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Davila E, Fernandez-Santos NA, Estrada-Franco JG, Wei L, Velázquez-Ramírez DD, García-Miranda R, Irecta Nájera C, Cruz-Cadena R, Guichard-Romero C, Rodriguez C, Tarleton R, Rodríguez-Pérez MA, Ochoa-Díaz-López H, Hamer GL, Hamer SA. Domestic Dog Infection with Trypanosoma cruzi from Northern and Southern Regions of Mexico. Vector Borne Zoonotic Dis 2024; 24:510-519. [PMID: 38949980 DOI: 10.1089/vbz.2023.0110] [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] [Indexed: 07/03/2024] Open
Abstract
Background: Chagas disease or American trypanosomiasis, caused by Trypanosoma cruzi and vectored by triatomines, affects millions of people worldwide. In endemic countries including Mexico, infections in domestic animals, such as dogs, may affect the risk of human disease when they serve as a source of infection to vectors that subsequently infect humans. Materials and Methods: We conducted a cross-sectional study of 296 dogs from two cities near the northern and southern borders of Mexico: Reynosa, Tamaulipas, and Tuxtla Gutierrez, Chiapas. Infection was measured based on testing of blood using T. cruzi quantitative PCR (qPCR) and up to three antibody detection assays. The StatPak immunochromatographic assay was used to screen samples and the indirect fluorescent antibody (IFA) and multiplex microsphere immunoassay (MIA) tests were used as secondary tests on all samples that screened positive and a subset of negatives. Serologic positivity was defined based on reactivity on at least two independent tests. Results: Of the 280 samples tested for parasite DNA, two (0.7%) were positive, one of which (0.4%) was confirmed as T. cruzi discrete typing unit TcIV. Overall, 72 (24.3%) samples were reactive for T. cruzi antibodies via StatPak of which 8 were also positive using MIA and 2 were also positive using IFA (including one of the PCR-positive dogs). Overall, nine dogs (3.4%) met study criteria of positivity based on either/both serology or PCR tests. Positive dogs were found in both regions of Mexico; five (2.7%) from Reynosa and four (3.6%) from Tuxtla Gutierrez. We found no association between infection status and state of origin, sex, age group, breed group, neighborhood, and whether other pets lived in the home. Conclusion: Our results re-emphasize dogs' utility as sentinels for T. cruzi in Mexico and underscore the need for improved veterinary diagnostic tests and parasite surveillance at the household level in endemic countries.
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Affiliation(s)
- Edward Davila
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, Texas, USA
| | - Nadia A Fernandez-Santos
- Department of Entomology, Texas A&M University, College Station, Texas, USA
- Instituto Politécnico Nacional, Centro de Biotecnología Genómica, Laboratorio de Biomedicina Molecular, Reynosa, Tamaulipas, Mexico
| | - José Guillermo Estrada-Franco
- Instituto Politécnico Nacional, Centro de Biotecnología Genómica, Laboratorio de Biomedicina Molecular, Reynosa, Tamaulipas, Mexico
| | - Lihua Wei
- Instituto Politécnico Nacional, Centro de Biotecnología Genómica, Laboratorio de Biomedicina Molecular, Reynosa, Tamaulipas, Mexico
| | | | - Rosario García-Miranda
- Departamento de Salud, El Colegio de la Frontera Sur (ECOSUR), San Cristóbal de Las Casas, México
- Escuela de Lenguas, Universidad Autónoma de Chiapas (UNACH), San Cristóbal de Las Casas, México
| | - Cesar Irecta Nájera
- Departamento de Salud, El Colegio de la Frontera Sur (ECOSUR), Villahermosa, México
| | - Raúl Cruz-Cadena
- Escuela de Ciencias Químicas, Universidad Autónoma de Chiapas (UNACH), Ocozocoautla de Espinosa, México
| | | | - Carlos Rodriguez
- Texas A&M Veterinary Medical Diagnostic Laboratory, College Station, Texas, USA
| | - Rick Tarleton
- Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia, USA
- Department of Cellular Biology, University of Georgia, Athens, Georgia, USA
| | - Mario A Rodríguez-Pérez
- Instituto Politécnico Nacional, Centro de Biotecnología Genómica, Laboratorio de Biomedicina Molecular, Reynosa, Tamaulipas, Mexico
| | - Héctor Ochoa-Díaz-López
- Departamento de Salud, El Colegio de la Frontera Sur (ECOSUR), San Cristóbal de Las Casas, México
| | - Gabriel L Hamer
- Department of Entomology, Texas A&M University, College Station, Texas, USA
| | - Sarah A Hamer
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, Texas, USA
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de França DA, Louro M, Zúquete S, Zanini DDS, de Moraes GN, Rocha GDS, Biondo LM, Fornazari F, Menozzi BD, da Fonseca IP, Langoni H. Trypanosoma cruzi in Bats (Chiroptera; Mammalia) from the Brazilian Atlantic Forest, São Paulo State. Microorganisms 2024; 12:945. [PMID: 38792775 PMCID: PMC11123848 DOI: 10.3390/microorganisms12050945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 04/30/2024] [Accepted: 05/04/2024] [Indexed: 05/26/2024] Open
Abstract
The causative agent of Chagas disease is Trypanosoma cruzi, which is widely distributed throughout the South American continent and extends into North America. Its occurrence in bats is poorly described and may impact the disease's maintenance and epidemiology. The aim of this study was to detect the agent by PCR assays targeting kDNA and nuclear DNA in the organs of 203 urban bats and rural vampire bats from the Brazilian Atlantic Forest, São Paulo state, during the pandemic period from 2020 to 2022. In total, 6 of the 203 bats (2.97%) were positive for T. cruzi. Infection was detected in 2% (2/101) of Desmodus rotundus, 33% (1/3) of Nyctinomops laticaudatus, 25% (1/4) of Artibeus lituratus, 4% (1/24) of Eumops glaucinus and in 2% (1/41) of Molossus molossus. The gene sequences obtained were assessed for quality and deposited in a public repository. Fruit bats were statistically associated with positivity for T. cruzi. To our knowledge, this study detected T. cruzi for the first time in bats from São Paulo state and in N. laticaudatus and E. glaucinus species.
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Affiliation(s)
- Danilo Alves de França
- Department of Animal Production and Preventive Veterinary Medicine, School of Veterinary Medicine and Animals Science, São Paulo State University, Botucatu 18618-681, SP, Brazil; (D.A.d.F.); (F.F.)
| | - Mariana Louro
- Department of Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Avenida da Universidade Técnica, 1300-477 Lisboa, Portugal (I.P.d.F.)
- CIISA—Centre for Interdisciplinary Research in Animal Health, Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Faculty of Veterinary Medicine, 1300-477 Lisbon, Portugal
| | - Sara Zúquete
- Department of Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Avenida da Universidade Técnica, 1300-477 Lisboa, Portugal (I.P.d.F.)
- CIISA—Centre for Interdisciplinary Research in Animal Health, Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Faculty of Veterinary Medicine, 1300-477 Lisbon, Portugal
| | - Dayane da Silva Zanini
- Department of Animal Production and Preventive Veterinary Medicine, School of Veterinary Medicine and Animals Science, São Paulo State University, Botucatu 18618-681, SP, Brazil; (D.A.d.F.); (F.F.)
| | - Gustavo Nunes de Moraes
- Department of Animal Production and Preventive Veterinary Medicine, School of Veterinary Medicine and Animals Science, São Paulo State University, Botucatu 18618-681, SP, Brazil; (D.A.d.F.); (F.F.)
| | - Gabrielle dos Santos Rocha
- Department of Animal Production and Preventive Veterinary Medicine, School of Veterinary Medicine and Animals Science, São Paulo State University, Botucatu 18618-681, SP, Brazil; (D.A.d.F.); (F.F.)
| | - Leandro Meneguelli Biondo
- National Institute of the Atlantic Forest (INMA), Brazilian Ministry of Science, Technology and Innovation, Santa Teresa 29650-000, ES, Brazil
- Interdisciplinary Graduate Studies, University of British Columbia, Kelowna, BC V1V 1V7, Canada
| | - Felipe Fornazari
- Department of Animal Production and Preventive Veterinary Medicine, School of Veterinary Medicine and Animals Science, São Paulo State University, Botucatu 18618-681, SP, Brazil; (D.A.d.F.); (F.F.)
| | - Benedito Donizete Menozzi
- Department of Animal Production and Preventive Veterinary Medicine, School of Veterinary Medicine and Animals Science, São Paulo State University, Botucatu 18618-681, SP, Brazil; (D.A.d.F.); (F.F.)
| | - Isabel Pereira da Fonseca
- Department of Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Avenida da Universidade Técnica, 1300-477 Lisboa, Portugal (I.P.d.F.)
- CIISA—Centre for Interdisciplinary Research in Animal Health, Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Faculty of Veterinary Medicine, 1300-477 Lisbon, Portugal
| | - Helio Langoni
- Department of Animal Production and Preventive Veterinary Medicine, School of Veterinary Medicine and Animals Science, São Paulo State University, Botucatu 18618-681, SP, Brazil; (D.A.d.F.); (F.F.)
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Pascual-Vázquez G, Alonso-Sardón M, Rodríguez-Alonso B, Pardo-Lledías J, Romero Alegría A, Fernández-Soto P, Muñoz Bellido JL, Muro A, Belhassen-García M. Molecular diagnosis of Chagas disease: a systematic review and meta-analysis. Infect Dis Poverty 2023; 12:95. [PMID: 37845734 PMCID: PMC10577976 DOI: 10.1186/s40249-023-01143-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/20/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND The complexity of the Chagas disease and its phases is impossible to have a unique test for both phases and a lot of different epidemiological scenarios. Currently, serology is the reference standard technique; occasionally, results are inconclusive, and a different diagnostic technique is needed. Some guidelines recommend molecular testing. A systematic review and meta-analysis of available molecular tools/techniques for the diagnosis of Chagas disease was performed to measure their heterogeneity and efficacy in detecting Trypanosoma cruzi infection in blood samples. METHODS A systematic review was conducted up to July 27, 2022, including studies published in international databases. Inclusion and exclusion criteria were defined to select eligible studies. Data were extracted and presented according to PRISMA 2020 guidelines. Study quality was assessed using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). A random-effects model was used to calculate pooled sensitivity, specificity, and diagnostic odds ratio (DOR). Forest plots and a summary of the receiving operating characteristics (SROC) curves displayed the outcomes. Heterogeneity was determined by I2 and Tau2 statistics and P values. Funnel plots and Deek's test were used to assess publication bias. A quantitative meta-analysis of the different outcomes in the two different clinical phases was performed. RESULTS We identified 858 records and selected 32 papers. Studies pertained to endemic countries and nonendemic areas with adult and paediatric populations. The sample sizes ranged from 17 to 708 patients. There were no concerns regarding the risk of bias and applicability of all included studies. A positive and nonsignificant correlation coefficient (S = 0.020; P = 0.992) was obtained in the set of studies that evaluated diagnostic tests in the acute phase population (ACD). A positive and significant correlation coefficient (S = 0.597; P < 0.000) was obtained in the case of studies performed in the chronic phase population (CCD). This resulted in high heterogeneity between studies, with the master mix origin and guanidine addition representing significant sources. INTERPRETATION/CONCLUSIONS AND RELEVANCE The results described in this meta-analysis (qualitative and quantitative analyses) do not allow the selection of the optimal protocol of molecular method for the study of Trypanosoma cruzi infection in any of its phases, among other reasons due to the complexity of this infection. Continuous analysis and optimization of the different molecular techniques is crucial to implement this efficient diagnosis in endemic areas.
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Affiliation(s)
- Guillermo Pascual-Vázquez
- Infectious and Tropical Diseases Group (E-INTRO), Biomedical Research Institute of Salamanca (IBSAL), Tropical Diseases Research Center of the University of Salamanca (CIETUS), Faculty of Pharmacy, University of Salamanca, Salamanca, Spain
| | - Montserrat Alonso-Sardón
- Area of Preventive Medicine, Epidemiology and Public Health, Department of Biomedical and Diagnostic Sciences, Faculty of Medicine, E-INTRO, IBSAL, CIETUS, University of Salamanca, Salamanca, Spain
| | - Beatriz Rodríguez-Alonso
- Internal Medicine Service, University Health Care Complex of Salamanca (CAUSA), E-INTRO, IBSAL, CIETUS, Salamanca, Spain
| | - Javier Pardo-Lledías
- Internal Medicine Department, Hospital Marqués de Valdecilla, University of Cantabria, IDIVAL (Valdecilla Research Institute), Santander, Spain
| | | | - Pedro Fernández-Soto
- Infectious and Tropical Diseases Group (E-INTRO), IBSAL. CIETUS. Faculty of Pharmacy, University of Salamanca, Salamanca, Spain
| | - Juan Luis Muñoz Bellido
- Microbiology and Parasitology Service, CAUSA, IBSAL, CIETUS, CSIC, Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
| | - Antonio Muro
- Infectious and Tropical Diseases Group (E-INTRO), IBSAL. CIETUS. Faculty of Pharmacy, University of Salamanca, Salamanca, Spain
| | - Moncef Belhassen-García
- Internal Medicine Service. Infectious Diseases Section, CAUSA, IBSAL, CIETUS, University of Salamanca, Paseo San Vicente 58-182, 37007, Salamanca, Spain.
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Valdés-Soto M, Burgdorf-Moisuk A, Raines J, Connolly M, Allen KE, Lineberry MW, Garner MM. TRYPANOSOMA CRUZI INFECTION IN THREE SLENDER-TAILED MEERKATS ( SURICATA SURICATTA). J Zoo Wildl Med 2023; 54:394-400. [PMID: 37428705 DOI: 10.1638/2022-0060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2023] [Indexed: 07/12/2023] Open
Abstract
Trypanosoma cruzi is a protozoan parasite primarily transmitted by triatomine insects (Hemiptera: subfamily Reduviidae) and is the cause of Chagas disease (CD). This report describes three cases of CD in a mob of five slender-tailed meerkats (Suricata suricatta) living in an outdoor exhibit at one zoological institution in Texas. The index case was a 9.5-yr-old female that presented with ataxia, lethargy, and pleural effusion. This case was diagnosed with CD postmortem via cytology, T. cruzi PCR of whole blood and lung fluid, and histology. Blood was opportunistically collected from the remaining four meerkats 28 d after the death of the index case and tested by PCR and serology. The second case was a clinically normal 7.5-yr-old male that tested PCR and antibody positive and the third case was a clinically normal 9-yr-old female that tested PCR positive. The second animal presented depressed, with pneumonia, and with continuous shivering 53 d after blood collection, and clinically improved after treatment with antibiotics and supportive care. Fifteen days later, the animal was found minimally responsive and died shortly thereafter. Histologic examination revealed Trypanosoma sp. amastigotes in the myocardium and the tissue was positive for T. cruzi DNA. The third meerkat, which received two separate courses of benznidazole over a span of almost 2 yr, was monitored routinely by PCR and serology and appeared clinically normal until found dead on exhibit 93 d after completion of the second treatment. Myocardium was positive for T. cruzi DNA. To the authors' knowledge, this case series is the first to document Chagas disease in meerkats and features associated cytologic and histologic findings.
