American Trypanosomiasis (Chagas Disease)

Rassi, Anis; Rezende, Joffre Marcondes de

doi:10.1016/j.idc.2012.03.002

Cited by 473 publications

(387 citation statements)

References 32 publications

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“…Therefore, immunological methods are the elective procedure to detect the presence of specific anti-T. cruzi antibodies in a patient's blood during the chronic phase. 7,8 However, immunological methods present some divergences because of the different protocols of antigen preparations and genetic variations of circulating strains, yielding differences in performance among available commercial tests. This is particularly worrying with regard to blood donor screening.…”

Section: Introductionmentioning

confidence: 99%

Chronic Chagas Disease Diagnosis: A Comparative Performance of Commercial Enzyme Immunoassay Tests

Santos¹,

Souza²,

Barros³

et al. 2016

The American Journal of Tropical Medicine and Hygiene

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Abstract. There is a significant heterogeneity in reported performance of serological assays for Chagas disease diagnosis. The conventional serology testing in laboratory diagnosis and in blood banks is unsatisfactory because of a high number of inconclusive and misclassified results. We aimed to assess the quality of four commercially available enzymelinked immunosorbent assay tests for their ability to detect Trypanosoma cruzi antibodies in 685 sera samples. Crossreactivity was assessed by using 748 sera from patients with unrelated diseases. Initially, we found that the reactivity index against T. cruzi antigen was statistically higher in sera from Chagas disease patients compared with those from non-chagasic patients, supporting the notion that all evaluated tests have a good discriminatory ability toward the diagnosis of T. cruzi infection in patients in the chronic phase of the disease. Although all tests were similarly sensitive for diagnosing T. cruzi infection, there were significant variations in terms of specificity and cross-reactivity among them. Indeed, we obtained divergent results when testing sera from patient with unrelated diseases, particularly leishmaniasis, with the levels of cross-reactivity being higher in tests using whole T. cruzi extracts compared with those using recombinant proteins. Our data suggest that all four tests may be used for the laboratory diagnosis and routine blood screening diagnose for Chagas disease. We also emphasize that, despite their general good performance, caution is needed when analyzing the results when these tests are performed in areas where other diseases, particularly leishmaniasis, are endemic.

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Section: Introductionmentioning

confidence: 99%

Chronic Chagas Disease Diagnosis: A Comparative Performance of Commercial Enzyme Immunoassay Tests

Santos¹,

Souza²,

Barros³

et al. 2016

The American Journal of Tropical Medicine and Hygiene

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“…Esto es, al finalizar la fase aguda. Sin embargo, un 10% de los pacientes mantienen alteraciones a nivel cardíaco, debido al pasar a una fase crónica sintomática, las manifestaciones cardíacas pueden evidenciarse como en este caso, con datos electrocardiográficos de dilatación [6][7][8][9][10] .…”

Section: Discussionunclassified

Cardiopatía Chagásica en un escolar: Reporte de caso

Méndez-Domínguez

Chi-Méndez

Canto-Losa

et al. 2017

Rev. chil. pediatr.

