.1520). CONCLUSIONS This study allowed the detection and quantification of T. cruzi by qPCR-XD in FS of Tr. infestans fed on patients with CChD. The highest parasite burden was observed in positive XD cases. qPCR-XD could be used in different studies related with the complex T. cruzi-vector-host interactions.
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Affiliation(s)
- Miguel Saavedra
- />Laboratorio de Parasitología Básico-Clínico, Programa de Biología Celular y Molecular, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Inés Zulantay
- />Laboratorio de Parasitología Básico-Clínico, Programa de Biología Celular y Molecular, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Werner Apt
- />Laboratorio de Parasitología Básico-Clínico, Programa de Biología Celular y Molecular, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Juan Castillo
- />Laboratorio de Parasitología Básico-Clínico, Programa de Biología Celular y Molecular, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Eduardo Araya
- />Laboratorio de Parasitología Básico-Clínico, Programa de Biología Celular y Molecular, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Gabriela Martínez
- />Laboratorio de Parasitología Básico-Clínico, Programa de Biología Celular y Molecular, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Jorge Rodríguez
- />Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Santiago, Chile
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Gómez-Palacio A, Lopera J, Rojas W, Bedoya G, Cantillo-Barraza O, Marín-Suarez J, Triana-Chávez O, Mejía-Jaramillo A. Multilocus analysis indicates that Trypanosoma cruzi I genetic substructure associated with sylvatic and domestic cycles is not an attribute conserved throughout Colombia. INFECTION GENETICS AND EVOLUTION 2015; 38:35-43. [PMID: 26631812 DOI: 10.1016/j.meegid.2015.11.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 11/24/2015] [Accepted: 11/25/2015] [Indexed: 10/22/2022]
Abstract
Trypanosoma cruzi, the causative agent of Chagas disease, has been classified into six discrete typing units (DTUs) named TcI to TcVI. Furthermore, subcontinental scale studies based on analysis of the splice leader intergenic region (SL-IR) of the mini-exon gene have subdivided TcI in five genetic groups (Ia-Ie) related to the domestic and non-domestic cycles. However, a current review of this marker among all the sequences deposited in the GenBank demonstrates no correlation between the genetic structure and the eco-epidemiological features of parasite transmission. In this study, we performed a multilocus analysis of TcI isolates from a diverse array of hosts and vectors in a wide eco-geographical area of Colombia. Sequences from SL-IR and mitochondrial cyt b genes as well as PCR-RFLP profiles for four nuclear genes were analyzed. Multilocus analysis indicates that genetic structuration associated with sylvatic and domestic cycles in Colombia is not an attribute conserved across the entire eco-geography where TcI can be found.
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Affiliation(s)
- Andrés Gómez-Palacio
- Grupo de Biología y Control de Enfermedades Infecciosas, BCEI, Universidad de Antioquia, Medellín, Colombia
| | - Juan Lopera
- Grupo de Genética Molecular, GENMOL, Universidad de Antioquia, Medellín, Colombia
| | - Winston Rojas
- Grupo de Genética Molecular, GENMOL, Universidad de Antioquia, Medellín, Colombia
| | - Gabriel Bedoya
- Grupo de Genética Molecular, GENMOL, Universidad de Antioquia, Medellín, Colombia
| | - Omar Cantillo-Barraza
- Grupo de Biología y Control de Enfermedades Infecciosas, BCEI, Universidad de Antioquia, Medellín, Colombia
| | - Johana Marín-Suarez
- Grupo de Biología y Control de Enfermedades Infecciosas, BCEI, Universidad de Antioquia, Medellín, Colombia
| | - Omar Triana-Chávez
- Grupo de Biología y Control de Enfermedades Infecciosas, BCEI, Universidad de Antioquia, Medellín, Colombia
| | - Ana Mejía-Jaramillo
- Grupo de Biología y Control de Enfermedades Infecciosas, BCEI, Universidad de Antioquia, Medellín, Colombia.