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Affiliation(s)
- Marcela Valdés-Soto
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Autónoma de Nuevo León, Francisco Villa S/ N Col. Ex Hacienda el Canadá, Escobedo, Nuevo León, México, 66050
| | | | | | | | - Kelly E Allen
- Oklahoma State University's College of Veterinary Medicine, OK 74078, USA
| | - Megan W Lineberry
- Oklahoma State University's College of Veterinary Medicine, OK 74078, USA
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Santos F, Magalhaes-Junior JT, de Oliveira Carneiro I, Lambert SM, da Silva Souza BMP, de Pauda AD, de Freitas MP, Franke CR. Wild mammals involved in the transmission of Trypanosoma cruzi and food sources of Triatoma sherlocki in an endemic region of northeastern Brazil. MEDICAL AND VETERINARY ENTOMOLOGY 2023; 37:396-406. [PMID: 36632712 DOI: 10.1111/mve.12641] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 12/22/2022] [Indexed: 05/18/2023]
Abstract
The present study, carried out in the municipality of Gentio do Ouro, Bahia, Brazil aimed to evaluate which wild mammals may be involved in the transmission of T. cruzi and which are the blood sources for triatomines collected in the study area. PCR analysis of 31 wild mammals captured revealed T. cruzi infection in 6.4% (2/31): one specimen of the opossum Didelphis albiventris (1/3) and one of the rodent Kerodon rupestris (1/5); despite being more frequent in the area, no specimen of the rodent Thrichomys sp. (0/23) was infected. A total of 169 triatomines were captured. The conclusive detection of food sources was possible only for Triatoma sherlocki Papa et al., 2002 (n = 56), with evidence for: K. rupestris (35.7%), Gallus (17.9%), D. albiventris (14.3%), Homo sapiens (14.3%), Tropidurus hispidus (7.1%), Leopardus geoffroyi (5.3%), Conepatus semistriatus (1.8%), Thrichomys inermis (1.8%) and Rattus norvegicus (1.8%). Triatomines of the species T. sherlocki showed food eclecticism, including feeding on humans, with some of them being captured at dwellings. These facts make this triatomine a potential link for the transmission of T. cruzi between wild and anthropic environments, highlighting a latent risk of the reemergence of Chagas disease outbreaks.
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Affiliation(s)
- Flavia Santos
- Programa de Pós-graduação em Ciência Animal nos Trópicos, Escola de Medicina Veterinária e Zootecnia, Universidade Federal da Bahia-UFBA, Salvador, Bahia, Brazil
- Centro Multidisciplinar do Campus de Barra (CMB), da Universidade Federal do Oeste da Bahia-UFOB, Barra, Bahia, Brazil
| | - Jairo Torres Magalhaes-Junior
- Centro Multidisciplinar do Campus de Barra (CMB), da Universidade Federal do Oeste da Bahia-UFOB, Barra, Bahia, Brazil
| | - Ianei de Oliveira Carneiro
- Campus Professor Barros, Universidade Salvador, Salvador, Bahia, Brazil
- Programa de Pós-graduação em Saúde Coletiva, Instituto de Saúde Coletiva (ISC), Universidade Federal da Bahia - UFBA, Salvador, Bahia, Brazil
| | - Sabrina Mota Lambert
- Laboratório de Biologia Celular e Molecular (LBCM) do Hospital de Medicina Veterinária Prof. Renato Rodemburg de Medeiros Neto (HOSPMEV), Universidade Federal da Bahia - UFBA, Salvador, Bahia, Brazil
| | - Bárbara Maria Paraná da Silva Souza
- Laboratório de Biologia Celular e Molecular (LBCM) do Hospital de Medicina Veterinária Prof. Renato Rodemburg de Medeiros Neto (HOSPMEV), Universidade Federal da Bahia - UFBA, Salvador, Bahia, Brazil
| | - Alini Dias de Pauda
- Centro Multidisciplinar do Campus de Barra (CMB), da Universidade Federal do Oeste da Bahia-UFOB, Barra, Bahia, Brazil
| | - Marcondes Pessoa de Freitas
- Centro Multidisciplinar do Campus de Barra (CMB), da Universidade Federal do Oeste da Bahia-UFOB, Barra, Bahia, Brazil
| | - Carlos Roberto Franke
- Programa de Pós-graduação em Ciência Animal nos Trópicos, Escola de Medicina Veterinária e Zootecnia, Universidade Federal da Bahia-UFBA, Salvador, Bahia, Brazil
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Allen KE, Lineberry MW. Trypanosoma cruzi and Other Vector-Borne Infections in Shelter Dogs in Two Counties of Oklahoma, United States. Vector Borne Zoonotic Dis 2022; 22:273-280. [PMID: 35580215 DOI: 10.1089/vbz.2021.0078] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Trypanosoma cruzi is an emerging zoonotic vector-borne parasite infecting dogs and other mammals in the United States. In this study we evaluated shelter dogs in one northeastern and one southeastern county in Oklahoma for prevalence of exposure to T. cruzi. Dogs were tested for antibodies against T. cruzi using the Chagas STAT PAK® assay and for T. cruzi in circulation by PCR. In addition, dogs were tested for evidence of infection with other vector-borne organisms using the SNAP® 4Dx® Plus Test and PCR. Overall, 26 of 197 (13.2%) shelter dogs had detectable antibodies against T. cruzi and 3 of 189 (1.6%) dogs were PCR positive. In addition, we found that 42 of 197 (21.3%) shelter dogs had evidence of exposure to or were infected with at least one vector-borne agent other than T. cruzi based on serology and/or PCR; 9 of 42 (21.4%) of these dogs were also positive for T. cruzi antibodies. Other infections identified in dogs included Anaplasma phagocytophilum, Anaplasma platys, Babesia sp. (Coco), Dirofilaria immitis, Ehrlichia canis, Ehrlichia chaffeensis, Ehrlichia ewingii, and Hepatozoon americanum. This study serves to boost state-wide veterinary and public health awareness of T. cruzi and other vector-borne pathogens infecting shelter dogs in Oklahoma. Results indicate the need for more comprehensive screening of shelter dogs in Oklahoma for exposure to vector-borne agents to enhance surveillance and to identify dogs in need of additional specific veterinary care.
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Affiliation(s)
- Kelly E Allen
- Department of Veterinary Pathobiology, College of Veterinary Medicine, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Megan W Lineberry
- Department of Veterinary Pathobiology, College of Veterinary Medicine, Oklahoma State University, Stillwater, Oklahoma, USA
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Worldwide Control and Management of Chagas Disease in a New Era of Globalization: a Close Look at Congenital Trypanosoma cruzi Infection. Clin Microbiol Rev 2022; 35:e0015221. [PMID: 35239422 PMCID: PMC9020358 DOI: 10.1128/cmr.00152-21] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Population movements have turned Chagas disease (CD) into a global public health problem. Despite the successful implementation of subregional initiatives to control vectorial and transfusional Trypanosoma cruzi transmission in Latin American settings where the disease is endemic, congenital CD (cCD) remains a significant challenge. In countries where the disease is not endemic, vertical transmission plays a key role in CD expansion and is the main focus of its control. Although several health organizations provide general protocols for cCD control, its management in each geopolitical region depends on local authorities, which has resulted in a multitude of approaches. The aims of this review are to (i) describe the current global situation in CD management, with emphasis on congenital infection, and (ii) summarize the spectrum of available strategies, both official and unofficial, for cCD prevention and control in countries of endemicity and nonendemicity. From an economic point of view, the early detection and treatment of cCD are cost-effective. However, in countries where the disease is not endemic, national health policies for cCD control are nonexistent, and official regional protocols are scarce and restricted to Europe. Countries of endemicity have more protocols in place, but the implementation of diagnostic methods is hampered by economic constraints. Moreover, most protocols in both countries where the disease is endemic and those where it is not endemic have yet to incorporate recently developed technologies. The wide methodological diversity in cCD diagnostic algorithms reflects the lack of a consensus. This review may represent a first step toward the development of a common strategy, which will require the collaboration of health organizations, governments, and experts in the field.
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Malcolm EL, Saunders AB, Vitt JP, Boutet BG, Hamer SA. Antiparasitic treatment with itraconazole and amiodarone in 2 dogs with severe, symptomatic Chagas cardiomyopathy. J Vet Intern Med 2022; 36:1100-1105. [PMID: 35388923 PMCID: PMC9151465 DOI: 10.1111/jvim.16422] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 03/14/2022] [Accepted: 03/25/2022] [Indexed: 01/06/2023] Open
Abstract
Chagas cardiomyopathy, caused by the protozoal parasite Trypanosoma cruzi, is characterized by arrhythmias, myocardial damage, heart failure, and sudden death. We describe 2 dogs with severe, symptomatic Chagas cardiomyopathy characterized by myocardial dysfunction and electrocardiographic abnormalities that were managed with a combination of cardiac medications and antiparasitic treatment with itraconazole and amiodarone. Both dogs died suddenly within 6 months of diagnosis. These cases highlight the need for early detection of Chagas disease in dogs and continued research to develop effective antiparasitic treatment protocols.
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Affiliation(s)
- Elizabeth L Malcolm
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Ashley B Saunders
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Jordan P Vitt
- Heart of Veterinary Cardiology PLLC, Seattle, Washington, USA
| | - Bruno G Boutet
- Caring Hearts Veterinary Cardiology, Grande-Digue, New Brunswick, Canada
| | - Sarah A Hamer
- Department of Veterinary Integrative Biosciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
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Allen KE, Lineberry MW. Detection of Trypansoma cruzi in Kissing Bugs (Hemiptera: Reduviidae: Triatominae) Collected Across Oklahoma. JOURNAL OF MEDICAL ENTOMOLOGY 2022; 59:675-680. [PMID: 34993549 DOI: 10.1093/jme/tjab211] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Indexed: 06/14/2023]
Abstract
Trypanosoma cruzi is the causative agent of Chagas disease in humans and dogs in the Americas. Transmission predominantly occurs via the feces of infected kissing bugs (Hemiptera: family Reduviidae; subfamily Triatominae) contaminating bite site wounds or mucous membranes. To better understand Chagas disease entomologic risk in Oklahoma, kissing bugs collected from within the state were tested for T. cruzi DNA. Data including county of insect collection, species and instar, and specific locations where specimens were found were collated. Triatomines were also tested by PCR to potentially identify DNA of vertebrate species on which specimens had recently fed. In total, 110 kissing bugs from 22 counties were tested. All triatomines were identified as Triatoma sanguisuga nymphs or adults, with the exception of one possible T. lecticularia adult. Trypanosoma cruzi DNA was detected in 22 (20%) triatomines from 12 counties spanning the state. The majority of T. cruzi PCR positive kissing bugs were found inside homes or associated structures (i.e., garages, porches). Vertebrate DNA was identified in 27 (24.5%) triatomines, with human DNA detected in 25 (92.6%) of these specimens, and canine and raccoon DNA detected in one specimen each (3.7%). Two specimens tested positive for both T. cruzi and human DNA and one specimen tested positive for both T. cruzi and raccoon DNA. Results from this study indicate that kissing bugs carrying T. cruzi are widespread in Oklahoma, that positive kissing bugs infest homes and associated structures, and that human-vector, canine-vector, and wildlife-vector contact all occur within the state.
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Affiliation(s)
- Kelly E Allen
- Department of Veterinary Pathobiology, Oklahoma State University's College of Veterinary Medicine, Stillwater, OK, USA
| | - Megan W Lineberry
- Department of Veterinary Pathobiology, Oklahoma State University's College of Veterinary Medicine, Stillwater, OK, USA
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Caranci AT, Grieco JP, Achee NL, Hoel DF, Bautista K, King R, Stewart VA, Murphy J, Masuoka P, Olsen CH. Distribution of Triatoma dimidiata sensu lato (Reduviidae: Triatominae) and Risk Factors Associated with Household Invasion in Northern Belize, Central America. JOURNAL OF MEDICAL ENTOMOLOGY 2022; 59:764-771. [PMID: 35064668 PMCID: PMC8924975 DOI: 10.1093/jme/tjab227] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Indexed: 06/14/2023]
Abstract
To date, Triatoma dimidiata sensu lato [Reduviidae: Triatominae (Latreille 1811)] remains the sole vector species associated with Chagas disease transmission reported from Belize. Human infection data are limited for Belize and the disease transmission dynamics have not been thoroughly investigated, yet the likelihood of autochthonous transmission is supported by the widespread collection of infected vectors from within local households. Here, we report updated infection rates of the vector population and infestation rates for villages in north and central Belize. Overall, 275 households were enrolled in an ongoing vector surveillance program. Of the 41 insects collected, 25 were PCR positive for T. cruzi, indicating an infection rate as high as 60%. To further characterize the epidemiological risk of human-vector contact, determinants of household invasion were modeled. Local households were surveyed and characterized with respect to over 25 key factors that may be associated with household infestation by T. dimidiata s.l. While final models were not strongly predictive with respect to the risk factors that were surveyed, likely due to the low number of collection observations, the presence of domestic/peri-domestic dogs, nearby light sources, and household structure materials could be the focus of continued risk assessments. In northern Belize, this vector survey lends support to T. dimidiata s.l. inhabiting sylvatic settings as opposed to the classical paradigm of domiciliated vector populations. This designation has strong implications for the local level of human exposure risk which can help guide vector surveillance and control resources.
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Affiliation(s)
- Angela T Caranci
- Northwest MVCD, 1966 Compton Avenue, Corona, CA 92881, USA
- Department of Preventive Medicine & Biostatistics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - John P Grieco
- Eck Institute of Global Health, University of Notre Dame, 120 Brown Hall, Notre Dame, IN 46556, USA
| | - Nicole L Achee
- Eck Institute of Global Health, University of Notre Dame, 120 Brown Hall, Notre Dame, IN 46556, USA
| | - David F Hoel
- Department of Preventive Medicine & Biostatistics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Kim Bautista
- Ministry of Health, East Block Independence Plaza, Belmopan, Belize
| | - Russell King
- Ministry of Health, East Block Independence Plaza, Belmopan, Belize
| | - V Ann Stewart
- Department of Preventive Medicine & Biostatistics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Jittawadee Murphy
- Department of Preventive Medicine & Biostatistics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Penny Masuoka
- Department of Preventive Medicine & Biostatistics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Cara H Olsen
- Department of Preventive Medicine & Biostatistics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
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OUP accepted manuscript. J Antimicrob Chemother 2022; 77:1748-1752. [DOI: 10.1093/jac/dkac093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 03/02/2022] [Indexed: 11/13/2022] Open
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Strauss M, Lo Presti MS, Ramírez JC, Bazán PC, Velázquez López DA, Báez AL, Paglini PA, Schijman AG, Rivarola HW. Differential tissue distribution of discrete typing units after drug combination therapy in experimental Trypanosoma cruzi mixed infection. Parasitology 2021; 148:1595-1601. [PMID: 35060468 PMCID: PMC11010057 DOI: 10.1017/s0031182021001281] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 06/15/2021] [Accepted: 07/12/2021] [Indexed: 11/06/2022]
Abstract
The aim of the present work was to evaluate the distribution of the different clones of the parasite prevailing after treatment with benznidazole (BZ) and clomipramine (CLO), in mice infected with Trypanosoma cruzi, Casibla isolate which consists of a mixture of two discrete typing units (DTUs). Albino Swiss mice were infected and treated with high and low concentrations of BZ (100 or 6.25 mg/kg), CLO (5 or 1.25 mg/kg), or the combination of both low doses (BZ6.25 + CLO1.25), during the acute phase of experimental infection. Treatment efficacy was evaluated by comparing parasitaemia, survival and tissular parasite presence. For DTUs genotyping, blood, skeletal and cardiac muscle samples were analysed by multiplex quantitative polymerase chain reaction. The combined treatment had similar outcomes to BZ6.25; BZ100 was the most effective treatment, but it failed to reach parasite clearance and produced greater histological alterations. Non-treated mice and the ones treated with monotherapies showed both DTUs while BZ6.25 + CLO1.25 treated mice showed only TcVI parasites in all the tissues studied. These findings suggest that the treatment may modify the distribution of infecting DTUs in host tissues. Coinfection with T. cruzi clones belonging to different DTUs reveals a complex scenario for the treatment of Chagas disease and search for new therapies.
