1
|
Urbano P, Hernández C, Ballesteros N, Vega L, Alvarado M, Velásquez-Ortiz N, Martínez D, Barragán K, Ramírez A, Páez-Triana L, Urrea V, Ramírez JD, González C. Exploring dietary differences among developmental stages of triatomines infected with Trypanosoma cruzi in different habitats. Int J Parasitol 2024; 54:559-568. [PMID: 38759833 DOI: 10.1016/j.ijpara.2024.05.001] [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: 12/28/2023] [Revised: 04/04/2024] [Accepted: 05/12/2024] [Indexed: 05/19/2024]
Abstract
Chagas disease affects millions of people in Colombia and worldwide, with its transmission influenced by ecological, environmental, and anthropogenic factors. There is a notable correlation between vector transmission cycles and the habitats of insect vectors of the parasite. However, the scale at which these cycles operate remains uncertain. While individual triatomine ecotopes such as palms provide conditions for isolated transmission cycles, recent studies examining triatomine blood sources in various habitats suggest a more intricate network of transmission cycles, linking wild ecotopes with human dwellings. This study aims to provide further evidence on the complexity of the scale of Trypanosoma cruzi transmission cycles, by exploring the different blood sources among developmental stages of infected triatomines in different habitats. We evaluated infection rates, parasite loads, feeding sources, and the distribution of Rhodnius prolixus insects in Attalea butyracea palms across three distinct habitats in Casanare, Colombia: peridomestics, pastures, and woodlands. Our results show that there is no clear independence in transmission cycles in each environment. Analyses of feeding sources suggest the movement of insects and mammals (primarily bats and didelphids) among habitats. A significant association was found between habitat and instar stages in collected R. prolixus. The N1 stage was correlated with pasture and woodland, while the N4 stage was related to pasture. Additionally, adult insects exhibited higher T. cruzi loads than N1, N2, and N3. We observed higher T. cruzi loads in insects captured in dwelling and pasture habitats, compared with those captured in woodland areas. Effective Chagas disease control strategies must consider the complexity of transmission cycles and the interplay between domestic and sylvatic populations of mammals and vectors.
Collapse
Affiliation(s)
- Plutarco Urbano
- Centro de Investigaciones en Microbiología y Parasitología Tropical (CIMPAT), Departamento de Ciencias Biológicas, Universidad de los Andes, Bogotá, Colombia; Grupo de Investigaciones Biológicas de la Orinoquia, Universidad Internacional del Trópico Americano (Unitrópico), Yopal, Colombia; Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia.
| | - Carolina Hernández
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia; Centro de Tecnología en Salud (CETESA), Innovaseq SAS, Bogotá, Colombia; Molecular Microbiology Laboratory, Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Nathalia Ballesteros
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Laura Vega
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Mateo Alvarado
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Natalia Velásquez-Ortiz
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Davinzon Martínez
- Grupo de Investigaciones Biológicas de la Orinoquia, Universidad Internacional del Trópico Americano (Unitrópico), Yopal, Colombia
| | - Karen Barragán
- Grupo de Investigaciones Biológicas de la Orinoquia, Universidad Internacional del Trópico Americano (Unitrópico), Yopal, Colombia
| | - Angie Ramírez
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Luisa Páez-Triana
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Vanessa Urrea
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Juan David Ramírez
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia; Molecular Microbiology Laboratory, Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Camila González
- Centro de Investigaciones en Microbiología y Parasitología Tropical (CIMPAT), Departamento de Ciencias Biológicas, Universidad de los Andes, Bogotá, Colombia.
