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Almeida CE, Máximo MM, Pires-Silva D, Takiya DM, Valença-Barbosa C, Viana MC, Reigada C, Iñiguez AM, Harry M, Folly-Ramos E. From molecules to ecosystems: Insights into a network of interactions for a Chagas disease outbreak using Triatoma brasiliensis as natural samplers. Acta Trop 2024; 251:107107. [PMID: 38190930 DOI: 10.1016/j.actatropica.2023.107107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 01/10/2024]
Abstract
Exploring the dynamics of disease transmission involves an understanding of complex interactions within the eco-epidemiologic framework. In the context of Chagas disease (CD), elements are mainly represented by the interactions among the pathogen, insect vector, host, humans and the environment. We performed quantitative and qualitative analyses on a dataset derived from 98 Triatoma brasiliensis infected by trypanosomatids, which were linked to a CD outbreak in the semi-arid region of northeastern Brazil. We extracted invertebrate-derived DNA (iDNA) from these insects, comprising 18 populations around the outbreak area, each indicative of various strata of anthropogenic influence. Food source (FS) diversity, representing potential parasite reservoirs, was determined through mitochondrial gene (cyt b) sequencing of vertebrates, and parasite genotyping was accessed using fluorescent amplified fragment barcodes (FFLB) of trypanosomatids. We also assessed the residents' awareness of breeding sites for CD vectors in the inspected houses. The quantification of Trypanosoma cruzi was estimated via real-time PCR and is denominated here as the average parasite load (PL) per insect (T. cruzi/intestinal unit). We aimed to address vector-parasite-host-environment interactions that were discussed based on their significance among the components. Notably, among the significant interactions, we observed that the PL in the insects was significantly influenced by FS. Infected insects that fed on the classic reservoir, Didelphis albiventris, and Galea spixii exhibited higher PLs, compared to those that fed on Kerodon rupestris (p < 0.04)-a primary host. While D. albiventris is already recognized as a synanthropic species, we propose that G. spixii may also be undergoing a synanthropic process. Conversely, domestic cats are frequently identified as FS in infected insects from the sylvatic environment, suggesting a possible change in their behavior towards a wild state. Therefore, we propose that neglected anthropogenic actions have facilitated the reciprocal (sylvatic-peridomestic) circulation of T. cruzi-especially noted for TcI because it was predominant in insects found in peridomestic environments. Residents are often unaware of the existence of insect breeding grounds near their homes, particularly when it involves the storage of materials without planning for use, such as piles of tiles, bricks and wood. Although indirect inferences about the interaction among vector-parasite-host-environment are still incipient, we highlight the potential use of vectors as natural samplers of biological and ecological components in transmitting the disease.
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Affiliation(s)
- Carlos E Almeida
- Universidade Federal da Paraíba (UFPB), Campus IV, Rio Tinto, Brasil; Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brasil.
| | - Milena M Máximo
- Universidade Federal da Paraíba (UFPB), Campus IV, Rio Tinto, Brasil
| | | | - Daniela M Takiya
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brasil
| | | | - Maria C Viana
- Universidade de Campinas (UNICAMP), Campinas, Brasil; Instituto Nacional de Câncer, Rio de Janeiro, Brasil
| | | | | | - Myriam Harry
- Université Paris-Saclay, CNRS, IRD, UMR EGCE, Evolution, Génomes, Comportement et Ecologie, IDEEV, Gif-sur-Yvette, France
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Beatty NL, Arango-Ferreira C, Gual-Gonzalez L, Zuluaga S, Nolan MS, Cantillo-Barraza O. Oral Chagas Disease in Colombia-Confirmed and Suspected Routes of Transmission. Trop Med Infect Dis 2024; 9:14. [PMID: 38251211 PMCID: PMC10819552 DOI: 10.3390/tropicalmed9010014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/21/2023] [Accepted: 12/28/2023] [Indexed: 01/23/2024] Open
Abstract
Chagas disease (CD) remains endemic throughout many regions of Colombia despite implementing decades of vector control strategies in several departments. Some regions have had a significant decrease in vectorial transmission, but the oral ingestion of Trypanosoma cruzi through consumption of contaminated food and drink products is increasingly described. This form of transmission has important public health relevance in Colombia due to an increase in reported acute CD cases and clinical manifestations that often lead to significant morbidity and mortality. Oral CD in Colombia has been associated with the consumption of contaminated fruit juices, such as palm wine, sugar cane, or tangerine juice and water for consumption, or contaminated surfaces where food has been prepared. Another interesting route of oral transmission includes ingestion of unbeknownst infected armadillos' blood, which is related to a traditional medicine practice in Colombia. Some earlier reports have also implemented consumption of infected bush meat as a source, but this is still being debated. Within the Amazon Basin, oral transmission is now considered the principal cause of acute CD in these regions. Furthermore, new cases of acute CD are now being seen in departments where CD has not been documented, and triatomine vectors are not naturally found, thus raising suspicion for oral transmission. The oral CD could also be considered a food-borne zoonosis, and odoriferous didelphid secretions have been implemented in contaminating the human dwelling environment, increasing the risk of consumption of infectious metacyclic trypomastigotes. In this article, we will discuss the complex transmission dynamics of oral CD in Colombia and further examine the unique clinical manifestations of this route of infection. New insights into the oral transmission of Trypanosoma cruzi are being discovered in Colombia, which can help bring increased awareness and a better understanding of this neglected tropical disease to reduce the burden of CD throughout Latin America.