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Affiliation(s)
- Mariana Strauss
- Instituto de Investigaciones en Ciencias de la Salud (INICSA) UNC-CONICET, Centro de Estudios e Investigación de la Enfermedad de Chagas y Leishmaniasis, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Santa Rosa 1085, X5000ESU-Córdoba, Argentina
| | - M. Silvina Lo Presti
- Instituto de Investigaciones en Ciencias de la Salud (INICSA) UNC-CONICET, Centro de Estudios e Investigación de la Enfermedad de Chagas y Leishmaniasis, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Santa Rosa 1085, X5000ESU-Córdoba, Argentina
| | - Juan C. Ramírez
- Laboratorio de Biología Molecular de la Enfermedad de Chagas (LaBMECh), Instituto de Investigaciones en Ingeniería Genética y Biología Molecular “Dr. Héctor N. Torres” (INGEBI-CONICET), Vuelta de Obligado 2490, C1428ADN Buenos Aires, Argentina
| | - P. Carolina Bazán
- Instituto de Investigaciones en Ciencias de la Salud (INICSA) UNC-CONICET, Centro de Estudios e Investigación de la Enfermedad de Chagas y Leishmaniasis, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Santa Rosa 1085, X5000ESU-Córdoba, Argentina
| | - Daniela A. Velázquez López
- Instituto de Investigaciones en Ciencias de la Salud (INICSA) UNC-CONICET, Centro de Estudios e Investigación de la Enfermedad de Chagas y Leishmaniasis, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Santa Rosa 1085, X5000ESU-Córdoba, Argentina
| | - Alejandra L. Báez
- Instituto de Investigaciones en Ciencias de la Salud (INICSA) UNC-CONICET, Centro de Estudios e Investigación de la Enfermedad de Chagas y Leishmaniasis, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Santa Rosa 1085, X5000ESU-Córdoba, Argentina
| | - Patricia A. Paglini
- Instituto de Investigaciones en Ciencias de la Salud (INICSA) UNC-CONICET, Centro de Estudios e Investigación de la Enfermedad de Chagas y Leishmaniasis, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Santa Rosa 1085, X5000ESU-Córdoba, Argentina
| | - Alejandro G. Schijman
- Laboratorio de Biología Molecular de la Enfermedad de Chagas (LaBMECh), Instituto de Investigaciones en Ingeniería Genética y Biología Molecular “Dr. Héctor N. Torres” (INGEBI-CONICET), Vuelta de Obligado 2490, C1428ADN Buenos Aires, Argentina
| | - Héctor W. Rivarola
- Instituto de Investigaciones en Ciencias de la Salud (INICSA) UNC-CONICET, Centro de Estudios e Investigación de la Enfermedad de Chagas y Leishmaniasis, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Santa Rosa 1085, X5000ESU-Córdoba, Argentina
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13
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Roca C, Málaga-Machaca ES, Verastegui MR, Scola B, Valencia-Ayala E, Menduiña MDC, Noazin S, Bowman NM, Tinajeros F, Gilman RH. IgG Subclasses and Congenital Transmission of Chagas Disease. Am J Trop Med Hyg 2021; 105:1187-1192. [PMID: 34491223 PMCID: PMC8592205 DOI: 10.4269/ajtmh.20-1524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 06/25/2021] [Indexed: 11/07/2022] Open
Abstract
The mechanism of vertical transmission of Trypanosoma cruzi is poorly understood. In this study, we evaluated the role of IgG subclasses in the congenital transmission of Chagas disease. We conducted a case-control study in a public maternity hospital in Santa Cruz, Bolivia, enrolling women at delivery. Thirty women who transmitted T. cruzi to their newborns (cases), and 51 women who did not (controls) were randomly selected from 676 total seropositive women. Trypanosoma cruzi-specific IgG1, IgG2, and IgG3 levels were measured by in-house ELISA. The IgG4 levels were unmeasurable as a result of low levels in all participants. Quantitative polymerase chain reaction results and demographic factors were also analyzed. One-unit increases in normalized absorbance ratio of IgG1 or IgG2 levels increased the odds of congenital T. cruzi transmission in Chagas-seropositive women by 2.0 (95% CI: 1.1-3.6) and 2.27 (95% CI: 0.9-5.7), adjusted for age and previous blood transfusion. Odds of congenital transmission were 7.0 times higher in parasitemic mothers (95% CI: 2.3-21.3, P < 0.01) compared with nonparasitemic mothers. We observed that all mothers with IgG1 ≥ 4 were transmitters (sensitivity = 20%, specificity = 100%). Additionally, no mothers with IgG2 < 1.13 were transmitters (sensitivity = 100%, specificity = 21.6%). We demonstrated that IgG subclasses and parasite presence in blood are associated with vertical transmission of T. cruzi and could identify women at increased risk for congenital transmission by measuring IgG subclasses. These measures have potential as objective screening tests to predict the congenital transmission of Chagas.
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Affiliation(s)
- Cristian Roca
- Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Laboratorio de Investigación de Enfermedades Infecciosas, Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Edith S. Málaga-Machaca
- Laboratorio de Investigación de Enfermedades Infecciosas, Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Manuela R. Verastegui
- Laboratorio de Investigación de Enfermedades Infecciosas, Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Billy Scola
- Miller School of Medicine, University of Miami, Miami, Florida
| | - Edward Valencia-Ayala
- Laboratorio de Investigación de Enfermedades Infecciosas, Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Sassan Noazin
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Natalie M. Bowman
- Department of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | | | - Robert H. Gilman
- Laboratorio de Investigación de Enfermedades Infecciosas, Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Asociación Benéfica PRISMA, Lima, Perú
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14
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Fernandes F, Moreira CHV, Oliveira LC, Souza-Basqueira M, Ianni BM, Lorenzo CD, Ramires FJA, Nastari L, Cunha-Neto E, Ribeiro AL, Lopes RD, Keating SM, Sabino EC, Mady C. Galectin-3 Associated with Severe Forms and Long-term Mortality in Patients with Chagas Disease. Arq Bras Cardiol 2021; 116:248-256. [PMID: 33656072 PMCID: PMC7909980 DOI: 10.36660/abc.20190403] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 12/27/2019] [Indexed: 11/19/2022] Open
Abstract
Fundamento As características histopatológicas da doença de Chagas (DCC) são: presença de miocardite, destruição das fibras cardíacas e fibrose miocárdica. A Galectina-3 (Gal-3) é um biomarcador envolvido no mecanismo de fibrose e inflamação que pode ser útil para a estratificação de indivíduos com DCC por risco. Objetivos Nosso objetivo foi avaliar se níveis elevados de Gal-3 estão associados a formas graves de cardiomiopatia chagásica (CC) e são preditivos de mortalidade. Métodos Estudamos doadores de sangue (DS) positivos para anti-T. cruzi: não-CC-DS (187 DS sem CC com eletrocardiograma [ECG] e fração de ejeção do ventrículo esquerdo [FEVE] normais); CC-Não-Dis-DS (46 DS com CC e apresentando ECG anormal, mas FEVE normal); e 153 controles negativos correspondentes. Esta amostra foi composta por 97 pacientes com CC grave (CC-Dis). Usamos as correlações de Kruskall-Wallis e Spearman para testar a hipótese de associações, assumindo um p bicaudal <0,05 como significativo. Resultados O nível de Gal-3 foi de 12,3 ng/mL para não-CC-DS, 12,0 ng/mL para CC-Não-Dis-DS, 13,8 ng/mL para controles e 15,4 ng/mL para CC-Dis. FEVE <50 foi associada a níveis mais elevados de Gal-3 (p=0,0001). Em nosso modelo de regressão linear ajustado, encontramos associação entre os níveis de Gal-3 e os parâmetros do ecocardiograma em indivíduos positivos para T. cruzi. Nos pacientes CC-Dis, encontramos uma associação significativa de níveis mais elevados de Gal-3 (≥15,3 ng/mL) e morte ou transplante cardíaco em acompanhamento de cinco anos (Hazard ratio – HR 3,11; IC95% 1,21– 8,04; p=0,019). Conclusões Em pacientes com CC, níveis mais elevados de Gal-3 estiveram significativamente associados a formas graves da doença e maior taxa de mortalidade em longo prazo, o que significa que pode ser um meio efetivo para identificar pacientes de alto risco. (Arq Bras Cardiol. 2021; 116(2):248-256)
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Affiliation(s)
- Fábio Fernandes
- Universidade de São Paulo Faculdade de Medicina Hospital das Clínicas Instituto do Coração, São Paulo, SP- Brasil
| | | | | | | | - Barbara Maria Ianni
- Universidade de São Paulo Faculdade de Medicina Hospital das Clínicas Instituto do Coração, São Paulo, SP- Brasil
| | | | - Felix José Alvarez Ramires
- Universidade de São Paulo Faculdade de Medicina Hospital das Clínicas Instituto do Coração, São Paulo, SP- Brasil
| | - Luciano Nastari
- Universidade de São Paulo Faculdade de Medicina Hospital das Clínicas Instituto do Coração, São Paulo, SP- Brasil
| | - Edecio Cunha-Neto
- Universidade de São Paulo Faculdade de Medicina Hospital das Clínicas Instituto do Coração, São Paulo, SP- Brasil
| | - Antonio L Ribeiro
- Universidade Federal de Minas Gerais - Centro de Telessaúde - Hospital das Clínicas, Belo Horizonte, MG - Brasil
| | | | - Sheila M Keating
- Blood Systems Research Institute, San Francisco, Califórnia - EUA
| | | | - Charles Mady
- Universidade de São Paulo Faculdade de Medicina Hospital das Clínicas Instituto do Coração, São Paulo, SP- Brasil
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15
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Basile L, Ciruela P, Requena-Méndez A, Vidal MJ, Dopico E, Martín-Nalda A, Sulleiro E, Gascon J, Jané M. Epidemiology of congenital Chagas disease 6 years after implementation of a public health surveillance system, Catalonia, 2010 to 2015. ACTA ACUST UNITED AC 2020; 24. [PMID: 31266591 PMCID: PMC6607740 DOI: 10.2807/1560-7917.es.2019.24.26.19-00011] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Chagas disease is endemic in Latin America and affects 8 million people worldwide. In 2010, Catalonia introduced systematic public health surveillance to detect and treat congenital Chagas disease. Aim The objective was to evaluate the health outcomes of the congenital Chagas disease screening programme during the first 6 years (2010–2015) after its introduction in Catalonia. Methods In a surveillance system, we screened pregnant women and newborns and other children of positive mothers, and treated Chagas-positive newborns and children. Diagnosis was confirmed for pregnant women and children with two positive serological tests and for newborns with microhaematocrit and/or PCR at birth or serology at age 9 months. Results From 2010 to 2015, the estimated screening coverage rate increased from 68.4% to 88.6%. In this period, 33,469 pregnant women were tested for Trypanosoma cruzi and 937 positive cases were diagnosed. The overall prevalence was 2.8 cases per 100 pregnancies per year (15.8 in Bolivian women). We followed 82.8% of newborns until serological testing at age 9–12 months and 28 were diagnosed with Chagas disease (congenital transmission rate: 4.17%). Of 518 siblings, 178 (34.3%) were tested and 14 (7.8%) were positive for T. cruzi. Having other children with Chagas disease and the heart clinical form of Chagas disease were maternal risk factors associated with congenital T. cruzi infection (p < 0.05). Conclusion The increased screening coverage rate indicates consolidation of the programme in Catalonia. The rate of Chagas disease congenital transmission in Catalonia is in accordance with the range in non-endemic countries.
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Affiliation(s)
- Luca Basile
- Public Health Agency of Catalonia, Barcelona, Spain
| | - Pilar Ciruela
- CIBER Epidemiology and Public Health CIBERESP, Carlos III Health Institute, Madrid, Spain.,Public Health Agency of Catalonia, Barcelona, Spain
| | - Ana Requena-Méndez
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic- Universitat de Barcelona, Barcelona, Spain
| | | | - Eva Dopico
- Laboratori Clínic de l'Hospitalet, Hospitalet de Llobregat, Barcelona, Spain
| | - Andrea Martín-Nalda
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron (HUVH), Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Elena Sulleiro
- Microbiology Department, Hospital Universitari Vall d'Hebron (HUVH), PROSICS Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Joaquim Gascon
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic- Universitat de Barcelona, Barcelona, Spain
| | - Mireia Jané
- CIBER Epidemiology and Public Health CIBERESP, Carlos III Health Institute, Madrid, Spain.,Public Health Agency of Catalonia, Barcelona, Spain
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16
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Cafferata ML, Toscani MA, Althabe F, Belizán JM, Bergel E, Berrueta M, Capparelli EV, Ciganda Á, Danesi E, Dumonteil E, Gibbons L, Gulayin PE, Herrera C, Momper JD, Rossi S, Shaffer JG, Schijman AG, Sosa-Estani S, Stella CB, Klein K, Buekens P. Short-course Benznidazole treatment to reduce Trypanosoma cruzi parasitic load in women of reproductive age (BETTY): a non-inferiority randomized controlled trial study protocol. Reprod Health 2020; 17:128. [PMID: 32831069 PMCID: PMC7446054 DOI: 10.1186/s12978-020-00972-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 08/03/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Retrospective observational studies suggest that transmission of Trypanosoma cruzi does not occur in treated women when pregnant later in life. The level of parasitemia is a known risk factor for congenital transmission. Benznidazole (BZN) is the drug of choice for preconceptional treatment to reduce parasitic load. The fear of treatment-related side effects limits the implementation of the Argentine guideline recommending BZN 60d/300 mg (or equivalent) treatment of T. cruzi seropositive women during the postpartum period to prevent transmission in a future pregnancy. A short and low dose BZN treatment might reduce major side effects and increase compliance, but its efficacy to reduce T. cruzi parasitic load compared to the standard 60d/300 mg course is not yet established. Clinical trials testing alternative BZN courses among women of reproductive age are urgently needed. METHODS AND DESIGN We are proposing to perform a double-blinded, non-inferiority randomized controlled trial comparing a short low dose 30-day treatment with BZN 150 mg/day (30d/150 mg) vs. BZN 60d/300 mg. We will recruit not previously treated T. cruzi seropositive women with a live birth during the postpartum period in Argentina, randomize them at 6 months postpartum, and follow them up with the following specific aims: Specific aim 1: to measure the effect of BZN 30d/150 mg compared to 60d/300 mg preconceptional treatment on parasitic load measured by the frequency of positive Polymerase Chain Reaction (PCR) (primary outcome) and by real-time quantitative PCR (qPCR), immediately and 10 months after treatment. Specific aim 2: to measure the frequency of serious adverse events and/or any adverse event leading to treatment interruption. TRIAL REGISTRATION ClinicalTrials.gov . Identifier: NCT03672487 . Registered 14 September 2018.
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Affiliation(s)
- María L Cafferata
- Instituto de Efectividad Clinica y Sanitaria (IECS), Buenos Aires, Argentina.
