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Alavez-Rosas D, Ballinas-López MG, Cruz-López L, Córdoba-Aguilar A. A baited trap for kissing bugs (Hemiptera: Reduviidae: Triatominae). Acta Trop 2024; 259:107368. [PMID: 39173727 DOI: 10.1016/j.actatropica.2024.107368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Revised: 08/09/2024] [Accepted: 08/20/2024] [Indexed: 08/24/2024]
Abstract
Chagas disease is a key vector-borne disease. This illness is caused by Trypanosoma cruzi Chagas, which is transmitted by triatomine bugs. Largely, the control of this disease relies on reducing such contact. We optimized the performance of a box trap in laboratory conditions to capture four triatomine species: Triatoma pallidipennis (Stål), Triatoma infestans Klug, Triatoma phyllosoma (Burmeister), and Rhodnius prolixus Stål. We varied four components for a box trap: material, color, height, and bait attractants. All species were captured more in corrugated cardboard traps than in other trap material. Moreover, T. infestans and R. prolixus were also captured in plywood traps. T. pallidipennis preferred traps of 15 × 15 × 4 cm and 20 × 20 × 4 cm, while T. phyllosoma and T. infestans were more captured in traps of 10 × 10 × 4 cm, and 15 × 15 × 4 cm. Rhodnius prolixus was more captured to 10 × 10 × 4 cm traps. T. pallidipennis was trapped with traps of any color tested, T. phyllosoma and T. infestans were captured more in red and yellow traps, and R. prolixus was mostly captured in blue, violet, and yellow traps. Triatoma pallidipennis was captured at any height above the ground, while T. phyllosoma, T. infestans, and R. prolixus were mostly captured 50, 100, and 150 cm above the ground. Regarding the lure, T. pallidipennis was trapped with four aldehydes + lactic acid + ammonia; T. infestans and R. prolixus were trapped with a blend of four aldehydes + lactic acid, a blend of the four aldehydes + ammonia, and a blend of four aldehydes + lactic acid + ammonia. Triatoma phyllosoma was trapped with any lure tested. These results showed that the trap boxes offer an alternative method for controlling Chagas disease.
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Affiliation(s)
- David Alavez-Rosas
- Instituto de Ecología, Universidad Nacional Autónoma de México, Ciudad Universitaria, Circuito exterior s/n, México, Ciudad de México 04510, Mexico
| | - María Gabriela Ballinas-López
- El Colegio de la Frontera Sur, Unidad Tapachula, Carretera Antiguo Aeropuerto Km. 2.5, Centro, Tapachula, México, Chiapas 30700, Mexico
| | - Leopoldo Cruz-López
- El Colegio de la Frontera Sur, Unidad Tapachula, Carretera Antiguo Aeropuerto Km. 2.5, Centro, Tapachula, México, Chiapas 30700, Mexico.
| | - Alex Córdoba-Aguilar
- Instituto de Ecología, Universidad Nacional Autónoma de México, Ciudad Universitaria, Circuito exterior s/n, México, Ciudad de México 04510, Mexico.
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2
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Rojas Panozo L, Rivera Nina S, Wehrendt DP, Casellas A, Pinto L, Mendez S, Kuo CW, Lozano DF, Ortiz L, Pinazo MJ, Picado A, Sanz S, Abril M, Gascon J, Wong S, Schijman AG, Torrico F, Alonso-Padilla J. Evaluation and validation of a PrintrLab-based LAMP assay to identify Trypanosoma cruzi in newborns in Bolivia: a proof-of-concept study. THE LANCET. MICROBE 2024; 5:100887. [PMID: 38971173 DOI: 10.1016/s2666-5247(24)00110-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 04/07/2024] [Accepted: 04/19/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND Vertical transmission of Trypanosoma cruzi represents approximately 20% of new Chagas disease cases. Early detection and treatment for women of childbearing age and newborns is a public health priority, but the lack of a simple and reliable diagnostic test remains a major barrier. We aimed to evaluate the performance of a point-of-care loop-mediated isothermal amplification (LAMP) assay for the detection of T cruzi. METHODS In this proof-of-concept study, we coupled a low-cost 3D printer repurposed for sample preparation and amplification (PrintrLab) to the Eiken T cruzi-LAMP prototype to detect vertically transmitted T cruzi, which we compared with standardised PCR and with the gold-standard algorithm (microscopy at birth and 2 months and serological study several months later). We screened pregnant women from two hospitals in the Bolivian Gran Chaco province, and those who were seropositive for T cruzi were offered the opportunity for their newborns to be enrolled in the study. Newborns were tested by microscopy, LAMP, and PCR at birth and 2 months, and by serology at 8 months. FINDINGS Between April 23 and Nov 17, 2018, 986 mothers were screened, among whom 276 were seropositive for T cruzi (28·0% prevalence, 95% CI 25·6-31·2). In total, 224 infants born to 221 seropositive mothers completed 8 months of follow-up. Congenital transmission was detected in nine of the 224 newborns (4·0% prevalence, 1·9-7·5) by direct microscopy observation, and 14 more cases were diagnosed serologically (6·3%, 3·6-10·3), accounting for an overall vertical transmission rate of 10·3% (6·6-15·0; 23 of 224). All microscopy-positive newborns were positive by PrintrLab-LAMP and by PCR, while these techniques respectively detected four and five extra positive cases among the remaining 215 microscopy-negative newborns. INTERPRETATION The PrintrLab-LAMP yielded a higher sensitivity than microscopy-based analysis. Considering the simpler use and expected lower cost of LAMP compared with PCR, our findings encourage its evaluation in a larger study over a wider geographical area. FUNDING Inter-American Development Bank.
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Affiliation(s)
- Lizeth Rojas Panozo
- Fundación Ciencias y Estudios Aplicados para el Desarrollo en Salud y Medio Ambiente (CEADES), Cochabamba, Bolivia
| | - Silvia Rivera Nina
- Fundación Ciencias y Estudios Aplicados para el Desarrollo en Salud y Medio Ambiente (CEADES), Cochabamba, Bolivia
| | - Diana P Wehrendt
- Laboratorio de Biología Molecular de La Enfermedad de Chagas, Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr. Héctor N. Torres" (INGEBI), Buenos Aires, Argentina
| | - Aina Casellas
- Barcelona Institute for Global Health (ISGlobal), Hospital Clinic - University of Barcelona, Barcelona, Spain
| | - Lilian Pinto
- Fundación Ciencias y Estudios Aplicados para el Desarrollo en Salud y Medio Ambiente (CEADES), Cochabamba, Bolivia
| | - Susana Mendez
- Barcelona Institute for Global Health (ISGlobal), Hospital Clinic - University of Barcelona, Barcelona, Spain
| | | | - Daniel F Lozano
- Fundación Ciencias y Estudios Aplicados para el Desarrollo en Salud y Medio Ambiente (CEADES), Cochabamba, Bolivia; Universidad Mayor de San Simón, Cochabamba, Bolivia
| | - Lourdes Ortiz
- Plataforma de Chagas Tarija - Universidad Autónoma Juan Misael Saracho, Tarija, Bolivia
| | - Maria-Jesus Pinazo
- Drugs for Neglected Diseases Initiative (DNDi), Rio de Janeiro, Brazil; CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Albert Picado
- Foundation for Innovative Diagnostics (FIND), Geneva, Switzerland
| | - Sergi Sanz
- Barcelona Institute for Global Health (ISGlobal), Hospital Clinic - University of Barcelona, Barcelona, Spain
| | | | - Joaquim Gascon
- Barcelona Institute for Global Health (ISGlobal), Hospital Clinic - University of Barcelona, Barcelona, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | | | - Alejandro G Schijman
- Laboratorio de Biología Molecular de La Enfermedad de Chagas, Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr. Héctor N. Torres" (INGEBI), Buenos Aires, Argentina
| | - Faustino Torrico
- Fundación Ciencias y Estudios Aplicados para el Desarrollo en Salud y Medio Ambiente (CEADES), Cochabamba, Bolivia; Universidad Mayor de San Simón, Cochabamba, Bolivia
| | - Julio Alonso-Padilla
- Barcelona Institute for Global Health (ISGlobal), Hospital Clinic - University of Barcelona, Barcelona, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain.
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3
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Wheelock A, Sandhu S, Reifler K, Carrion M, Bourque DL, Hamer DH, Hochberg NS. Improving Clinician Awareness of and Screening for Chagas Disease with an Educational Intervention. Am J Trop Med Hyg 2024; 111:380-386. [PMID: 38889732 PMCID: PMC11310624 DOI: 10.4269/ajtmh.23-0483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 02/16/2024] [Indexed: 06/20/2024] Open
Abstract
Chagas disease is an underrecognized, chronic, and potentially life-threatening disease caused by the parasite Trypanosoma cruzi. We aimed to improve awareness and screening for Chagas disease among patients from endemic areas using a large safety-net academic hospital system in the United States. We developed an educational intervention consisting of a case-based didactic session presented to physicians, trainees, and other healthcare providers at conferences across different departments. Performance on a knowledge assessment administered before and after the presentation was analyzed with paired Student's t-test for within-subject difference testing. Institutional testing rates for T. cruzi were evaluated for an equal time period (29 months) before and after the start of the intervention. Testing rates were compared by a Welch's unequal variances t-test and by interrupted time series based on multivariate linear regression. Eleven educational sessions were held over the intervention period, and 103 participants completed the pre- and post-presentation surveys. The mean survey scores were 59.2% before the presentation and 96.6% after presentation (P <0.001). Trypanosoma cruzi testing during the postintervention period was significantly higher than testing during the pre-intervention period (171 patients pre-intervention versus 378 patients postintervention [P = 0.015]). Notable increases in testing from the pre-intervention to postintervention periods occurred among midwives (1-68 patients tested) and trainees (57-133 patients tested). Overall, 56/537 (10.4%) nonduplicate T. cruzi commercial screening tests were positive. Testing increased over time, both at an institutional level and within targeted departments. In addition to the educational program, other factors likely influenced expanded testing.
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Affiliation(s)
- Alyse Wheelock
- Section of Preventive Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts
- Section of Infectious Diseases, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts
| | - Sukhmeet Sandhu
- Department of Medicine, Boston Medical Center, Boston, Massachusetts
| | - Katherine Reifler
- Section of Infectious Diseases, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts
| | - Malwina Carrion
- Boston University Sargent College of Health and Rehabilitation Sciences, Boston, Massachusetts
| | - Daniel L. Bourque
- Section of Infectious Diseases, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts
| | - Davidson H. Hamer
- Section of Infectious Diseases, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts
- Center on Emerging Infectious Diseases, Boston University, Boston, Massachusetts
| | - Natasha S. Hochberg
- Section of Infectious Diseases, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts
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4
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Antequera A, Molin-Veglia AD, López-Alcalde J, Álvarez-Díaz N, Muriel A, Muñoz J. Reactivation of Trypanosoma cruzi infection in immunosuppressed patients: a systematic review and meta-analysis. Clin Microbiol Infect 2024; 30:980-988. [PMID: 38697392 DOI: 10.1016/j.cmi.2024.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 04/12/2024] [Accepted: 04/22/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND The risk of Trypanosoma cruzi reactivation is poorly understood. Previous studies evaluating the risk of reactivation report imprecise findings, and recommendations for monitoring and management from clinical guidelines rely on consensus opinion. OBJECTIVES We conducted a systematic review and meta-analysis to estimate the cumulative T. cruzi reactivation incidence in immunosuppressed adults, summarize the available evidence on prognostic factors for reactivation, and examine its prognostic effect on mortality. DATA SOURCES MEDLINE, Embase, LILACS, Clinical Trials, and CENTRAL from inception to 4 July 2022. STUDY ELIGIBILITY CRITERIA Studies reporting the incidence of T. cruzi reactivation. PARTICIPANTS Immunosuppressed adults chronically infected by T. cruzi. METHODS Two authors independently extracted data (including, but not limited to, incidence data, reactivation definition, follow-up, treatment, monitoring schedule, examined prognostic factors) and evaluated the risk of bias. We pooled cumulative incidence using a random-effects model. RESULTS Twenty-two studies (806 participants) were included. The overall pooled incidence of T. cruzi reactivation was 27% (95% CI, 19-36), with the highest pooled proportion in the sub-group of transplant recipients (36%; 95% CI, 25-48). The highest risk period was in the first 6 months after transplant (32%; 95% CI, 17-58), decreasing drastically the number of new cases later. People living with HIV and patients with autoimmune diseases experienced significantly lower cumulative reactivation incidences (17%; 95% CI, 8-29 and 18%; 95% CI, 9-29, respectively). A single study explored the independent effect of benznidazole and found benefits for preventing reactivations. No studies evaluated the independent association between reactivation and mortality, while sensitivity analysis results using unadjusted estimates were inconclusive. The heterogeneity of diagnostic algorithms was substantial. CONCLUSIONS Reactivation occurs in three out of ten T. cruzi-seropositive immunosuppressed adults. These findings can assist clinicians and panel guidelines in tailoring monitoring schedules. There is a great need for an accurate definition of reactivation and targeted monitoring.