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Affiliation(s)
- Norman L. Beatty
- Division of Infectious Diseases and Global Medicine, Department of Medicine, University of Florida College of Medicine, Gainesville, FL 32610, USA;
- Emerging Pathogens Institute, University of Florida, Gainesville, FL 32610, USA
| | - Catalina Arango-Ferreira
- Departamento de Pediatría, Hospital San Vicente Fundación, Medellín 050010, Colombia;
- Departamento de Pediatría, Facultad de Medicina, Universidad de Antioquia, Medellín 050010, Colombia
| | - Lídia Gual-Gonzalez
- Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (L.G.-G.); (M.S.N.)
| | - Sara Zuluaga
- Grupo Biología y Control de Enfermedades Infecciosas, Universidad de Antioquia, Medellín 050010, Colombia;
| | - Melissa S. Nolan
- Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (L.G.-G.); (M.S.N.)
| | - Omar Cantillo-Barraza
- Grupo Biología y Control de Enfermedades Infecciosas, Universidad de Antioquia, Medellín 050010, Colombia;
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López-García A, Gilabert JA. Oral transmission of Chagas disease from a One Health approach: A systematic review. Trop Med Int Health 2023; 28:689-698. [PMID: 37488635 DOI: 10.1111/tmi.13915] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
OBJECTIVE To analyse acute Chagas disease (CD) outbreaks through a qualitative systematic review and discuss the determinants for its prevention and control. METHODS Review of studies in which clinical cases of oral transmission were confirmed by parasitological and/or serological tests that included an epidemiological investigation of sources of infection, vectors and reservoirs. RESULTS Thirty-two outbreaks (1965-2022) were analysed. The main foods involved in oral transmission outbreaks are homemade fruit juices. Different species of vectors were identified. Reservoirs were mainly dogs, rodents and large American opossums (didelphids). CONCLUSION Under a One Health approach, environmental changes are one of the factors responsible of the rise of oral transmission of CD. Entomological surveillance of vectors and control of the changes in wild and domestic reservoirs and reinforcement of hygiene measures around food in domestic and commercial sites are needed.
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Affiliation(s)
- Alejandra López-García
- Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, Complutense University of Madrid, Madrid, Spain
| | - Juan A Gilabert
- Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, Complutense University of Madrid, Madrid, Spain
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Limeira CH, Oliveira MD, Júnior JPA, Malossi CD, Ullmann LS, Silva MLCR, Azevedo SS, Alves CJ. Molecular detection of Trypanosoma cruzi in equids in a semiarid zone of Pernambuco - Brazil. Vet Parasitol Reg Stud Reports 2023; 37:100815. [PMID: 36623895 DOI: 10.1016/j.vprsr.2022.100815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 10/25/2022] [Accepted: 11/28/2022] [Indexed: 12/02/2022]
Abstract
Trypanosoma cruzi is the etiological agent of Chagas disease, a neglected and frequently occurring zoonosis in Central and South American countries. Wild mammals and domestic dogs are the main reservoirs of the parasite in the wild and domestic cycles, respectively. The vectors have a wide variety of food sources that can influence transmission cycles. The aim of this study was to determine the prevalence of T. cruzi infection in donkeys (Equus asininos) and mules (Equus mulus) living in rural areas of the Brazilian semi-arid region. Whole-blood samples from 72 equids (65 donkeys and 7 mules) were analyzed by nested polymerase chain reaction (nested PCR). A total of 51.39% of the samples (37/72) were positive. Phylogenetic analysis identified discrete typing units TcI and TcII, which suggested the possibility that donkeys and mules might be participating in domestic/peridomestic and wild transmission cycles. This was the first report of T. cruzi infection in donkeys and mules in Brazil, with high prevalence of positive animals. This places these animals as potential reservoirs for the parasite and the particular features of these hosts, the presence of vectors and the socioeconomic characteristics of the population under semiarid conditions create interactions that may favor transmission and overlapping T. cruzi infection cycles.