- Unidad de Investigación Clínica y Epidemiológica Montevideo (UNICEM), Montevideo, Uruguay.
| | - María A Toscani
- Instituto de Efectividad Clinica y Sanitaria (IECS), Buenos Aires, Argentina
| | - Fernando Althabe
- Maternal and Perinatal Health. UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research (SRH), World Health Organization, Geneva, Switzerland
| | - Jose M Belizán
- Instituto de Efectividad Clinica y Sanitaria (IECS), Buenos Aires, Argentina
| | - Eduardo Bergel
- Instituto de Efectividad Clinica y Sanitaria (IECS), Buenos Aires, Argentina
| | - Mabel Berrueta
- Instituto de Efectividad Clinica y Sanitaria (IECS), Buenos Aires, Argentina
| | - Edmund V Capparelli
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego (UCSD), San Diego, USA
- Schools of Medicine, University of California, San Diego (UCSD), San Diego, USA
| | - Álvaro Ciganda
- Instituto de Efectividad Clinica y Sanitaria (IECS), Buenos Aires, Argentina
- Unidad de Investigación Clínica y Epidemiológica Montevideo (UNICEM), Montevideo, Uruguay
| | - Emmaria Danesi
- Centro Nacional de Diagnóstico e Investigación en Endemoepidemias (CeNDIE) ANLIS Dr. C. G. Malbrán, Buenos Aires, Argentina
| | - Eric Dumonteil
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, USA
| | - Luz Gibbons
- Instituto de Efectividad Clinica y Sanitaria (IECS), Buenos Aires, Argentina
| | - Pablo E Gulayin
- Instituto de Efectividad Clinica y Sanitaria (IECS), Buenos Aires, Argentina
| | - Claudia Herrera
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, USA
| | - Jeremiah D Momper
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego (UCSD), San Diego, USA
| | - Steven Rossi
- Schools of Medicine, University of California, San Diego (UCSD), San Diego, USA
| | - Jeffrey G Shaffer
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, USA
| | - Alejandro G Schijman
- Laboratorio de Biología Molecular de la Enfermedad de Chagas (LaBMECh), Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr. Héctor Torres" (INGEBI), Buenos Aires, Argentina
| | - Sergio Sosa-Estani
- Drugs for Neglected Diseases initiative - Latin America (DNDi), Rio de Janeiro, Brazil
- Centro de Investigaciones en Epidemiología y Salud Pública (CIESP-IECS), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Candela B Stella
- Instituto de Efectividad Clinica y Sanitaria (IECS), Buenos Aires, Argentina
| | - Karen Klein
- Instituto de Efectividad Clinica y Sanitaria (IECS), Buenos Aires, Argentina
| | - Pierre Buekens
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, USA
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Meyers AC, Purnell JC, Ellis MM, Auckland LD, Meinders M, Hamer SA. Nationwide Exposure of U.S. Working Dogs to the Chagas Disease Parasite, Trypanosoma cruzi. Am J Trop Med Hyg 2020; 102:1078-1085. [PMID: 32189615 PMCID: PMC7204581 DOI: 10.4269/ajtmh.19-0582] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Trypanosoma cruzi is a zoonotic protozoan parasite vectored by triatomine insects that are endemic to the Americas, including the southern United States. Surveillance of domestic dogs for T. cruzi exposure allows for the determination of geographic regions of transmission that are relevant for human and animal health. The U.S. Department of Homeland Security (DHS) working dogs provide critical security and detection services across the country, and many train or work in the southern United States, where they are at risk for T. cruzi exposure. We sampled blood from 1,610 working dogs (predominantly Belgian Malinois, German shepherds, and Labrador retrievers) from six task forces (including the Transportation Security Administration, Customs and Border Protection, Secret Service, and more) and two canine training centers across 41 states from 2015 to 2018. Canine sera that were reactive on at least two independent serological assays were considered positive for anti-T.-cruzi antibodies. In addition, up to three independent polymerase chain reaction (PCR) assays were used to detect and type T. cruzi DNA. Overall seroprevalence was 7.5%, and four dogs (0.25%, n = 1,610) had detectable parasite DNA in the blood, comprising parasite discrete taxonomic units (DTUs) TcIV and a coinfection of TcI/TcIV. Dogs that worked within versus outside of the geographic range of established triatomines showed comparable seroprevalence (7.3% and 9.2%, respectively; P = 0.61). Determining the prevalence of T. cruzi in these working dogs and looking at spatially associated risk factors have practical implications for disease risk management and could assist with improved control measures to protect both animal and human health.
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Affiliation(s)
- Alyssa C Meyers
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, Texas
| | - Julia C Purnell
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, Texas
| | - Megan M Ellis
- College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Lisa D Auckland
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, Texas
| | - Marvin Meinders
- Department of Homeland Security, Office of Health Affairs, Washington, District of Columbia
| | - Sarah A Hamer
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, Texas
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MicroRNA-155 Deficiency Exacerbates Trypanosoma cruzi Infection. Infect Immun 2020; 88:IAI.00948-19. [PMID: 32312766 DOI: 10.1128/iai.00948-19] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 04/13/2020] [Indexed: 12/30/2022] Open
Abstract
Chagas disease, caused by the intracellular protozoan parasite Trypanosoma cruzi, is a public health problem affecting 6 to 8 million people, mainly in Latin America. The role of microRNAs in the pathogenesis of Chagas disease has not been well described. Here, we investigate the role of microRNA-155 (miR-155), a proinflammatory host innate immune regulator responsible for T helper type 1 and type 17 (Th1 and Th17) development and macrophage responses during T. cruzi infection. For this, we compared the survival and parasite growth and distribution in miR-155-/- and wild-type (WT) C57BL/6 mice. The lack of miR-155 caused robust parasite infection and diminished survival of infected mice, while WT mice were resistant to infection. Immunological analysis of infected mice indicated that, in the absence of miR-155, there was decreased interferon gamma (IFN-γ) and tumor necrosis factor alpha (TNF-α) production. In addition, we found that there was a significant reduction of CD8-positive (CD8+) T cells, natural killer (NK) cells, and NK-T cells and increased accumulation of neutrophils and inflammatory monocytes in miR-155-/- mice. Collectively, these data indicate that miR-155 is an important immune regulatory molecule critical for the control of T. cruzi infection.
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Zecca IB, Hodo CL, Slack S, Auckland L, Hamer SA. Trypanosoma cruzi infections and associated pathology in urban-dwelling Virginia opossums ( Didelphis virginiana). Int J Parasitol Parasites Wildl 2020; 11:287-293. [PMID: 32215248 PMCID: PMC7090276 DOI: 10.1016/j.ijppaw.2020.03.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 03/07/2020] [Accepted: 03/07/2020] [Indexed: 01/08/2023]
Abstract
Trypanosoma cruzi, a zoonotic protozoan parasite, infects a wide range of mammals. The southern United States has endemic sylvatic transmission cycles maintained by several species of wildlife and domestic dogs. We hypothesized that urban-dwelling opossums (Didelphis virginiana) in South Texas are infected with T. cruzi, and that tissue pathology would be associated with infection. In 2017, we collected blood, heart tissue and anal gland secretions from 100 wild opossums across three seasons that were trapped by animal control in South Texas. In addition, anal gland tissue and intercostal muscle were collected from 43 of the 100 opossums for which time allowed the extra tissue collection. All blood, tissue, and secretion samples were screened for T. cruzi DNA using qPCR with confirmation of positive status achieved through one or more additional PCR assays, including a qPCR to determine the parasite discrete typing unit (DTU). T. cruzi DNA was detected in at least one tissue of 15% of the opossums sampled: blood clot (9%), heart tissue (10%), anal gland secretions (12%), intercostal muscle (16.3%), and anal gland tissue (11.6%). Infection was detected in two or more different tissue types in nine of the opossums. The 35 tissues for which parasite DTU was determined were exclusively 'Tcl'- a DTU previously associated with locally-acquired human disease in the United States. T. cruzi-positive opossums were nearly 14 times more likely to exhibit significant heart lesions on histopathology (lympoplasmacytic inflammation±fibrosis) when compared to negative opossums (OR = 13.56, CI = 1.23-751.28, p-value = 0.03). Three triatomines were opportunistically collected from the study site, of which two were infected (66.7%), and bloodmeal analysis revealed canine, opossum, and human bloodmeals. Given the presence of parasite in opossum blood, unique potential for shedding of parasite in anal glad secretions, and evidence of vectors feeding on opossums, it is likely that opossums serve as wild reservoirs around urban dwellings in South Texas.
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Affiliation(s)
- Italo B. Zecca
- Texas A&M University College of Veterinary Medicine & Biomedical Sciences, 4458 TAMU, College Station, TX, 77843-4458, USA
| | - Carolyn L. Hodo
- Texas A&M University College of Veterinary Medicine & Biomedical Sciences, 4458 TAMU, College Station, TX, 77843-4458, USA
- The University of Texas MD Anderson Cancer Center, Michale E. Keeling Center for Comparative Medicine and Research, 650 Cool Water Drive, Bastrop, TX, 78602, USA
| | - Sarah Slack
- Texas A&M University College of Veterinary Medicine & Biomedical Sciences, 4458 TAMU, College Station, TX, 77843-4458, USA
| | - Lisa Auckland
- Texas A&M University College of Veterinary Medicine & Biomedical Sciences, 4458 TAMU, College Station, TX, 77843-4458, USA
| | - Sarah A. Hamer
- Texas A&M University College of Veterinary Medicine & Biomedical Sciences, 4458 TAMU, College Station, TX, 77843-4458, USA
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20
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Alonso-Vega C, Losada-Galván I, Pinazo MJ, Sancho Mas J, Brustenga JG, Alonso-Padilla J. The senseless orphanage of Chagas disease. Expert Opin Orphan Drugs 2019. [DOI: 10.1080/21678707.2019.1701432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
| | | | | | - Javier Sancho Mas
- ISGlobal - Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
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Hagström L, Marques ALP, Nitz N, Hecht MM. The use of qPCR in human Chagas disease: a systematic review. Expert Rev Mol Diagn 2019; 19:875-894. [DOI: 10.1080/14737159.2019.1659729] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Luciana Hagström
- Laboratório Interdisciplinar de Biociências, Faculdade de Medicina, Universidade de Brasília, Campus Darcy Ribeiro, Brasília, Brazil
| | - Ana Luisa Pereira Marques
- Laboratório Interdisciplinar de Biociências, Faculdade de Medicina, Universidade de Brasília, Campus Darcy Ribeiro, Brasília, Brazil
| | - Nadjar Nitz
- Laboratório Interdisciplinar de Biociências, Faculdade de Medicina, Universidade de Brasília, Campus Darcy Ribeiro, Brasília, Brazil
| | - Mariana Machado Hecht
- Laboratório Interdisciplinar de Biociências, Faculdade de Medicina, Universidade de Brasília, Campus Darcy Ribeiro, Brasília, Brazil
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Detection of Trypanosoma cruzi strains circulating in Córdoba department (Colombia) isolated from triatomines (Hemiptera: Reduviidae) collected by the community. ACTA ACUST UNITED AC 2019; 39:265-277. [PMID: 31529814 DOI: 10.7705/biomedica.v39i2.3973] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Indexed: 11/21/2022]
Abstract
INTRODUCTION From 2011 to 2016, 24 cases of Chagas disease were reported in Córdoba according to the national public health surveillance system (Sistema Nacional de Vigilancia en Salud Pública, Sivigila), but the information regarding Trypanosoma cruzi circulating strains and infection rates are unknown. OBJECTIVES To establish the triatomine species with which people come in contact and recognize as Chagas disease vectors, as well as to assess the infection with trypanosomes and make an exploratory approach to host feeding preferences with the participation of the local community. MATERIALS AND METHODS Triatomines sampling was conducted in 12 municipalities between 2011 and 2016; T. cruzi infection was established by k-PCR, SAT-PCR, while strain genotyping was done by mini-exon and SL-IR (spliced-leader intergenic region) sequence characterization. We also screened for blood sources. RESULTS Local community members collected the majority of triatomines and we identified three species: Rhodnius pallescens, Panstrongylus geniculatus, and Eratyrus cuspidatus. The overall T. cruzi infection rate in collected triatomines was 66.6% and we detected the TcIDOM and TcI sylvatic strains. Community-based insect collection allowed reporting the presence of P. geniculatus in two new disperse rural settlements, T. cruzi infection of P. geniculatus in Córdoba, and the first report of triatomines infected with T. cruzi in Montería municipality. CONCLUSIONS These results revealed the presence of triatomines infected with T. cruzi inside dwellings in five municipalities of Córdoba. The dominant circulating T. cruzi strain was TcIDOM, a genotype associated with human Chagas disease and cardiomyopathies in Colombia. Our results highlight the importance of local community participation in entomological surveillance tasks.
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Bustos PL, Milduberger N, Volta BJ, Perrone AE, Laucella SA, Bua J. Trypanosoma cruzi Infection at the Maternal-Fetal Interface: Implications of Parasite Load in the Congenital Transmission and Challenges in the Diagnosis of Infected Newborns. Front Microbiol 2019; 10:1250. [PMID: 31231337 PMCID: PMC6568191 DOI: 10.3389/fmicb.2019.01250] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 05/20/2019] [Indexed: 12/29/2022] Open
Abstract
Trypanosoma cruzi is the protozoan unicellular parasite that causes Chagas disease. It can be transmitted from infected mothers to their babies via the connatal route, thus being able to perpetuate even in the absence of Triatomine insect vectors. Chagas disease was originally endemic in Central and South America, but migration of infected women of childbearing age has spread the T. cruzi congenital infection to non-endemic areas like North America, Europe, Japan, and Australia. Currently, 7 million people are affected by this infection worldwide. This review focuses on the relevance of the T. cruzi parasite levels in different aspects of the congenital T. cruzi infection such as the mother-to-child transmission rate, the maternal and fetal immune response, and its impact on the diagnosis of infected newborns. Improvements in detection of this parasite, with tools that can be easily adapted to be used in remote rural areas, will make the early diagnosis of infected children possible, allowing a prompt trypanocidal treatment and avoiding the current loss of opportunities for the diagnosis of 100% of T. cruzi congenitally infected infants.