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Affiliation(s)
- Alba Antequera
- Barcelona Institute for Global Health, Hospital Clínic Universitat de Barcelona (UB), Barcelona, Spain.
| | - Agustina Dal Molin-Veglia
- Barcelona Institute for Global Health, Hospital Clínic Universitat de Barcelona (UB), Barcelona, Spain
| | - Jesús López-Alcalde
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Spain; Clinical Biostatistics Unit, Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain; CIBERESP, Madrid, Spain; Institute for Complementary and Integrative Medicine, University Hospital Zurich and University Zurich, Zurich, Switzerland
| | - Noelia Álvarez-Díaz
- Medical Library, Hospital Universitario Ramon y Cajal, Irycis, Madrid, Spain
| | - Alfonso Muriel
- Clinical Biostatistics Unit, Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain; CIBERESP, Madrid, Spain; Department of Nursing and Physiotherapy, Universidad Alcalá de Henares, Alcalá de Henares, Spain
| | - José Muñoz
- Barcelona Institute for Global Health, Hospital Clínic Universitat de Barcelona (UB), Barcelona, Spain
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5
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Hamer GL, Fimbres-Macias JP, Juarez JG, Downs CH, Carbajal E, Melo M, Garza DY, Killets KC, Wilkerson GK, Carrera-Treviño R, Corona-Barrera E, Tello-Campa AA, Rojas-Mesta MR, Borden JH, Banfield MG, Hamer SA. Development of an operational trap for collection, killing, and preservation of triatomines (Hemiptera: Reduviidae): the kissing bug kill trap. JOURNAL OF MEDICAL ENTOMOLOGY 2024:tjae087. [PMID: 39024462 DOI: 10.1093/jme/tjae087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 06/12/2024] [Accepted: 07/02/2024] [Indexed: 07/20/2024]
Abstract
Surveillance of triatomines or kissing bugs (Hemiptera: Reduviidae: Triatominae), the insect vectors of Trypanosoma cruzi, a Chagas disease agent, is hindered by the lack of an effective trap. To develop a kissing bug trap, we made iterative improvements over 3 years on a basic design resulting in 7 trap prototypes deployed across field sites in Texas, United States and Northern Mexico, yielding the capture of 325 triatomines of 4 species (Triatoma gerstaeckeri [Stål], T. sanguisuga [LeConte], T. neotomae [Neiva], and T. rubida [Uhler]). We began in 2019 with vertical transparent tarpaulin panel traps illuminated with artificial light powered by AC current, which were successful in autonomous trapping of flying triatomines, but were expensive, labor-intensive, and fragile. In 2020, we switched to white LED lights powered by a solar cell. We tested a scaled-down version of the vertical panel traps, a commercial cross-vane trap, and a multiple-funnel trap. The multiple-funnel traps captured 2.6× more kissing bugs per trap-day than cross-vane traps and approached the performance of the vertical panel traps in number of triatomines captured, number of triatomines per trap-day and triatomines per arthropod bycatch. Multiple-funnel traps required the least labor, were more durable, and had the highest triatomines per day per cost. Propylene glycol in the collection cups effectively preserved captured triatomines allowing for molecular detection of T. cruzi. The trapping experiments established dispersal patterns for the captured species. We conclude that multiple-funnel traps with solar-powered LED lights should be considered for adoption as surveillance and potentially mass-trapping management tools for triatomines.
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Affiliation(s)
- Gabriel L Hamer
- Department of Entomology, Texas A&M University, College Station, TX, USA
| | - Juan P Fimbres-Macias
- Veterinary Integrative Biosciences, Texas A&M School of Veterinary Medicine & Biomedical Sciences, College Station, TX, USA
| | - Jose G Juarez
- Department of Entomology, Texas A&M University, College Station, TX, USA
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, Ciudad de Guatemala, Guatemala
| | - Christopher H Downs
- Department of Entomology, Texas A&M University, College Station, TX, USA
- BanfieldBio, Inc., Woodinville, WA, USA
| | | | | | - Danya Y Garza
- Department of Entomology, Texas A&M University, College Station, TX, USA
| | - Keswick C Killets
- Veterinary Integrative Biosciences, Texas A&M School of Veterinary Medicine & Biomedical Sciences, College Station, TX, USA
| | - Gregory K Wilkerson
- MD Anderson Cancer Center, Michale E. Keeling Center for Comparative Medicine and Research, Bastrop, TX, USA
- Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill NC, USA
| | - Rogelio Carrera-Treviño
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Autónoma de Nuevo León, General Escobedo, México
| | - Enrique Corona-Barrera
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Autónoma de Tamaulipas, Ciudad Victoria, México
| | - Arturo Arabied Tello-Campa
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Autónoma de Nuevo León, General Escobedo, México
| | - Martha Rocío Rojas-Mesta
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Autónoma de Nuevo León, General Escobedo, México
| | | | | | - Sarah A Hamer
- Veterinary Integrative Biosciences, Texas A&M School of Veterinary Medicine & Biomedical Sciences, College Station, TX, USA
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6
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Sabino EC, Nunes MCP, Blum J, Molina I, Ribeiro ALP. Cardiac involvement in Chagas disease and African trypanosomiasis. Nat Rev Cardiol 2024:10.1038/s41569-024-01057-3. [PMID: 39009679 DOI: 10.1038/s41569-024-01057-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/13/2024] [Indexed: 07/17/2024]
Abstract
Trypanosomiases are diseases caused by various species of protozoan parasite in the genus Trypanosoma, each presenting with distinct clinical manifestations and prognoses. Infections can affect multiple organs, with Trypanosoma cruzi predominantly affecting the heart and digestive system, leading to American trypanosomiasis or Chagas disease, and Trypanosoma brucei primarily causing a disease of the central nervous system known as human African trypanosomiasis or sleeping sickness. In this Review, we discuss the effects of these infections on the heart, with particular emphasis on Chagas disease, which continues to be a leading cause of cardiomyopathy in Latin America. The epidemiology of Chagas disease has changed substantially since 1990 owing to the emigration of over 30 million Latin American citizens, primarily to Europe and the USA. This movement of people has led to the global dissemination of individuals infected with T. cruzi. Therefore, cardiologists worldwide must familiarize themselves with Chagas disease and the severe, chronic manifestation - Chagas cardiomyopathy - because of the expanded prevalence of this disease beyond traditional endemic regions.
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Affiliation(s)
- Ester Cerdeira Sabino
- Department of Pathology, Instituto de Medicina Tropical da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil.
| | - Maria Carmo P Nunes
- Hospital das Clínicas and Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
| | - Johannes Blum
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Israel Molina
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Antonio Luiz P Ribeiro
- Hospital das Clínicas and Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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7
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Kerai A, Gadodia R, Aberra T, Shakhtour O, Chou J, Mahana I, Patel P, Medvedofsky D, Marcus R. Seroprevalence of Chagas Cardiomyopathy Among Hospitalized Latin American Immigrants Within a Washington, DC, Hospital. JACC. HEART FAILURE 2024:S2213-1779(24)00497-9. [PMID: 39023494 DOI: 10.1016/j.jchf.2024.05.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Accepted: 05/28/2024] [Indexed: 07/20/2024]
Affiliation(s)
- Ajay Kerai
- MedStar Washington Hospital Center, Washington, DC, USA.
| | | | - Tsion Aberra
- MedStar Washington Hospital Center, Washington, DC, USA
| | | | - Jiling Chou
- MedStar Health Research Institute, Hyattsville, Maryland, USA
| | - Ingy Mahana
- MedStar Washington Hospital Center, Washington, DC, USA
| | - Puja Patel
- MedStar Washington Hospital Center, Washington, DC, USA
| | | | - Rachel Marcus
- MedStar Union Memorial Hospital, Baltimore, Maryland, USA; Latin American Society of Chagas, Virginia Beach, Virginia, USA
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8
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Bernabé KJ, Dumonteil E, Herrera C. Clinician Knowledge of Chagas Disease After an Educational Intervention. JAMA Netw Open 2024; 7:e2419906. [PMID: 38954417 PMCID: PMC11220560 DOI: 10.1001/jamanetworkopen.2024.19906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 05/01/2024] [Indexed: 07/04/2024] Open
Abstract
This survey study describes the self-reported medical knowledge among physicians before and after attending a lecture on Chagas disease.
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Affiliation(s)
- Kerlly J. Bernabé
- Department of Tropical Medicine and Infectious Disease, School of Public Health and Tropical Medicine, and Vector-Borne and Infectious Disease Research Center, Tulane University, New Orleans, Louisiana
| | - Eric Dumonteil
- Department of Tropical Medicine and Infectious Disease, School of Public Health and Tropical Medicine, and Vector-Borne and Infectious Disease Research Center, Tulane University, New Orleans, Louisiana
| | - Claudia Herrera
- Department of Tropical Medicine and Infectious Disease, School of Public Health and Tropical Medicine, and Vector-Borne and Infectious Disease Research Center, Tulane University, New Orleans, Louisiana
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9
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Clark EH, Bern C. Chronic Chagas Disease in the US. JAMA 2024; 331:2037-2038. [PMID: 38776070 DOI: 10.1001/jama.2024.3717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/19/2024]
Abstract
This JAMA Insights provides recommendations for Chagas disease screening, diagnosis, and management in the US
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Affiliation(s)
- Eva H Clark
- Section of Infectious Diseases, Division of Tropical Medicine, Department of Pediatrics, Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Caryn Bern
- Department of Epidemiology and Biostatistics, University of California San Francisco School of Medicine, San Francisco
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10
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Clark EH, Messenger LA, Whitman JD, Bern C. Chagas disease in immunocompromised patients. Clin Microbiol Rev 2024; 37:e0009923. [PMID: 38546225 PMCID: PMC11237761 DOI: 10.1128/cmr.00099-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024] Open
Abstract
SUMMARYAs Chagas disease remains prevalent in the Americas, it is important that healthcare professionals and researchers are aware of the screening, diagnosis, monitoring, and treatment recommendations for the populations of patients they care for and study. Management of Trypanosoma cruzi infection in immunocompromised hosts is challenging, particularly because, regardless of antitrypanosomal treatment status, immunocompromised patients with Chagas disease are at risk for T. cruzi reactivation, which can be lethal. Evidence-based practices to prevent and manage T. cruzi reactivation vary depending on the type of immunocompromise. Here, we review available data describing Chagas disease epidemiology, testing, and management practices for various populations of immunocompromised individuals, including people with HIV and patients undergoing solid organ and hematopoietic stem cell transplantation.
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Affiliation(s)
- Eva H Clark
- Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
- Division of Tropical Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Louisa A Messenger
- Department of Environmental and Occupational Health, University of Nevada Las Vegas, Las Vegas, Nevada, USA
| | - Jeffrey D Whitman
- Department of Laboratory Medicine, University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Caryn Bern
- Department of Epidemiology and Biostatistics, University of California San Francisco School of Medicine, San Francisco, California, USA
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11
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Murta SMF, Lemos Santana PA, Jacques Dit Lapierre TJW, Penteado AB, El Hajje M, Navarro Vinha TC, Liarte DB, de Souza ML, Goulart Trossini GH, de Oliveira Rezende Júnior C, de Oliveira RB, Ferreira RS. New drug discovery strategies for the treatment of benznidazole-resistance in Trypanosoma cruzi, the causative agent of Chagas disease. Expert Opin Drug Discov 2024; 19:741-753. [PMID: 38715393 DOI: 10.1080/17460441.2024.2349155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 04/25/2024] [Indexed: 05/22/2024]
Abstract
INTRODUCTION Benznidazole, the drug of choice for treating Chagas Disease (CD), has significant limitations, such as poor cure efficacy, mainly in the chronic phase of CD, association with side effects, and parasite resistance. Understanding parasite resistance to benznidazole is crucial for developing new drugs to treat CD. AREAS COVERED Here, the authors review the current understanding of the molecular basis of benznidazole resistance. Furthermore, they discuss the state-of-the-art methods and critical outcomes employed to evaluate the efficacy of potential drugs against T. cruzi, aiming to select better compounds likely to succeed in the clinic. Finally, the authors describe the different strategies employed to overcome resistance to benznidazole and find effective new treatments for CD. EXPERT OPINION Resistance to benznidazole is a complex phenomenon that occurs naturally among T. cruzi strains. The combination of compounds that inhibit different metabolic pathways of the parasite is an important strategy for developing a new chemotherapeutic protocol.
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Affiliation(s)
- Silvane Maria Fonseca Murta
- Grupo de Genômica Funcional de Parasitos - Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brazil
| | - Pedro Augusto Lemos Santana
- Departamento de Produtos Farmacêuticos, Faculdade de Farmácia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | | | - André Berndt Penteado
- Departamento de Farmacia, Faculdade de Ciencias Farmacêuticas, Universidade de São Paulo, São Paulo, Brazil
| | - Marissa El Hajje
- Departamento de Farmacia, Faculdade de Ciencias Farmacêuticas, Universidade de São Paulo, São Paulo, Brazil
| | | | | | - Mariana Laureano de Souza
- Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | | | | | - Renata Barbosa de Oliveira
- Departamento de Produtos Farmacêuticos, Faculdade de Farmácia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Rafaela Salgado Ferreira
- Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
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12
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Agudelo Higuita NI, Beatty NL, Forsyth C, Henao-Martínez AF, Manne-Goehler J. Chagas disease in the United States: a call for increased investment and collaborative research. LANCET REGIONAL HEALTH. AMERICAS 2024; 34:100768. [PMID: 38798947 PMCID: PMC11127192 DOI: 10.1016/j.lana.2024.100768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/26/2024] [Accepted: 05/02/2024] [Indexed: 05/29/2024]
Abstract
Chagas disease, caused by the protozoan Trypanosoma cruzi, is a highly overlooked parasitic infection within the United States. It affects an estimated 300,000 individuals, often remaining asymptomatic for years before triggering severe complications such as cardiomyopathy in 30-40% of cases. While many contract the disease in Latin America, its transmission by local vectors in the southern U.S. presents a significant challenge. Unfortunately, limited access to diagnosis and treatment persists, alongside unresolved gaps in healthcare systems and disease pathogenesis. In this viewpoint, we discuss the need for focused research and public health initiatives, with U.S. research institutions playing a crucial role in developing new treatments and identifying biomarkers. Furthermore, investigating the genetic variations of T. cruzi between North and South America is vital for improving diagnostic and treatment strategies. Urgent action is required to implement national and local programs, bolstering healthcare responses and advancing research efforts.Q4As per journal style section heading 'Introduction' is mandatory, hence we have introduced the heading. Please check, and correct if necessary.ResolvedQ5If there are any drug dosages in your article, please verify them and indicate that you have done so by initialing this query.ResolvedQ6Please supply the year of publication.ResolvedFootnoteView Edit Log9.