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Affiliation(s)
- Clécio Henrique Limeira
- Programa de Pós-graduação em Ciência e Saúde Animal, Universidade Federal de Campina Grande, Av. Universitária s/n, CEP 58708-110 Patos, Paraíba, Brazil.
| | - Murilo Duarte Oliveira
- Instituto Federal de Educação do Sertão Pernambucano, Rodovia BR 232, km 508, Salgueiro, Pernambuco, Brazil
| | - João Pessoa Araújo Júnior
- Instituto de Biotecnologia (IBTEC), Universidade Estadual Paulista (UNESP), Alameda das Tecomarias, s/n, Chácara Capão Bonito, CEP 18607-440 Botucatu, São Paulo, Brazil
| | - Camila Dantas Malossi
- Instituto de Biotecnologia (IBTEC), Universidade Estadual Paulista (UNESP), Alameda das Tecomarias, s/n, Chácara Capão Bonito, CEP 18607-440 Botucatu, São Paulo, Brazil
| | - Leila Sabrina Ullmann
- Instituto de Biotecnologia (IBTEC), Universidade Estadual Paulista (UNESP), Alameda das Tecomarias, s/n, Chácara Capão Bonito, CEP 18607-440 Botucatu, São Paulo, Brazil; Faculdade de Medicina Veterinária e Zootecnia (FAMEZ), Universidade Federal de Mato Grosso do Sul (UFMS), Avenida Senador Filinto Müller, 2443, Pioneiros, CEP 79070-900 Campo Grande, Mato Grosso do Sul, Brazil
| | - Maria Luana Cristiny Rodrigues Silva
- Programa de Pós-graduação em Ciência e Saúde Animal, Universidade Federal de Campina Grande, Av. Universitária s/n, CEP 58708-110 Patos, Paraíba, Brazil
| | - Sérgio Santos Azevedo
- Programa de Pós-graduação em Ciência e Saúde Animal, Universidade Federal de Campina Grande, Av. Universitária s/n, CEP 58708-110 Patos, Paraíba, Brazil
| | - Clebert José Alves
- Programa de Pós-graduação em Ciência e Saúde Animal, Universidade Federal de Campina Grande, Av. Universitária s/n, CEP 58708-110 Patos, Paraíba, Brazil
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High Parasitic Loads Quantified in Sylvatic Triatoma melanica, a Chagas Disease Vector. Pathogens 2022; 11:pathogens11121498. [PMID: 36558833 PMCID: PMC9785645 DOI: 10.3390/pathogens11121498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 11/29/2022] [Accepted: 12/01/2022] [Indexed: 12/13/2022] Open
Abstract
Triatoma melanica is a sylvatic vector species in Brazil. In We aimed to characterize the Trypanosoma cruzi discrete typing units (DTUs), the parasitic loads, and the blood meal sources of insects collected in rocky outcrops in rural areas in the state of Minas Gerais. An optical microscope (OM) and kDNA-PCR were used to examine natural infection by T. cruzi, and positive samples were genotyped by conventional multilocus PCR. Quantification of the T. cruzi load was performed using qPCR, and the blood meal sources were identified by Sanger sequencing the 12S rRNA gene. A total of 141 T. melanica were captured. Of these, ~55% (61/111) and ~91% (63/69) were positive by OM and KDNA-PCR, respectively. We genotyped ~89% (56/63) of the T. cruzi-positive triatomines, with TcI (~55%, 31/56) being the most prevalent DTU, followed by TcIII (~20%, 11/56) and TcII (~7%, 4/56). Only TcI+TcIII mixed infections were detected in 10 (~18%) specimens. A wide range of variation in the parasitic loads of T. melanica was observed, with an overall median value of 104 parasites/intestine, with females having higher T. cruzi loads than N2, N4, and N5. TcII showed lower parasitic loads compared to TcI and TcIII. The OM positive diagnosis odds ratio between T. cruzi infection when the parasite load is 107 compared to 103 was approximately 29.1. The most frequent blood meal source was Kerodon rupestris (~58%), followed by Thrichomys apereoides (~18%), Wiedomys cerradensis (~8%), Galactis cuja (~8%) and Gallus gallus (~8%). Our findings characterize biological and epidemiological aspects of the sylvatic population of T. melanica in the study area, highlighting the need to extend surveillance and control to this vector.