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Affiliation(s)
- Patricia L Bustos
- Instituto Nacional de Parasitología "Dr. Mario Fatala Chaben" - ANLIS C. G. Malbrán, Buenos Aires, Argentina
| | - Natalia Milduberger
- Instituto Nacional de Parasitología "Dr. Mario Fatala Chaben" - ANLIS C. G. Malbrán, Buenos Aires, Argentina.,Centro de Altos Estudios en Ciencias Humanas y de la Salud (CAECIHS), Universidad Abierta Interamericana, Buenos Aires, Argentina
| | - Bibiana J Volta
- Instituto Nacional de Parasitología "Dr. Mario Fatala Chaben" - ANLIS C. G. Malbrán, Buenos Aires, Argentina
| | - Alina E Perrone
- Instituto Nacional de Parasitología "Dr. Mario Fatala Chaben" - ANLIS C. G. Malbrán, Buenos Aires, Argentina
| | - Susana A Laucella
- Instituto Nacional de Parasitología "Dr. Mario Fatala Chaben" - ANLIS C. G. Malbrán, Buenos Aires, Argentina
| | - Jacqueline Bua
- Instituto Nacional de Parasitología "Dr. Mario Fatala Chaben" - ANLIS C. G. Malbrán, Buenos Aires, Argentina.,Centro de Altos Estudios en Ciencias Humanas y de la Salud (CAECIHS), Universidad Abierta Interamericana, Buenos Aires, Argentina
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24
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Ferreira Filho JCR, Braz LMA, Andrino MLA, Yamamoto L, Kanunfre KA, Okay TS. Mitochondrial and satellite real time-PCR for detecting T. cruzi DTU II strain in blood and organs of experimentally infected mice presenting different levels of parasite load. Exp Parasitol 2019; 200:13-15. [DOI: 10.1016/j.exppara.2019.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 03/07/2019] [Accepted: 03/17/2019] [Indexed: 01/23/2023]
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25
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Ayala Hoyos CJ, Hernández Mendoza CM, Eyes Escalante M, Romero Ricardo LR, Alvarez Rodriguez RA, Blanco Tuirán P. Detección de infección natural por Trypanosoma cruzi (Trypanosomatidae) en triatominos del municipio de Colosó, Colombia. ACTA BIOLÓGICA COLOMBIANA 2019. [DOI: 10.15446/abc.v24n1.72306] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
El reporte de triatominos infectados por Trypanosoma cruzi en un área silvestre del municipio de Colosó, hizo necesario determinar las especies de vectores en cercanía a las viviendas de la vereda Jorro, por ser el asentamiento rural próximo al hallazgo. En la presente nota, se informa por primera vez para el municipio la presencia de especies de triatominos de importancia epidemiológica con un alto porcentaje de infección por el parásito, además, de ampliar la distribución de estos vectores en el departamento de Sucre. Para ello, se realizaron capturas de los insectos en 13 viviendas por búsqueda activa, vigilancia comunitaria y trampas de luz. La determinación de la infección natural se llevó a cabo por observación directa al microscopio y amplificación por PCR del ADN de T. cruzi presente en el contenido intestinal de los triatominos. En total se capturaron 40 ejemplares de las especies Panstrongylus geniculatus, Rhodnius pallescens, Eratyrus cuspidatus y Triatoma dimidiata. La mayoría de los individuos fueron recolectados en el extradomicilio,con un menor porcentaje de insectos adultos encontrados en ambientes domésticos y la tasa de infección natural en los insectos fue del 85 %.x
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26
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Ramírez JC, da Cruz Moreira O. Assessing Parasite Load in Chagas Disease Patients by Quantitative Multiplex Real-Time PCR. Methods Mol Biol 2019; 1955:215-225. [PMID: 30868530 DOI: 10.1007/978-1-4939-9148-8_16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The development of accurate diagnostic tools and surrogate markers of parasitological response to treatment are priorities in Chagas disease (CD) research. For years, the detection of Trypanosoma cruzi DNA by PCR has proved to be useful in some clinical scenarios like acute CD, including cases of congenital transmission, CD reactivation in immunosuppressed patients, and posttreatment follow-up. In that sense, the implementation of quantitative real-time PCR (qPCR) assays was an important step in the development of more reliable tools for CD molecular diagnostics and treatment follow-up. In the last decade, two multicenter PCR studies allowed the harmonization and validation of standard operating procedures for PCR-based detection and quantification of T. cruzi DNA in blood samples. Herein we describe the two most used protocols to quantify parasitic load in human blood samples by multiplex qPCR assays and discuss some aspects to consider during planning and executing these procedures.
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Affiliation(s)
- Juan Carlos Ramírez
- Laboratorio de Biología Molecular de la Enfermedad de Chagas, Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr. Héctor N. Torres" (INGEBI), CONICET, Buenos Aires, Argentina.
| | - Otacilio da Cruz Moreira
- Laboratório de Biología Molecular e Doenças Endêmicas, Instituto Oswaldo Cruz/Fiocruz, Rio de Janeiro, Brazil
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27
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Picado A, Cruz I, Redard-Jacot M, Schijman AG, Torrico F, Sosa-Estani S, Katz Z, Ndung’u JM. The burden of congenital Chagas disease and implementation of molecular diagnostic tools in Latin America. BMJ Glob Health 2018; 3:e001069. [PMID: 30364393 PMCID: PMC6195131 DOI: 10.1136/bmjgh-2018-001069] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 09/01/2018] [Accepted: 09/10/2018] [Indexed: 11/21/2022] Open
Abstract
It is estimated that between 8000 and 15 000 Trypanosoma cruzi infected babies are born every year to infected mothers in Chagas disease endemic countries. Currently, poor access to and performance of the current diagnostic algorithm, based on microscopy at birth and serology at 8–12 months after delivery, is one of the barriers to congenital Chagas disease (CCD) control. Detection of parasite DNA using molecular diagnostic tools could be an alternative or complement to current diagnostic methods, but its implementation in endemic regions remains limited. Prompt diagnosis and treatment of CCD cases would have a positive clinical and epidemiological impact. In this paper, we analysed the burden of CCD in Latin America, and the potential use of molecular tests to improve access to early diagnosis and treatment of T. cruzi infected newborns.
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Affiliation(s)
- Albert Picado
- Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland
| | - Israel Cruz
- Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland
| | - Maël Redard-Jacot
- Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland
| | - Alejandro G Schijman
- Laboratorio de Biología Molecular de la Enfermedad de Chagas, Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr. Héctor Torres", Buenos Aires, Argentina
| | - Faustino Torrico
- Faculty of Medicine, Universidad Mayor de San Simón, Cochabamba, Bolivia
- Fundación CEADES, Cochabamba, Bolivia
| | - Sergio Sosa-Estani
- Centro de Investigación de Epidemiología y Salud Pública (CIESP-IECS), CONICET, Buenos Aires, Argentina
- Drugs for Neglected Diseases initiative (DNDi), Rio de Janeiro, Brazil
| | - Zachary Katz
- Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland
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Trypanosoma cruzi in a Mexican Free-Tailed Bat ( Tadarida brasiliensis) in Oklahoma, USA. J Wildl Dis 2018; 55:444-448. [PMID: 30277832 DOI: 10.7589/2018-04-095] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Trypanosoma cruzi is a vector-borne protozoan parasite that infects seven million individuals in Central and South America and is the etiologic agent of Chagas disease. There are increasing reports of endemic transmission within the southern US. Trypanosoma cruzi occurs in wild raccoons and dogs in Oklahoma, but its endemicity in the state is poorly studied. We suspected Mexican free-tailed bats ( Tadarida brasiliensis) contributed to the endemicity of T. cruzi in Oklahoma due to their annual migration from Central America to their North American maternity roosts. During the summer of 2017, we sampled 361 Mexican free-tailed bats for T. cruzi at three maternity roosts in Oklahoma. We collected wing tissues, extracted T. cruzi DNA, amplified target DNA by PCR using the primers TCZ1/TCZ2, and observed amplification by gel electrophoresis. One juvenile Mexican free-tailed bat was positive for T. cruzi resulting in a 0.27% prevalence in the 361 sampled bats. Our finding of a wild bat naturally infected with T. cruzi in Oklahoma provided insight on the endemicity of T. cruzi in underrepresented endemic areas. The positive sample was sequenced, confirmed as T. cruzi, and uploaded to GenBank (no. MG869732). Future research will focus on monitoring T. cruzi prevalence in wild bats and insect vectors to better understand the enzootic emergence of this neglected tropical parasite.
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29
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Orantes LC, Monroy C, Dorn PL, Stevens L, Rizzo DM, Morrissey L, Hanley JP, Rodas AG, Richards B, Wallin KF, Helms Cahan S. Uncovering vector, parasite, blood meal and microbiome patterns from mixed-DNA specimens of the Chagas disease vector Triatoma dimidiata. PLoS Negl Trop Dis 2018; 12:e0006730. [PMID: 30335763 PMCID: PMC6193617 DOI: 10.1371/journal.pntd.0006730] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 08/02/2018] [Indexed: 12/25/2022] Open
Abstract
Chagas disease, considered a neglected disease by the World Health Organization, is caused by the protozoan parasite Trypanosoma cruzi, and transmitted by >140 triatomine species across the Americas. In Central America, the main vector is Triatoma dimidiata, an opportunistic blood meal feeder inhabiting both domestic and sylvatic ecotopes. Given the diversity of interacting biological agents involved in the epidemiology of Chagas disease, having simultaneous information on the dynamics of the parasite, vector, the gut microbiome of the vector, and the blood meal source would facilitate identifying key biotic factors associated with the risk of T. cruzi transmission. In this study, we developed a RADseq-based analysis pipeline to study mixed-species DNA extracted from T. dimidiata abdomens. To evaluate the efficacy of the method across spatial scales, we used a nested spatial sampling design that spanned from individual villages within Guatemala to major biogeographic regions of Central America. Information from each biotic source was distinguished with bioinformatics tools and used to evaluate the prevalence of T. cruzi infection and predominant Discrete Typing Units (DTUs) in the region, the population genetic structure of T. dimidiata, gut microbial diversity, and the blood meal history. An average of 3.25 million reads per specimen were obtained, with approximately 1% assigned to the parasite, 20% to the vector, 11% to bacteria, and 4% to putative blood meals. Using a total of 6,405 T. cruzi SNPs, we detected nine infected vectors harboring two distinct DTUs: TcI and a second unidentified strain, possibly TcIV. Vector specimens were sufficiently variable for population genomic analyses, with a total of 25,710 T. dimidiata SNPs across all samples that were sufficient to detect geographic genetic structure at both local and regional scales. We observed a diverse microbiotic community, with significantly higher bacterial species richness in infected T. dimidiata abdomens than those that were not infected. Unifrac analysis suggests a common assemblage of bacteria associated with infection, which co-occurs with the typical gut microbial community derived from the local environment. We identified vertebrate blood meals from five T. dimidiata abdomens, including chicken, dog, duck and human; however, additional detection methods would be necessary to confidently identify blood meal sources from most specimens. Overall, our study shows this method is effective for simultaneously generating genetic data on vectors and their associated parasites, along with ecological information on feeding patterns and microbial interactions that may be followed up with complementary approaches such as PCR-based parasite detection, 18S eukaryotic and 16S bacterial barcoding.
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Affiliation(s)
- Lucia C. Orantes
- Rubenstein School of Environment and Natural Resources, University of Vermont, Burlington, Vermont, United States of America
| | - Carlota Monroy
- Laboratorio de Entomología Aplicada y Parasitología, Escuela de Biología, Universidad San Carlos de Guatemala, Ciudad de Guatemala, Guatemala
| | - Patricia L. Dorn
- Department of Biological Sciences, Loyola University New Orleans, New Orleans, Louisiana, United States of America
| | - Lori Stevens
- Department of Biology, University of Vermont, Burlington, Vermont, United States of America
| | - Donna M. Rizzo
- Department of Civil and Environmental Engineering, University of Vermont, Burlington, Vermont, United States of America
| | - Leslie Morrissey
- Rubenstein School of Environment and Natural Resources, University of Vermont, Burlington, Vermont, United States of America
| | - John P. Hanley
- Department of Civil and Environmental Engineering, University of Vermont, Burlington, Vermont, United States of America
| | - Antonieta Guadalupe Rodas
- Laboratorio de Entomología Aplicada y Parasitología, Escuela de Biología, Universidad San Carlos de Guatemala, Ciudad de Guatemala, Guatemala
| | - Bethany Richards
- Department of Biological Sciences, Loyola University New Orleans, New Orleans, Louisiana, United States of America
| | - Kimberly F. Wallin
- Rubenstein School of Environment and Natural Resources, University of Vermont, Burlington, Vermont, United States of America
- USDA Forest Service, Northern Research Station, Burlington, Vermont, United States of America
| | - Sara Helms Cahan
- Department of Biology, University of Vermont, Burlington, Vermont, United States of America
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30
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Schijman AG. Molecular diagnosis of Trypanosoma cruzi. Acta Trop 2018; 184:59-66. [PMID: 29476727 DOI: 10.1016/j.actatropica.2018.02.019] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 02/05/2018] [Accepted: 02/14/2018] [Indexed: 01/01/2023]
Abstract
Chagas disease, caused by the kinetoplastid protozoan Trypanosoma cruzi, affects millions of people, most of them neglected populations. The different phases of the disease, the transmission mode and the high genetic variability of the parasite determine that molecular detection methods display different degree of success. Molecular diagnostic tests may be employed during epidemiological surveys of transmission, for early diagnosis of congenital transmission and acute infections due to oral transmission, transfusion or transplantation routes, reactivation due to immunosuppression and monitoring of treatment response in chronically infected patients receiving trypanocidal chemotherapy. This manuscript summarizes the most widely used molecular tools to detect T. cruzi infection in different epidemiological and clinical scenarios.
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Affiliation(s)
- Alejandro G Schijman
- Laboratorio de Biología Molecular de la Enfermedad de Chagas, Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr. Hector Torres" (INGEBI-CONICET), Ciudad de Buenos Aires, Argentina.
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31
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Azevedo PHR, Xavier MAP, Silva GND, Costa PAD, Carneiro CM, Brasileiro Filho G. Anti-serum validation for use in immunohistochemistry for Trypanosoma cruzi detection. Rev Soc Bras Med Trop 2018; 51:467-474. [DOI: 10.1590/0037-8682-0011-2018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 07/04/2018] [Indexed: 11/21/2022] Open
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32
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Blakely BN, Hanson SF, Romero A. Survival and Transstadial Persistence of Trypanosoma cruzi in the bed bug (Hemiptera: Cimicidae). JOURNAL OF MEDICAL ENTOMOLOGY 2018; 55:742-746. [PMID: 29381783 DOI: 10.1093/jme/tjx252] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Indexed: 06/07/2023]
Abstract
Bed bug populations are increasing around the world at an alarming rate and have become a major public health concern. The appearance of bed bug populations in areas where Chagas disease is endemic raises questions about the role of these insects in the transmission of Trypanosoma cruzi, the etiological agent of the disease. In a series of laboratory evaluations, bed bug adults and nymphs were experimentally fed with T. cruzi-infected blood to assess the ability of T. cruzi to survive inside the bed bug and throughout the insect's molting process. Live T. cruzi were observed in gut contents of experimentally infected bed bug adults via light microscopy and the identity of the parasite was confirmed via polymerase chain reaction analysis. T. cruzi persisted at least 97-d postinfection in adult bed bugs. Nymphal stage bed bugs that were infected with T. cruzi maintained the parasite after molting, indicating that transstadial passage of T. cruzi in bed bugs took place. This report provides further evidence of acquisition, maintenance, and for the first time, transstadial persistence of T. cruzi in bed bugs.