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Affiliation(s)
- Nelson Iván Agudelo Higuita
- Department of Medicine, Section of Infectious Diseases, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Instituto de Enfermedades Infecciosas y Parasitología Antonio Vidal, Tegucigalpa, Honduras
| | - Norman L. Beatty
- Department of Medicine, Division of Infectious Diseases and Global Medicine, University of Florida College of Medicine, Gainesville, FL, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Colin Forsyth
- Drugs for Neglected Diseases Initiative–North America, New York, NY, USA
| | - Andrés F. Henao-Martínez
- Division of Infectious Diseases, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jennifer Manne-Goehler
- Division of Infectious Diseases, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
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13
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Khan AA, Langston HC, Walsh L, Roscoe R, Jayawardhana S, Francisco AF, Taylor MC, McCann CJ, Kelly JM, Lewis MD. Enteric nervous system regeneration and functional cure of experimental digestive Chagas disease with trypanocidal chemotherapy. Nat Commun 2024; 15:4400. [PMID: 38782898 PMCID: PMC11116530 DOI: 10.1038/s41467-024-48749-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 05/09/2024] [Indexed: 05/25/2024] Open
Abstract
Digestive Chagas disease (DCD) is an enteric neuropathy caused by Trypanosoma cruzi infection. There is a lack of evidence on the mechanism of pathogenesis and rationales for treatment. We used a female C3H/HeN mouse model that recapitulates key clinical manifestations to study how infection dynamics shape DCD pathology and the impact of treatment with the front-line, anti-parasitic drug benznidazole. Curative treatment 6 weeks post-infection resulted in sustained recovery of gastrointestinal transit function, whereas treatment failure led to infection relapse and gradual return of DCD symptoms. Neuro/immune gene expression patterns shifted from chronic inflammation to a tissue repair profile after cure, accompanied by increased cellular proliferation, glial cell marker expression and recovery of neuronal density in the myenteric plexus. Delaying treatment until 24 weeks post-infection led to partial reversal of DCD, suggesting the accumulation of permanent tissue damage over the course of chronic infection. Our study shows that murine DCD pathogenesis is sustained by chronic T. cruzi infection and is not an inevitable consequence of acute stage denervation. The risk of irreversible enteric neuromuscular tissue damage and dysfunction developing highlights the importance of prompt diagnosis and treatment. These findings support the concept of treating asymptomatic, T. cruzi-infected individuals with benznidazole to prevent DCD development.
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Affiliation(s)
- Archie A Khan
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK
| | - Harry C Langston
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK
| | - Louis Walsh
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK
| | - Rebecca Roscoe
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK
| | - Shiromani Jayawardhana
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK
| | - Amanda Fortes Francisco
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK
| | - Martin C Taylor
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK
| | - Conor J McCann
- Stem Cells and Regenerative Medicine, University College London, Great Ormond Street Institute of Child Health, London, UK
| | - John M Kelly
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK
| | - Michael D Lewis
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK.
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, CV4 7AJ, Coventry, UK.
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14
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Roman-Campos D, Marin-Neto JA, Santos-Miranda A, Kong N, D’Avila A, Rassi A. Arrhythmogenic Manifestations of Chagas Disease: Perspectives From the Bench to Bedside. Circ Res 2024; 134:1379-1397. [PMID: 38723031 PMCID: PMC11081486 DOI: 10.1161/circresaha.124.324507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2024]
Abstract
Chagas cardiomyopathy caused by infection with the intracellular parasite Trypanosoma cruzi is the most common and severe expression of human Chagas disease. Heart failure, systemic and pulmonary thromboembolism, arrhythmia, and sudden cardiac death are the principal clinical manifestations of Chagas cardiomyopathy. Ventricular arrhythmias contribute significantly to morbidity and mortality and are the major cause of sudden cardiac death. Significant gaps still exist in the understanding of the pathogenesis mechanisms underlying the arrhythmogenic manifestations of Chagas cardiomyopathy. This article will review the data from experimental studies and translate those findings to draw hypotheses about clinical observations. Human- and animal-based studies at molecular, cellular, tissue, and organ levels suggest 5 main pillars of remodeling caused by the interaction of host and parasite: immunologic, electrical, autonomic, microvascular, and contractile. Integrating these 5 remodeling processes will bring insights into the current knowledge in the field, highlighting some key features for future management of this arrhythmogenic disease.
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Affiliation(s)
- Danilo Roman-Campos
- Departamento de Biofísica, Escola Paulsita de Medicina, Laboratório de Cardiobiologia, Universidade Federal de São Paulo, São Paulo, SP, Brazil (D.R-C)
| | - José Antonio Marin-Neto
- Unidade de Hemodinâmica e Cardiologia Intervencionista, Escola de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil (J.A.M-N.)
| | - Artur Santos-Miranda
- Departamento de Fisiologia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil (A.S.-M)
| | - Nathan Kong
- Departamento de Biofísica, Escola Paulsita de Medicina, Laboratório de Cardiobiologia, Universidade Federal de São Paulo, São Paulo, SP, Brazil (D.R-C)
- Unidade de Hemodinâmica e Cardiologia Intervencionista, Escola de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil (J.A.M-N.)
- Departamento de Fisiologia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil (A.S.-M)
- Hospital do Coração Anis Rassi, Goiânia, GO, Brazil (A.R.J.)
| | - André D’Avila
- Departamento de Biofísica, Escola Paulsita de Medicina, Laboratório de Cardiobiologia, Universidade Federal de São Paulo, São Paulo, SP, Brazil (D.R-C)
- Unidade de Hemodinâmica e Cardiologia Intervencionista, Escola de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil (J.A.M-N.)
- Departamento de Fisiologia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil (A.S.-M)
- Hospital do Coração Anis Rassi, Goiânia, GO, Brazil (A.R.J.)
| | - Anis Rassi
- Hospital do Coração Anis Rassi, Goiânia, GO, Brazil (A.R.J.)
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15
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Hayon J, Lupo S, Poveda C, Jones KM, Qian Q, Wu H, Giordano TP, Fleischmann CJ, Bern C, Whitman JD, Clark EH. Adaptation of Chagas Disease Screening Recommendations for a Community of At-risk HIV in the United States. Clin Infect Dis 2024; 78:453-456. [PMID: 37805935 DOI: 10.1093/cid/ciad616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/05/2023] [Accepted: 10/04/2023] [Indexed: 10/10/2023] Open
Abstract
Chagas disease (CD), caused by Trypanosoma cruzi, is underdiagnosed in the United States. Improved screening strategies are needed, particularly for people at risk for life-threatening sequelae of CD, including people with human immunodeficiency virus (HIV, PWH). Here we report results of a CD screening strategy applied at a large HIV clinic serving an at-risk population.
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Affiliation(s)
- Jesica Hayon
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA
| | - Sofia Lupo
- McGovern School of Medicine, University of Texas, Houston, Texas, USA
| | - Cristina Poveda
- National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, USA
- Department of Pediatrics, Division of Tropical Medicine, Baylor College of Medicine, Houston, Texas, USA
- Texas Children's Hospital Center for Vaccine Development, Houston, Texas, USA
| | - Kathryn M Jones
- National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, USA
- Department of Pediatrics, Division of Tropical Medicine, Baylor College of Medicine, Houston, Texas, USA
- Texas Children's Hospital Center for Vaccine Development, Houston, Texas, USA
| | - Qian Qian
- Department of Biostatistics & Data Science, School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Hulin Wu
- Department of Biostatistics & Data Science, School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Thomas P Giordano
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA
- Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas, USA
| | - Charles J Fleischmann
- Department of Laboratory Medicine, University of California SanFrancisco School of Medicine, San Francisco, California, USA
| | - Caryn Bern
- Department of Epidemiology and Biostatistics, University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Jeffrey D Whitman
- Department of Laboratory Medicine, University of California SanFrancisco School of Medicine, San Francisco, California, USA
| | - Eva H Clark
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA
- National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, USA
- Department of Pediatrics, Division of Tropical Medicine, Baylor College of Medicine, Houston, Texas, USA
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16
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Kelly EA, Echeverri Alegre JI, Promer K, Hayon J, Iordanov R, Rangwalla K, Zhang JJ, Fang Z, Huang C, Bittencourt CE, Reed S, Andrade RM, Bern C, Clark EH, Whitman JD. Chagas Disease Diagnostic Practices at Four Major Hospital Systems in California and Texas. J Infect Dis 2024; 229:198-202. [PMID: 37853514 PMCID: PMC11032249 DOI: 10.1093/infdis/jiad404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/15/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Chagas disease (CD) is a parasitic disease that affects ∼300 000 people living in the United States. CD leads to cardiac and/or gastrointestinal disease in up to 30% of untreated people. However, end-organ damage can be prevented with early diagnosis and antiparasitic therapy. METHODS We reviewed electronic health records of patients who underwent testing for CD at four hospital systems in California and Texas between 2016 and 2020. Descriptive analyses were performed as a needs assessment for improving CD diagnosis. RESULTS In total, 470 patients were tested for CD. Cardiac indications made up more than half (60%) of all testing, and the most frequently cited cardiac condition was heart failure. Fewer than 1% of tests were ordered by obstetric and gynecologic services. Fewer than half (47%) of patients had confirmatory testing performed at the Centers for Disease Control and Prevention. DISCUSSION Four major hospitals systems in California and Texas demonstrated low overall rates of CD diagnostic testing, testing primarily among older patients with end-organ damage, and incomplete confirmatory testing. This suggests missed opportunities to diagnose CD in at-risk individuals early in the course of infection when antiparasitic treatment can reduce the risk of disease progression and prevent vertical transmission.
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Affiliation(s)
- Emily A Kelly
- Department of Laboratory Medicine, University of California, SanFrancisco, San Francisco, California, USA
| | | | - Katherine Promer
- Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, San Diego, California, USA
| | - Jesica Hayon
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA
| | - Roumen Iordanov
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA
| | - Khuzaima Rangwalla
- School of Medicine, University of California, SanFrancisco, San Francisco, California, USA
| | - Jerry J Zhang
- School of Biological Sciences, University of California, Irvine, Irvine, California, USA
| | - Zian Fang
- School of Biological Sciences, University of California, Irvine, Irvine, California, USA
| | - Cindy Huang
- School of Biological Sciences, University of California, Irvine, Irvine, California, USA
| | | | - Sharon Reed
- Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, San Diego, California, USA
- Department of Pathology, University of California, San Diego, San Diego, California, USA
| | - Rosa M Andrade
- Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, California, USA
| | - Caryn Bern
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | - Eva H Clark
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA
| | - Jeffrey D Whitman
- Department of Laboratory Medicine, University of California, SanFrancisco, San Francisco, California, USA
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17
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de Lima ACB, Mendes VG, Ferreira RR, Nisimura LM, Horita SIM, Veloso HH, Costa AR, da Silva GMS, Sangenis LHC, Holanda MT, Rimolo L, Cunha AB, Garzoni LR, Hasslocher-Moreno AM, Mediano MFF, Moreira ODC, Britto C, Saraiva RM. Predictors of Trypanosoma cruzi PCR positivity in patients with chronic Chagas disease. Mem Inst Oswaldo Cruz 2023; 118:e230115. [PMID: 38126526 PMCID: PMC10727046 DOI: 10.1590/0074-02760230115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 11/10/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND A positive Trypanosoma cruzi polymerase chain reaction (PCR) is associated with a worse prognosis in patients with chronic Chagas disease (CD). OBJECTIVES To study the association of clinical, electrocardiographic, and echocardiographic characteristics and biomarker blood levels with positive T. cruzi PCR in chronic CD. METHODS This is a single-centre observational cross-sectional study. Positive T. cruzi PCR association with clinical, electrocardiographic, and echocardiographic characteristics, and biomarker blood levels were studied by logistic regression analysis. p values < 0.05 were considered significant. FINDINGS Among 333 patients with chronic CD (56.4% men; 62 ± 10 years), T. cruzi PCR was positive in 41.1%. Stepwise multivariate logistic regression showed an independent association between positive T. cruzi PCR and diabetes mellitus {odds ratio (OR) 0.53 [95% confidence interval (CI) 0.30-0.93]; p = 0.03}, right bundle branch block [OR 1.78 (95% CI 1.09-2.89); p = 0.02], and history of trypanocidal treatment [OR 0.13 (95% CI 0.04-0.38); p = 0.0002]. Among patients with a history of trypanocidal treatment (n = 39), only four (10%) patients had a positive T. cruzi PCR. MAIN CONCLUSIONS Among several studied parameters, only diabetes mellitus, right bundle branch block, and history of trypanocidal treatment showed an independent association with positive T. cruzi PCR. History of trypanocidal treatment was a strong protective factor against a positive T. cruzi PCR.
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Affiliation(s)
- Ana Carolina Bastos de Lima
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Biologia Molecular e Doenças Endêmicas, Rio de Janeiro, RJ, Brasil
| | - Veronica Gonçalves Mendes
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Pesquisa Clínica em Doença de Chagas, Rio de Janeiro, RJ, Brasil
| | - Roberto Rodrigues Ferreira
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Inovações em Terapias, Ensino e Bioprodutos, Rio de Janeiro, RJ, Brasil
| | - Lindice Mitie Nisimura
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Inovações em Terapias, Ensino e Bioprodutos, Rio de Janeiro, RJ, Brasil
| | - Samuel Iwao Maia Horita
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Inovações em Terapias, Ensino e Bioprodutos, Rio de Janeiro, RJ, Brasil
| | - Henrique H Veloso
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Pesquisa Clínica em Doença de Chagas, Rio de Janeiro, RJ, Brasil
| | - Andréa R Costa
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Pesquisa Clínica em Doença de Chagas, Rio de Janeiro, RJ, Brasil
| | - Gilberto Marcelo S da Silva
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Pesquisa Clínica em Doença de Chagas, Rio de Janeiro, RJ, Brasil
| | - Luiz Henrique C Sangenis
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Pesquisa Clínica em Doença de Chagas, Rio de Janeiro, RJ, Brasil
| | - Marcelo T Holanda
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Pesquisa Clínica em Doença de Chagas, Rio de Janeiro, RJ, Brasil
| | - Lorena Rimolo
- Universidade Federal Fluminense, Hospital Universitário Antonio Pedro, Niterói, RJ, Brasil
| | - Ademir B Cunha
- Universidade Federal Fluminense, Hospital Universitário Antonio Pedro, Niterói, RJ, Brasil
| | - Luciana Ribeiro Garzoni
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Inovações em Terapias, Ensino e Bioprodutos, Rio de Janeiro, RJ, Brasil
| | - Alejandro Marcel Hasslocher-Moreno
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Pesquisa Clínica em Doença de Chagas, Rio de Janeiro, RJ, Brasil
| | - Mauro Felippe F Mediano
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Pesquisa Clínica em Doença de Chagas, Rio de Janeiro, RJ, Brasil
| | - Otacílio da Cruz Moreira
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Virologia e Parasitologia Molecular, Rio de Janeiro, RJ, Brasil
| | - Constança Britto
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Biologia Molecular e Doenças Endêmicas, Rio de Janeiro, RJ, Brasil
| | - Roberto M Saraiva
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Pesquisa Clínica em Doença de Chagas, Rio de Janeiro, RJ, Brasil
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18
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Herrera C, Bernabé KJ, Dumonteil E, DeCuir J, Thompson JM, Avendano M, Tu W, Leonhardt MM, Northland BA, Frederick J, Prieto B, Paternina-Caicedo A, Ortega E, Fonseca M, Hincapie M, Echeverri M. Assessment of Community Awareness and Screening of Chagas Disease in the Latin American Community of Greater New Orleans. Trop Med Infect Dis 2023; 8:515. [PMID: 38133447 PMCID: PMC10747578 DOI: 10.3390/tropicalmed8120515] [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: 10/27/2023] [Revised: 11/30/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023] Open
Abstract
Chagas disease is a public health problem in the Americas, from the southern United States (USA) to Argentina. In the USA, less than 1% of domestic cases have been identified and less than 0.3% of total cases have received treatment. Little is known about affected immigrant Latin American communities. A prospective study was conducted to assess knowledge about Chagas disease among the Latin American community living in the Greater New Orleans area. Participants answered a baseline questionnaire, viewed a short educational video presentation, completed a post-presentation questionnaire, and were screened with an FDA-approved blood rapid diagnostic test (RDT). A total of 154 participants from 18 Latin American countries (n = 138) and the USA (n = 16) were enrolled and screened for Trypanosoma cruzi infection. At baseline, 57% of the participants knew that Chagas disease is transmitted through an insect vector, and 26% recognized images of the vector. Following the administration of an educational intervention, the participants' knowledge regarding vector transmission increased to 91% and 35% of participants were able to successfully identify images of the vector. Five participants screened positive for T. cruzi infection, indicating a 3.24% [95%CI: 1.1-7.5%] prevalence of Trypanosoma cruzi infection within the Latin American community of the New Orleans area. Results highlight the urgent need for improving access to education and diagnostics of Chagas disease.
