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Dorn PL, Monroy MC, Stevens L. Sustainable, integrated control of native vectors: The case of Chagas disease in Central America. FRONTIERS IN TROPICAL DISEASES 2022. [DOI: 10.3389/fitd.2022.971000] [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
Despite successes in reducing transmission, Chagas disease (American trypanosomiasis) remains the greatest economic burden of any parasitic disease in Latin America afflicting mostly the poor and further contributing to poverty. We review a long-term (2001-2022), integrated Ecohealth approach that addresses sustainable development goals to reduce risk of Chagas transmission by the main native vector in Central America, Triatoma dimidiata, s.l. The basis of the Ecohealth intervention was the identification of the risk factors for house infestation, an understanding of and collaboration with local communities, and genetic and proteomic studies that revealed the epidemiology and mechanisms of the rapid reinfestation seen following insecticide application. We review the development of this approach from a pilot project in two Guatemalan villages, to an expanded initiative across three countries with vastly different ecology, cultures, and municipal organization, and finally development of a multi-institutional, large-scale project to develop a strategy to tackle the remaining hot spots in Central America. This integrated Ecohealth approach resulted in reduced risk of transmission as measured by a sustained decrease in house infestation without further use of insecticides, a reduction in vectors with human blood meals and the Chagas parasite, as well as other health and economic benefits. We discuss lessons learned and how this approach could be applied to other vector-borne diseases.
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Medina-Rivera M, Cárdenas WB, Erickson D, Mehta S. Gold Nanoshells-Based Lateral Flow Assay for the Detection of Chagas Disease at the Point-of-Care. Am J Trop Med Hyg 2022; 107:323-327. [PMID: 35895419 PMCID: PMC9393437 DOI: 10.4269/ajtmh.21-1119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 04/11/2022] [Indexed: 08/03/2023] Open
Abstract
Chagas disease is a neglected parasitic infection and a major public health problem in the Americas. It remains underdiagnosed in the United States and internationally due to the lack of affordable testing and disparities in healthcare, particularly for those most at risk. We describe a proof-of-concept lateral flow immunoassay employing a recombinant Chagas multiantigen conjugated to gold nanoshells (AuNS) to detect circulating human anti-Chagas IgG antibodies. This is one of the first lateral flow immunoassays to capitalize on the larger surface area of AuNS compared with nanoparticles that can help amplify low-magnitude signals. Results were compared with 42 positive and negative Chagas serum samples, of which a subset of 27 samples was validated against an ELISA (Hemagen®). The sensitivity and specificity of our assay were 83% and 95%, respectively. These results suggest that an AuNS-based rapid testing for Chagas disease could facilitate in-field screening/diagnosis with a performance comparable to commercial methods.
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Affiliation(s)
- Melisa Medina-Rivera
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
- Institute for Nutritional Sciences, Global Health, and Technology (INSiGHT), Cornell University, Ithaca, New York
| | - Washington B. Cárdenas
- Laboratorio para Investigaciones Biomédicas, Escuela Superior Politécnica del Litoral, Guayaquil, Guayas, Ecuador
| | - David Erickson
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
- Institute for Nutritional Sciences, Global Health, and Technology (INSiGHT), Cornell University, Ithaca, New York
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, New York
| | - Saurabh Mehta
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
- Institute for Nutritional Sciences, Global Health, and Technology (INSiGHT), Cornell University, Ithaca, New York
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Lynn MK, Dye-Braumuller KC, Beatty NL, Dorn PL, Klotz SA, Stramer SL, Townsend RL, Kamel H, Vannoy JM, Sadler P, Montgomery SP, Rivera HN, Nolan MS. Evidence of likely autochthonous Chagas disease in the southwestern United States: A case series of Trypanosoma cruzi seropositive blood donors. Transfusion 2022; 62:1808-1817. [PMID: 35895440 PMCID: PMC9543114 DOI: 10.1111/trf.17026] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/31/2022] [Accepted: 05/31/2022] [Indexed: 11/28/2022]
Abstract
Background Chagas disease is a parasitic infection that can insidiously cause non‐ischemic cardiomyopathy. Given the largely silent nature of this progressive disease, asymptomatic blood donors pose potential blood transfusion risk. Blood donation screening has become an unintentional form of Chagas disease surveillance, with thousands of new cases identified since national surveillance was initiated in 2007. Study Design and Methods We recruited T. cruzi‐positive blood donors identified from California and Arizona blood centers for confirmatory blood screening and assessment of lifetime infection risk. Results Among eight suspected cases, we identified four confirmed US autochthonous infections. The current manuscript details the transmission sources, healthcare‐seeking behaviors post‐blood donation resulting, and clinical course of disease among persons without any history of travel to endemic Latin American countries. Discussion This manuscript presents four additional US‐acquired Chagas disease cases and identifies an opportunity for blood centers to assist in confronting barriers surrounding Chagas disease in the US.