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Affiliation(s)
- Brittny N Blakely
- Department of Entomology, Plant Pathology and Weed Science, New Mexico State University, Las Cruces, NM
| | - Stephen F Hanson
- Department of Entomology, Plant Pathology and Weed Science, New Mexico State University, Las Cruces, NM
| | - Alvaro Romero
- Department of Entomology, Plant Pathology and Weed Science, New Mexico State University, Las Cruces, NM
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Ramírez JC, Torres C, Curto MDLA, Schijman AG. New insights into Trypanosoma cruzi evolution, genotyping and molecular diagnostics from satellite DNA sequence analysis. PLoS Negl Trop Dis 2017; 11:e0006139. [PMID: 29253860 PMCID: PMC5749901 DOI: 10.1371/journal.pntd.0006139] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 01/02/2018] [Accepted: 11/28/2017] [Indexed: 11/18/2022] Open
Abstract
Trypanosoma cruzi has been subdivided into seven Discrete Typing Units (DTUs), TcI-TcVI and Tcbat. Two major evolutionary models have been proposed to explain the origin of hybrid lineages, but while it is widely accepted that TcV and TcVI are the result of genetic exchange between TcII and TcIII strains, the origin of TcIII and TcIV is still a matter of debate. T. cruzi satellite DNA (SatDNA), comprised of 195 bp units organized in tandem repeats, from both TcV and TcVI stocks were found to have SatDNA copies type TcI and TcII; whereas contradictory results were observed for TcIII stocks and no TcIV sequence has been analyzed yet. Herein, we have gone deeper into this matter analyzing 335 distinct SatDNA sequences from 19 T. cruzi stocks representative of DTUs TcI-TcVI for phylogenetic inference. Bayesian phylogenetic tree showed that all sequences were grouped in three major clusters, which corresponded to sequences from DTUs TcI/III, TcII and TcIV; whereas TcV and TcVI stocks had two sets of sequences distributed into TcI/III and TcII clusters. As expected, the lowest genetic distances were found between TcI and TcIII, and between TcV and TcVI sequences; whereas the highest ones were observed between TcII and TcI/III, and among TcIV sequences and those from the remaining DTUs. In addition, signature patterns associated to specific T. cruzi lineages were identified and new primers that improved SatDNA-based qPCR sensitivity were designed. Our findings support the theory that TcIII is not the result of a hybridization event between TcI and TcII, and that TcIV had an independent origin from the other DTUs, contributing to clarifying the evolutionary history of T. cruzi lineages. Moreover, this work opens the possibility of typing samples from Chagas disease patients with low parasitic loads and improving molecular diagnostic methods of T. cruzi infection based on SatDNA sequence amplification.
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Affiliation(s)
- Juan C. Ramírez
- Laboratorio de Biología Molecular de la Enfermedad de Chagas, Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr. Héctor N. Torres" (INGEBI), CONICET, Buenos Aires, Argentina
- * E-mail: (JCR); (AGS)
| | - Carolina Torres
- Departamento de Microbiología, Inmunología y Biotecnología, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina
- CONICET, Buenos Aires, Argentina
| | - María de los A. Curto
- Laboratorio de Biología Molecular de la Enfermedad de Chagas, Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr. Héctor N. Torres" (INGEBI), CONICET, Buenos Aires, Argentina
| | - Alejandro G. Schijman
- Laboratorio de Biología Molecular de la Enfermedad de Chagas, Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr. Héctor N. Torres" (INGEBI), CONICET, Buenos Aires, Argentina
- * E-mail: (JCR); (AGS)
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Buekens P, Cafferata ML, Alger J, Althabe F, Belizán JM, Bustamante N, Carlier Y, Ciganda A, Del Cid JH, Dumonteil E, Gamboa-León R, García JA, Gibbons L, Graiff O, Maldonado JG, Herrera C, Howard E, Lara LS, López B, Matute ML, Ramírez-Sierra MJ, Robles MC, Sosa-Estani S, Truyens C, Valladares C, Wesson DM, Zúniga C, For The Congenital Chagas Working Group. Congenital Transmission of Trypanosoma cruzi in Argentina, Honduras, and Mexico: An Observational Prospective Study. Am J Trop Med Hyg 2017; 98:478-485. [PMID: 29210352 DOI: 10.4269/ajtmh.17-0516] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Compared with South America, there is a lack of epidemiologic studies about the risk of congenital transmission of Trypanosoma cruzi in Central America and Mexico. It has been suggested that T. cruzi genotypes might differ by region and that congenital transmission might vary according to the parasite's genotype. Our objective was to compare T. cruzi congenital transmission rates in three countries. We performed an observational prospective study in 2011-2014 enrolling women at delivery in one hospital in Argentina, two hospitals in Honduras, and two hospitals in Mexico. Congenital T. cruzi infection was defined as the presence of one or more of the following criteria: presence of parasites in cord blood (direct parasitological microscopic examination) with positive polymerase chain reaction (PCR) in cord blood, presence of parasites in infant's blood at 4-8 weeks (direct parasitological microscopic examination), and persistence of T. cruzi-specific antibodies at 10 months, as measured by at least two tests. Among 28,145 enrolled women, 347 had at least one antibody rapid test positive in cord blood and a positive enzyme-linked immunosorbent assay in maternal blood. PCR in maternal blood was positive in 73.2% of the cases, and genotyping identified a majority of non-TcI in the three countries. We found no (0.0%; 95% confidence interval [CI]: 0.0, 2.0) confirmed congenital case in Honduras. Congenital transmission was 6.6% (95% CI: 3.1, 12.2) in Argentina and 6.3% (95% CI: 0.8, 20.8) in Mexico. Trypanosoma cruzi non-TcI predominated and risks of congenital transmission were similar in Argentina and Mexico.
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Affiliation(s)
- Pierre Buekens
- Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - María Luisa Cafferata
- Unidad de Investigación Clínica y Epidemiológica Montevideo (UNICEM), Montevideo, Uruguay
| | - Jackeline Alger
- Hospital Escuela Universitario, Facultad de Ciencias Médicas, UNAH, Tegucigalpa, Honduras
| | - Fernando Althabe
- Instituto de Efectividad Clínica y Sanitaria (IECS), Buenos Aires, Argentina
| | - José M Belizán
- Instituto de Efectividad Clínica y Sanitaria (IECS), Buenos Aires, Argentina
| | | | - Yves Carlier
- Laboratory of Parasitology, Faculty of Medicine, Université Libre de Bruxelles (ULB), Brussels, Belgium.,Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Alvaro Ciganda
- Unidad de Investigación Clínica y Epidemiológica Montevideo (UNICEM), Montevideo, Uruguay
| | | | - Eric Dumonteil
- Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | | | - Jorge A García
- Hospital Escuela Universitario, Facultad de Ciencias Médicas, UNAH, Tegucigalpa, Honduras
| | - Luz Gibbons
- Instituto de Efectividad Clínica y Sanitaria (IECS), Buenos Aires, Argentina
| | - Olga Graiff
- Instituto de Maternidad y Ginecología Nuestra Señora de las Mercedes, San Miguel de Tucumán, Argentina
| | - Jesús Gurubel Maldonado
- Centro de Investigaciones Regionales "Dr. Hideyo Noguchi," Universidad Autónoma de Yucatán, Mérida, México
| | - Claudia Herrera
- Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Elizabeth Howard
- Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Laura Susana Lara
- Instituto de Maternidad y Ginecología Nuestra Señora de las Mercedes, San Miguel de Tucumán, Argentina
| | | | - María Luisa Matute
- Laboratorio Nacional de Vigilancia de la Salud, Secretaría de Salud de Honduras, Tegucigalpa, Honduras
| | - María Jesús Ramírez-Sierra
- Centro de Investigaciones Regionales "Dr. Hideyo Noguchi," Universidad Autónoma de Yucatán, Mérida, México
| | - María Cecilia Robles
- Instituto de Maternidad y Ginecología Nuestra Señora de las Mercedes, San Miguel de Tucumán, Argentina
| | - Sergio Sosa-Estani
- Instituto Nacional de Parasitología "Dr. Mario Fatala Chaben," CONICET, ANLIS, Buenos Aires, Argentina.,Instituto de Efectividad Clínica y Sanitaria (IECS), Buenos Aires, Argentina
| | - Carine Truyens
- Laboratory of Parasitology, Faculty of Medicine, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Christian Valladares
- Laboratorio Nacional de Vigilancia de la Salud, Secretaría de Salud de Honduras, Tegucigalpa, Honduras
| | - Dawn M Wesson
- Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Concepción Zúniga
- Hospital Escuela Universitario, Facultad de Ciencias Médicas, UNAH, Tegucigalpa, Honduras
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Meyers AC, Meinders M, Hamer SA. Widespread Trypanosoma cruzi infection in government working dogs along the Texas-Mexico border: Discordant serology, parasite genotyping and associated vectors. PLoS Negl Trop Dis 2017; 11:e0005819. [PMID: 28787451 PMCID: PMC5560752 DOI: 10.1371/journal.pntd.0005819] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Revised: 08/17/2017] [Accepted: 07/20/2017] [Indexed: 01/03/2023] Open
Abstract
Background Chagas disease, caused by the vector-borne protozoan Trypanosoma cruzi, is increasingly recognized in the southern U.S. Government-owned working dogs along the Texas-Mexico border could be at heightened risk due to prolonged exposure outdoors in habitats with high densities of vectors. We quantified working dog exposure to T. cruzi, characterized parasite strains, and analyzed associated triatomine vectors along the Texas-Mexico border. Methodology/Principle findings In 2015–2016, we sampled government working dogs in five management areas plus a training center in Texas and collected triatomine vectors from canine environments. Canine serum was tested for anti-T. cruzi antibodies with up to three serological tests including two immunochromatographic assays (Stat-Pak and Trypanosoma Detect) and indirect fluorescent antibody (IFA) test. The buffy coat fraction of blood and vector hindguts were tested for T. cruzi DNA and parasite discrete typing unit was determined. Overall seroprevalence was 7.4 and 18.9% (n = 528) in a conservative versus inclusive analysis, respectively, based on classifying weakly reactive samples as negative versus positive. Canines in two western management areas had 2.6–2.8 (95% CI: 1.0–6.8 p = 0.02–0.04) times greater odds of seropositivity compared to the training center. Parasite DNA was detected in three dogs (0.6%), including TcI and TcI/TcIV mix. Nine of 20 (45%) T. gerstaeckeri and T. rubida were infected with TcI and TcIV; insects analyzed for bloodmeals (n = 11) fed primarily on canine (54.5%). Conclusions/Significance Government working dogs have widespread exposure to T. cruzi across the Texas-Mexico border. Interpretation of sample serostatus was challenged by discordant results across testing platforms and very faint serological bands. In the absence of gold standard methodologies, epidemiological studies will benefit from presenting a range of results based on different tests/interpretation criteria to encompass uncertainty. Working dogs are highly trained in security functions and potential loss of duty from the clinical outcomes of infection could affect the work force and have broad consequences. Chagas disease, a potentially deadly cardiac disease of humans, canines and other mammals is caused by the parasite Trypanosoma cruzi. The parasite is primarily transmitted to dogs by ingestion of infected triatomine ‘kissing bug’ vectors or through contact with the insect’s feces. Previous studies concluded that stray and shelter dogs are at high risk of infection in the southern U.S. We proposed that high-value U.S. government working dogs along the Texas-Mexico border may also be at high risk because of their activities in regions with established, infected vector populations. We sampled 528 working dogs along the Texas-Mexico border, and found that 7.4–18.9% of dogs were positive for T. cruzi antibodies and a small proportion (0.6%) also had parasite circulating in the blood. We collected two species of kissing bugs from the canine environments and used molecular approaches to determine that 45% were positive for T. cruzi and the majority had recently fed on canines. We highlight the need for better diagnostic tools for canine Chagas disease research and diagnosis. The widespread burden of T. cruzi infection in the government working dogs could be associated with far-reaching consequences for both animal and human well-being.
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Affiliation(s)
- Alyssa C. Meyers
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, Texas, United States of America
| | - Marvin Meinders
- Office of Health Affairs, Department of Homeland Security, Washington D.C., United States of America
| | - Sarah A. Hamer
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, Texas, United States of America
- * E-mail:
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Cura CI, Ramírez JC, Rodríguez M, Lopez-Albízu C, Irazu L, Scollo K, Sosa-Estani S. Comparative Study and Analytical Verification of PCR Methods for the Diagnosis of Congenital Chagas Disease. J Mol Diagn 2017; 19:673-681. [PMID: 28727985 DOI: 10.1016/j.jmoldx.2017.05.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 05/02/2017] [Accepted: 05/03/2017] [Indexed: 11/17/2022] Open
Abstract
Congenital infection is currently the first cause of new cases of Chagas disease in Argentina and nonendemic areas worldwide. Its diagnosis is of utmost importance to guarantee curative treatment. To improve such diagnosis, a transfer process of PCR tests to the national laboratory network has been initiated. We performed a comparative study of four PCR assays [two end-point PCR and two duplex real-time quantitative PCR (qPCR) procedures] to detect Trypanosoma cruzi DNA in blood samples. Because satellite DNA and kinetoplastid DNA qPCR methods showed the best performance and the use of two different molecular targets for confirmatory purposes has been recommended, these methods were selected to perform the transfer process and, in consequence, subjected to an analytical verification protocol based on international guidelines. The anticipated reportable range was verified between 0.25 and 105 parasite equivalents per milliliter of blood (par. eq./mL) for both qPCR methods, and the limit of detection was estimated to be 0.87 (95% CI, 0.62-1.24) and 0.43 (95% CI, 0.32-0.59) par. eq./mL for satellite DNA and kinetoplastid DNA qPCR methods, respectively. In addition, both qPCR methods showed trueness and verified precision in the highest and the lowest concentrations tested. This work provides critical knowledge of the technology transfer process planned to cover laboratories of the regional network with known installed facilities.
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Affiliation(s)
- Carolina I Cura
- National Institute of Parasitology "Dr. Mario Fatala Chaben", Administración Nacional de Laboratorios e Institutos de Salud Dr. Carlos G. Malbrán, Buenos Aires, Argentina.
| | - Juan C Ramírez
- Institute of Investigation in Genetic Engineering and Molecular Biology "Dr. Héctor N. Torres", Buenos Aires, Argentina
| | - Marcelo Rodríguez
- National Institute of Infectious Diseases, National Laboratories and Health Institutes Administration "Dr. Carlos G. Malbrán", Buenos Aires, Argentina
| | - Constanza Lopez-Albízu
- National Institute of Parasitology "Dr. Mario Fatala Chaben", Administración Nacional de Laboratorios e Institutos de Salud Dr. Carlos G. Malbrán, Buenos Aires, Argentina
| | - Lucía Irazu
- National Institute of Infectious Diseases, National Laboratories and Health Institutes Administration "Dr. Carlos G. Malbrán", Buenos Aires, Argentina
| | - Karenina Scollo
- National Institute of Parasitology "Dr. Mario Fatala Chaben", Administración Nacional de Laboratorios e Institutos de Salud Dr. Carlos G. Malbrán, Buenos Aires, Argentina
| | - Sergio Sosa-Estani
- National Institute of Parasitology "Dr. Mario Fatala Chaben", Administración Nacional de Laboratorios e Institutos de Salud Dr. Carlos G. Malbrán, Buenos Aires, Argentina
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Seiringer P, Pritsch M, Flores-Chavez M, Marchisio E, Helfrich K, Mengele C, Hohnerlein S, Bretzel G, Löscher T, Hoelscher M, Berens-Riha N. Comparison of four PCR methods for efficient detection of Trypanosoma cruzi in routine diagnostics. Diagn Microbiol Infect Dis 2017; 88:225-232. [PMID: 28456430 DOI: 10.1016/j.diagmicrobio.2017.04.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 03/06/2017] [Accepted: 04/04/2017] [Indexed: 01/08/2023]
Abstract
Due to increased migration, Chagas disease has become an international health problem. Reliable diagnosis of chronically infected people is crucial for prevention of non-vectorial transmission as well as treatment. This study compared four distinct PCR methods for detection of Trypanosoma cruzi DNA for the use in well-equipped routine diagnostic laboratories. DNA was extracted of T. cruzi-positive and negative patients' blood samples and cultured T. cruzi, T. rangeli as well as Leishmania spp. One conventional and two real-time PCR methods targeting a repetitive Sat-DNA sequence as well as one conventional PCR method targeting the variable region of the kDNA minicircle were compared for sensitivity, intra- and interassay precision, limit of detection, specificity and cross-reactivity. Considering the performance, costs and ease of use, an algorithm for PCR-diagnosis of patients with a positive serology for T. cruzi antibodies was developed.