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Affiliation(s)
- Claudia Herrera
- Department of Tropical Medicine, Tulane University School of Public Health & Tropical Medicine, New Orleans, LA 70112, USA; (K.J.B.); (E.D.); (J.D.); (J.M.T.); (M.A.); (W.T.); (J.F.)
| | - Kerlly J. Bernabé
- Department of Tropical Medicine, Tulane University School of Public Health & Tropical Medicine, New Orleans, LA 70112, USA; (K.J.B.); (E.D.); (J.D.); (J.M.T.); (M.A.); (W.T.); (J.F.)
| | - Eric Dumonteil
- Department of Tropical Medicine, Tulane University School of Public Health & Tropical Medicine, New Orleans, LA 70112, USA; (K.J.B.); (E.D.); (J.D.); (J.M.T.); (M.A.); (W.T.); (J.F.)
| | - James DeCuir
- Department of Tropical Medicine, Tulane University School of Public Health & Tropical Medicine, New Orleans, LA 70112, USA; (K.J.B.); (E.D.); (J.D.); (J.M.T.); (M.A.); (W.T.); (J.F.)
| | - Julie M. Thompson
- Department of Tropical Medicine, Tulane University School of Public Health & Tropical Medicine, New Orleans, LA 70112, USA; (K.J.B.); (E.D.); (J.D.); (J.M.T.); (M.A.); (W.T.); (J.F.)
| | - Mariana Avendano
- Department of Tropical Medicine, Tulane University School of Public Health & Tropical Medicine, New Orleans, LA 70112, USA; (K.J.B.); (E.D.); (J.D.); (J.M.T.); (M.A.); (W.T.); (J.F.)
| | - Weihong Tu
- Department of Tropical Medicine, Tulane University School of Public Health & Tropical Medicine, New Orleans, LA 70112, USA; (K.J.B.); (E.D.); (J.D.); (J.M.T.); (M.A.); (W.T.); (J.F.)
| | - Maxwell M. Leonhardt
- Department of Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA; (M.M.L.); (B.A.N.)
| | - Bianka A. Northland
- Department of Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA; (M.M.L.); (B.A.N.)
| | - Jynx Frederick
- Department of Tropical Medicine, Tulane University School of Public Health & Tropical Medicine, New Orleans, LA 70112, USA; (K.J.B.); (E.D.); (J.D.); (J.M.T.); (M.A.); (W.T.); (J.F.)
| | - Bryn Prieto
- Department of Social, Behavioral, and Population Sciences, Tulane University School of Public Health & Tropical Medicine, New Orleans, LA 70112, USA;
| | - Angel Paternina-Caicedo
- Department of Epidemiology, Tulane University School of Public Health & Tropical Medicine, New Orleans, LA 70112, USA;
| | - Emma Ortega
- Office of Public Health-Infectious Disease Epidemiology, Louisiana Department of Health, New Orleans, LA 70802, USA;
| | - Maria Fonseca
- College of Pharmacy, Xavier University of Louisiana, New Orleans, LA 70125, USA; (M.F.); (M.H.); (M.E.)
| | - Marcela Hincapie
- College of Pharmacy, Xavier University of Louisiana, New Orleans, LA 70125, USA; (M.F.); (M.H.); (M.E.)
| | - Margarita Echeverri
- College of Pharmacy, Xavier University of Louisiana, New Orleans, LA 70125, USA; (M.F.); (M.H.); (M.E.)
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Kwon S, Casleton BG, Rivera GZ, Gella MM, Winkler EL, Kieffer JW, Osuna AB, Casey TM, Yun HC, Marcus JE. Infectious etiologies among post-donation deferrals in a military blood donation center. Transfusion 2023; 63:2265-2272. [PMID: 37850496 DOI: 10.1111/trf.17584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/19/2023] [Accepted: 09/28/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND The burden of transfusion-transmitted infections among blood recipients remains low due to extensive pre- and post-donation screening. However, the military has the unique challenge of providing blood in austere environments with limited testing capabilities. This study evaluates the infectious etiologies of deferred blood donors at a large military blood donation center. METHODS All blood donors at the Armed Service Blood Bank Center, San Antonio, between 2017 and 2022 with positive post-donation screening for hepatitis C (HCV), hepatitis B (HBV), human immunodeficiency virus (HIV), human T-lymphotropic virus (HTLV-I/II), Zika (2018-2021), West Nile virus, Trypanosoma cruzi, Treponema pallidum, or Babesia microti (2020-2022) were evaluated. Donors were deferred based on Food and Drug Administration (FDA) guidance. RESULTS Two-hundred and thirteen (213) donors met FDA criteria for deferral. T. pallidum (n = 45, 50.3 per 100,000), HCV (n = 34, 38.0 per 100,000), and HBV (n = 19, 21.2 per 100,000) were the most common pathogens among those with both positive screening and confirmatory testing. The majority of HIV (95%), Chagas (78%), HTLV-I/II (50%) deferrals were due to indeterminate confirmatory tests following initial positive screens. The majority of deferrals for HBV were for a second occurrence of a positive screen despite negative confirmatory testing. CONCLUSION The rates of post-donation deferral for transfusion-transmissible infections were low in this military cohort. Our findings suggest that donor testing in deployed service members should focus on HBV, HCV, and T. pallidum and highlight the need for better diagnostics for HIV, Chagas, and HTLV-I/II.
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Affiliation(s)
- Somin Kwon
- School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Brian G Casleton
- Armed Services Blood Bank Center-San Antonio, Joint Base San Antonio-Lackland, San Antonio, Texas, USA
| | - Glorimar Z Rivera
- Armed Services Blood Bank Center-San Antonio, Joint Base San Antonio-Lackland, San Antonio, Texas, USA
| | - Melita M Gella
- Armed Services Blood Bank Center-San Antonio, Joint Base San Antonio-Lackland, San Antonio, Texas, USA
- Department of Veterans Affairs, Audie Murphy VA Hospital, San Antonio, Texas, USA
| | - Erin L Winkler
- Trainee Health Surveillance, Joint Base San Antonio-Lackland, San Antonio, Texas, USA
| | - John W Kieffer
- Trainee Health Surveillance, Joint Base San Antonio-Lackland, San Antonio, Texas, USA
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Angela B Osuna
- Trainee Health Surveillance, Joint Base San Antonio-Lackland, San Antonio, Texas, USA
| | - Theresa M Casey
- Trainee Health Surveillance, Joint Base San Antonio-Lackland, San Antonio, Texas, USA
| | - Heather C Yun
- Infectious Diseases Service, Department of Medicine, Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, Fort Sam Houston, Texas, USA
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Joseph E Marcus
- Infectious Diseases Service, Department of Medicine, Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, Fort Sam Houston, Texas, USA
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
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20
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Olivo-Freites C, Sy H, Cardenas-Alvarez J, Vega-Batista F, Henao-Martínez AF. Trypanosoma cruzi Central Nervous System Infection-Pathogenesis, Clinical Manifestations, Diagnosis, and Treatment. CURRENT TROPICAL MEDICINE REPORTS 2023; 10:186-198. [PMID: 38983718 PMCID: PMC11233130 DOI: 10.1007/s40475-023-00300-0] [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] [Accepted: 10/03/2023] [Indexed: 07/11/2024]
Abstract
Purpose of Review Chagas disease (CD) is a neglected tropical disease from the American continent that commonly causes cardiovascular disease. Some patients develop neurological manifestations. We discuss and summarize the pathogenesis, clinical characteristics, diagnosis, and treatment of the central nervous system manifestations of CD. Recent Findings Cerebrospinal fluid quantitative polymerase chain reaction tests and next-generation sequencing in tissue samples have facilitated disease diagnosis and follow-up. Novel presentations, including retinitis, are now reported. A new MRI sign called "Bunch of açai berries appearance"-multiple hypointense nodular lesions-has been described recently. Treatment with benznidazole at higher doses and the role of therapeutic drug monitoring need to be further studied in this setting. Summary A high suspicion index is paramount to diagnosing Chagas' central nervous system involvement. Standardized molecular diagnostics can aid in the initial workup. Future development of new therapeutic drugs is crucial because of the toxicity profile of the currently available medications.
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Affiliation(s)
| | - Hendrik Sy
- Division of Infectious Disease, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jorge Cardenas-Alvarez
- Department of Medicine, Division of Infectious Disease, Columbia University Irving Medical Center, New York, NY 10032, USA
| | | | - Andrés F Henao-Martínez
- Department of Medicine, Division of Infectious Diseases, University of Colorado Anschutz Medical Campus, 12700 E. 19th Avenue, Mail Stop B168, Aurora, CO, USA
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21
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Henao-Martínez AF, Olivo-Freites C, Higuita NIA, Ferraz C, Franco-Paredes C, Tuells J, Woc-Colburn L, Villalpando-Carrión S, Chastain DB, Rassi A. Clinical Characteristics and Outcomes of Chagas Disease in the United States: A Multicenter Retrospective Analysis. Am J Trop Med Hyg 2023; 109:1006-1011. [PMID: 37696508 PMCID: PMC10622470 DOI: 10.4269/ajtmh.23-0361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 07/27/2023] [Indexed: 09/13/2023] Open
Abstract
Chagas disease affects approximately 300,000 patients in the United States. We evaluated a multicenter U.S.-based network to obtain clinical characteristics and outcomes of chronic Chagas disease by disease forms. This was a U.S.-based, multicenter, population-based, retrospective cohort study. We queried TriNetX, a global research network, to identify patients with dual-positive IgG serology for Trypanosoma cruzi. We captured outcomes of interest for up to 5 years. We found 429 patients with evidence of dual-positive T. cruzi IgG out of 19,831 patients with an available test result from 31 U.S. medical centers. The positive proportion for those tested was 2.2%, up to 4.6% among Hispanics. We found a prevalence of a positive Chagas serology of 0.02% among Hispanics. Cardiomyopathy risk reached an annual rate of 1.3% during the initial 5 years of follow-up among patients with the indeterminate form. We found no new events for pulmonary embolism, sudden death, or left ventricular aneurysms at 5 years. Annual risks for arrhythmias and stroke for chronic Chagas cardiomyopathy (CCC) were 1.6% and 0.8%, respectively. The yearly mortality and hospitalization rates for CCC were 2.7% and 17.1%, respectively. Only 13 patients had a documented antitrypanosomal therapy course within 6 months after diagnosis. Of those receiving treatment, 10 patients received benznidazole and three nifurtimox. Chagas disease screening in patients from endemic areas living in the United States remains crucial. Chronic Chagas cardiomyopathy carries a considerable disease burden, translating into increased morbidity and mortality and an enlarging medical health service utilization.
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Affiliation(s)
- Andrés F. Henao-Martínez
- Division of Infectious Diseases, Department of Medicine, University of Colorado Denver, Aurora, Colorado
| | | | - Nelson I. Agudelo Higuita
- Department of Medicine, Section of Infectious Diseases, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
- Instituto de Enfermedades Infecciosas y Parasitología Antonio Vidal, Tegucigalpa, Honduras
| | - Carolina Ferraz
- Division of Infectious Diseases, Department of Medicine, University of Colorado Denver, Aurora, Colorado
| | - Carlos Franco-Paredes
- Hospital Infantil de México, Ciudad de México, Mexico
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panama
| | - Jose Tuells
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, Alicante, Spain
| | | | | | - Daniel B. Chastain
- Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Albany, Georgia
| | - Anis Rassi
- Division of Cardiology, Anis Rassi Hospital, Goiânia, Brazil
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22
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Rodriguez CA, Busselman RE, Shen H, Saunders AB, Tarleton R, Hamer SA. Validation of a multiplex microsphere immunoassay for detection of antibodies to Trypanosoma cruzi in dogs. J Vet Diagn Invest 2023; 35:704-709. [PMID: 37670473 PMCID: PMC10621557 DOI: 10.1177/10406387231198525] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023] Open
Abstract
The vector-borne protozoan parasite Trypanosoma cruzi causes Chagas disease in humans, dogs, and many other mammalian hosts. Canine Chagas disease is increasingly diagnosed in dogs of the southern United States where triatomine insect vectors occur, and there are limited veterinary testing options; only the indirect fluorescent antibody (IFA) test is offered at a single accredited diagnostic laboratory. We evaluated a multiplex microsphere immunoassay (MIA) for the detection of antibodies against T. cruzi in dogs and compared it with existing serologic methods to establish cutoff values and relative sensitivity and specificity. We tested 135 canine sera that had been characterized using the IFA and off-label use of 2 commercial rapid assays with our multiplex MIA against 12 antigens: 9 T. cruzi antigens, a negative control recombinant protein (green fluorescent protein, GFP), a Leishmania antigen, and a canine parvovirus antigen (used as an antibody control given near-ubiquitous parvoviral vaccination). The median fluorescence intensity (MFI) ratio between each T. cruzi antigen and GFP was calculated for every sample. Samples with an antigen:GFP MFI ratio > 4 SDs above the mean of 25 known-negative sera were considered positive to that antigen. Samples testing positive to ≥ 2 antigens were considered positive for T. cruzi antibodies. Compared to the IFA, our multiplex MIA had a relative sensitivity of 100% and specificity of 97.0%. Given its precision, high-throughput format, potential for automation, and lack of subjective interpretation, our multiplex MIA should be considered a valid and improved assay for T. cruzi antibodies in dogs.
