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Kmetiuk LB, Tirado TC, Biondo LM, Biondo AW, Figueiredo FB. Leishmania spp. in indigenous populations: A mini-review. Front Public Health 2022; 10:1033803. [PMID: 36620288 PMCID: PMC9815601 DOI: 10.3389/fpubh.2022.1033803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
Leishmaniasis, considered a neglected vector-borne disease complex of global concern, has a significant impact on indigenous communities due to daily human and animal exposure in periurban, rural, and naturally preserved areas. This mini-review aims to assess and discuss studies of leishmaniasis in these communities of the New World and Old World, particularly those in the Americas and Asia. Such indigenous communities have been mostly built in poor traditional households with no mosquito-net protection, mostly located in environmentally protected areas, favoring vectors and reservoirs. The presence of leishmaniasis cases surrounding such indigenous areas indicated a high risk of infection, which may have been historically underestimated due to a lack of surveillance, even at present. The absence of studies of indigenous populations in recognized endemic areas may reflect insufficient health services. In conclusion, the persistence of this neglectful scenario may impact tragic outcomes and potential outbreaks in indigenous peoples and surroundings populations worldwide.
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Affiliation(s)
- Louise Bach Kmetiuk
- Graduate Program in Biosciences and Biotechnology, Instituto Carlos Chagas, Fundação Oswaldo Cruz, Curitiba, Paraná, Brazil,Louise Bach Kmetiuk ✉
| | - Thais Cristina Tirado
- Graduate Program in Biosciences and Biotechnology, Instituto Carlos Chagas, Fundação Oswaldo Cruz, Curitiba, Paraná, Brazil,Reference Laboratory for Leishmaniasis, Instituto Carlos Chagas, Fundação Oswaldo Cruz, Curitiba, Paraná, Brazil
| | - Leandro Meneguelli Biondo
- National Institute of the Atlantic Forest (INMA), Brazilian Ministry of Science, Technology, and Innovation, Santa Teresa, Espírito Santo, Brazil
| | - Alexander Welker Biondo
- Department of Veterinary Medicine, Federal University of Paraná (UFPR), Curitiba, Paraná, Brazil
| | - Fabiano Borges Figueiredo
- Graduate Program in Biosciences and Biotechnology, Instituto Carlos Chagas, Fundação Oswaldo Cruz, Curitiba, Paraná, Brazil,Reference Laboratory for Leishmaniasis, Instituto Carlos Chagas, Fundação Oswaldo Cruz, Curitiba, Paraná, Brazil,*Correspondence: Fabiano Borges Figueiredo ✉
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Ibarra-Meneses AV, Corbeil A, Wagner V, Onwuchekwa C, Fernandez-Prada C. Identification of asymptomatic Leishmania infections: a scoping review. Parasit Vectors 2022; 15:5. [PMID: 34983616 PMCID: PMC8727076 DOI: 10.1186/s13071-021-05129-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/11/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Asymptomatic Leishmania infection may play an important role in the transmission of the parasite in endemic areas. At present there is no consensus on the definition of asymptomatic Leishmania infection, nor is there a safe and accessible gold standard test for its identification. METHODS This paper presents a scoping review to summarize definitions of asymptomatic Leishmania infection found in the literature, as well as to detail the approach (molecular, serological, cellular, and/or parasitological tests) used by researchers to identify this asymptomatic population. A scoping review of published and gray literature related to asymptomatic Leishmania infection was conducted; retrieved citations were screened based on predefined eligibility criteria, and relevant data items were extracted from eligible articles. The analysis is descriptive and is presented using tables, figures, and thematic narrative synthesis. RESULTS We conducted a screening of 3008 articles, of which 175 were selected for the full review. Of these articles, we selected 106 that met the inclusion criteria. These articles were published between 1991 and 2021, and in the last 5 years, up to 38 articles were reported. Most of the studies were conducted in Brazil (26%), Spain (14%), India (12%), Bangladesh (10%), and Ethiopia (7%). Of the studies, 84.9% were conducted in the immunocompetent population, while 15.1% were conducted in the immunosuppressed population (HIV, immunosuppressive drugs, and organ transplantation population). We report 14 different techniques and 10 strategies employed by researchers to define asymptomatic Leishmania infection in an endemic area. CONCLUSIONS The definition of asymptomatic Leishmania infection is not unified across the literature, but often includes the following criteria: residence (or extended stay) in a Leishmania-endemic area, no reported signs/symptoms compatible with leishmaniasis, and positive on a combination of serological, molecular, cellular, and/or parasitological tests. Caution is recommended when comparing results of different studies on the subject of asymptomatic infections, as the reported prevalence cannot be confidently compared between areas due to the wide variety of tests employed by research groups. More research on the importance of asymptomatic immunosuppressed and immunocompetent Leishmania-positive populations in leishmaniasis epidemiology is required.