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Affiliation(s)
- Peter Seiringer
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Leopoldstr. 5, 80802 Munich, Germany; German Center for Infection Research (DZIF), partner site Munich, Munich, Germany.
| | - Michael Pritsch
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Leopoldstr. 5, 80802 Munich, Germany; German Center for Infection Research (DZIF), partner site Munich, Munich, Germany.
| | - María Flores-Chavez
- Servicio de Parasitología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Ctra. Majadahonda-Pozuelo km 2, Madrid, Spain.
| | - Edoardo Marchisio
- Dia.Pro Diagnostic BioProbes srl, Via Giosuè n°27, 20099 Sesto San Giovanni, Milan, Italy.
| | - Kerstin Helfrich
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Leopoldstr. 5, 80802 Munich, Germany.
| | - Carolin Mengele
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Leopoldstr. 5, 80802 Munich, Germany.
| | - Stefan Hohnerlein
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Leopoldstr. 5, 80802 Munich, Germany.
| | - Gisela Bretzel
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Leopoldstr. 5, 80802 Munich, Germany.
| | - Thomas Löscher
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Leopoldstr. 5, 80802 Munich, Germany.
| | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Leopoldstr. 5, 80802 Munich, Germany; German Center for Infection Research (DZIF), partner site Munich, Munich, Germany.
| | - Nicole Berens-Riha
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Leopoldstr. 5, 80802 Munich, Germany.
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Antunes AP, Ribeiro ALP, Sabino EC, Silveira MF, Oliveira CDL, Botelho ACDC. Benznidazole therapy for Chagas disease in asymptomatic Trypanosoma cruzi -seropositive former blood donors: evaluation of the efficacy of different treatment regimens. Rev Soc Bras Med Trop 2017; 49:713-720. [PMID: 28001218 DOI: 10.1590/0037-8682-0165-2016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 09/23/2016] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION: Chagas disease currently affects 5.7 million people in Latin America and is emerging in non-endemic countries. There is no consensus concerning the efficacy of trypanocidal therapy for patients with the chronic form of the disease. We evaluated cardiac function and sociodemographic, clinical, and serologic characteristics of a group of asymptomatic Trypanosoma cruzi-seropositive former blood donors, and compared the effects of benznidazole treatment applied for different lengths of time. METHODS: Blood donors who screened positive for T. cruzi between 1998 and 2002 were recruited 10 years later for follow-up (n = 244); 46 individuals had received treatment. Three subjects had terminated treatment prematurely. The remaining 43 individuals were divided into two groups: individuals who had received benznidazole therapy for 50-60 days (n = 28; BT ≤60 group) or more than 60 days (n = 15; BT >60). Serologic assays, biochemical tests, electrocardiographic, echocardiographic, and clinical examinations were performed on all participants. Parasite loads were determined by qualitative and quantitative polymerase chain reaction. RESULTS: Parasitemia was significantly reduced in the BT ≤60 and BT >60 groups compared with the untreated group. There were no differences in epidemiologic profiles or clinical, biochemical, electrocardiographic, or echocardiographic data between any of the groups. CONCLUSIONS: Despite elimination or significant reduction in parasitemia in patients with chronic Chagas disease who received benznidazole, there was no clinical difference between those who were treated for >60 days and those treated for a shorter duration. Furthermore, the adverse effects of benznidazole appear to be less severe than previous reports would suggest.
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Affiliation(s)
- André Pires Antunes
- Programa de Pós-Graduação em Ciências da Saúde, Departamento de Clínica Médica, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil
| | - Antônio Luiz Pinho Ribeiro
- Hospital das Clínicas, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ester Cerdeira Sabino
- Departamento de Doenças Infecciosas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Marise Fagundes Silveira
- Programa de Pós-Graduação em Ciências da Saúde, Departamento de Clínica Médica, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil
| | | | - Ana Cristina de Carvalho Botelho
- Programa de Pós-Graduação em Ciências da Saúde, Departamento de Clínica Médica, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil
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Aleman A, Guerra T, Maikis TJ, Milholland MT, Castro-Arellano I, Forstner MRJ, Hahn D. The Prevalence of Trypanosoma cruzi, the Causal Agent of Chagas Disease, in Texas Rodent Populations. ECOHEALTH 2017; 14:130-143. [PMID: 28091763 DOI: 10.1007/s10393-017-1205-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 11/24/2016] [Accepted: 12/22/2016] [Indexed: 06/06/2023]
Abstract
Rodent species were assessed as potential hosts of Trypanosoma cruzi, the etiologic agent of Chagas disease, from five sites throughout Texas in sylvan and disturbed habitats. A total of 592 rodents were captured, resulting in a wide taxonomic representation of 11 genera and 15 species. Heart samples of 543 individuals were successfully analyzed by SybrGreen-based quantitative PCR (qPCR) targeting a 166 bp fragment of satellite DNA of T. cruzi. Eight rodents representing six species from six genera and two families were infected with T. cruzi. This is the first report of T. cruzi in the pygmy mouse (Baiomys taylori) and the white-footed mouse (Peromyscus leucopus) for the USA. All infected rodents were from the southernmost site (Las Palomas Wildlife Management Area). No differences in pathogen prevalence existed between disturbed habitats (5 of 131 tested; 3.8%) and sylvan habitats (3 of 40 tested; 7.5%). Most positives (n = 6, 16% prevalence) were detected in late winter with single positives in both spring (3% prevalence) and fall (1% prevalence). Additionally, 30 Triatoma insects were collected opportunistically from sites in central Texas. Fifty percent of these insects, i.e., 13 T. gerstaeckeri (68%), and two T. lecticularia (100%) were positive for T. cruzi. Comparative sequence analyses of 18S rRNA of samples provided identical results with respect to detection of the presence or absence of T. cruzi and assigned T. cruzi from rodents collected in late winter to lineage TcI. T. cruzi from Triatoma sp. and rodents from subsequent collections in spring and fall were different, however, and could not be assigned to other lineages with certainty.
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Affiliation(s)
- Adriana Aleman
- Department of Biology, Texas State University, 601 University Drive, San Marcos, TX, 78666, USA
| | - Trina Guerra
- Department of Biology, Texas State University, 601 University Drive, San Marcos, TX, 78666, USA
| | - Troy J Maikis
- Department of Biology, Texas State University, 601 University Drive, San Marcos, TX, 78666, USA
| | - Matthew T Milholland
- Department of Biology, Texas State University, 601 University Drive, San Marcos, TX, 78666, USA
| | - Ivan Castro-Arellano
- Department of Biology, Texas State University, 601 University Drive, San Marcos, TX, 78666, USA.
| | - Michael R J Forstner
- Department of Biology, Texas State University, 601 University Drive, San Marcos, TX, 78666, USA
| | - Dittmar Hahn
- Department of Biology, Texas State University, 601 University Drive, San Marcos, TX, 78666, USA
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da Costa PA, Segatto M, Durso DF, de Carvalho Moreira WJ, Junqueira LL, de Castilho FM, de Andrade SA, Gelape CL, Chiari E, Teixeira-Carvalho A, Junho Pena SD, Machado CR, Franco GR, Filho GB, Vieira Moreira MDC, Mara Macedo A. Early polymerase chain reaction detection of Chagas disease reactivation in heart transplant patients. J Heart Lung Transplant 2017; 36:797-805. [PMID: 28320630 DOI: 10.1016/j.healun.2017.02.018] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 02/15/2017] [Accepted: 02/17/2017] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Heart transplantation is a valuable therapeutic option for Chagas disease patients with severe cardiomyopathy. During patient follow-up, the differential diagnosis between cardiac transplant rejection and Chagas disease infection reactivation remains a challenging task, which hinders rapid implementation of the appropriate treatment. Herein we investigate whether polymerase chain reaction (PCR) strategies could facilitate early detection of Trypanosoma cruzi (T cruzi) in transplanted endomyocardial biopsies (EMBs). METHODS In this study we analyzed 500 EMB specimens obtained from 58 chagasic cardiac transplant patients, using PCR approaches targeted to nuclear (rDNA 24Sα) and kinetoplastid (kDNA) markers, and compared the efficiency of these approaches with that of other tests routinely used. RESULTS T cruzi DNA was detected in 112 EMB specimens derived from 39 patients (67.2%). The first positive result occurred at a median 1.0 month post-transplant. Conventional histopathologic, blood smear and hemoculture analyses showed lower sensitivity and higher median time to the first positive result. Patient follow-up revealed that 31 of 39 PCR-positive cases presented clinical reactivation of Chagas disease at different time-points after transplantation. PCR techniques showed considerable sensitivity (0.82) and specificity (0.60), with area under the receiver operating characteristic (ROC) curves of 0.708 (p = 0.001). Moreover, PCR techniques anticipated the clinical signs of Chagas disease reactivation by up to 36 months, with a median time of 6 months and an average of 9.1 months. CONCLUSIONS We found a good association between the PCR diagnosis and the clinical signs of the disease, indicating that the PCR approaches used herein are suitable for early diagnosis of Chagas disease reactivation, with high potential to assist physicians in treatment decisions. For this purpose, an algorithm is proposed for surveillance based on the molecular tests.
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Affiliation(s)
- Priscilla Almeida da Costa
- Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Marcela Segatto
- Departamento de Genética, Instituto de Biociências, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Danielle Fernandes Durso
- Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Wagson José de Carvalho Moreira
- Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Lucas Lodi Junqueira
- Hospital das Clinicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Fábio Morato de Castilho
- Hospital das Clinicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Silvio Amadeu de Andrade
- Hospital das Clinicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Cláudio Léo Gelape
- Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Egler Chiari
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Andréa Teixeira-Carvalho
- Centro de Pesquisas René Rachou, Fiocruz-Minas, Grupo Integrado de Pesquisas em Biomarcadores, Belo Horizonte, Minas Gerais, Brazil
| | - Sergio Danilo Junho Pena
- Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Carlos Renato Machado
- Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Gloria Regina Franco
- Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Geraldo Brasileiro Filho
- Departamento de Patologia da Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Andréa Mara Macedo
- Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Garcia MN, Burroughs H, Gorchakov R, Gunter SM, Dumonteil E, Murray KO, Herrera CP. Molecular identification and genotyping of Trypanosoma cruzi DNA in autochthonous Chagas disease patients from Texas, USA. INFECTION GENETICS AND EVOLUTION 2017; 49:151-156. [PMID: 28095298 DOI: 10.1016/j.meegid.2017.01.016] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 01/12/2017] [Accepted: 01/14/2017] [Indexed: 12/27/2022]
Abstract
The parasitic protozoan Trypanosoma cruzi, the causative agent of Chagas disease, is widely distributed throughout the Americas, from the southern United States (US) to northern Argentina, and infects at least 6 million people in endemic areas. Much remains unknown about the dynamics of T. cruzi transmission among mammals and triatomine vectors in sylvatic and peridomestic eco-epidemiological cycles, as well as of the risk of transmission to humans in the US. Identification of T. cruzi DTUs among locally-acquired cases is necessary for enhancing our diagnostic and clinical prognostic capacities, as well as to understand parasite transmission cycles. Blood samples from a cohort of 15 confirmed locally-acquired Chagas disease patients from Texas were used for genotyping T. cruzi. Conventional PCR using primers specific for the minicircle variable region of the kinetoplastid DNA (kDNA) and the highly repetitive genomic satellite DNA (satDNA) confirmed the presence of T. cruzi in 12/15 patients. Genotyping was based on the amplification of the intergenic region of the miniexon gene of T. cruzi and sequencing. Sequences were analyzed by BLAST and phylogenetic analysis by Maximum Likelihood method allowed the identification of non-TcI DTUs infection in six patients, which corresponded to DTUs TcII, TcV or TcVI, but not to TcIII or TcIV. Two of these six patients were also infected with a TcI DTU, indicating mixed infections in those individuals. Electrocardiographic abnormalities were seen among patients with single non-TcI and mixed infections of non-TcI and TcI DTUs. Our results indicate a greater diversity of T. cruzi DTUs circulating among autochthonous human Chagas disease cases in the southern US, including for the first time DTUs from the TcII-TcV-TcVI group. Furthermore, the DTUs infecting human patients in the US are capable of causing Chagasic cardiac disease, highlighting the importance of parasite detection in the population.
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Affiliation(s)
- Melissa N Garcia
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - Hadley Burroughs
- Department of Tropical Medicine, Vector-Borne Infectious Disease Research Center, Tulane University, School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Rodion Gorchakov
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - Sarah M Gunter
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - Eric Dumonteil
- Department of Tropical Medicine, Vector-Borne Infectious Disease Research Center, Tulane University, School of Public Health and Tropical Medicine, New Orleans, LA, USA; Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Autonomous University of Yucatan (UADY), Merida, Yucatan, Mexico
| | - Kristy O Murray
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - Claudia P Herrera
- Department of Tropical Medicine, Vector-Borne Infectious Disease Research Center, Tulane University, School of Public Health and Tropical Medicine, New Orleans, LA, USA.
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Montes-Rincón LM, Galaviz-Silva L, González-Bravo FE, Molina-Garza ZJ. Trypanosoma cruzi seroprevalence in pregnant women and screening by PCR and microhaematocrit in newborns from Guanajuato, Mexico. Acta Trop 2016; 164:100-106. [PMID: 27596439 DOI: 10.1016/j.actatropica.2016.08.029] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 07/21/2016] [Accepted: 08/31/2016] [Indexed: 11/27/2022]
Abstract
Chagas disease is caused by an infection with the protozoan hemoflagellate Trypanosoma cruzi, and it is a major endemic health problem in Latin America. The congenital route is one of the main non-vectorial pathways of transmission, which can arise either in the chronic or acute phase of maternal infection. Serological screening of T. cruzi infection was performed in 520 pregnant women and newborns at the Hospital General Regional de León, Guanajuato, Mexico, between 2014 and 2015. Anti-T. cruzi antibodies were detected in 20 mothers (4%) by ELISA and HIA with four PCR-positive newborn cases. Risk factors were identified according to an epidemiological survey, and the most significant (P<0.050) factors associated with T. cruzi infection were the building materials of dwellings, the presence of pets and dwellings located in rural areas. This study constitutes the first systematic study on congenital Chagas disease and the epidemiological risk factors in Guanajuato. Our results represent the probability of an incidence of 770 cases per 100,000 births during a period of 12 months, with a vertical transmission rate by 0.8%, which highlights the necessity to establish reliable serological and PCR tests in pregnant women to prevent vertical transmission. However, it is also important to follow-up the newborns from seropositive mothers for one year, which is necessary, as many children yielded negative results.
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Affiliation(s)
- Laura Mayela Montes-Rincón
- Universidad Autónoma de Nuevo León, Facultad de Ciencias Biológicas, Laboratorio de Patología Molecular y Experimental, Ave. Universidad SN, Cd. Universitaria, San Nicolás de los Garza, Nuevo León 66451, Mexico
| | - Lucio Galaviz-Silva
- Universidad Autónoma de Nuevo León, Facultad de Ciencias Biológicas, Laboratorio de Patología Molecular y Experimental, Ave. Universidad SN, Cd. Universitaria, San Nicolás de los Garza, Nuevo León 66451, Mexico
| | | | - Zinnia Judith Molina-Garza
- Universidad Autónoma de Nuevo León, Facultad de Ciencias Biológicas, Laboratorio de Patología Molecular y Experimental, Ave. Universidad SN, Cd. Universitaria, San Nicolás de los Garza, Nuevo León 66451, Mexico.