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Affiliation(s)
- Carlos A. Rodriguez
- Texas A&M Veterinary Medical Diagnostic Laboratory, College Station, TX, USA
- Departments of Veterinary Integrative Biosciences, School of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Rachel E. Busselman
- Departments of Veterinary Integrative Biosciences, School of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Huifeng Shen
- Emory University School of Medicine, Atlanta, GA, USA
- University of Georgia, Athens, GA, USA
| | - Ashley B. Saunders
- Small Animal Clinical Sciences, School of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | | | - Sarah A. Hamer
- Departments of Veterinary Integrative Biosciences, School of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX, USA
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23
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Manrique G, Rojas JC, Lorenzo Figueiras AN, Barrozo RB, Guerenstein PG. Highlights, challenges, and perspectives in basic and applied chemical ecology of triatomines. CURRENT OPINION IN INSECT SCIENCE 2023; 59:101101. [PMID: 37595884 DOI: 10.1016/j.cois.2023.101101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 08/10/2023] [Indexed: 08/20/2023]
Abstract
Triatomines are vectors of Chagas disease. Due to failures in their control, there is an urgent need for more efficient and environmentally friendly monitoring and control tools. These hematophagous insects rely heavily on chemical information from the environment to detect hosts and cues/signals from conspecifics. Chemical ecology includes the elucidation of the functional role of chemicals mediating interactions between organisms. Studies on the chemical ecology of triatomines are leading to novel methods for their monitor and control. Thus, laboratory tests to develop chemical attractants and repellents are promissory and have led to the design of, for example, efficient baited traps. However, the monitoring and control tools proposed until now have not been as effective in the field.
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Affiliation(s)
- Gabriel Manrique
- Laboratorio de Fisiología de Insectos, Instituto de Biodiversidad y Biología Experimental y Aplicada (IBBEA), CONICET-UBA, Departamento de Biodiversidad y Biología Experimental, Facultad Ciencias Exactas y Naturales, Universidad de Buenos Aires, Argentina
| | - Julio C Rojas
- Departamento de Ecología de Artrópodos y Manejo de Plagas, El Colegio de la Frontera Sur, Carretera Antiguo Aeropuerto km 2.5, Tapachula, Chiapas, Mexico
| | - Alicia N Lorenzo Figueiras
- Laboratorio de Fisiología de Insectos, Instituto de Biodiversidad y Biología Experimental y Aplicada (IBBEA), CONICET-UBA, Departamento de Biodiversidad y Biología Experimental, Facultad Ciencias Exactas y Naturales, Universidad de Buenos Aires, Argentina
| | - Romina B Barrozo
- Laboratorio de Neuroetología de Insectos, Instituto de Biodiversidad y Biología Experimental y Aplicada (IBBEA), CONICET-UBA, Departamento de Biodiversidad y Biología Experimental, Facultad Ciencias Exactas y Naturales, Universidad de Buenos Aires, Argentina
| | - Pablo G Guerenstein
- Laboratorio de Estudio de la Biología de Insectos, Centro de Investigación Científica y Transferencia Tecnológica a la Producción (CONICET-UADER-Gob de Entre Ríos), Diamante, Entre Ríos, Argentina; Facultad de Ingeniería, Universidad Nacional de Entre Ríos, Oro Verde, Entre Ríos, Argentina.
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24
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Muir D, Vargas G, Torres JR, Ávila-Agüero ML. Acute Chagas Disease Presenting as Preseptal Cellulitis. Pediatr Ann 2023; 52:e394-e397. [PMID: 37820707 DOI: 10.3928/19382359-20230829-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
Chagas disease, also known as American trypanosomiasis, is caused by Trypanosoma cruzi, a parasite transmitted by hematophagous triatomine insects (subfamily Triatominae) belonging to the Reduviidae family, order Hemiptera. Infection occurs through contact with the feces of the infected vector at the site of its bite or on intact mucosa. [Pediatr Ann. 2023;52(10):e394-e397.].
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25
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Beatty NL, Bhosale CR, Torhorst CW, Burkett-Cadena ND, Oi FM, Forsyth CJ, Wisely SM. Integrated pest management strategies targeting the Florida kissing bug, Triatoma sanguisuga: Preventing this vector of Chagas disease from invading your home. CURRENT RESEARCH IN PARASITOLOGY & VECTOR-BORNE DISEASES 2023; 4:100144. [PMID: 37841307 PMCID: PMC10570570 DOI: 10.1016/j.crpvbd.2023.100144] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/10/2023] [Accepted: 09/19/2023] [Indexed: 10/17/2023]
Abstract
Triatomines (Hemiptera: Reduviidae: Triatominae), commonly called "kissing bugs", are blood-sucking pests and vectors of the protozoan parasite Trypanosoma cruzi, the causative agent of Chagas disease (CD). Eleven species of kissing bugs occur throughout the southern half of the USA, four of which are well known to invade human dwellings. Certain kissing bugs in the USA are known to transmit T. cruzi to humans and other animals and their bites can also lead to serious allergic reactions, including anaphylaxis. In Florida, the kissing bug Triatoma sanguisuga frequently invades homes, bites residents, and has been found infected with T. cruzi, placing humans and companion animals at risk for CD. This review outlines integrated pest management (IPM) strategies for minimizing human exposure to T. sanguisuga and CD. A comprehensive IPM plan for kissing bugs includes detailed inspections, removal of vertebrate host nesting areas, and kissing bug harborage, home improvements to exclude kissing bugs from entering structures, pest removal, and judicious use of pesticides. This approach can limit or eliminate kissing bug entry into residential structures, thereby preventing kissing bug bites, and CD infections in humans and companion animals.
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Affiliation(s)
- Norman L. Beatty
- University of Florida College of Medicine, Department of Medicine, Division of Infectious Diseases and Global Medicine, Gainesville, FL, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Chanakya R. Bhosale
- Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, Florida, USA
| | - Carson W. Torhorst
- University of Florida Institute of Food and Agricultural Sciences, Department of Wildlife Ecology and Conservation, Gainesville, FL, USA
| | - Nathan D. Burkett-Cadena
- Florida Medical Entomology Laboratory, University of Florida Institute of Food and Agricultural Sciences, Vero Beach, FL, USA
| | - Faith M. Oi
- University of Florida Institute of Food and Agricultural Sciences, Entomology and Nematology Department, Gainesville, FL, USA
| | | | - Samantha M. Wisely
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
- University of Florida Institute of Food and Agricultural Sciences, Department of Wildlife Ecology and Conservation, Gainesville, FL, USA
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26
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Silberstein E, Chung CC, Debrabant A. The transcriptome landscape of 3D-cultured placental trophoblasts reveals activation of TLR2 and TLR3/7 in response to low Trypanosoma cruzi parasite exposure. Front Microbiol 2023; 14:1256385. [PMID: 37799608 PMCID: PMC10548471 DOI: 10.3389/fmicb.2023.1256385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/04/2023] [Indexed: 10/07/2023] Open
Abstract
Vertical transmission of Trypanosoma cruzi (T. cruzi) become a globalized health problem accounting for 22% of new cases of Chagas disease (CD). Congenital infection is now considered the main route of CD spread in non-endemic countries where no routine disease testing of pregnant women is implemented. The main mechanisms that lead to fetal infection by T. cruzi remain poorly understood. Mother-to-child transmission may occur when bloodstream trypomastigotes interact with the syncytiotrophoblasts (SYNs) that cover the placenta chorionic villi. These highly specialized cells function as a physical barrier and modulate immune responses against pathogen infections. To model the human placenta environment, we have previously used a three-dimensional (3D) cell culture system of SYNs that exhibits differentiation characteristics comparable to placental trophoblasts. Further, we have shown that 3D-grown SYNs are highly resistant to T. cruzi infection. In this work, we used RNA sequencing and whole transcriptome analysis to explore the immunological signatures that drive SYNs' infection control. We found that the largest category of differentially expressed genes (DEGs) are associated with inflammation and innate immunity functions. Quantitative RT-PCR evaluation of selected DEGs, together with detection of cytokines and chemokines in SYNs culture supernatants, confirmed the transcriptome data. Several genes implicated in the Toll-like receptors signaling pathways were upregulated in 3D-grown SYNs. In fact, TLR2 blockade and TLR3/7 knockdown stimulated T. cruzi growth, suggesting that these molecules play a significant role in the host cell response to infection. Ingenuity Pathway Analysis of DEGs predicted the activation of canonical pathways such as S100 protein family, pathogen induced cytokine storm, wound healing, HIF1α signaling and phagosome formation after T. cruzi exposure. Our findings indicate that SYNs resist infection by eliciting a constitutive pro-inflammatory response and modulating multiple defense mechanisms that interfere with the parasite's intracellular life cycle, contributing to parasite killing and infection control.
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Affiliation(s)
- Erica Silberstein
- Laboratory of Emerging Pathogens, Office of Blood Research and Review, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, United States
| | - Charles C. Chung
- High-performance Integrated Virtual Environment Team, Office of Biostatistics and Epidemiology, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, United States
| | - Alain Debrabant
- Laboratory of Emerging Pathogens, Office of Blood Research and Review, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, United States
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27
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Ríos-Gutiérrez A, Torres S, Arunachalam V. An updated estimation approach for SEIR models with stochastic perturbations: Application to COVID-19 data in Bogotá. PLoS One 2023; 18:e0285624. [PMID: 37603570 PMCID: PMC10441809 DOI: 10.1371/journal.pone.0285624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 04/26/2023] [Indexed: 08/23/2023] Open
Abstract
This paper studies the updated estimation method for estimating the transmission rate changes over time. The models for the population dynamics under SEIR epidemic models with stochastic perturbations are analysed the dynamics of the COVID-19 pandemic in Bogotá, Colombia. We performed computational experiments to interpret COVID-19 dynamics using actual data for the proposed models. We estimate the model parameters and updated their estimates for reported infected and recovered data.
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Affiliation(s)
- Andrés Ríos-Gutiérrez
- Department of Statistics, Universidad Nacional de Colombia, Bogotá, Colombia
- School of Mathematics, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Soledad Torres
- CIMFAV - Facultad de Ingeniería, Universidad de Valparaíso, Valparaíso, Chile
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28
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Saldivar MA, Michelen YE, Milla L, Kalogeropoulos AP, Sin E, Hellman HL, Gilman RH, Marcos LA. Seroprevalence of Chagas Disease among People of Latin American Descent Living in Suffolk County, Long Island, New York. Am J Trop Med Hyg 2023; 109:319-321. [PMID: 37460089 PMCID: PMC10397435 DOI: 10.4269/ajtmh.23-0258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 06/01/2023] [Indexed: 08/04/2023] Open
Abstract
This cross-sectional study estimated a one-time point seroprevalence rate of Chagas disease among people of Latin American descent in Suffolk County, Long Island, New York. Subjects who met the inclusion criteria were screened using the Chagas Detect Plus Rapid Test (InBios, Seattle, WA) with confirmation via Trypanosoma cruzi enzyme immunoassay and T. cruzi immunoblot assay. Administration of a questionnaire regarding demographics and risk factors followed. A seroprevalence rate of 10.74% was found. Identified risk factors included prior residence in a palm leaf house (odds ratio [OR], 10.42; P = 0.003; 95% CI, 2.18-49.76), residence in a house with triatomines (OR, 9.03; P = 0.006; 95% CI, 1.90-42.88), and history of triatomine bite (OR, 9.52; P = 0.009; 95% CI, 1.75-51.77). Our findings emphasize the importance of this frequently underdiagnosed disease and help highlight the importance of early screening among high-risk populations.
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Affiliation(s)
- Miguel A. Saldivar
- Division of Infectious Diseases, Department of Internal Medicine, Stony Brook University, Stony Brook, New York
| | - Yamil E. Michelen
- Division of Infectious Diseases, Department of Internal Medicine, Stony Brook University, Stony Brook, New York
| | - Lucia Milla
- Division of Infectious Diseases, Department of Internal Medicine, Stony Brook University, Stony Brook, New York
| | - Andreas P. Kalogeropoulos
- Division of Cardiology, Department of Internal Medicine, Stony Brook University, Stony Brook, New York
| | - Eric Sin
- Division of Infectious Diseases, Department of Internal Medicine, Stony Brook University, Stony Brook, New York
| | - Harriet L. Hellman
- Department of Pediatrics, Hampton Community Health Care, Southampton, New York
| | - Robert H. Gilman
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Luis A. Marcos
- Division of Infectious Diseases, Department of Internal Medicine, Stony Brook University, Stony Brook, New York
- Department of Microbiology and Immunology, Stony Brook University, Stony Brook, New York
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29
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Beltrami M, Grande R, Giacomelli A, Sabaini F, Biondo L, Longo M, Grosso S, Oreni L, Fadelli S, Galimberti L, Ridolfo AL, Antinori S. Chagas disease prevalence among migrants from El Salvador in Milan: a cross- sectional study of an often-overlooked population. Infect Dis (Lond) 2023; 55:559-566. [PMID: 37317783 DOI: 10.1080/23744235.2023.2222817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/02/2023] [Accepted: 06/03/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Chagas disease (CD) is considered to be highly endemic in El Salvador, where its prevalence is estimated to be 1.3-3.7%. Although more than 40,000 migrants from El Salvador are currently living in Europe (particularly in Spain and Italy), there are few data regarding the prevalence of CD in this population. The aim of this study was to evaluate the prevalence of CD among Salvadorans living in Italy. METHODS A cross-sectional serological survey of CD among Salvadorans living in the metropolitan area of Milan was carried out between October 2017 and December 2019. The participants' blood samples were tested for Trypanosoma cruzi antibodies using two different serological assays. The collected demographic data included their biological sex, province of origin, the type of housing in their country of origin, and family history of CD. RESULTS Of the 384 subjects who voluntarily participated in the study, five (1.3%, most coming from La Paz) were positive to both serological assays and therefore conclusively diagnosed as having CD. Five other subjects had discrepant serological results but were not positive to a third assay. Three of the five subjects with a diagnosis of CD completed medical staging, one of whom had chronic disease (digestive and cardiac involvement). CONCLUSIONS The prevalence of CD among Salvadorans living in Milan is similar to that estimated by the WHO in 2010. Although they are often overlooked in CD surveys, Salvadoran migrants should be included in CD control programs in countries in which the disease is not endemic.