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Affiliation(s)
- Mary K Lynn
- Department of Epidemiology and Biostatistics Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Kyndall C Dye-Braumuller
- Department of Epidemiology and Biostatistics Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Norman L Beatty
- Division of Infectious Diseases & Global Medicine, Department of Medicine, University of Florida, Gainesville, Florida, USA.,Department of Medicine, University of Arizona, Tucson, Arizona, USA
| | - Patricia L Dorn
- Department of Biological Sciences, Loyola University New Orleans, New Orleans, Louisiana, USA
| | - Stephen A Klotz
- Department of Medicine, University of Arizona, Tucson, Arizona, USA
| | - Susan L Stramer
- Scientific Affairs, American Red Cross, Gaithersburg, Maryland, USA
| | | | - Hany Kamel
- Corporate Medical Affairs, Vitalant, Scottsdale, Arizona, USA
| | | | - Patrick Sadler
- Central California Blood Center, Fresno, California, USA
| | - Susan P Montgomery
- Division of Parasitic Diseases and Malaria, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Hilda N Rivera
- Division of Parasitic Diseases and Malaria, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Melissa S Nolan
- Department of Epidemiology and Biostatistics Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
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Pacheco GJ, Fulton L, Betancourt J, Shanmugam R, Granados PS. Geospatial analysis as a tool to identify target areas for Chagas disease education for healthcare providers. BMC Infect Dis 2022; 22:590. [PMID: 35788197 PMCID: PMC9252050 DOI: 10.1186/s12879-022-07577-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 06/29/2022] [Indexed: 11/10/2022] Open
Abstract
Chagas Disease (CD) is a neglected zoonotic disease of the Americas. It can be fatal if not diagnosed and treated in its early stages. Using geospatial and sensitivity analysis, this study focuses on understanding how to better allocate resources and educational information to areas in the United States, specifically Texas, that have the potential for increased risk of CD cases and the associated costs of addressing the disease. ICD-9 and 10 inpatient hospital diagnostic codes were used to illustrate the salience of potentially missed CD diagnoses (e.g., cardiomyopathic diagnoses) and where these are occurring with more frequency. Coding software along with GIS and Microsoft Excel 3D mapping were used to generate maps to illustrate where there may be a need for increased statewide surveillance and screening of populations at greater risk for CD. The CD cases reported to the Texas Department of State Healthcare Services (TxDSHS) are not homogenously dispersed throughout the state but rather, reveal that the incidences are in clusters and primarily in urban areas, where there is increased access to physician care, CD research and diagnostic capabilities.
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Affiliation(s)
- Gerardo J Pacheco
- School of Health Administration, Texas State University, San Marcos, TX, 78666, USA.
| | - Lawrence Fulton
- School of Health Administration, Texas State University, San Marcos, TX, 78666, USA
| | - Jose Betancourt
- School of Health Administration, Texas State University, San Marcos, TX, 78666, USA
| | - Ram Shanmugam
- School of Health Administration, Texas State University, San Marcos, TX, 78666, USA
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Marcus R, Henao-Martínez AF, Nolan M, Livingston E, Klotz SA, Gilman RH, Miranda-Schaeubinger M, Meymandi S. Recognition and screening for Chagas disease in the USA. Ther Adv Infect Dis 2021; 8:20499361211046086. [PMID: 34589212 PMCID: PMC8474340 DOI: 10.1177/20499361211046086] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 08/24/2021] [Indexed: 12/01/2022] Open
Abstract
Chagas disease (CD), caused by the protozoan Trypanosoma cruzi,
is a public health concern, mainly among countries in South and Central America.
However, despite the large number of immigrants from endemic countries living in
the USA, awareness of CD is poor in the medical community, and therefore it is
significantly underdiagnosed. To avoid the catastrophic cardiac complications of
CD and to prevent maternal–fetal transmission, widespread educational programs
highlighting the need for diagnosis are urgently needed.
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Affiliation(s)
- Rachel Marcus
- LASOCHA, MedStar Union Memorial Hospital, Baltimore, MD 21218-2829, USA
| | - Andrés F Henao-Martínez
- Division of Infectious Diseases, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Melissa Nolan
- Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Elizabeth Livingston
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA
| | - Stephen A Klotz
- Division of Infectious Diseases, University of Arizona, Tucson, AZ, USA
| | - Robert H Gilman
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Sheba Meymandi
- Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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