Early Detection of Chronic Asymptomatic Chagas Infection

Rosa, Ezequiel de la; Paglini-Oliva, Patrícia; Prato, Laura Beatriz; Benizio, Evangelina; Triquell, María Fernanda; Muñoz, Sonia Edith; Fernández, Elmer

doi:10.12659/msm.907735

Cited by 6 publications

(5 citation statements)

References 34 publications

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“…A particular challenge that contributes to the uncertainty in the definition of asymptomatic infection is finding good diagnostics for identifying asymptomatics and stratifying them into those who are likely to develop symptoms and those who are not [ 48–50 ]. Such diagnostics would enable better patient care and selection of interventions to reduce transmission [ 38 , 51 ].…”

Section: Discussionmentioning

confidence: 99%

The Hidden Hand of Asymptomatic Infection Hinders Control of Neglected Tropical Diseases: A Modeling Analysis

Rock,

Chapman,

Dobson

et al. 2024

Clinical Infectious Diseases

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Background Neglected tropical diseases are responsible for considerable morbidity and mortality in low-income populations. International efforts have reduced their global burden, but transmission is persistent and case-finding-based interventions rarely target asymptomatic individuals. Methods We develop a generic mathematical modeling framework for analyzing the dynamics of visceral leishmaniasis in the Indian sub-continent (VL), gambiense sleeping sickness (gHAT), and Chagas disease and use it to assess the possible contribution of asymptomatics who later develop disease (pre-symptomatics) and those who do not (non-symptomatics) to the maintenance of infection. Plausible interventions, including active screening, vector control, and reduced time to detection, are simulated for the three diseases. Results We found that the high asymptomatic contribution to transmission for Chagas and gHAT and the apparently high basic reproductive number of VL may undermine long-term control. However, the ability to treat some asymptomatics for Chagas and gHAT should make them more controllable, albeit over relatively long time periods due to the slow dynamics of these diseases. For VL, the toxicity of available therapeutics means the asymptomatic population cannot currently be treated, but combining treatment of symptomatics and vector control could yield a quick reduction in transmission. Conclusions Despite the uncertainty in natural history, it appears there is already a relatively good toolbox of interventions to eliminate gHAT, and it is likely that Chagas will need improvements to diagnostics and their use to better target pre-symptomatics. The situation for VL is less clear, and model predictions could be improved by additional empirical data. However, interventions may have to improve to successfully eliminate this disease.

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Section: Discussionmentioning

confidence: 99%

The Hidden Hand of Asymptomatic Infection Hinders Control of Neglected Tropical Diseases: A Modeling Analysis

Rock,

Chapman,

Dobson

et al. 2024

Clinical Infectious Diseases

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“…A particular challenge that contributes to the uncertainty in the definition of asymptomatic infection is finding good diagnostics for identifying asymptomatics and stratifying them into those who are likely to develop symptoms and those who are not [45-47]. Such diagnostics would enable better patient care and selection of interventions to reduce transmission [38, 48].…”

Section: Discussionmentioning

confidence: 99%

The hidden hand of asymptomatic infection hinders control of neglected tropical diseases

Rock,

Chapman,

Dobson

et al. 2023

Preprint

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Neglected tropical diseases are responsible for considerable morbidity and mortality in low-income populations. International efforts have reduced their global burden, but transmission is persistent and case-finding-based interventions rarely target asymptomatic individuals. We develop a generic mathematical modelling framework for analysing the dynamics of visceral leishmaniasis in the Indian sub-continent (VL),gambiensesleeping sickness (gHAT), and Chagas disease and use it to assess the possible contribution of asymptomatics who later develop disease (pre-symptomatics) and those who do not (non-symptomatics) to the maintenance of infection. Plausible interventions, including active screening, vector control and reduced time to detection, are simulated for the three diseases. We conclude that currently available tools could bring new infections under control for gHAT and Chagas disease – albeit over a long period of time for Chagas disease – but that VL will be more difficult to control with existing interventions. gHAT protocols that allow for treatment of parasitologically positive asymptomatics result in better control of infection compared to syndromic diagnosis required for VL. This work highlights that the high asymptomatic contribution to transmission for Chagas and gHAT and the apparently high basic reproductive number of VL may greatly undermine long-term control, but that precise predictions are hampered by uncertainty in natural history.

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“…Diagnostic methods differ depending on the stage of infection, favoring direct methods in the acute phase and serological methods in the chronic phase [ 13 ]. Molecular methods detect the parasite in all phases of the disease, and due to their higher sensitivity, provide positive results in infected patients who are negative in traditional parasitological tests [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Parasite Burden of Trypanosoma cruzi in Whole Blood and Buffy Coat Determined by Real-Time PCR in Individuals with Chronic Chagas Disease

Liempi,

Zulantay,

Varela

et al. 2024

Microorganisms

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The objective of this study was to compare, by qPCR, the circulating blood parasite load of Trypanosoma cruzi in the buffy coat, and in whole blood mixed with boiled and unboiled guanidine hydrochloride-EDTA buffer, of individuals with chronic ChD. The concentration and purity of DNA were evaluated in a Nanodrop Denovix DS-11FX Series Spectrophotometer (DeNovix Inc., Wilmington, NC, USA). The parasite load was determined with the Taqman® qPCR system using a Stratagene Mx3000P thermocycler (Agilent Technologies, Santa Clara, CA, USA) with Cruzi 1 and Cruzi 2 satellite primers. Student’s t-test with Bonferroni correction, Chi-squared (χ2) tests and Spearman’s correlation coefficient were applied. The concentration and purity of DNA were higher in the buffy coat. Parasite DNA was detected and quantifiable in the three types of samples in seven patients, without statistically significant differences in the parasite load obtained. Higher correlations were found between the total DNA concentrations and the parasite loads obtained in the samples of the buffy coat.

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Early Detection of Chronic Asymptomatic Chagas Infection

Cited by 6 publications

References 34 publications

The Hidden Hand of Asymptomatic Infection Hinders Control of Neglected Tropical Diseases: A Modeling Analysis

The Hidden Hand of Asymptomatic Infection Hinders Control of Neglected Tropical Diseases: A Modeling Analysis

The hidden hand of asymptomatic infection hinders control of neglected tropical diseases

Parasite Burden of Trypanosoma cruzi in Whole Blood and Buffy Coat Determined by Real-Time PCR in Individuals with Chronic Chagas Disease

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