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Affiliation(s)
- Ana Victoria Ibarra-Meneses
- Département de Pathologie et Microbiologie, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada.,The Research Group on Infectious Diseases in Production Animals (GREMIP), Faculty of Veterinary Medicine, Université de Montréal, Saint Hyacinthe, Canada
| | - Audrey Corbeil
- Département de Pathologie et Microbiologie, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada.,The Research Group on Infectious Diseases in Production Animals (GREMIP), Faculty of Veterinary Medicine, Université de Montréal, Saint Hyacinthe, Canada
| | - Victoria Wagner
- Département de Pathologie et Microbiologie, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada.,The Research Group on Infectious Diseases in Production Animals (GREMIP), Faculty of Veterinary Medicine, Université de Montréal, Saint Hyacinthe, Canada
| | - Chukwuemeka Onwuchekwa
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Christopher Fernandez-Prada
- Département de Pathologie et Microbiologie, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada. .,The Research Group on Infectious Diseases in Production Animals (GREMIP), Faculty of Veterinary Medicine, Université de Montréal, Saint Hyacinthe, Canada.
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Gutfraind A, Peterson JK, Billig Rose E, Arevalo-Nieto C, Sheen J, Condori-Luna GF, Tankasala N, Castillo-Neyra R, Condori-Pino C, Anand P, Naquira-Velarde C, Levy MZ. Integrating evidence, models and maps to enhance Chagas disease vector surveillance. PLoS Negl Trop Dis 2018; 12:e0006883. [PMID: 30496172 PMCID: PMC6289469 DOI: 10.1371/journal.pntd.0006883] [Citation(s) in RCA: 8] [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: 04/11/2018] [Revised: 12/11/2018] [Accepted: 09/29/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Until recently, the Chagas disease vector, Triatoma infestans, was widespread in Arequipa, Perú, but as a result of a decades-long campaign in which over 70,000 houses were treated with insecticides, infestation prevalence is now greatly reduced. To monitor for T. infestans resurgence, the city is currently in a surveillance phase in which a sample of houses is selected for inspection each year. Despite extensive data from the control campaign that could be used to inform surveillance, the selection of houses to inspect is often carried out haphazardly or by convenience. Therefore, we asked, how can we enhance efforts toward preventing T. infestans resurgence by creating the opportunity for vector surveillance to be informed by data? METHODOLOGY/PRINCIPAL FINDINGS To this end, we developed a mobile app that provides vector infestation risk maps generated with data from the control campaign run in a predictive model. The app is intended to enhance vector surveillance activities by giving inspectors the opportunity to incorporate the infestation risk information into their surveillance activities, but it does not dictate which houses to surveil. Therefore, a critical question becomes, will inspectors use the risk information? To answer this question, we ran a pilot study in which we compared surveillance using the app to the current practice (paper maps). We hypothesized that inspectors would use the risk information provided by the app, as measured by the frequency of higher risk houses visited, and qualitative analyses of inspector movement patterns in the field. We also compared the efficiency of both mediums to identify factors that might discourage risk information use. Over the course of ten days (five with each medium), 1,081 houses were visited using the paper maps, of which 366 (34%) were inspected, while 1,038 houses were visited using the app, with 401 (39%) inspected. Five out of eight inspectors (62.5%) visited more higher risk houses when using the app (Fisher's exact test, p < 0.001). Among all inspectors, there was an upward shift in proportional visits to higher risk houses when using the app (Mantel-Haenszel test, common odds ratio (OR) = 2.42, 95% CI 2.00-2.92), and in a second analysis using generalized linear mixed models, app use increased the odds of visiting a higher risk house 2.73-fold (95% CI 2.24-3.32), suggesting that the risk information provided by the app was used by most inspectors. Qualitative analyses of inspector movement revealed indications of risk information use in seven out of eight (87.5%) inspectors. There was no difference between the app and paper maps in the number of houses visited (paired t-test, p = 0.67) or inspected (p = 0.17), suggesting that app use did not reduce surveillance efficiency. CONCLUSIONS/SIGNIFICANCE Without staying vigilant to remaining and re-emerging vector foci following a vector control campaign, disease transmission eventually returns and progress achieved is reversed. Our results suggest that, when provided the opportunity, most inspectors will use risk information to direct their surveillance activities, at least over the short term. The study is an initial, but key, step toward evidence-based vector surveillance.