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Affiliation(s)
- Martina Beltrami
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Italy
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | | | - Andrea Giacomelli
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Federico Sabaini
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Italy
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Lidia Biondo
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Italy
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Margherita Longo
- Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Silvia Grosso
- Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Letizia Oreni
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Italy
| | | | - Laura Galimberti
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Anna Lisa Ridolfo
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Spinello Antinori
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Italy
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
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30
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Marin-Neto JA, Rassi A, Oliveira GMM, Correia LCL, Ramos Júnior AN, Luquetti AO, Hasslocher-Moreno AM, Sousa ASD, Paola AAVD, Sousa ACS, Ribeiro ALP, Correia Filho D, Souza DDSMD, Cunha-Neto E, Ramires FJA, Bacal F, Nunes MDCP, Martinelli Filho M, Scanavacca MI, Saraiva RM, Oliveira Júnior WAD, Lorga-Filho AM, Guimarães ADJBDA, Braga ALL, Oliveira ASD, Sarabanda AVL, Pinto AYDN, Carmo AALD, Schmidt A, Costa ARD, Ianni BM, Markman Filho B, Rochitte CE, Macêdo CT, Mady C, Chevillard C, Virgens CMBD, Castro CND, Britto CFDPDC, Pisani C, Rassi DDC, Sobral Filho DC, Almeida DRD, Bocchi EA, Mesquita ET, Mendes FDSNS, Gondim FTP, Silva GMSD, Peixoto GDL, Lima GGD, Veloso HH, Moreira HT, Lopes HB, Pinto IMF, Ferreira JMBB, Nunes JPS, Barreto-Filho JAS, Saraiva JFK, Lannes-Vieira J, Oliveira JLM, Armaganijan LV, Martins LC, Sangenis LHC, Barbosa MPT, Almeida-Santos MA, Simões MV, Yasuda MAS, Moreira MDCV, Higuchi MDL, Monteiro MRDCC, Mediano MFF, Lima MM, Oliveira MTD, Romano MMD, Araujo NNSLD, Medeiros PDTJ, Alves RV, Teixeira RA, Pedrosa RC, Aras Junior R, Torres RM, Povoa RMDS, Rassi SG, Alves SMM, Tavares SBDN, Palmeira SL, Silva Júnior TLD, Rodrigues TDR, Madrini Junior V, Brant VMDC, Dutra WO, Dias JCP. SBC Guideline on the Diagnosis and Treatment of Patients with Cardiomyopathy of Chagas Disease - 2023. Arq Bras Cardiol 2023; 120:e20230269. [PMID: 37377258 PMCID: PMC10344417 DOI: 10.36660/abc.20230269] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023] Open
Affiliation(s)
- José Antonio Marin-Neto
- Universidade de São Paulo , Faculdade de Medicina de Ribeirão Preto , Ribeirão Preto , SP - Brasil
| | - Anis Rassi
- Hospital do Coração Anis Rassi , Goiânia , GO - Brasil
| | | | | | | | - Alejandro Ostermayer Luquetti
- Centro de Estudos da Doença de Chagas , Hospital das Clínicas da Universidade Federal de Goiás , Goiânia , GO - Brasil
| | | | - Andréa Silvestre de Sousa
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
| | | | - Antônio Carlos Sobral Sousa
- Universidade Federal de Sergipe , São Cristóvão , SE - Brasil
- Hospital São Lucas , Rede D`Or São Luiz , Aracaju , SE - Brasil
| | | | | | | | - Edecio Cunha-Neto
- Universidade de São Paulo , Faculdade de Medicina da Universidade, São Paulo , SP - Brasil
| | - Felix Jose Alvarez Ramires
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Fernando Bacal
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | - Martino Martinelli Filho
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Maurício Ibrahim Scanavacca
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Roberto Magalhães Saraiva
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
| | | | - Adalberto Menezes Lorga-Filho
- Instituto de Moléstias Cardiovasculares , São José do Rio Preto , SP - Brasil
- Hospital de Base de Rio Preto , São José do Rio Preto , SP - Brasil
| | | | | | - Adriana Sarmento de Oliveira
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | - Ana Yecê das Neves Pinto
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
| | | | - Andre Schmidt
- Universidade de São Paulo , Faculdade de Medicina de Ribeirão Preto , Ribeirão Preto , SP - Brasil
| | - Andréa Rodrigues da Costa
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
| | - Barbara Maria Ianni
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | - Carlos Eduardo Rochitte
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
- Hcor , Associação Beneficente Síria , São Paulo , SP - Brasil
| | | | - Charles Mady
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Christophe Chevillard
- Institut National de la Santé Et de la Recherche Médicale (INSERM), Marselha - França
| | | | | | | | - Cristiano Pisani
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | | | | | - Edimar Alcides Bocchi
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Evandro Tinoco Mesquita
- Hospital Universitário Antônio Pedro da Faculdade Federal Fluminense , Niterói , RJ - Brasil
| | | | | | | | | | | | - Henrique Horta Veloso
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
| | - Henrique Turin Moreira
- Hospital das Clínicas , Faculdade de Medicina de Ribeirão Preto , Universidade de São Paulo , Ribeirão Preto , SP - Brasil
| | | | | | | | - João Paulo Silva Nunes
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
- Fundação Zerbini, Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | | | | | | | | | - Luiz Cláudio Martins
- Universidade Estadual de Campinas , Faculdade de Ciências Médicas , Campinas , SP - Brasil
| | | | | | | | - Marcos Vinicius Simões
- Universidade de São Paulo , Faculdade de Medicina de Ribeirão Preto , Ribeirão Preto , SP - Brasil
| | | | | | - Maria de Lourdes Higuchi
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | - Mauro Felippe Felix Mediano
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
- Instituto Nacional de Cardiologia (INC), Rio de Janeiro, RJ - Brasil
| | - Mayara Maia Lima
- Secretaria de Vigilância em Saúde , Ministério da Saúde , Brasília , DF - Brasil
| | | | | | | | | | - Renato Vieira Alves
- Instituto René Rachou , Fundação Oswaldo Cruz , Belo Horizonte , MG - Brasil
| | - Ricardo Alkmim Teixeira
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Roberto Coury Pedrosa
- Hospital Universitário Clementino Fraga Filho , Instituto do Coração Edson Saad - Universidade Federal do Rio de Janeiro , RJ - Brasil
| | | | | | | | | | - Silvia Marinho Martins Alves
- Ambulatório de Doença de Chagas e Insuficiência Cardíaca do Pronto Socorro Cardiológico Universitário da Universidade de Pernambuco (PROCAPE/UPE), Recife , PE - Brasil
| | | | - Swamy Lima Palmeira
- Secretaria de Vigilância em Saúde , Ministério da Saúde , Brasília , DF - Brasil
| | | | | | - Vagner Madrini Junior
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | | | - João Carlos Pinto Dias
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
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31
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Proaño A, Dumonteil E, Herrera C. Chagas Disease Diagnostic Testing in Two Academic Hospitals in New Orleans, Louisiana: A Call to Action. Trop Med Infect Dis 2023; 8:tropicalmed8050277. [PMID: 37235325 DOI: 10.3390/tropicalmed8050277] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/09/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
Chagas disease, caused by the protozoa parasite Trypanosoma cruzi, is an anthropozoonosis that represents a major public health problem in the Americas, affecting 7 million people with at least 65 million at risk. We sought to assess the intensity of disease surveillance based on diagnostic test requests from hospitals in New Orleans, Louisiana. We extracted information from send-out labs at two major tertiary academic hospitals in New Orleans, Louisiana, USA, from 1 January 2018 to 1 December 2020. We found that in these three years there were 27 patients for whom Chagas disease testing was ordered. Most of these patients were male (70%), with a median age of 40 years old, and their most common ethnical background was Hispanic (74%). These findings demonstrate undertesting of this neglected disease in our region. Given the low Chagas disease surveillance, we need to increase awareness, health promotion, and education among healthcare workers.
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Affiliation(s)
- Alvaro Proaño
- Department of Pediatrics, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Eric Dumonteil
- Department of Tropical Medicine, Vector-Borne and Infectious Disease Research Center, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Claudia Herrera
- Department of Tropical Medicine, Vector-Borne and Infectious Disease Research Center, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA
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Chancey RJ, Edwards MS, Montgomery SP. Congenital Chagas Disease. Pediatr Rev 2023; 44:213-221. [PMID: 37002357 PMCID: PMC10313159 DOI: 10.1542/pir.2022-005857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Affiliation(s)
- Rebecca J Chancey
- Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA
| | | | - Susan P Montgomery
- Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA
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33
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Fimbres-Macias JP, Harris TA, Hamer SA, Hamer GL. Phenology and environmental predictors of Triatoma sanguisuga dispersal in east-central Texas, United States. Acta Trop 2023; 240:106862. [PMID: 36787862 DOI: 10.1016/j.actatropica.2023.106862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/08/2023] [Accepted: 02/10/2023] [Indexed: 02/16/2023]
Abstract
Of 11 triatomine species in the United States (US), Triatoma sanguisuga has the widest distribution across a 23-state region encompassing the southeastern US. This species consistently feeds on humans and dogs and has a high infection prevalence with the Chagas parasite Trypanosoma cruzi, with over 30-60% of adults infected. Little is known about the phenology and environmental predictors of dispersal activity of Triatoma sanguisuga. Using manual searches standardized by effort, we sampled kissing bugs in east central Texas, US every other night from June to November 2020 to determine their phenology and environmental predictors of activity. We found 176 triatomines alive, all of which were T. sanguisuga, with peak collections in early August and cessation of activity by late October; the phenology as determined by this active surveillance matched what has been reported using a passive community science approach. Using a negative binomial regression, we found temperature to have a positive correlation with T. sanguisuga dispersal activity, while wind speed had a significant negative correlation. We identified increased collections during sampling sessions with precipitation during the preceding 22 h. Further, wind from the southwest - the direction of most of the sylvatic habitat in the study area - was correlated with an increased dispersal activity, suggesting wind-facilitated dispersal. Given concerns for human and animal Chagas disease within the distribution of T. sanguisuga, vector control strategies can be adapted based on the factors influencing dispersal behavior.
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Affiliation(s)
- Juan P Fimbres-Macias
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, TX 77843, USA
| | - Trevor A Harris
- Department of Statistics, Texas A&M University, College Station, TX 77843, USA
| | - Sarah A Hamer
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, TX 77843, USA
| | - Gabriel L Hamer
- Department of Entomology, Texas A&M University, College Station, TX 77843, USA.
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34
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Alvim JM, Venturini G, Oliveira TGM, Seidman JG, Seidman CE, Krieger JE, Pereira AC. mTOR signaling inhibition decreases lysosome migration and impairs the success of Trypanosoma cruzi infection and replication in cardiomyocytes. Acta Trop 2023; 240:106845. [PMID: 36709791 DOI: 10.1016/j.actatropica.2023.106845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 01/27/2023]
Abstract
Chagas disease is caused by the parasite Trypanosoma cruzi (T. cruzi) and, among all the chronic manifestations of the disease, Chronic Chagas Cardiomyopathy (CCC) is the most severe outcome. Despite high burden and public health importance in Latin America, there is a gap in understanding the molecular mechanisms that results in CCC development. Previous studies showed that T. cruzi uses the host machinery for infection and replication, including the repurposing of the responses to intracellular infection such as mitochondrial activity, vacuolar membrane, and lysosomal activation in benefit of parasite infection and replication. One common signaling upstream to many responses to parasite infection is mTOR pathway, previous associated to several downstream cellular mechanisms including autophagy, mitophagy and lysosomal activation. Here, using human iPSC derived cardiomyocytes (hiPSCCM), we show the mTOR pathway is activated in hiPSCCM after T. cruzi infection, and the inhibition of mTOR with rapamycin reduced number of T. cruzi 48 h post infection (hpi). Rapamycin treatment also reduced lysosome migration from nuclei region to cell periphery resulting in less T. cruzi inside the parasitophorous vacuole (PV) in the first hour of infection. In addition, the number of parasites leaving the PV to the cytoplasm to replicate in later times of infection was also lower after rapamycin treatment. Altogether, our data suggest that host's mTOR activation concomitant with parasite infection modulates lysosome migration and that T. cruzi uses this mechanism to achieve infection and replication. Modulating this mechanism with rapamycin impaired the success of T. cruzi life cycle independent of mitophagy.