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ResumenIntroducción: La enfermedad de Chagas (ECh) o tripanosomiasis americana es una enfermedad transmitida principalmente por insectos hematófagos detectados en zonas rurales y urbanas desde México hasta Argentina. De acuerdo a la Organización Panamericana de la Salud, entre 7,7 y 10 millones de personas cursan con infección crónica. La ECh es causada por el protozoario flagelado Trypanosoma cruzi. Posterior al contacto inicial con el vector, la fase aguda es comúnmente seguida por una fase silente que dura 15-20 años antes de debutar con manifestaciones cardíacas, neurológi-cas o gastrointestinales. Objetivo: Analizar el curso clínico atípico de un caso de cardiopatía chagásica en un paciente pediátrico del sureste de México. Caso clínico: El paciente consultó al desarrollar un chagoma en la pierna izquierda. Cinco meses después, se observó en su electrocardiograma una taquicardia sinusal y un crecimiento auricular izquierdo con ondas P anchas e intervalo QT prolongado. En la radiografía de tórax se observó cardiomegalia (índice cardiotorácico = 0,52); en el ecocardiograma transtorácico mostró dilatación del atrio y ventrículo izquierdos. Conclusión: Es importante realizar evaluaciones cardíacas oportunas en pacientes pediátricos con ECh, pues no debe asumirse que cursarán con una fase silente o que debutarán tardíamente con cardiopatía. Keywords:Chagas Cardiomyopathy; Trypanosoma cruzi; Chagas Disease; Cardiomegaly Abstract Introduction: Chagas disease also known as American Trypanosomiasis is mainly caused by haematophagous insects widely distributed from Mexico to Argentina. According to the Panamerican Health Organization, 7.7 to 10 million people are living with chronic infection. Chagas disease is caused by Trypanosoma cruzi, a protozoan transmitted by triatomine vectors. After an initial acute phase, Chagas is followed by a silent phase that lasts 15-20 years before debuting with cardiac, neurological or gastrointestinal manifestations. Objective: To analyze the atypical clinical course

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“…Clinical presentation is characterized by thromboembolic events, arrhythmias, and heart failure (HF); such symptoms account for the majority of morbidity, mortality, and decreased quality of life attributable to Chagas disease (5) (6) (7) . Chagas heart failure (CHF) is associated with higher mortality rates than HF from other etiologies, and accounts for 25-30% of death among patients with Chagas disease (8) .…”

Section: Introductionmentioning

confidence: 99%

Cardiac rehabilitation program in patients with Chagas heart failure: a single-arm pilot study

Mediano

Mendes

Pinto

et al. 2016

Rev. Soc. Bras. Med. Trop.

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Introduction:The benefit of a cardiac rehabilitation (CR) program for patients with Chagas heart failure (CHF) remains unclear. Therefore, we aimed to investigate the effects of CR for CHF patients. Methods: A single-arm pilot study, including 12 patients with CHF, was performed. Patients participated in an 8-month physical exercise intervention, comprising aerobic, strength, and stretching exercises (3 times per week, 60 minutes per session). Nutritional and pharmaceutical counseling were also performed. Functional capacity (cardiopulmonary exercise test), muscle respiratory strength (manovacuometry), and body composition (anthropometry and skinfolds) were evaluated at baseline, and after 4 and 8 months of intervention. Cardiac function (echocardiography), biomarkers (lipid profile, glucose, and glycated hemoglobin) and quality of life (Minnesota Living with Heart Failure Questionnaire) were assessed at baseline and at the end of the intervention. Results: Seven of 12 patients included in the study completed the 8-month follow-up period. Only 2 moderate adverse events occurred during the exercise training. Functional capacity improved after 4 months of CR, while left ventricular ejection fraction (LVEF) and respiratory strength improved after 8 months. Patients with right ventricular (RV) dysfunction at baseline exhibited an improvement in functional capacity after 4 months, and improvements in left ventricular (LV) diastolic pressure, respiratory strength, and quality of life at the end of follow-up. Conversely, those with normal baseline RV function demonstrated LVEF increases that were not observed in patients with RV dysfunction. Conclusions: CR was feasible, safe, and has important clinical benefits for patients with CHF, specifically for cardiac function and muscle respiratory strength.

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American Trypanosomiasis (Chagas Disease)

Cited by 473 publications

References 32 publications

Chronic Chagas Disease Diagnosis: A Comparative Performance of Commercial Enzyme Immunoassay Tests

Chronic Chagas Disease Diagnosis: A Comparative Performance of Commercial Enzyme Immunoassay Tests

Cardiopatía Chagásica en un escolar: Reporte de caso

Cardiac rehabilitation program in patients with Chagas heart failure: a single-arm pilot study

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