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Affiliation(s)
- Alexander Gutfraind
- Laboratory for Mathematical Analysis of Data, Complexity and Conflicts, Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, IL, United States of America
- Division of Hepatology, Department of Medicine, Loyola University Medical Center, Maywood, IL, United States of America
| | - Jennifer K. Peterson
- Department of Biostatistics, Epidemiology & Informatics; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Erica Billig Rose
- Department of Biostatistics, Epidemiology & Informatics; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Claudia Arevalo-Nieto
- Zoonotic Disease Research Laboratory, One Health Unit, Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Justin Sheen
- Department of Biostatistics, Epidemiology & Informatics; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
- Zoonotic Disease Research Laboratory, One Health Unit, Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Gian Franco Condori-Luna
- Zoonotic Disease Research Laboratory, One Health Unit, Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Narender Tankasala
- Laboratory for Mathematical Analysis of Data, Complexity and Conflicts, Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Ricardo Castillo-Neyra
- Department of Biostatistics, Epidemiology & Informatics; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Carlos Condori-Pino
- Zoonotic Disease Research Laboratory, One Health Unit, Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Priyanka Anand
- Department of Biostatistics, Epidemiology & Informatics; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Cesar Naquira-Velarde
- Zoonotic Disease Research Laboratory, One Health Unit, Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Michael Z. Levy
- Department of Biostatistics, Epidemiology & Informatics; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
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De Winne K, Büscher P, Luquetti AO, Tavares SBN, Oliveira RA, Solari A, Zulantay I, Apt W, Diosque P, Monje Rumi M, Gironès N, Fresno M, Lopez-Velez R, Perez-Molina JA, Monge-Maillo B, Garcia L, Deborggraeve S. The Trypanosoma cruzi satellite DNA OligoC-TesT and Trypanosoma cruzi kinetoplast DNA OligoC-TesT for diagnosis of Chagas disease: a multi-cohort comparative evaluation study. PLoS Negl Trop Dis 2014; 8:e2633. [PMID: 24392177 PMCID: PMC3879245 DOI: 10.1371/journal.pntd.0002633] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 11/26/2013] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The Trypanosoma cruzi satellite DNA (satDNA) OligoC-TesT is a standardised PCR format for diagnosis of Chagas disease. The sensitivity of the test is lower for discrete typing unit (DTU) TcI than for TcII-VI and the test has not been evaluated in chronic Chagas disease patients. METHODOLOGY/PRINCIPAL FINDINGS We developed a new prototype of the OligoC-TesT based on kinetoplast DNA (kDNA) detection. We evaluated the satDNA and kDNA OligoC-TesTs in a multi-cohort study with 187 chronic Chagas patients and 88 healthy endemic controls recruited in Argentina, Chile and Spain and 26 diseased non-endemic controls from D.R. Congo and Sudan. All specimens were tested in duplicate. The overall specificity in the controls was 99.1% (95% CI 95.2%-99.8%) for the satDNA OligoC-TesT and 97.4% (95% CI 92.6%-99.1%) for the kDNA OligoC-TesT. The overall sensitivity in the patients was 67.9% (95% CI 60.9%-74.2%) for the satDNA OligoC-TesT and 79.1% (95% CI 72.8%-84.4%) for the kDNA OligoC-Test. CONCLUSIONS/SIGNIFICANCE Specificities of the two T. cruzi OligoC-TesT prototypes are high on non-endemic and endemic controls. Sensitivities are moderate but significantly (p = 0.0004) higher for the kDNA OligoC-TesT compared to the satDNA OligoC-TesT.
