Molecular diagnosis of Trypanosoma cruzi

Schijman, Alejandro G.

doi:10.1016/j.actatropica.2018.02.019

Cited by 80 publications

(64 citation statements)

References 107 publications

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“…Similar rates of positivity have been previously reported for untreated CD chronic patients outside of endemic areas [20][21]. Moreover, PCR sensitivity reported in several studies performed in Latin America achieved results higher than 60% in chronic patients [22]. The use of different PCR protocols; the likelihood of re-infection episodes; or parasitological factors such as heterogeneous distribution of different strains could explain this difference.…”

Section: Discussionsupporting

confidence: 82%

Usefulness of real-time PCR during follow-up of patients treated with Benznidazole for chronic Chagas disease: Experience in two referral centers in Barcelona

et al. 2020

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Background Antitrypanosomal treatment with Benznidazole (BZ) or Nifurtimox may be recommended for patients with chronic Chagas disease (CD) to reduce the onset or progression of symptoms. However, such treatment has limited efficacy and high level of toxic effects. In addition, the current cure biomarker (serology conversion) precludes any treatment assessment unless a prolonged follow-up is arranged. PCR is thus the most useful, alternative surrogate marker for evaluating responses to treatment. The aim of this study is to describe the usefulness of real-time PCR in monitoring BZ treatment within a large cohort of chronic CD cases in Barcelona. Methodology/Principal findings A total of 370 chronic CD patients were monitored with real-time PCR post-BZ treatment. The median follow-up was 4 years (IQR 2.2-5.3y), with a median of 3 clinical visits (IQR 2-4). Only 8 patients (2.2%) presented with at least one incident of positive real-time PCR after treatment and were therefore considered as treatment failure. Four of those failure patients had completed full course treatment, whereas the remaining cases had defaulted with a statistical difference between both groups (p = 0.02). Half of the failure patients had undergone less than 4 years of follow-up monitoring all presented with parasitemia before treatment. Conclusions/Significance BZ treatment failure was highly infrequent in our cohort. BZ discontinuation was a risk factor for positive real-time PCR results during clinical follow-up. Regular testing with real-time

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Section: Discussionsupporting

confidence: 82%

Usefulness of real-time PCR during follow-up of patients treated with Benznidazole for chronic Chagas disease: Experience in two referral centers in Barcelona

et al. 2020

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“…This may account in part for the estimation that one in two of all congenital infections with CD are missed [76]. New molecular diagnostic tools such as PCR, which is used in the United States for the diagnosis of congenital CD, may eventually facilitate less cumbersome diagnosis of such cases if they can be successfully adapted to clinical settings [ In patients who are immunosuppressed, detection of the parasite by a direct parasitological test or exponential increase of parasitic load on quantitative PCR must be considered a reactivation, and the affected individual should receive anti-parasitic treatment immediately to avoid severe morbidity and/or mortality [81,82].…”

Section: Diagnosis Of T Cruzi In Special Populationsmentioning

confidence: 99%

WHF IASC Roadmap on Chagas Disease

et al. 2020

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Background: Chagas Disease is a neglected tropical disease caused by the protozoan Trypanosoma cruzi, with some of the most serious manifestations affecting the cardiovascular system. It is a chronic, stigmatizing condition, closely associated with poverty and affecting close to 6 million people globally. Although historically the disease was limited to endemic areas of Latin America recent years have seen an increasing global spread. In addition to the morbidity and mortality associated with the disease, the social and economic burdens on individuals and society are substantial. Often called the 'silent killer', Chagas disease is characterized by a long, asymptomatic phase in affected indivi duals. A pproximately 30% then go on develop chronic Chagas cardiomyopathy and other serious cardiac complications such as stroke, rhythm disturbances and severe heart failure. Methods: In a collaboration of the World Hearth Federation (WHF) and the Inter-American S ociety of Cardiology (IASC) a writing group consisting of 20 diverse experts on Chagas disease (CD) was convened. The group provided up to date expert knowledge based on their area of expertise. An extensive review of the literature describing obstacles to diagnosis and treatment Echeverría et al: WHF IASC Roadmap on Chagas Disease Art. 26, page 2 of 31 of CD along with proposed solutions was conducted. A survey was sent to all WHF Members and, using snowball sampling to widen the consultation, to a variety of health care professionals working in the CD global health community. The results were analyzed, open comments were reviewed and consolidated, and the findings were incorporated into this document, thus ensuring a consensus representation. Results: The WHF IASC Roadmap on Chagas Disease offers a comprehensive summary of current knowledge on prevention, diagnosis and management of the disease. In providing an analysis of 'roadblocks' in access to comprehensive care for Chagas disease patients, the document serves as a framework from which strategies for implementation such as national plans can be formulated. Several dimensions are considered in the analysis: healthcare system capabilities, governance, financing, community awareness and advocacy. Conclusion: The WHF IASC Roadmap proposes strategies and evidence-based solutions for healthcare professionals, health authorities and governments to help overcome the barriers to comprehensive care for Chagas disease patients. This roadmap describes an ideal patient care pathway, and explores the roadblocks along the way, offering potential solutions based on available research and examples in practice. It represents a call to action to decision-makers and health care professionals to step up efforts to eradicate Chagas disease.

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“…Real-time PCR have been developed with greater sensitivity than previous methods. For the design of primers, the variable region of the minicircle kinetoplast DNA (kDNA), a repeat tandem sequence of nuclear DNA (stDNA), ribosomal RNA (rRNA) or the paraflagellar rod (PFR) genes have been used [103,104].…”

Section: Lamp In Diagnosis Of American Try-panosomiasis (T Cruzi)mentioning

confidence: 99%

Applying Loop-mediated Isothermal Amplification (LAMP) in the Diagnosis of Malaria, Leishmaniasis and Trypanosomiasis as Point-of-Care Tests (POCTs)

Dea-Ayuela

Galiana‐Roselló

Lalatsa

et al. 2018

CTMC

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One of the main objectives of the WHO is controlling transmission of parasitic protozoa vector-borne diseases. A quick and precise diagnosis is critical in selecting the optimal therapeutic regime that avoids unnecessary treatments and the emergence of resistance. Molecular assays based on loopmediated isothermal amplification (LAMP) techniques are a good alternative to light microscopy and antigen-based rapid diagnostic tests in developing countries, since they allow for a large amount of genetic material generated from a few copies of DNA, and use primers that lead to high sensitivity and specificity, while the amplification process can be performed in isothermal conditions without the need of sophisticated equipment to interpret the results. In this review, the main advances in the development of LAMP assays for the diagnosis of malaria, leishmaniasis and Chagas' disease are discussed as well as the feasibility of their implementation in developing countries and use as point-of-care diagnostic tests.

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Molecular diagnosis of Trypanosoma cruzi

Cited by 80 publications

References 107 publications

Usefulness of real-time PCR during follow-up of patients treated with Benznidazole for chronic Chagas disease: Experience in two referral centers in Barcelona

Usefulness of real-time PCR during follow-up of patients treated with Benznidazole for chronic Chagas disease: Experience in two referral centers in Barcelona

WHF IASC Roadmap on Chagas Disease

Applying Loop-mediated Isothermal Amplification (LAMP) in the Diagnosis of Malaria, Leishmaniasis and Trypanosomiasis as Point-of-Care Tests (POCTs)

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