Discrepancies and consequences of indirect hemagglutination, indirect immunofluorescence and Elisa tests for the diagnosis of Chagas disease

Souza, Regina Maia de; Neto, Vicente Amato

doi:10.1590/s0036-46652012000300005

Cited by 9 publications

(8 citation statements)

References 4 publications

(3 reference statements)

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“…This is contrary to most studies, which show a relatively good concordance among tests, and only a 1–2 % of inconclusive results [ 18 , 19 ]. However, a study in Brazil also reported a high discordance among hemaglutination, immunofluorescence and ELISA tests [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Highly discordant serology against Trypanosoma cruzi in central Veracruz, Mexico: role of the antigen used for diagnostic

et al. 2015

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BackgroundChagas disease is a parasitic disease caused by the protozoan parasite Trypanosoma cruzi. In Mexico, the burden of the disease is difficult to estimate and improving surveillance for Chagas disease is an important priority. We aimed here at determining the seroprevalence of T. cruzi infection in humans in a rural community in Veracruz.MethodsSerum samples (196) were analyzed for T. cruzi infection using five enzyme-linked immunosorbent assay (ELISA) tests: two in-house tests based on crude parasite extract and three commercial ELISA kits. Because of highly discordant results, we further explored the importance of parasite antigens and strains by western-blot analysis.ResultsA total of 74 samples (37.7 %) were reactive with at least one ELISA, but discordance among tests was very high. The best agreement was between Chagatest recombinant and Chagatek ELISA (Kappa index = 0.798). The agreement between other combinations of tests ranged from 0.038 to 0.518. Discordant samples were confirmed by western-blot analysis using up to nine parasite strains, giving a seroprevalence of 33.7 %.ConclusionsCommercial tests had a very limited ability to detect T. cruzi infection in the study population. In-house tests based on crude parasite antigens showed a greater sensitivity but were still unable to detect all cases of T. cruzi infection, even when based on a local parasite strain. The high seroprevalence confirmed the hyper-endemicity of T. cruzi infection in the region. Reliable epidemiological surveillance of Chagas disease will require the development of improved diagnostic tests.Electronic supplementary materialThe online version of this article (doi:10.1186/s13071-015-1072-2) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Highly discordant serology against Trypanosoma cruzi in central Veracruz, Mexico: role of the antigen used for diagnostic

et al. 2015

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“…The discrepancies were attributable to the type of parasite antigen; IIF detects a specific antibody that reacts with a parasite membrane antigen, whereas HI detects an antibody that reacts with a subcellular antigen. Each of these serological reactions operates in different specificity systems [70]. Another study in Spain was found to have a higher sensitivity (97-100%), and for serological screening of T. cruzi infection, a combination of tests is needed [71].…”

Section: The World Of Diagnosis For Chagas Disease: a Discordant Paramentioning

confidence: 99%

“…To date, T. cruzi diagnostic present problems of sensitivity, making the diagnosis confusing and often requiring additional testing [40,70,71]. In congenital cases, it has been observed that discordance between the samples analyzed also occurs, and discordant results were confirmed by a third diagnostic test [72].…”

Section: The World Of Diagnosis For Chagas Disease: a Discordant Paramentioning

confidence: 99%

More than a Hundred Years in the Search for an Accurate Diagnosis for Chagas Disease: Current Panorama and Expectations

López‐Monteon¹,

Dumonteil²,

Ramos-Ligonio³

2019

Current Topics in Neglected Tropical Diseases

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Chagas disease, or American trypanosomiasis, is a parasitic disease of the Americas. In nature, Trypanosoma cruzi is transmitted through various species of triatomine bugs. However, non-vectorial transmission can also occur, such as transmission through blood products or by transplanting infected organs, by vertical transmission, and lately by oral route. Currently, Chagas disease affects approximately 6-7 million people worldwide, and the process of urbanization in Latin America and migratory movements from endemic countries have led to Chagas disease being diagnosed in areas where the infection is not endemic. There are several methods for diagnosing Chagas disease. Some of these are mostly used for research purposes, while others are used in routine diagnostic laboratories. According to the World Health Organization (WHO), chronic Chagas disease diagnosis is based on two serological techniques. To establish a definitive diagnosis, the results must be concordant. In the case of discordances, the WHO proposes repeating serology in a new sample, and if results remain inconclusive, a confirmatory test should be performed. This chapter shows aspects of the diagnosis of Chagas disease, which varies in its sensitivity and specificity, and its use depends on the geographical location, the available resources, and the purpose of the diagnosis.

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“…For diagnosis in chronic phase, either asymptomatic or symptomatic phases, several immunological techniques have been developed for the detection of specific IgG antibodies against epimastigotes extracts of T. cruzi, including the Indirect Immuno fluorescence (IF), the Enzyme-Linked Immuno-Sorbent Assay (ELISA) and Indirect Hemagglutination (IH). 8,[39][40][41][42] The majority of immunological tests commercially available use recombinant antigens, synthetic peptides and antigens obtained from non-native strains antigenically different from local strains, which generates low specificity and sensitivity in the tests. 40,43 Since no single standard reference test is available yet, diagnosis should base on the presence of IgG against various T. cruzi antigens by using at least two serological assays with different antigens.…”

Section: Serological Diagnosismentioning

confidence: 99%

Chagas disease: an overview of diagnosis

Rodea¹,

Cuevas²,

Ramos³

et al. 2018

JMEN

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Abbreviations: IF, indirect immuno fluorescence; ELISA, enzyme-linked immuno-sorbent assay; IH, indirect hemagglutination; SAPA/TS, shed acute-phase antigens/transsialidase; TESA: trypomastigote excreted and secreted antigen; IA: immunoagglutination assay; Ab, antibodies; Ag, antigens; PCR, polymerase chain reaction J Microbiol Exp. 2018;6(3):151-157. 151 AbstractChagas disease, caused by the flagellated protozoan Trypanosoma cruzi, afflicts millions of people, mainly affecting poor and neglected populations. The different transmission routes, the high genetic variability of the parasite, the different detection methods as well as the distinct phases of the disease, influence negatively the diagnosis accuracy of the disease. Diagnostic tests can range from simple parasitological techniques to complex molecular and serological techniques that can be used for early diagnosis in the acute phase of the disease, the determination of congenital transmission, to determine the epidemiological behavior of the disease, to detect the presence of the parasite, both in blood transfusions, as in organ transplantation, among others. This review addresses some of the most widely used tools to detect T. cruzi infection in different scenarios.

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Discrepancies and consequences of indirect hemagglutination, indirect immunofluorescence and Elisa tests for the diagnosis of Chagas disease

Cited by 9 publications

References 4 publications

Highly discordant serology against Trypanosoma cruzi in central Veracruz, Mexico: role of the antigen used for diagnostic

Highly discordant serology against Trypanosoma cruzi in central Veracruz, Mexico: role of the antigen used for diagnostic

More than a Hundred Years in the Search for an Accurate Diagnosis for Chagas Disease: Current Panorama and Expectations

Chagas disease: an overview of diagnosis

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