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Affiliation(s)
- Koen De Winne
- Department of Biomedical Sciences, Parasite Diagnostics Unit, Institute of Tropical Medicine, Antwerp, Belgium
| | - Philippe Büscher
- Department of Biomedical Sciences, Parasite Diagnostics Unit, Institute of Tropical Medicine, Antwerp, Belgium
| | - Alejandro O. Luquetti
- Instituto de Patología Tropical e Saúde Pública and Hospital das Clínicas, Universidade Federal de Goiás, Goiania, Brazil
| | - Suelene B. N. Tavares
- Instituto de Patología Tropical e Saúde Pública and Hospital das Clínicas, Universidade Federal de Goiás, Goiania, Brazil
| | - Rodrigo A. Oliveira
- Instituto de Patología Tropical e Saúde Pública and Hospital das Clínicas, Universidade Federal de Goiás, Goiania, Brazil
| | - Aldo Solari
- Programa de Biología Celular y Molecular, ICBM, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Ines Zulantay
- Programa de Biología Celular y Molecular, ICBM, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Werner Apt
- Programa de Biología Celular y Molecular, ICBM, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Patricio Diosque
- Unidad de Epidemiología Molecular (UEM), Instituto de Patología Experimental, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Salta, Argentina
| | - Mercedes Monje Rumi
- Unidad de Epidemiología Molecular (UEM), Instituto de Patología Experimental, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Salta, Argentina
| | - Nuria Gironès
- Centro de Biología Molecular Severo Ochoa, Consejo Superior de Investigaciones Cientificas (CSIC)-Universidad Autónoma de Madrid (UAM), Cantoblanco, Madrid, Spain
| | - Manuel Fresno
- Centro de Biología Molecular Severo Ochoa, Consejo Superior de Investigaciones Cientificas (CSIC)-Universidad Autónoma de Madrid (UAM), Cantoblanco, Madrid, Spain
| | - Rogelio Lopez-Velez
- Tropical Medicine & Clinical Parasitology, Infectious Diseases Department, Ramón y Cajal Hospital, Madrid, Spain
| | - José A. Perez-Molina
- Tropical Medicine & Clinical Parasitology, Infectious Diseases Department, Ramón y Cajal Hospital, Madrid, Spain
| | - Begoña Monge-Maillo
- Tropical Medicine & Clinical Parasitology, Infectious Diseases Department, Ramón y Cajal Hospital, Madrid, Spain
| | - Lineth Garcia
- Facultad de Medicina, Universidad Mayor de San Simón, Cochabamba, Bolivia
| | - Stijn Deborggraeve
- Department of Biomedical Sciences, Parasite Diagnostics Unit, Institute of Tropical Medicine, Antwerp, Belgium
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Anti-leishmania infantum IgG antibody avidity in visceral leishmaniasis. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2013; 20:1697-702. [PMID: 24006136 DOI: 10.1128/cvi.00367-13] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
IgG avidity tests are used to discriminate acute from chronic infections. There are few reports on the IgG avidity profile of patients with visceral leishmaniasis (VL). This study investigated the anti-Leishmania IgG avidity in patients with classic VL (n = 10), patients showing clinical cure after treatment (n = 18), and asymptomatic subjects with at least one positive Leishmania test (n = 20). All subjects were from areas in Brazil where VL is endemic. Serum samples were collected from each subject on two different occasions. IgG avidity was evaluated by Western blotting. The proportion of high-avidity antibodies was higher in all samples from patients with classic VL. In contrast, low-avidity antibodies predominated in subjects with a history of VL, including 13 cases (72.2%) in the first assessment and 14 (77.8%) in the second. Fifteen (75%) of the asymptomatic subjects presented a predominance of low-avidity antibodies in the first assessment, and the frequency of high-avidity antibodies increased over time in seven subjects (35%) of this group. Antibodies against the 14- and/or 16-kDa antigen fraction were detected in the first assessment in all patients with classic VL, in 10 (55.5%) treated patients, and in 10 (50%) asymptomatic subjects. These were high-avidity antibodies in most cases. In the asymptomatic group, an increase in IgG avidity against the 14- and/or 16-kDa antigen fraction was observed in three cases (15%). The results indicate distinct responses in infected and asymptomatic subjects, probably associated with the length of time after infection. In this respect, IgG avidity tests represent a new approach to better characterize asymptomatic VL.