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Trypanosoma cruzi infection in the wild Chagas disease vector, Mepraia spinolai: Parasitic load, discrete typing units, and blood meal sources. Acta Trop 2022; 229:106365. [PMID: 35150641 DOI: 10.1016/j.actatropica.2022.106365] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/06/2022] [Accepted: 02/08/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Mepraia spinolai, a wild vector of Trypanosoma cruzi in Chile, is an abundant triatomine species that is frequently infected by the parasite that causes Chagas disease. The aim of this study was to determine if the parasitic load of T. cruzi in M. spinolai is related to its blood meal source and the infecting DTUs of T. cruzi. METHODS The vector was captured in rural areas. In the laboratory, DNA was extracted from its abdomen and T. cruzi was quantified using qPCR. Real time PCR assays for four T. cruzi DTUs were performed. Blood meal sources were identified by real-time PCR amplification of vertebrate cytochrome b gene sequences coupled with high resolution melting (HRM). RESULTS Trypanosoma cruzi was detected in 735 M. spinolai; in 484 we identified one blood meal source, corresponding to human, sylvatic, and domestic species. From these, in 224 we were able to discriminate the infecting DTU. When comparing the parasitic loads between the unique blood meal sources, no significant differences were found, but infections with more than one DTU showed higher parasitic loads than single infections. DTU TcI was detected in a high proportion of the samples. CONCLUSIONS Higher parasitic loads are related to a greater number of T. cruzi DTUs infecting M. spinolai, and this triatomine seems to have a wide span of vertebrate species in its diet.
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Souza TKMD, Westphalen EVN, Westphalen SDR, Taniguchi HH, Elias CR, Motoie G, Gava R, Pereira-Chioccola VL, Novaes CTG, Carvalho NB, Bocchi EA, Cruz FDDD, Rocha MC, Shinjo SK, Shikanai-Yasuda MA, Ortiz PA, Teixeira MMG, Tolezano JE. Genetic diversity of Trypanosoma cruzi strains isolated from chronic chagasic patients and non-human hosts in the state of São Paulo, Brazil. Mem Inst Oswaldo Cruz 2022; 117:e220125. [PMID: 36383785 PMCID: PMC9651066 DOI: 10.1590/0074-02760220125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 09/16/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Trypanosoma cruzi shows an exuberant genetic diversity. Currently, seven phylogenetic lineages, called discrete typing units (DTUs), are recognised: TcI-TcVI and Tcbat. Despite advances in studies on T. cruzi and its populations, there is no consensus regarding its heterogeneity. OBJECTIVES This study aimed to perform molecular characterisation of T. cruzi strains, isolated in the state of São Paulo, to identify the DTUs involved and evaluate their genetic diversity. METHODS T. cruzi strains were isolated from biological samples of chronic chagasic patients, marsupials and triatomines through culture techniques and subjected to molecular characterisation using the fluorescent fragment length barcoding (FFLB) technique. Subsequently, the results were correlated with complementary information to enable better discrimination between the identified DTUs. FINDINGS It was possible to identify TcI in two humans and two triatomines; TcII/VI in 19 humans, two marsupials and one triatomine; and TcIII in one human host, an individual that also presented a result for TcI, which indicated the possibility of a mixed infection. Regarding the strains characterised by the TcII/VI profile, the correlation with complementary information allowed to suggest that, in general, these parasite populations indeed correspond to the TcII genotype. MAIN CONCLUSIONS The TcII/VI profile, associated with domestic cycles and patients with chronic Chagas disease, was the most prevalent among the identified DTUs. Furthermore, the correlation of the study results with complementary information made it possible to suggest that TcII is the predominant lineage of this work.
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