| |
Collapse
|
2
|
Segura-Alba ML, Hernandez C, Guerra AP, Luna N, Cortes LJ, Acevedo CR, Ballesteros N, Ayala MS, Vera MJ, Caicedo Diaz RA, Ardila SC, Flórez AC, Patiño LH, Paniz-Mondolfi AE, Ramírez JD. Acute Chagas disease outbreaks in Colombia in 2019. IJID REGIONS 2024; 12:100410. [PMID: 39228675 PMCID: PMC11369394 DOI: 10.1016/j.ijregi.2024.100410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 07/17/2024] [Accepted: 07/19/2024] [Indexed: 09/05/2024]
Abstract
This study seeks to address the critical knowledge gap surrounding the acute phase of Chagas disease in Colombia, with a specific focus on cases reported in 2019. The acute phase of Chagas disease is a pivotal period for intervention, yet it remains poorly understood, particularly in regions where oral transmission is presumed to be a significant factor. By analyzing these recent cases, our research aims to provide a deeper understanding of the dynamics of Chagas disease during its acute phase in Colombia in 2019. This understanding is essential not only for improving disease management and treatment strategies but also for enhancing public health responses to this neglected tropical disease. In particular, our study highlights the importance of identifying and addressing the unique challenges posed by oral transmission routes, which have been increasingly recognized within Colombia's Chagas disease landscape.
Collapse
Affiliation(s)
| | - Carolina Hernandez
- Centro de Investigaciones en Microbiología y Biotecnología - UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
- Molecular Microbiology Laboratory, Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
| | | | - Nicolas Luna
- Centro de Investigaciones en Microbiología y Biotecnología - UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | | | | | - Natalia Ballesteros
- Centro de Investigaciones en Microbiología y Biotecnología - UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | | | - Mauricio Javier Vera
- Subdirección de enfermedades transmisibles, Ministerio de Salud y Protección Social Bogotá, Colombia
| | | | | | | | - Luz H. Patiño
- Centro de Investigaciones en Microbiología y Biotecnología - UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Alberto E. Paniz-Mondolfi
- Molecular Microbiology Laboratory, Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Juan David Ramírez
- Centro de Investigaciones en Microbiología y Biotecnología - UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
- Molecular Microbiology Laboratory, Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
| |
Collapse
|
3
|
Olivera MJ, Rincón Acevedo CY, Olivera AJ, Mendez-Cardona S, Vera Soto MJ. Addressing Chagas disease from a One Health perspective: risk factors, lessons learned and prevention of oral transmission outbreaks in Colombia. SCIENCE IN ONE HEALTH 2024; 3:100066. [PMID: 39077384 PMCID: PMC11262278 DOI: 10.1016/j.soh.2024.100066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 03/25/2024] [Indexed: 07/31/2024]
Abstract
Background Chagas disease (CD) is transmitted by vectors but can also be transmitted orally through contaminated food, drinks, or meat. The One Health perspective aims to understand the complex interaction between human, animal, and environmental health in controlling disease. This study analyzed risk factors and drew lessons from past outbreaks of orally transmitted CD to develop effective preventive strategies. Methods A simultaneous mixed methods study was conducted. The study consisted of two phases: an ecological epidemiological analysis at the municipal level using secondary data spanning from 1992 to 2023, and semistructured interviews with health providers and policymakers at the national level in Colombia. The results from both phases were triangulated to gain a comprehensive understanding of the topic. Results A total of 64 outbreaks, infecting 302 individuals, were reported. Most of these outbreaks (89.2%) were classified as family-related, and they occurred most frequently during the months of April to June (46.6%). It is worth noting that a significant number of these outbreaks took place in municipalities that lacked vector control plans. Risk factors for oral transmission included the location of food preparation, poor housing quality, food preparation water source, the presence of vectors/marsupials, forest type, and climatic variables. Interviews conducted emphasized the importance of implementing outbreak plans and providing staff training to effectively address the issue. Conclusion A One Health approach strengthening prevention, surveillance, case management and cross-sectoral collaboration is needed to control outbreaks and reduce transmission in Colombia. Preparedness plans and education of health professionals are also important. This study identified modifiable risk factors to guide public health interventions.