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Factors associated with visceral leishmaniasis in the americas: a systematic review and meta-analysis. PLoS Negl Trop Dis 2013; 7:e2182. [PMID: 23638203 PMCID: PMC3636096 DOI: 10.1371/journal.pntd.0002182] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2012] [Accepted: 03/17/2013] [Indexed: 01/30/2023] Open
Abstract
Background Still today, more than 30 years after the beginning of the process of visceral leishmaniasis' urbanization, there is little knowledge about the risk factors for its occurrence, despite their relevance to the control and understanding of disease dynamics. The present study is the first systematic review with meta-analysis about factors associated with Leishmania infantum infection in humans in the Americas. Methods and Findings After searching different databases, consultations to the reference lists of articles and to experts in the field, 51 studies were reviewed. Theoretical discussions or meta-analysis of p-values or of effect sizes were used to pool information about each variable. The Q test and the I2 statistic were used to assess heterogeneities among the studies. Male sex was associated with visceral leishmaniasis in studies which used the leishmanin skin test for diagnosis and in those where the outcome was the clinical disease; the opposite occurred when serological diagnosis was applied. Younger individuals were less frequently infected than adults, but were more prone to illness. Although with different levels of evidence and of heterogeneity, the presence of dogs at home, higher dog seropositivity in nearby areas, lower socioeconomic status and highly vegetated areas were associated with L. infantum infection. This was not noticed for the presence of chickens in the house and with nutritional status. Susceptibilities to bias and limitations in the analysis and in the description of results were often identified in the studies analyzed. Conclusions Results showed the existence of consistent patterns for some of the factors analyzed and should be taken into account in developing more effective and well-targeted control measures. Studies must be conducted in new areas of the continent, with improved methodological quality and prioritizing the investigation of the patterns identified and their causes, as well as variables for which knowledge is poor. Visceral leishmaniasis (VL) is the most severe clinical form of leishmaniasis. In the Americas, VL is a zoonosis caused by the protozoan parasite Leishmania infantum, an intracellular micro-organism transmitted to humans through the bite of female phlebotomine sand flies. The domestic dog is considered the main reservoir and human beings are dead-end hosts. The disease occurs in 12 countries of the New World and Brazil accounts for 90% of the reported cases. The factors associated with infection are only partially understood, making harder understanding the disease dynamics and the development of effective and well-targeted control measures. Our work is the first systematic review with meta-analysis about factors associated with human visceral leishmaniasis in the Americas. It provides an organization of the available information, the description of more accurate data on the role of each of the factors studied, the evaluation of possible causes of heterogeneity in the results of the studies as well as the analysis of the quality of publications and limitations in the existing knowledge. The results of this study might be useful in the definition of which and where target interventions should be delivered, and for guiding researchers towards the development of future studies of better methodological quality.
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Trypanosoma cruzi Infection in an Indigenous Kariña Community in Eastern Venezuela. ACTA ACUST UNITED AC 2012. [DOI: 10.1155/2012/138259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We investigated the seroprevalence of Trypanosoma cruzi infection in an indigenous Kariña population in eastern Venezuela. A total of 175 serum samples were collected in the community of Piñantal during February 2009. Interviews targeting socioeconomic and environmental factors associated with the T. cruzi transmission were also conducted. Samples were evaluated using trypomastigote excreted/secreted antigens (TESAs) in an ELISA format. TESA-ELISA positive samples were confirmed by indirect haemagglutination (HAI) (Wiener). A nonsystematic collection of vectors was also undertaken. T. cruzi seroprevalence was 7.43% according to both assays, and the mean age of infected patients was 48.61±10.40 years (range 34 to 73 years). The vector infection rate was 20.00% (2/10). T. cruzi seropositivity was associated with a history of triatomine bites, the ability to recognize the vector and poor knowledge about Chagas disease, but no associations were found with gender, house type, knowledge of how the disease is transmitted, or the presence of vectors or animals inside dwellings. To our knowledge, this is the first study of the seroprevalence of T. cruzi in an indigenous population in eastern Venezuela. All of the epidemiological variables required for the establishment of active vectorial transmission of T. cruzi were present in this community.