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Urdaneta-Morales S. Chagas' disease: an emergent urban zoonosis. The caracas valley (Venezuela) as an epidemiological model. Front Public Health 2014; 2:265. [PMID: 25520950 PMCID: PMC4252636 DOI: 10.3389/fpubh.2014.00265] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 11/14/2014] [Indexed: 01/10/2023] Open
Abstract
The unprecedented emergence of important public health and veterinary zoonoses is usually a result of exponential population growth and globalization of human activities. I characterized Chagas’ disease as an emergent zoonosis in the Caracas Valley (Venezuela) due to the following findings: the presence of reservoirs (Didelphis marsupialis, Rattus rattus) and vectors (Panstrongylus geniculatus, Panstrongylus rufotuberculatus) infected with Trypanosoma cruzi in urbanized or marginalized areas; the elevated contact between P. geniculatus and human beings detected by parasitological and molecular examinations of triatomine feces demonstrated the possibility of transmission risks; a study of outbreaks of urban Chagas’ disease reported the first proven case of oral transmission of T. cruzi to human beings; the risk of transmission of glandular metacyclic stages from marsupials by experimental ocular and oral instillation; mice genitalia infected with T. cruzi contaminated blood resulted in the formation of amastigotes very close to the lumen suggesting that there may be a possibility of infection via their release into the urine and thence to the exterior; the ubiquitous histotropism and histopathology of T. cruzi was demonstrated using a mouse model; the presence of experimental T. cruzi pseudocysts in adipose, bone-cartilage, and eye tissue indicated a potential risk for transplants. Socio-sanitary programs that include improvements in housing, vector control, and access to medical treatment, as well as strategies aimed at combating social inequalities, poverty, and underdevelopment should be undertaken in those areas where zoonoses are most prevalent. Disciplines, such as Ecology, Epidemiology, Medical Entomology, Human and Veterinary Medicine, Environmental Studies, Public Health, Social and Political Studies, Immunology, Microbiology, and Pharmacology could all provide important contributions that aim to reduce the occurrence of factors governing the spread of emergent diseases.
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Affiliation(s)
- Servio Urdaneta-Morales
- Laboratory for the Biology of Vectors and Parasites, Tropical Zoology and Ecology Institute, Central University of Venezuela , Caracas , Venezuela
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Cantillo-Barraza O, Chaverra D, Marcet P, Arboleda-Sánchez S, Triana-Chávez O. Trypanosoma cruzi transmission in a Colombian Caribbean region suggests that secondary vectors play an important epidemiological role. Parasit Vectors 2014; 7:381. [PMID: 25141852 PMCID: PMC4261283 DOI: 10.1186/1756-3305-7-381] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 08/05/2014] [Indexed: 11/10/2022] Open
Abstract
Background Colombia, as part of The Andean Countries Initiative has given priority to triatomine control programs to eliminate primary (domiciliated) vector species such as Rhodnius prolixus and Triatoma dimidiata. However, recent events of Trypanosoma cruzi transmission in localities where R. prolixus and T. dimidiata are not present suggest that other species are involved in the T. cruzi transmission cycle. Methods We studied T. cruzi transmission on Margarita Island, located on the Magdalena River in the Colombian Caribbean region, where a high number of non-domiciliated triatomines infected with T. cruzi inside human dwellings have been observed. A cross-sectional survey including serological studies in humans and parasitological and molecular methods in vectors and reservoirs was conducted. We investigated risk factors for human infection and house infestation, and evaluated the association between abundance of wild triatomines in palm trees (Attalea butyracea) across municipalities, seasons and anthropogenic land use. Results The T. cruzi seroprevalence rate in humans was 1.7% (13/743) and autochthonous active T. cruzi transmission was detected. The infection risk was associated with the capture of triatomines in human dwellings. Five wild mammal species were infected with T. cruzi, where Didelphis marsupialis was the main reservoir host with an 86.3% (19/22) infection rate. TcIb was the only genotype present among vectors. Triatomine abundance was significantly higher in Ecosystem 2, as well as in the dry season. Despite the absence of triatomine domiciliation in this area, T. cruzi active transmission was registered with a human seroprevalence rate similar to that reported in areas with domesticated R. prolixus. Conclusions This study illustrates the importance of secondary and household invading triatomines in Chagas disease epidemiology in the Caribbean lowlands of Colombia.
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Affiliation(s)
| | | | | | | | - Omar Triana-Chávez
- Grupo Biología y Control de Enfermedades Infecciosas (BCEI), Sede de Investigación Universitaria, Universidad de Antioquia, Medellín, Colombia.
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