Collapse
Affiliation(s)
- Mario J. Olivera
- Grupo de Parasitología, Instituto Nacional de Salud de Colombia, Bogotá 111321, D.C., Colombia
| | - Claudia Yaneth Rincón Acevedo
- Dirección de Vigilancia y Análisis del Riesgo en Salud Pública, Instituto Nacional de Salud, Bogotá 111321, D.C., Colombia
| | - Antonio José Olivera
- Departamento de Psicología, Corporación Universitaria del Caribe, Sincelejo, 700001, Colombia
| | - Sergio Mendez-Cardona
- Grupo de Entomología, Instituto Nacional de Salud de Colombia, Bogotá 111321, D.C., Colombia
- Florida Medical Entomology Laboratory, University of Florida, Vero Beach, FL 32962, USA
| | - Mauricio Javier Vera Soto
- Dirección de Promoción y Prevención, Ministerio de Salud y Protección Social, Bogotá 110311, D.C., Colombia
| |
Collapse
|
4
|
Beatty NL, Arango-Ferreira C, Gual-Gonzalez L, Zuluaga S, Nolan MS, Cantillo-Barraza O. Oral Chagas Disease in Colombia-Confirmed and Suspected Routes of Transmission. Trop Med Infect Dis 2024; 9:14. [PMID: 38251211 PMCID: PMC10819552 DOI: 10.3390/tropicalmed9010014] [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: 10/23/2023] [Revised: 12/21/2023] [Accepted: 12/28/2023] [Indexed: 01/23/2024] Open
Abstract
Chagas disease (CD) remains endemic throughout many regions of Colombia despite implementing decades of vector control strategies in several departments. Some regions have had a significant decrease in vectorial transmission, but the oral ingestion of Trypanosoma cruzi through consumption of contaminated food and drink products is increasingly described. This form of transmission has important public health relevance in Colombia due to an increase in reported acute CD cases and clinical manifestations that often lead to significant morbidity and mortality. Oral CD in Colombia has been associated with the consumption of contaminated fruit juices, such as palm wine, sugar cane, or tangerine juice and water for consumption, or contaminated surfaces where food has been prepared. Another interesting route of oral transmission includes ingestion of unbeknownst infected armadillos' blood, which is related to a traditional medicine practice in Colombia. Some earlier reports have also implemented consumption of infected bush meat as a source, but this is still being debated. Within the Amazon Basin, oral transmission is now considered the principal cause of acute CD in these regions. Furthermore, new cases of acute CD are now being seen in departments where CD has not been documented, and triatomine vectors are not naturally found, thus raising suspicion for oral transmission. The oral CD could also be considered a food-borne zoonosis, and odoriferous didelphid secretions have been implemented in contaminating the human dwelling environment, increasing the risk of consumption of infectious metacyclic trypomastigotes. In this article, we will discuss the complex transmission dynamics of oral CD in Colombia and further examine the unique clinical manifestations of this route of infection. New insights into the oral transmission of Trypanosoma cruzi are being discovered in Colombia, which can help bring increased awareness and a better understanding of this neglected tropical disease to reduce the burden of CD throughout Latin America.
Collapse
Affiliation(s)
- Norman L. Beatty
- Division of Infectious Diseases and Global Medicine, Department of Medicine, University of Florida College of Medicine, Gainesville, FL 32610, USA;
- Emerging Pathogens Institute, University of Florida, Gainesville, FL 32610, USA
| | - Catalina Arango-Ferreira
- Departamento de Pediatría, Hospital San Vicente Fundación, Medellín 050010, Colombia;
- Departamento de Pediatría, Facultad de Medicina, Universidad de Antioquia, Medellín 050010, Colombia
| | - Lídia Gual-Gonzalez
- Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (L.G.-G.); (M.S.N.)
| | - Sara Zuluaga
- Grupo Biología y Control de Enfermedades Infecciosas, Universidad de Antioquia, Medellín 050010, Colombia;
| | - Melissa S. Nolan
- Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (L.G.-G.); (M.S.N.)