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Ríos-Osorio LA, Crespo-González JJ, Zapata-Tamayo MA. Etnometodología para la comprensión y el manejo de la Enfermedad de Chagas en las poblaciones indígenas Wiwa asentadas en la vertiente suroriental de la Sierra Nevada de Santa Marta. SAUDE E SOCIEDADE 2012. [DOI: 10.1590/s0104-12902012000200017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
El objetivo de este trabajo fue establecer prevalencia de la Enfermedad de Chagas en las comunidades Wiwa de la Sierra Nevada de Santa Marta trascendiendo el modelo de investigación biomédica sustentado en el paradigma positivista, e involucrando la dimensión sociocultural y ambiental que caracteriza este fenómeno, desde la sostenibilidad como un nuevo paradigma de las ciencias. Se realizó un muestreo probabilístico de las 15 comunidades Wiwa asentadas en la zona de San Juan del César, Departamento de la Guajira, se realizaron los procedimientos biomédicos definidos para investigaciones epidemiológicas, paralelamente se realizaron procedimientos culturales desde el saber tradicional de las comunidades Wiwa, garantizando la armonía de las comunidades ante la agresión biomédica de su espacio ambiental, social y cultural. Se obtuvo una prevalencia de 33.5%, concordante con las cifras de Enfermedad de Chagas encontradas en las otras vertientes de la sierra, reflejando condiciones similares que predisponen a la presencia de la enfermedad. Se estableció como esta enfermedad es inexistente en el sistema médico tradicional de los Wiwa, y sólo el insecto vector es reconocido aunque no considerado como agente perturbador de la salud de las comunidades. A partir de la consideración del vector como eje integrador de las dos culturas se describen las características sociales, ambientales y culturales que definen la Enfermedad de Chagas en los Wiwa y de esta forma, la posibilidad de su comprensión y manejo desde factores complementarios al modelo biomédico.
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ELISA versus PCR for diagnosis of chronic Chagas disease: systematic review and meta-analysis. BMC Infect Dis 2010; 10:337. [PMID: 21108793 PMCID: PMC3004908 DOI: 10.1186/1471-2334-10-337] [Citation(s) in RCA: 91] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2009] [Accepted: 11/25/2010] [Indexed: 11/10/2022] Open
Abstract
Background Most current guidelines recommend two serological tests to diagnose chronic Chagas disease. When serological tests are persistently inconclusive, some guidelines recommend molecular tests. The aim of this investigation was to review chronic Chagas disease diagnosis literature and to summarize results of ELISA and PCR performance. Methods A systematic review was conducted searching remote databases (MEDLINE, LILACS, EMBASE, SCOPUS and ISIWeb) and full texts bibliography for relevant abstracts. In addition, manufacturers of commercial tests were contacted. Original investigations were eligible if they estimated sensitivity and specificity, or reliability -or if their calculation was possible - of ELISA or PCR tests, for chronic Chagas disease. Results Heterogeneity was high within each test (ELISA and PCR) and threshold effect was detected only in a particular subgroup. Reference standard blinding partially explained heterogeneity in ELISA studies, and pooled sensitivity and specificity were 97.7% [96.7%-98.5%] and 96.3% [94.6%-97.6%] respectively. Commercial ELISA with recombinant antigens studied in phase three investigations partially explained heterogeneity, and pooled sensitivity and specificity were 99.3% [97.9%-99.9%] and 97.5% [88.5%-99.5%] respectively. ELISA's reliability was seldom studied but was considered acceptable. PCR heterogeneity was not explained, but a threshold effect was detected in three groups created by using guanidine and boiling the sample before DNA extraction. PCR sensitivity is likely to be between 50% and 90%, while its specificity is close to 100%. PCR reliability was never studied. Conclusions Both conventional and recombinant based ELISA give useful information, however there are commercial tests without technical reports and therefore were not included in this review. Physicians need to have access to technical reports to understand if these serological tests are similar to those included in this review and therefore correctly order and interpret test results. Currently, PCR should not be used in clinical practice for chronic Chagas disease diagnosis and there is no PCR test commercially available for this purpose. Tests limitations and directions for future research are discussed.