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Affiliation(s)
- Juliana M Alvim
- Heart Institute, Clinical Hospital, Faculty of Medicine, University of São Paulo, Brazil; Laboratory of Genetics and Molecular Cardiology, Clinical Hospital, Faculty of Medicine, University of São Paulo, Brazil
| | - Gabriela Venturini
- Heart Institute, Clinical Hospital, Faculty of Medicine, University of São Paulo, Brazil; Laboratory of Genetics and Molecular Cardiology, Clinical Hospital, Faculty of Medicine, University of São Paulo, Brazil; Department of Genetics, Harvard Medical School, United States.
| | - Theo G M Oliveira
- Heart Institute, Clinical Hospital, Faculty of Medicine, University of São Paulo, Brazil; Laboratory of Genetics and Molecular Cardiology, Clinical Hospital, Faculty of Medicine, University of São Paulo, Brazil; Fundação Pró-Sangue Hemocentro de São Paulo, Brazil
| | | | - Christine E Seidman
- Department of Genetics, Harvard Medical School, United States; Brigham and Women's Hospital, Harvard Medical School, United States; Howard Hughes Medical Institute (HHMI), United States
| | - José E Krieger
- Heart Institute, Clinical Hospital, Faculty of Medicine, University of São Paulo, Brazil; Laboratory of Genetics and Molecular Cardiology, Clinical Hospital, Faculty of Medicine, University of São Paulo, Brazil
| | - Alexandre C Pereira
- Heart Institute, Clinical Hospital, Faculty of Medicine, University of São Paulo, Brazil; Laboratory of Genetics and Molecular Cardiology, Clinical Hospital, Faculty of Medicine, University of São Paulo, Brazil; Department of Genetics, Harvard Medical School, United States
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35
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Rios LE, Lokugamage N, Garg NJ. Effects of Acute and Chronic Trypanosoma cruzi Infection on Pregnancy Outcomes in Mice: Parasite Transmission, Mortality, Delayed Growth, and Organ Damage in Pups. THE AMERICAN JOURNAL OF PATHOLOGY 2023; 193:313-331. [PMID: 36565805 PMCID: PMC10013038 DOI: 10.1016/j.ajpath.2022.11.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 10/20/2022] [Accepted: 11/30/2022] [Indexed: 12/22/2022]
Abstract
Chagas disease is caused by Trypanosoma cruzi. This study aimed to determine the effects of T. cruzi infection on fertility rate and health of the newborn pups in pregnant mice. Female mice were challenged with T. cruzi and mated at 21 days (acute parasitemic phase) or 90 days (chronic parasite persistence phase) after infection. Pups were examined for growth up to 20 days after birth; and parasite burden in brain, heart, skeletal muscle, and intestine was measured by real-time quantitative PCR. The inflammatory infiltrate, necrosis, and fibrosis in pups' heart and brain tissues were evaluated by histology. T. cruzi infection in dams delayed the onset of pregnancy, decreased the fertility rate, and led to vertical transmission of parasite to the pups. Furthermore, infected dams delivered pups that exhibited decreased survival rate, decreased birth weight, and decreased growth rate. Significantly increased inflammation, necrosis, and fibrosis of cardiac and brain tissues were noted in pups born to infected dams. Initial challenge with higher parasite dose had more detrimental effects on fertility rate and pups' health in both acutely and chronically infected dams. In conclusion, mice offer a promising model to evaluate the efficacy of new vaccines and therapeutic drugs in controlling the acute and chronic maternal T. cruzi infection and congenital transmission to newborns, and in improving the fertility rate and pups' health outcomes.
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Affiliation(s)
- Lizette E Rios
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas; Department of Biochemistry, Cellular and Molecular Biology, University of Texas Medical Branch, Galveston, Texas
| | - Nandadeva Lokugamage
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas
| | - Nisha J Garg
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas; Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, Texas.
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36
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Teal E, Herrera C, Dumonteil E. Metabolomics of developmental changes in Triatoma sanguisuga gut microbiota. PLoS One 2023; 18:e0280868. [PMID: 36827319 PMCID: PMC9955940 DOI: 10.1371/journal.pone.0280868] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 01/10/2023] [Indexed: 02/25/2023] Open
Abstract
Triatoma sanguisuga is one of the major vectors of Trypanosoma cruzi in the southeastern US, where it sustains a robust zoonotic parasite transmission cycle and occasional human infections. A better understanding of triatomine development may allow for alternative approaches to insecticide-based vector control. Indeed, the role of the gut microbiota and bacterial endosymbionts in triatomine development and in their vectorial capacity is emerging. We investigated here the differences in microbiota among nymph and adult T. sanguisuga, to shed light on the metabolomic interactions occurring during development. Microbiota composition was assessed by 16s gene amplification and deep sequencing from field-caught adult bugs and their laboratory-raised progeny. Significant differences in microbiota bacterial diversity and composition were observed between nymphs and adults. Laboratory-raised nymphs showed a higher taxonomic diversity, and at least seven families predominated. On the other hand, field-caught adults had a lower bacterial diversity and four families comprised most of the microbiota. These differences in compositions were associated with differences in predicted metabolism, with laboratory-raised nymphs microbiota metabolizing a limited diversity of carbon sources, with potential for resource competition between bacterial families, and the production of lactic acid as a predominant fermentation product. On the other hand, field-caught adult microbiota was predicted to metabolize a broader diversity of carbon sources, with complementarity rather than competition among taxa, and produced a diverse range of products in a more balanced manner. The restricted functionality of laboratory-raised nymph microbiota may be associated with their poor development in captivity, and further understanding of the metabolic interactions at play may lead to alternative vector control strategies targeting triatomine microbiota.
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Affiliation(s)
- Evan Teal
- Department of Tropical Medicine, School of Public Health and Tropical Medicine, and Vector-Borne and Infectious Disease Research Center, Tulane University, New Orleans, Louisiana, United States of America
| | - Claudia Herrera
- Department of Tropical Medicine, School of Public Health and Tropical Medicine, and Vector-Borne and Infectious Disease Research Center, Tulane University, New Orleans, Louisiana, United States of America
| | - Eric Dumonteil
- Department of Tropical Medicine, School of Public Health and Tropical Medicine, and Vector-Borne and Infectious Disease Research Center, Tulane University, New Orleans, Louisiana, United States of America
- * E-mail:
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37
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TORCH Congenital Syndrome Infections in Central America's Northern Triangle. Microorganisms 2023; 11:microorganisms11020257. [PMID: 36838223 PMCID: PMC9964893 DOI: 10.3390/microorganisms11020257] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 01/08/2023] [Accepted: 01/16/2023] [Indexed: 01/21/2023] Open
Abstract
TORCH pathogens are a group of globally prevalent infectious agents that may cross the placental barrier, causing severe negative sequalae in neonates, including fetal death and lifelong morbidity. TORCH infections are classically defined by Toxoplasma gondii, other infectious causes of concern (e.g., syphilis, Zika virus, malaria, human immunodeficiency virus), rubella virus, cytomegalovirus, and herpes simplex viruses. Neonatal disorders and congenital birth defects are the leading causes of neonatal mortality in Central America's Northern Triangle, yet little is known about TORCH congenital syndrome in this region. This review synthesizes the little that is known regarding the most salient TORCH infections among pregnant women and neonates in Central America's Northern Triangle and highlights gaps in the literature that warrant further research. Due to the limited publicly available information, this review includes both peer-reviewed published literature and university professional degree theses. Further large-scale studies should be conducted to clarify the public health impact these infections in this world region.
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38
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Barbiero A, Mazzi M, Mantella A, Trotta M, Rossolini GM, Antonelli A, Bordonaro P, Colao MG, Speciale AR, Di Benedetto T, Di Tommaso M, Mantengoli E, Petraglia F, Galli L, Pezzati M, Dani C, Caldes Pinilla MJ, Berni C, Dannaoui B, Albajar Viñas P, Bartoloni A, Zammarchi L. A Questionnaire Integrated with the Digital Medical Record Improved the Coverage of a Control Program for Congenital Chagas Disease in Tuscany, Italy. Microorganisms 2023; 11:154. [PMID: 36677446 PMCID: PMC9866674 DOI: 10.3390/microorganisms11010154] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 12/31/2022] [Accepted: 01/02/2023] [Indexed: 01/11/2023] Open
Abstract
The leading route of Chagas disease transmission in nonendemic countries is congenital. However, policies concerning screening, prevention, and management of congenital Chagas disease are rare in these settings. Since 2012, serological screening for Chagas disease should be provided for pregnant women at risk in Tuscany, Italy according to a Regional resolution. Due to difficulties in the implementation, in November 2019, a checklist aimed at identifying pregnant women at risk for Chagas disease was introduced in digital clinical records at Careggi University Hospital, Florence, Italy. In order to evaluate the effectiveness of the "Chagas checklist", data about the number of deliveries by women at risk and their screening coverage between 2012 and June 2022 were collected. Out of 1348 deliveries by women at risk, 626 (47%) Trypanosoma cruzi serology tests were performed during the study period. The annual screening coverage increased from an average of 40.3% between 2012 and 2019 to 75.7% between 2020 and June 2022, underlining the big impact of the checklist. Four Chagas disease serological tests out of 626 (0.6%) resulted positive, corresponding to 2 affected women. No cases of congenital transmission occurred. The study showed that a simple digital tool led to a tangible improvement in the coverage of the screening program; its application in a setting where digital charts are available will contribute to the control and elimination of congenital Chagas disease.
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Affiliation(s)
- Anna Barbiero
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
| | - Martina Mazzi
- School of Human Health Sciences, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
| | - Antonia Mantella
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
- Tuscany Regional Referral Center for Tropical Diseases, Careggi University Hospital, 50134 Florence, Italy
| | - Michele Trotta
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, Italy
- Tuscany Regional Referral Center for Infectious Diseases in Pregnancy, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, Italy
| | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
- Clinical Microbiology and Virology Unit, Careggi University Hospital, 50134 Florence, Italy
| | - Alberto Antonelli
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
| | - Patrizia Bordonaro
- Hospital General Laboratory, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, Italy
| | - Maria Grazia Colao
- Clinical Microbiology and Virology Unit, Careggi University Hospital, 50134 Florence, Italy
| | - Anna Rosa Speciale
- Department of Health Sciences, Obstetrics and Gynecology Branch, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
| | - Tullio Di Benedetto
- Department of Health Sciences, Obstetrics and Gynecology Branch, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
| | - Mariarosaria Di Tommaso
- Department of Health Sciences, Obstetrics and Gynecology Branch, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
| | - Elisabetta Mantengoli
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, Italy
| | - Felice Petraglia
- Biomedical, Experimental and Clinical Sciences “Mario Serio”, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
| | - Luisa Galli
- Department of Health Sciences University of Florence, Paediatric Infectious Diseases Division, Anna Meyer Children’s University Hospital, Viale Pieraccini 24, 50139 Florence, Italy
| | - Marco Pezzati
- Pediatric Unit, Santa Maria Annunziata Hospital, AUSL Toscana Centro, Via Antella, 58, Bagno a Ripoli, 50012 Florence, Italy
| | - Carlo Dani
- Department of Neuroscience, Psychology, Drug Research and Child Health, Careggi University Hospital of Florence, Largo Brambilla 3, 50134 Florence, Italy
| | - Maria José Caldes Pinilla
- Tuscany Regional Center for Global Health, Anna Meyer Children’s University Hospital, Viale Pieraccini 24, 50139 Florence, Italy
| | - Cecilia Berni
- Citizenship Rights and Social Cohesion Directorate, Tuscany Region, Via Camillo Cavour, 2, 50122 Florence, Italy
| | - Bassam Dannaoui
- Technological Innovation in Clinical-Assistance Activities Unit, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134 Florence, Italy
| | - Pedro Albajar Viñas
- Department of Control of Neglected Tropical Diseases, World Health Organization, Avenue Appia 20, CH-1211 Geneva, Switzerland
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
- Tuscany Regional Referral Center for Tropical Diseases, Careggi University Hospital, 50134 Florence, Italy
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, Italy
| | - Lorenzo Zammarchi
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
- Tuscany Regional Referral Center for Tropical Diseases, Careggi University Hospital, 50134 Florence, Italy
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, Italy
- Tuscany Regional Referral Center for Infectious Diseases in Pregnancy, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, Italy
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Tawaraishi T, Ochida A, Akao Y, Itono S, Kamaura M, Akther T, Shimada M, Canan S, Chowdhury S, Cao Y, Condroski K, Engkvist O, Francisco A, Ghosh S, Kaki R, Kelly JM, Kimura C, Kogej T, Nagaoka K, Naito A, Pairaudeau G, Radu C, Roberts I, Shum D, Watanabe NA, Xie H, Yonezawa S, Yoshida O, Yoshida R, Mowbray C, Perry B. Collaborative Virtual Screening Identifies a 2-Aryl-4-aminoquinazoline Series with Efficacy in an In Vivo Model of Trypanosoma cruzi Infection. J Med Chem 2023; 66:1221-1238. [PMID: 36607408 PMCID: PMC9884087 DOI: 10.1021/acs.jmedchem.2c00775] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Probing multiple proprietary pharmaceutical libraries in parallel via virtual screening allowed rapid expansion of the structure-activity relationship (SAR) around hit compounds with moderate efficacy against Trypanosoma cruzi, the causative agent of Chagas Disease. A potency-improving scaffold hop, followed by elaboration of the SAR via design guided by the output of the phenotypic virtual screening efforts, identified two promising hit compounds 54 and 85, which were profiled further in pharmacokinetic studies and in an in vivo model of T. cruzi infection. Compound 85 demonstrated clear reduction of parasitemia in the in vivo setting, confirming the interest in this series of 2-(pyridin-2-yl)quinazolines as potential anti-trypanosome treatments.