| | - Omar Cantillo-Barraza
- Grupo Biología y Control de Enfermedades Infecciosas, Universidad de Antioquia, Medellín 050010, Colombia;
| |
Collapse
|
5
|
Ledien J, Cucunubá ZM, Parra-Henao G, Rodríguez-Monguí E, Dobson AP, Adamo SB, Castellanos LG, Basáñez MG, Nouvellet P. From serological surveys to disease burden: a modelling pipeline for Chagas disease. Philos Trans R Soc Lond B Biol Sci 2023; 378:20220278. [PMID: 37598701 PMCID: PMC10440172 DOI: 10.1098/rstb.2022.0278] [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: 11/20/2022] [Accepted: 06/29/2023] [Indexed: 08/22/2023] Open
Abstract
In 2012, the World Health Organization (WHO) set the elimination of Chagas disease intradomiciliary vectorial transmission as a goal by 2020. After a decade, some progress has been made, but the new 2021-2030 WHO roadmap has set even more ambitious targets. Innovative and robust modelling methods are required to monitor progress towards these goals. We present a modelling pipeline using local seroprevalence data to obtain national disease burden estimates by disease stage. Firstly, local seroprevalence information is used to estimate spatio-temporal trends in the Force-of-Infection (FoI). FoI estimates are then used to predict such trends across larger and fine-scale geographical areas. Finally, predicted FoI values are used to estimate disease burden based on a disease progression model. Using Colombia as a case study, we estimated that the number of infected people would reach 506 000 (95% credible interval (CrI) = 395 000-648 000) in 2020 with a 1.0% (95%CrI = 0.8-1.3%) prevalence in the general population and 2400 (95%CrI = 1900-3400) deaths (approx. 0.5% of those infected). The interplay between a decrease in infection exposure (FoI and relative proportion of acute cases) was overcompensated by a large increase in population size and gradual population ageing, leading to an increase in the absolute number of Chagas disease cases over time. This article is part of the theme issue 'Challenges and opportunities in the fight against neglected tropical diseases: a decade from the London Declaration on NTDs'.
Collapse
Affiliation(s)
- Julia Ledien
- School of Life Sciences, University of Sussex, Falmer, Brighton BN1 9RH, UK
| | - Zulma M. Cucunubá
- Departamento de Epidemiología Clínica y Bioestadística, Facultad de Medicina, Universidad Pontificia Javeriana, 110231 Bogotá, Colombia
| | - Gabriel Parra-Henao
- Centro de Investigación en Salud para el Trópico, Universidad Cooperativa de Colombia, 470002, Santa Marta, Colombia
- National Institute of Health, 111321 Bogotá, Colombia
| | - Eliana Rodríguez-Monguí
- Departamento de Epidemiología Clínica y Bioestadística, Facultad de Medicina, Universidad Pontificia Javeriana, 110231 Bogotá, Colombia
- Independent consultant to the Neglected, Tropical and Vector Borne Diseases Program, Pan American Health Organization (PAHO), Colombia
| | - Andrew P. Dobson
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ 08544, USA
| | - Susana B. Adamo
- Center for International Earth Science Information Network (CIESIN), Columbia Climate School, Columbia University, New York, NY 10025, USA
| | - Luis Gerardo Castellanos
- Department of Communicable Diseases and Environmental Determinants of Health, Pan American Health Organization (PAHO), Washington, DC 20037, USA
| | - María-Gloria Basáñez
- London Centre for Neglected Tropical Disease Research (LCNTDR) & MRC Centre for Global Infectious Disease Analysis (GIDA), Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London SW7 2AZ, UK
| | - Pierre Nouvellet
- School of Life Sciences, University of Sussex, Falmer, Brighton BN1 9RH, UK
- London Centre for Neglected Tropical Disease Research (LCNTDR) & MRC Centre for Global Infectious Disease Analysis (GIDA), Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London SW7 2AZ, UK
| |
Collapse
|
6
|
López-García A, Gilabert JA. Oral transmission of Chagas disease from a One Health approach: A systematic review. Trop Med Int Health 2023; 28:689-698. [PMID: 37488635 DOI: 10.1111/tmi.13915] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
OBJECTIVE To analyse acute Chagas disease (CD) outbreaks through a qualitative systematic review and discuss the determinants for its prevention and control. METHODS Review of studies in which clinical cases of oral transmission were confirmed by parasitological and/or serological tests that included an epidemiological investigation of sources of infection, vectors and reservoirs. RESULTS Thirty-two outbreaks (1965-2022) were analysed. The main foods involved in oral transmission outbreaks are homemade fruit juices. Different species of vectors were identified. Reservoirs were mainly dogs, rodents and large American opossums (didelphids). CONCLUSION Under a One Health approach, environmental changes are one of the factors responsible of the rise of oral transmission of CD. Entomological surveillance of vectors and control of the changes in wild and domestic reservoirs and reinforcement of hygiene measures around food in domestic and commercial sites are needed.