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Gouvêa MV, Werneck GL, Costa CHN, de Amorim Carvalho FA. Factors associated to Montenegro skin test positivity in Teresina, Brazil. Acta Trop 2007; 104:99-107. [PMID: 17825238 DOI: 10.1016/j.actatropica.2007.07.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2006] [Revised: 05/27/2007] [Accepted: 07/27/2007] [Indexed: 11/16/2022]
Abstract
Visceral leishmaniasis (VL) is an emerging infectious disease of urban areas in Brazil. To better understand this process, we have studied the association between reaction to the Montenegro skin test (MST), and demographic, socioeconomic and environmental factors in an urban area with high force of transmission. Associations between variables were expressed by prevalence ratios and their respective 95% confidence intervals estimated by using Poisson regression models with robust variance. Higher prevalence of positivity to MST was detected among male and older participants, and among subjects who owned dogs for 3 or more years. Individuals with higher literacy and living in households with three or more persons showed lower prevalence of MST reaction. These results suggest that the identification of high-risk groups might be feasible and useful for targeting interventions.
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Affiliation(s)
- Marcus Vinicius Gouvêa
- Núcleo de Estudos de Saúde Coletiva, Universidade Federal do Rio de Janeiro e Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
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Teixeira AR, Monteiro PS, Rebelo JM, Argañaraz ER, Vieira D, Lauria-Pires L, Nascimento R, Vexenat CA, Silva AR, Ault SK, Costa JM. Emerging Chagas Disease: Trophic Network and Cycle of Transmission ofTrypanosoma cruzifrom Palm Trees in the Amazon. Emerg Infect Dis 2001. [DOI: 10.3201/eid0701.070100] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Steven K. Ault
- Pan-American Health Organization/World Health Organization, Brasília, Brazil
| | - Jackson M. Costa
- Pan-American Health Organization/World Health Organization, Brasília, Brazil
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Teixeira AR, Monteiro PS, Rebelo JM, Argañaraz ER, Vieira D, Lauria-Pires L, Nascimento R, Vexenat CA, Silva AR, Ault SK, Costa JM. Emerging Chagas disease: trophic network and cycle of transmission of Trypanosoma cruzi from palm trees in the Amazon. Emerg Infect Dis 2001; 7:100-12. [PMID: 11266300 PMCID: PMC2631687 DOI: 10.3201/eid0701.700100] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
A trophic network involving molds, invertebrates, and vertebrates, ancestrally adapted to the palm tree (Attalaea phalerata) microhabitat, maintains enzootic Trypanosoma cruzi infections in the Amazonian county Paço do Lumiar, state of Maranhão, Brazil. We assessed seropositivity for T. cruzi infections in the human population of the county, searched in palm trees for the triatomines that harbor these infections, and gathered demographic, environmental, and socioeconomic data. Rhodnius pictipes and R. neglectus in palm-tree frond clefts or in houses were infected with T. cruzi (57% and 41%, respectively). Human blood was found in 6.8% of R. pictipes in houses, and 9 of 10 wild Didelphis marsupialis had virulent T. cruzi infections. Increasing human population density, rain forest deforestation, and human predation of local fauna are risk factors for human T. cruzi infections.
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Affiliation(s)
- A R Teixeira
- Chagas' Disease Multidisciplinary Research Laboratory, Faculty of Medicine, University of Brasília, P.O. Box 04536, Postcode 70.919.970, Brasília, DF, Brazil.
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