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Affiliation(s)
- Taisuke Tawaraishi
- Takeda
Pharmaceutical Company Limited, 26-1 Muraoka-Higashi 2-chrome, Fujisawa, Kanagawa 251-8555, Japan
| | - Atsuko Ochida
- Takeda
Pharmaceutical Company Limited, 26-1 Muraoka-Higashi 2-chrome, Fujisawa, Kanagawa 251-8555, Japan
| | - Yuichiro Akao
- Takeda
Pharmaceutical Company Limited, 26-1 Muraoka-Higashi 2-chrome, Fujisawa, Kanagawa 251-8555, Japan
| | - Sachiko Itono
- Takeda
Pharmaceutical Company Limited, 26-1 Muraoka-Higashi 2-chrome, Fujisawa, Kanagawa 251-8555, Japan
| | - Masahiro Kamaura
- Takeda
Pharmaceutical Company Limited, 26-1 Muraoka-Higashi 2-chrome, Fujisawa, Kanagawa 251-8555, Japan
| | - Thamina Akther
- Takeda
Pharmaceutical Company Limited, 26-1 Muraoka-Higashi 2-chrome, Fujisawa, Kanagawa 251-8555, Japan
| | - Mitsuyuki Shimada
- Takeda
Pharmaceutical Company Limited, 26-1 Muraoka-Higashi 2-chrome, Fujisawa, Kanagawa 251-8555, Japan
| | - Stacie Canan
- Celgene
Corporation, Celgene Global Health, 10300 Campus Point Drive, San Diego, California 92121, United States
| | - Sanjoy Chowdhury
- TCG
Lifesciences, Plot No-7,
Salt Lake Electronics Complex, BN Block, Sector V, Kolkata 700091, India
| | - Yafeng Cao
- WuXi
AppTec Company Ltd., 666 Gaoxin Road, East Lake High-Tech Development Zone, Wuhan 430075, People’s Republic of China
| | - Kevin Condroski
- Celgene
Corporation, Celgene Global Health, 10300 Campus Point Drive, San Diego, California 92121, United States
| | - Ola Engkvist
- AstraZeneca
Discovery Sciences, R&D, Pepparedsleden 1, 431 50 Mölndal, Sweden
| | - Amanda Francisco
- London School
of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, U.K.
| | - Sunil Ghosh
- TCG
Lifesciences, Plot No-7,
Salt Lake Electronics Complex, BN Block, Sector V, Kolkata 700091, India
| | - Rina Kaki
- Shionogi
& Co., Ltd, 3-1-1,
Futaba-cho, Toyonaka-shi, Osaka 561-0825, Japan
| | - John M. Kelly
- London School
of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, U.K.
| | - Chiaki Kimura
- Shionogi
& Co., Ltd, 3-1-1,
Futaba-cho, Toyonaka-shi, Osaka 561-0825, Japan
| | - Thierry Kogej
- AstraZeneca
Discovery Sciences, R&D, Pepparedsleden 1, 431 50 Mölndal, Sweden
| | - Kazuya Nagaoka
- Eisai
Co., Ltd, 1-3, Tokodai
5-chome, Tsukuba, Ibaraki 300-2635, Japan
| | - Akira Naito
- Shionogi
& Co., Ltd, 3-1-1,
Futaba-cho, Toyonaka-shi, Osaka 561-0825, Japan
| | - Garry Pairaudeau
- AstraZeneca,
Discovery Sciences, R&D, The Darwin Building, 310 Milton Road, Milton, Cambridge CB4 0WG, U.K.
| | - Constantin Radu
- Institut
Pasteur Korea, 16, Daewangpangyo-ro
712 beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13488, Republic of Korea
| | - Ieuan Roberts
- AstraZeneca,
Discovery Sciences, R&D, The Darwin Building, 310 Milton Road, Milton, Cambridge CB4 0WG, U.K.
| | - David Shum
- Institut
Pasteur Korea, 16, Daewangpangyo-ro
712 beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13488, Republic of Korea
| | - Nao-aki Watanabe
- Eisai
Co., Ltd, 1-3, Tokodai
5-chome, Tsukuba, Ibaraki 300-2635, Japan
| | - Huanxu Xie
- WuXi
AppTec Company Ltd., 666 Gaoxin Road, East Lake High-Tech Development Zone, Wuhan 430075, People’s Republic of China
| | - Shuji Yonezawa
- Shionogi
& Co., Ltd, 3-1-1,
Futaba-cho, Toyonaka-shi, Osaka 561-0825, Japan
| | - Osamu Yoshida
- Shionogi
& Co., Ltd, 3-1-1,
Futaba-cho, Toyonaka-shi, Osaka 561-0825, Japan
| | - Ryu Yoshida
- Shionogi
& Co., Ltd, 3-1-1,
Futaba-cho, Toyonaka-shi, Osaka 561-0825, Japan
| | - Charles Mowbray
- Drugs for Neglected
Diseases Initiative, 15 Chemin Camille Vidart, Geneva 1202, Switzerland
| | - Benjamin Perry
- Drugs for Neglected
Diseases Initiative, 15 Chemin Camille Vidart, Geneva 1202, Switzerland,
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Vásconez-González J, Izquierdo-Condoy JS, Fernandez-Naranjo R, Gamez-Rivera E, Tello-De-la-Torre A, Guerrero-Castillo GS, Ruiz-Sosa C, Ortiz-Prado E. Severe Chagas disease in Ecuador: a countrywide geodemographic epidemiological analysis from 2011 to 2021. Front Public Health 2023; 11:1172955. [PMID: 37143984 PMCID: PMC10151800 DOI: 10.3389/fpubh.2023.1172955] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 04/04/2023] [Indexed: 05/06/2023] Open
Abstract
Background Chagas disease is a neglected and often forgotten tropical disease caused by the Trypanosoma cruzi. This parasite can be transmitted through the direct contact of human skin with feces and urine of the triatomine insect. According to the World Health Organization (WHO), an estimated 6-7 million people are infected worldwide, killing at least 14,000 every year. The disease has been reported in 20 of the 24 provinces of Ecuador, with El Oro, Guayas, and Loja being the most affected. Methodology We analyzed the morbidity and mortality rates of severe Chagas disease in Ecuador on a nationwide, population-based level. Hospitalization cases and deaths were also examined based on altitude, including low (< 2,500 m) and high (> 2,500 m) altitudes, according to the International Society. Data was retrieved from the National Institute of Statistics and Census hospital admissions and in-hospital mortality databases from 2011 to 2021. Results A total of 118 patients have been hospitalized in Ecuador since 2011 due to Chagas disease. The overall in-hospital mortality rate was 69.4% (N = 82). Men have a higher incidence rate (4.8/1,000,000) than women, although women have a significantly higher mortality rate than men (6.9/1,000,000). Conclusion Chagas disease is a severe parasitic condition that primarily affects rural and poorer areas of Ecuador. Men are more likely to be infected due to differences in work and sociocultural activities. Using average elevation data, we conducted a geodemographic analysis to assess incidence rates by altitude. Our findings indicate that the disease is more common at low and moderate altitudes, but recent increases in cases at higher altitudes suggest that environmental changes, such as global warming, could be driving the proliferation of disease-carrying vectors in previously unaffected areas.
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Affiliation(s)
- Jorge Vásconez-González
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | - Juan S. Izquierdo-Condoy
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | - Raul Fernandez-Naranjo
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | - Esteban Gamez-Rivera
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | - Andrea Tello-De-la-Torre
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | | | - Carlos Ruiz-Sosa
- Postgraduate in Gastroenterology and Digestive Endoscopy, Faculty of Medicine, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | - Esteban Ortiz-Prado
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
- *Correspondence: Esteban Ortiz-Prado,
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Gulas-Wroblewski BE, Gorchakov R, Kairis RB, Dowler RC, Murray KO. Prevalence of Trypanosoma cruzi, the Etiologic Agent of Chagas Disease, Infection in Texas Skunks (Mammalia: Mephitidae). Vector Borne Zoonotic Dis 2023; 23:18-28. [PMID: 36633561 PMCID: PMC10024073 DOI: 10.1089/vbz.2022.0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background: Chagas disease is one of the world's most neglected tropical diseases, infecting over six million people across the Americas. The hemoparasite Trypanosoma cruzi is the etiological agent for the disease, circulating in domestic, peridomestic, and sylvatic transmission cycles that are maintained by triatomine vectors and a diversity of wild and synanthropic hosts. Public health and wildlife management interventions targeting the interruption of T. cruzi transmission rely on an understanding of the dynamics driving the ecology of this zoonotic pathogen. One wildlife host that purportedly plays a role in the transmission of Chagas disease within the southern United States is the striped skunk (Mephitis mephitis), although infection prevalence in this species is poorly understood. Materials and Methods: To this end, we conducted a PCR-based surveillance of T. cruzi in 235 wild skunks, representing 4 species, across 76 counties and 10 ecoregions in Texas, United States, along with an evaluation of risk factors associated with the infection. Results: We recovered an overall T. cruzi prevalence of 17.9% for all mephitid taxa aggregated, ranging between 6.7% for plains spotted skunks (Spilogale putorius interrupta) and 42.9% for western spotted skunks (Spilogale gracilis). We report the first cases of T. cruzi infection in plains spotted and American hog-nosed skunks (Conepatus leuconotus), of important note for conservation medicine since populations of both species are declining within Texas. Although not statistically significant, we also detected trends for juveniles to exhibit greater infection risk than adults and for differential sex biases in T. cruzi prevalence between taxa, which align with variations in species-specific seasonal activity patterns. No geographic or taxonomic risk factors were identified. Conclusion: Our study contributed key data for population viability analyses and epidemiologic models in addition to providing a baseline for future T. cruzi surveillance among skunks and other wildlife species.
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Affiliation(s)
- Bonnie E. Gulas-Wroblewski
- Division of Tropical Medicine, Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA
- Texas A&M Natural Resources Institute, College Station, Texas, USA
| | - Rodion Gorchakov
- Division of Tropical Medicine, Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA
| | - Rebecca B. Kairis
- Division of Tropical Medicine, Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA
- William T. Shearer Center for Human Immunobiology, Texas Children's Hospital, Houston, Texas, USA
| | - Robert C. Dowler
- Department of Biology, Angelo State University, San Angelo, Texas, USA
| | - Kristy O. Murray
- Division of Tropical Medicine, Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA
- William T. Shearer Center for Human Immunobiology, Texas Children's Hospital, Houston, Texas, USA
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42
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Evaluation of the Chagas VirClia ® and Chagas TESA VirClia ® for the Diagnosis of Trypanosoma cruzi Infection. Pathogens 2022; 12:pathogens12010050. [PMID: 36678398 PMCID: PMC9864210 DOI: 10.3390/pathogens12010050] [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: 12/03/2022] [Revised: 12/22/2022] [Accepted: 12/26/2022] [Indexed: 12/31/2022] Open
Abstract
Chagas disease (CD), caused by the protozoan Trypanosoma cruzi, is an important problem of public health even in regions where it is not endemic. Spain ranks second worldwide in terms of imported cases of T. cruzi infection in the chronic phase. The diagnosis in this stage is made via the detection of antibodies against T. cruzi. Therefore, we aimed to evaluate the sensitivity and specificity of two fully automated chemiluminescence immunoassays, Chagas VirClia® (CHR), which uses a mixture of recombinant antigens, and Chagas TESA VirClia® (TESA), the first chemiluminescence assay based on excretion-secretion antigens of trypomastigotes, both designed in monotest format. A retrospective case-control study was performed using 105 well-characterized samples: 49 from patients with CD, 22 from uninfected individuals, and 32 from patients with other pathologies. Sensitivity was 98% for CHR and 92% for TESA. In contrast, the specificity in both was 100%. Cross-reactivity was observed in leishmaniasis (2/10). CHR meets the criteria to become a tool for serological screening, while TESA has the potential for confirmation and cross-reaction discrimination. The monotest format allows its application in laboratories with a small number of samples. The high specificity of both assays is useful in areas where leishmaniasis is endemic.
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43
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Simón M, Ladrón de Guevara P, Polo SA, Sierra S, Segovia M. The community pharmacy as a strategic ally in the fight against Chagas disease. Travel Med Infect Dis 2022; 52:102527. [PMID: 36539020 DOI: 10.1016/j.tmaid.2022.102527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/09/2022] [Accepted: 12/16/2022] [Indexed: 12/23/2022]
Affiliation(s)
- Marina Simón
- Regional Unit of Tropical Medicine, Microbiology Service, Virgen de La Arrixaca University Clinical Hospital, Murcia, Spain.
| | | | | | | | - Manuel Segovia
- Regional Unit of Tropical Medicine, Microbiology Service, Virgen de La Arrixaca University Clinical Hospital, Murcia, Spain; Department of Genetics and Microbiology, University of Murcia, Spain
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44
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Candia-Puma MA, Machaca-Luque LY, Roque-Pumahuanca BM, Galdino AS, Giunchetti RC, Coelho EAF, Chávez-Fumagalli MA. Accuracy of Diagnostic Tests for the Detection of Chagas Disease: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2022; 12:2752. [PMID: 36359595 PMCID: PMC9689806 DOI: 10.3390/diagnostics12112752] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 11/02/2023] Open
Abstract
The present systematic review and meta-analysis about the accuracy of diagnostic tests aim to describe the findings of literature over the last thirty years for the diagnosis of Chagas disease (CD). This work aimed to determine the accuracy of diagnostic techniques for CD in the disease's acute and chronic phases. The PubMed database was searched for studies published between 1990 and 2021 on CD diagnostics. Fifty-six published studies that met the criteria were analyzed and included in the meta-analysis, evaluating diagnostic accuracy through sensitivity and specificity. For Enzyme-Linked Immunosorbent Assay (ELISA), Fluorescent Antibody Technique (IFAT), Hemagglutination Test (HmT), Polymerase Chain Reaction (PCR), and Real-Time Polymerase Chain Reaction (qPCR) diagnosis methods, the sensitivity had a median of 99.0%, 78.0%, 75.0%, 76.0%, and 94.0%, respectively; while specificity presented a median of 99.0%, 99.0%, 99.0%, 98.0%, and 98.0%, respectively. This meta-analysis showed that ELISA and qPCR techniques had a higher performance compared to other methods of diagnosing CD in the chronic and acute phases, respectively. It was concluded utilizing the Area Under the Curve restricted to the false positive rates (AUCFPR), that the ELISA diagnostic test presents the highest performance in diagnosing acute and chronic CD, compared to serological and molecular tests. Future studies focusing on new CD diagnostics approaches should be targeted.
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Affiliation(s)
- Mayron Antonio Candia-Puma
- Computational Biology and Chemistry Research Group, Vicerrectorado de Investigación, Universidad Católica de Santa María, Arequipa 04000, Peru
- Facultad de Ciencias Farmacéuticas, Bioquímicas y Biotecnológicas, Universidad Católica de Santa María, Arequipa 04000, Peru
| | - Laura Yesenia Machaca-Luque
- Computational Biology and Chemistry Research Group, Vicerrectorado de Investigación, Universidad Católica de Santa María, Arequipa 04000, Peru
- Facultad de Ciencias Farmacéuticas, Bioquímicas y Biotecnológicas, Universidad Católica de Santa María, Arequipa 04000, Peru
| | - Brychs Milagros Roque-Pumahuanca
- Computational Biology and Chemistry Research Group, Vicerrectorado de Investigación, Universidad Católica de Santa María, Arequipa 04000, Peru
- Facultad de Ciencias Farmacéuticas, Bioquímicas y Biotecnológicas, Universidad Católica de Santa María, Arequipa 04000, Peru
| | - Alexsandro Sobreira Galdino
- Laboratório de Biotecnologia de Microrganismos, Universidade Federal São João Del-Rei, Divinópolis 35501-296, MG, Brazil
| | - Rodolfo Cordeiro Giunchetti
- Laboratório de Biologia das Interações Celulares, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais, INCT-DT, Salvador 40015-970, BA, Brazil
| | - Eduardo Antonio Ferraz Coelho
- Programa de Pós-Graduação em Ciências da Saúde, Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
- Departamento de Patologia Clínica, COLTEC, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Miguel Angel Chávez-Fumagalli
- Computational Biology and Chemistry Research Group, Vicerrectorado de Investigación, Universidad Católica de Santa María, Arequipa 04000, Peru
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