Collapse
Affiliation(s)
- Alejandra López-García
- Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, Complutense University of Madrid, Madrid, Spain
| | - Juan A Gilabert
- Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, Complutense University of Madrid, Madrid, Spain
| |
Collapse
|
7
|
Vergara HD, Gómez CH, Faccini-Martínez ÁA, Herrera AC, López MJ, Camacho C, Muñoz L, Cruz-Saavedra L, Hernández C, Ramírez JD. Acute Chagas Disease Outbreak among Military Personnel, Colombia, 2021. Emerg Infect Dis 2023; 29:1882-1885. [PMID: 37610186 PMCID: PMC10461683 DOI: 10.3201/eid2909.230886] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023] Open
Abstract
We report an acute Chagas disease outbreak among soldiers in Colombia. Trypanosoma cruzi infection was confirmed through parasitology, serology, and molecular methods. Among 9 affected soldiers, 2 died; 7 were hospitalized and received benznidazole treatment, which produced favorable outcomes. Personnel patrolling rural areas in Colombia could be at increased risk for Chagas disease.
Collapse
|
8
|
Gysin G, Urbano P, Brandner-Garrod L, Begum S, Kristan M, Walker T, Hernández C, Ramírez JD, Messenger LA. Towards environmental detection of Chagas disease vectors and pathogen. Sci Rep 2022; 12:9849. [PMID: 35701602 PMCID: PMC9194887 DOI: 10.1038/s41598-022-14051-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/31/2022] [Indexed: 12/02/2022] Open
Abstract
Chagas disease vector control relies on prompt, accurate identification of houses infested with triatomine bugs for targeted insecticide spraying. However, most current detection methods are laborious, lack standardization, have substantial operational costs and limited sensitivity, especially when triatomine bug densities are low or highly focal. We evaluated the use of FTA cards or cotton-tipped swabs to develop a low-technology, non-invasive method of detecting environmental DNA (eDNA) from both triatomine bugs and Trypanosoma cruzi for use in household surveillance in eastern Colombia, an endemic region for Chagas disease. Study findings demonstrated that Rhodnius prolixus eDNA, collected on FTA cards, can be detected at temperatures between 21 and 32 °C, when deposited by individual, recently blood-fed nymphs. Additionally, cotton-tipped swabs are a feasible tool for field sampling of both T. cruzi and R. prolixus eDNA in infested households and may be preferable due to their lower cost. eDNA detection should not yet replace current surveillance tools, but instead be evaluated in parallel as a more sensitive, higher-throughput, lower cost alternative. eDNA collection requires virtually no skills or resources in situ and therefore has the potential to be implemented in endemic communities as part of citizen science initiatives to control Chagas disease transmission.
Collapse
Affiliation(s)
- Grace Gysin
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Plutarco Urbano
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia.,Grupo de Investigaciones Biológicas de la Orinoquia, Universidad Internacional del Trópico Americano (Unitrópico), Yopal, Colombia
| | - Luke Brandner-Garrod
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Shahida Begum
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Mojca Kristan
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Thomas Walker
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Carolina Hernández
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia.,Centro de Tecnología en Salud (CETESA), Innovaseq SAS, Bogotá, Colombia
| | - Juan David Ramírez
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia.,Molecular Microbiology Laboratory, Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Louisa A Messenger
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
| |
Collapse
|
9
|
Alarcón de Noya B, Díaz-Bello Z, Ruiz-Guevara R, Noya O. Chagas Disease Expands Its Epidemiological Frontiers From Rural to Urban Areas. FRONTIERS IN TROPICAL DISEASES 2022. [DOI: 10.3389/fitd.2022.799009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The infection with the hemoflagellate parasite Trypanosoma cruzi originates from America where the wildlife cycle remains to alternate between mammals and hematophagous triatomines. Transmission through contamination of the bite site by vector feces containing highly infectious forms of parasite or direct ingestion of T. cruzi-infected triatomines appear to be the dominant transmission mechanisms. Man joins the transmission when he enters this wild environment or takes the leaves of palms carrying vectors to build houses. Rural Chagas disease develops associated with populations of low economic resources, with infection and reinfection of vector bites since childhood, and the consequent evolution toward chronic cases in adults, when there is little therapeutic benefit to infected people. The progressive migration of people from rural to urban areas and the adaptation of vectors to the peripheries of cities due to displacement caused by deforestation or urbanization that has favored the presence of enzootic cycles with Panstrongylus geniculatus as the most widely distributed species and mammals (synanthropic and domestic) allow vector transmission by ingestion of food contaminated with excrements containing infectious trypomastigotes as the dominant transmission mechanism in the urban environment. Human-to-human transmissions through vertical mother–child infection, transfusions, organ transplants, and the possibility of sexual transmission, transform the epidemiology and the clinical evolution of Chagas disease in the urban environment. Vectors of American trypanosomiasis are no longer restricted to the endemic area, but its presence has been demonstrated in nonendemic areas of the United States, Asia, and other latitudes. The worldwide plague of bedbugs (Cimex lectularius) threatens the possibility of expansion of transmission since they are vectors susceptible to infection, transmission to mammals, trans-stadial penetration, and not being affected by T. cruzi infection at least experimentally. These factors, added to the presence of an unknown number of migrating Latin American asymptomatic carriers together with the presence of triatomines in other continents, have initiated the globalization of a pathology originating in the American continent. Only with an integrative approach, based on new and better tolerated and efficient drugs, vaccines and residual action insecticides, all of them included in an epidemiological surveillance program.
Collapse
|
10
|
Rodrigues WF, Miguel CB, Marques LC, da Costa TA, de Abreu MCM, Oliveira CJF, Lazo-Chica JE. Predicting Blood Parasite Load and Influence of Expression of iNOS on the Effect Size of Clinical Laboratory Parameters in Acute Trypanosoma cruzi Infection With Different Inoculum Concentrations in C57BL/6 Mice. Front Immunol 2022; 13:850037. [PMID: 35371021 PMCID: PMC8974915 DOI: 10.3389/fimmu.2022.850037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 02/24/2022] [Indexed: 01/14/2023] Open
Abstract
In Chagas disease, the initial responses of phagocyte-mediated innate immunity are strongly associated with the control of Trypanosoma cruzi and are mediated by various signaling pathways, including the inducible nitric oxide synthetase (iNOS) pathway. The clinical and laboratory manifestations of Chagas disease depend on the parasite–host relationship, i.e., the responsive capacity of the host immune system and the immunogenicity of the parasite. Here, we evaluated effect sizes in clinical and laboratory parameters mediated by acute infection with different concentrations of T. cruzi inoculum in mice immunosuppressed via iNOS pathway inactivation. Infection was induced in C57BL/6 wild-type and iNOS-/- mice with the “Y” strain of T. cruzi at three inoculum concentrations (3 × 102, 3 × 103, and 3 × 104). Parasitemia and mortality in both mouse strains were monitored. Immunohistochemistry was performed to quantify amastigotes in cardiac tissues and cardiac musculature cells. Biochemical parameters, such as blood urea nitrogen, sodium, albumin, and globulin concentrations, among others, were measured, and cytokine concentrations were also measured. Effect sizes were determined by the eta squared formula. Compared with that in wild-type animals, mice with an absence of iNOS expression demonstrated a greater parasite load, with earlier infection and a delayed parasitemia peak. Inoculum concentration was positively related to death in the immunosuppressed subgroup. Nineteen parameters (hematological, biochemical, cytokine-related, and histopathological) in the immunocompetent subgroup and four in the immunosuppressed subgroup were associated with parasitemia. Parasitemia, biochemical parameters, and hematological parameters were found to be predictors in the knockout group. The impact of effect sizes on the markers evaluated based on T. cruzi inoculum concentration was notably high in the immunocompetent group (Cohen’s d = 88.50%; p <.001). These findings contribute to the understanding of physiopathogenic mechanisms underlying T. cruzi infection and also indicate the influence of the concentration of T. cruzi during infection and the immunosuppression through the iNOS pathway in clinical laboratory heterogeneity reported in acute Chagas disease.
Collapse
Affiliation(s)
- Wellington Francisco Rodrigues
- Postgraduate Course in Health Sciences, Federal University of Triângulo Mineiro, Uberaba, Brazil
- *Correspondence: Wellington Francisco Rodrigues,
| | - Camila Botelho Miguel
- Biosciences Unit, Centro Universitário de Mineiros, Mineiros, Brazil
- Postgraduate Course in Tropical Medicine and Infectology, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | | | - Thiago Alvares da Costa
- Postgraduate Course in Tropical Medicine and Infectology, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | | | - Carlo José Freire Oliveira
- Postgraduate Course in Health Sciences, Federal University of Triângulo Mineiro, Uberaba, Brazil
- Postgraduate Course in Tropical Medicine and Infectology, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Javier Emilio Lazo-Chica
- Cell Biology Laboratory, Institute of Biological and Natural Sciences of the Federal University of Triângulo Mineiro, Uberaba, Brazil
| |
Collapse
|
11
|
Gual-Gonzalez L, Arango-Ferreira C, Lopera-Restrepo LC, Cantillo-Barraza O, Marín DV, Bustamante NR, Triana-Chavez O, Nolan MS. Acute Pediatric Chagas Disease in Antioquia, Colombia: A Geographic Location of Suspected Oral Transmission. Microorganisms 2021; 10:8. [PMID: 35056459 PMCID: PMC8781947 DOI: 10.3390/microorganisms10010008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/17/2021] [Accepted: 12/18/2021] [Indexed: 11/16/2022] Open
Abstract
Chagas disease, Trypanosoma cruzi infection, is an insidious cause of heart failure in Latin America. Early diagnosis and treatment are critical to prevent irreversible myocardial damage that progressively accumulates over decades. Several structural barriers account for the less than 1% of cases in Colombia being treated, including poor physician knowledge, especially considering that some regions are considered non-endemic. The two cases reported here represent an emerging epidemiologic scenario associated with pediatric Chagas disease. Both cases are suspected oral transmitted parasitic infection in a geographic region of Colombia (Andean region of Antioquia) where no previous oral transmission of Chagas disease had been reported. Their clinical histories and course of disease are presented here to increase physician awareness of the epidemiologic risk factors and clinical manifestations associated with pediatric oral Chagas disease in Antioquia department, Colombia.
Collapse
Affiliation(s)
- Lídia Gual-Gonzalez
- Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Catalina Arango-Ferreira
- Departamento de Pediatría Hospital San Vicente Fundación, Medellin 050010, Colombia;
- Departamento de Pediatría, Facultad de Medicina, Universidad de Antioquia, MMedellin 050010, Colombia; (D.V.M.); (N.R.B.)
| | | | - Omar Cantillo-Barraza
- Grupo Biología y Control de Enfermedades Infecciosas, Universidad de Antioquia, Medellin 050010, Colombia; (O.C.-B.); (O.T.-C.)
| | - Daniela Velásquez Marín
- Departamento de Pediatría, Facultad de Medicina, Universidad de Antioquia, MMedellin 050010, Colombia; (D.V.M.); (N.R.B.)
| | - Natalia Restrepo Bustamante
- Departamento de Pediatría, Facultad de Medicina, Universidad de Antioquia, MMedellin 050010, Colombia; (D.V.M.); (N.R.B.)
| | - Omar Triana-Chavez
- Grupo Biología y Control de Enfermedades Infecciosas, Universidad de Antioquia, Medellin 050010, Colombia; (O.C.-B.); (O.T.-C.)
| | - Melissa S. Nolan
- Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| |
Collapse
|