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Bazán PC, Lo Presti MS, Strauss M, Báez AL, Miler N, Paglini PA, Rivarola HW. Quantitative PCR and unconventional serological methods to evaluate clomipramine treatment effectiveness in experimental Trypanosoma cruzi infection. Exp Mol Pathol 2016; 101:274-280. [DOI: 10.1016/j.yexmp.2016.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 09/21/2016] [Accepted: 09/22/2016] [Indexed: 11/24/2022]
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Curtis-Robles R, Lewis BC, Hamer SA. High Trypanosoma cruzi infection prevalence associated with minimal cardiac pathology among wild carnivores in central Texas. Int J Parasitol Parasites Wildl 2016; 5:117-23. [PMID: 27330982 PMCID: PMC4900435 DOI: 10.1016/j.ijppaw.2016.04.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 04/07/2016] [Accepted: 04/09/2016] [Indexed: 01/01/2023]
Abstract
Infection with the zoonotic vector-borne protozoal parasite Trypanosoma cruzi causes Chagas disease in humans and dogs throughout the Americas. Despite the recognized importance of various wildlife species for perpetuating Trypanosoma cruzi in nature, relatively little is known about the development of cardiac disease in infected wildlife. Using a cross-sectional study design, we collected cardiac tissue and blood from hunter-donated wildlife carcasses- including raccoon (Procyon lotor), coyote (Canis latrans), gray fox (Urocyon cinereoargenteus), and bobcat (Lynx rufus) - from central Texas, a region with established populations of infected triatomine vectors and increasing diagnoses of Chagas disease in domestic dogs. Based on PCR analysis, we found that 2 bobcats (14.3%), 12 coyotes (14.3%), 8 foxes (13.8%), and 49 raccoons (70.0%) were positive for T. cruzi in at least one sample (right ventricle, apex, and/or blood clot). Although a histologic survey of right ventricles showed that 21.1% of 19 PCR-positive hearts were characterized by mild lymphoplasmocytic infiltration, no other lesions and no amastigotes were observed in any histologic section. DNA sequencing of the TcSC5D gene revealed that raccoons were infected with T. cruzi strain TcIV, and a single racoon harbored a TcI/TcIV mixed infection. Relative to other wildlife species tested here, our data suggest that raccoons may be important reservoirs of TcIV in Texas and a source of infection for indigenous triatomine bugs. The overall high level of infection in this wildlife community likely reflects high levels of vector contact, including ingestion of bugs. Although the relationship between the sylvatic cycle of T. cruzi transmission and human disease risk in the United States has yet to be defined, our data suggest that hunters and wildlife professionals should take precautions to avoid direct contact with potentially infected wildlife tissues.
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Affiliation(s)
- Rachel Curtis-Robles
- College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, 4458 TAMU, College Station, TX 77843, USA
| | - Barbara C. Lewis
- Texas A&M Veterinary Medical Diagnostic Laboratory, P.O. Drawer 3040, College Station, TX 77841-3040, USA
| | - Sarah A. Hamer
- College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, 4458 TAMU, College Station, TX 77843, USA
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Vicco MH, Rodeles L, Capovilla GS, Perrig M, Choque AGH, Marcipar I, Bottasso O, Rodriguez C, Cuña W. IgG Autoantibodies Induced by T. cruzi During Pregnancy: Correlation with Gravidity Complications and Early Outcome Assessment of the Newborns. Matern Child Health J 2016; 20:2057-64. [PMID: 27318490 DOI: 10.1007/s10995-016-2035-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Objective The aim of the present research was to evaluate the correlation of vertically transmitted IgG antibodies induced by T. cruzi and newborn early outcome assessment, mainly birth weight and gestational age. Methods We performed a cross-sectional study with 183 pregnant women (64 with asymptomatic Chagas disease) and their newborns. Both were subjected to complete clinical examination. Peripheral parasitemia was assessed in mother and neonates by parasite detection through microscopic examination of the buffycoat from mother's peripheral and cord blood. Antibodies induced by T. cruzi, such as anti-FRA, anti-B13, anti-p2β and anti-T. cruzi were assessed by immunoassay. Birth weight, general condition evaluation by APGAR Score and gestational age by Capurro Score, were determined in newborns. Results The rate of stillbirth background and pregnancy-induced hypertension were higher in patients with Chagas disease (p = 0.01 and p = 0.02, respectively). Parasitemia was detectable in 17 mothers and 4 newborns. The newborns of mothers with detectable parasitemia presented decreased gestational age (p = 0.006) and body weight (p = 0.04). Mostly all the mothers with Chagas disease and all their newborns have positive values of antibodies induced by T. cruzi; however, only anti-p2β showed to be related to the presence of complication during pregnancy (OR 2.35, p = 0.036), and to low birth weight (OR 1.55, p = 0.02). Conclusions Low birth weight and decreased postnatal estimation of maturity were related to detectable parasitemia in the mother. Also, vertical transmission of T. cruzi-induced autoantibodies might have clinical implication in newborns given the negative association between anti-p2β values and weight.
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Affiliation(s)
- Miguel Hernán Vicco
- Laboratorio de Tecnología Inmunológica, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Ciudad Universitaria, CC242, 3000, Santa Fe, Argentina. .,Facultad de Ciencias Médicas, Universidad Nacional del Litoral, Santa Fe, Argentina.
| | - Luz Rodeles
- Laboratorio de Tecnología Inmunológica, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Ciudad Universitaria, CC242, 3000, Santa Fe, Argentina.,Facultad de Ciencias Médicas, Universidad Nacional del Litoral, Santa Fe, Argentina
| | | | - Melina Perrig
- Laboratorio de Tecnología Inmunológica, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Ciudad Universitaria, CC242, 3000, Santa Fe, Argentina
| | | | - Iván Marcipar
- Laboratorio de Tecnología Inmunológica, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Ciudad Universitaria, CC242, 3000, Santa Fe, Argentina
| | - Oscar Bottasso
- Instituto de Inmunología Clínica y Experimental de Rosario, CONICET-UNR, Rosario, Argentina
| | - Celeste Rodriguez
- Unidad de Inmunología Parasitaria, Facultad de Medicina, Universidad Mayor de San Andrés, La Paz, Bolivia
| | - Washington Cuña
- Unidad de Inmunología Parasitaria, Facultad de Medicina, Universidad Mayor de San Andrés, La Paz, Bolivia
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46
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Cancino-Faure B, Fisa R, Alcover MM, Jimenez-Marco T, Riera C. Detection and Quantification of Viable and Nonviable Trypanosoma cruzi Parasites by a Propidium Monoazide Real-Time Polymerase Chain Reaction Assay. Am J Trop Med Hyg 2016; 94:1282-9. [PMID: 27139452 PMCID: PMC4889745 DOI: 10.4269/ajtmh.15-0693] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 03/07/2016] [Indexed: 01/06/2023] Open
Abstract
Molecular techniques based on real-time polymerase chain reaction (qPCR) allow the detection and quantification of DNA but are unable to distinguish between signals from dead or live cells. Because of the lack of simple techniques to differentiate between viable and nonviable cells, the aim of this study was to optimize and evaluate a straightforward test based on propidium monoazide (PMA) dye action combined with a qPCR assay (PMA-qPCR) for the selective quantification of viable/nonviable epimastigotes of Trypanosoma cruzi PMA has the ability to penetrate the plasma membrane of dead cells and covalently cross-link to the DNA during exposure to bright visible light, thereby inhibiting PCR amplification. Different concentrations of PMA (50-200 μM) and epimastigotes of the Maracay strain of T. cruzi (1 × 10(5)-10 parasites/mL) were assayed; viable and nonviable parasites were tested and quantified by qPCR with a TaqMan probe specific for T. cruzi. In the PMA-qPCR assay optimized at 100 μM PMA, a significant qPCR signal reduction was observed in the nonviable versus viable epimastigotes treated with PMA, with a mean signal reduction of 2.5 logarithm units and a percentage of signal reduction > 98%, in all concentrations of parasites assayed. This signal reduction was also observed when PMA-qPCR was applied to a mixture of live/dead parasites, which allowed the detection of live cells, except when the concentration of live parasites was low (10 parasites/mL). The PMA-qPCR developed allows differentiation between viable and nonviable epimastigotes of T. cruzi and could thus be a potential method of parasite viability assessment and quantification.
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Affiliation(s)
- Beatriz Cancino-Faure
- Laboratori de Parasitologia, Departament de Microbiologia i Parasitologia Sanitàries, Facultat de Farmàcia, Universitat de Barcelona, Barcelona, Spain; Fundació Banc de Sang i Teixits de les Illes Balears, Mallorca, Balearic Islands, Spain; IUNICS Institut Universitari d'Investigació en Ciències de la Salut, Universitat de les Illes Balears, Spain
| | - Roser Fisa
- Laboratori de Parasitologia, Departament de Microbiologia i Parasitologia Sanitàries, Facultat de Farmàcia, Universitat de Barcelona, Barcelona, Spain; Fundació Banc de Sang i Teixits de les Illes Balears, Mallorca, Balearic Islands, Spain; IUNICS Institut Universitari d'Investigació en Ciències de la Salut, Universitat de les Illes Balears, Spain
| | - M Magdalena Alcover
- Laboratori de Parasitologia, Departament de Microbiologia i Parasitologia Sanitàries, Facultat de Farmàcia, Universitat de Barcelona, Barcelona, Spain; Fundació Banc de Sang i Teixits de les Illes Balears, Mallorca, Balearic Islands, Spain; IUNICS Institut Universitari d'Investigació en Ciències de la Salut, Universitat de les Illes Balears, Spain
| | - Teresa Jimenez-Marco
- Laboratori de Parasitologia, Departament de Microbiologia i Parasitologia Sanitàries, Facultat de Farmàcia, Universitat de Barcelona, Barcelona, Spain; Fundació Banc de Sang i Teixits de les Illes Balears, Mallorca, Balearic Islands, Spain; IUNICS Institut Universitari d'Investigació en Ciències de la Salut, Universitat de les Illes Balears, Spain
| | - Cristina Riera
- Laboratori de Parasitologia, Departament de Microbiologia i Parasitologia Sanitàries, Facultat de Farmàcia, Universitat de Barcelona, Barcelona, Spain; Fundació Banc de Sang i Teixits de les Illes Balears, Mallorca, Balearic Islands, Spain; IUNICS Institut Universitari d'Investigació en Ciències de la Salut, Universitat de les Illes Balears, Spain
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Survey of Feral Swine ( Sus scrofa ) Infection with the Agent of Chagas Disease ( Trypanosoma cruzi ) in Texas, 2013-14. J Wildl Dis 2016; 52:627-30. [PMID: 27224214 DOI: 10.7589/2015-08-208] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
: Feral swine ( Sus scrofa ) are an invasive species and reservoir of numerous zoonotic pathogens in the US, and Texas leads the nation in the estimated population size of feral hogs. Texas also harbors enzootic transmission cycles of the protozoan parasite Trypanosoma cruzi , agent of Chagas disease. Given previous evidence that swine can serve as reservoirs of T. cruzi in Latin America and new evidence of triatomines (kissing bugs) feeding on swine in Texas, we measured the prevalence of T. cruzi infection in feral swine in Texas. From 2013 to 2014, we sampled blood and/or cardiac tissue from 78 feral swine across 14 Texas counties (seven with and seven without prior documentation of kissing bug occurrence) and used PCR and histopathology to detect T. cruzi infection. We determined an overall infection prevalence of 6% (3 of 54) based on PCR evaluation of cardiac tissue, and no blood samples were positive (n=72). All three positive pigs were from counties where kissing bugs are documented. No T. cruzi amastigotes were noted on histopathology (n=54). Sarcocysts were observed in 10 (18%) of the samples, five of which also had mild focal areas of degeneration and inflammatory cell infiltration. Eco-epidemiologic investigations can provide an assessment of contributions of feral hogs to maintenance of T. cruzi across a landscape to help protect human and animal health.
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Vitt JP, Saunders AB, O'Brien MT, Mansell J, Ajithdoss DK, Hamer SA. Diagnostic Features of Acute Chagas Myocarditis with Sudden Death in a Family of Boxer Dogs. J Vet Intern Med 2016; 30:1210-5. [PMID: 27163180 PMCID: PMC5084738 DOI: 10.1111/jvim.13967] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 03/11/2016] [Accepted: 04/21/2016] [Indexed: 01/04/2023] Open
Affiliation(s)
- J P Vitt
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - A B Saunders
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - M T O'Brien
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - J Mansell
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - D K Ajithdoss
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - S A Hamer
- Department of Veterinary Integrative Biosciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
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Tenney TD, Curtis-Robles R, Snowden KF, Hamer SA. Shelter dogs as sentinels for Trypanosoma cruzi transmission across Texas. Emerg Infect Dis 2016; 20:1323-6. [PMID: 25062281 PMCID: PMC4111162 DOI: 10.3201/eid2008.131843] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Chagas disease, an infection with the parasite Trypanosoma cruzi, is increasingly diagnosed among humans in the southern United States. We assessed exposure of shelter dogs in Texas to T. cruzi; seroprevalence across diverse ecoregions was 8.8%. Canine serosurveillance is a useful tool for public health risk assessment.
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Levy MZ, Tustin A, Castillo-Neyra R, Mabud TS, Levy K, Barbu CM, Quispe-Machaca VR, Ancca-Juarez J, Borrini-Mayori K, Naquira-Velarde C, Ostfeld RS. Bottlenecks in domestic animal populations can facilitate the emergence of Trypanosoma cruzi, the aetiological agent of Chagas disease. Proc Biol Sci 2016; 282:rspb.2014.2807. [PMID: 26085582 DOI: 10.1098/rspb.2014.2807] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Faeces-mediated transmission of Trypanosoma cruzi (the aetiological agent of Chagas disease) by triatomine insects is extremely inefficient. Still, the parasite emerges frequently, and has infected millions of people and domestic animals. We synthesize here the results of field and laboratory studies of T. cruzi transmission conducted in and around Arequipa, Peru. We document the repeated occurrence of large colonies of triatomine bugs (more than 1000) with very high infection prevalence (more than 85%). By inoculating guinea pigs, an important reservoir of T. cruzi in Peru, and feeding triatomine bugs on them weekly, we demonstrate that, while most animals quickly control parasitaemia, a subset of animals remains highly infectious to vectors for many months. However, we argue that the presence of these persistently infectious hosts is insufficient to explain the observed prevalence of T. cruzi in vector colonies. We posit that seasonal rains, leading to a fluctuation in the price of guinea pig food (alfalfa), leading to annual guinea pig roasts, leading to a concentration of vectors on a small subpopulation of animals maintained for reproduction, can propel T. cruzi through vector colonies and create a considerable force of infection for a pathogen whose transmission might otherwise fizzle out.
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Affiliation(s)
- Michael Z Levy
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA Universidad Peruana Cayetano Heredia/University of Pennsylvania Chagas Disease Field Laboratory, Arequipa, Peru
| | - Aaron Tustin
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ricardo Castillo-Neyra
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA Universidad Peruana Cayetano Heredia/University of Pennsylvania Chagas Disease Field Laboratory, Arequipa, Peru
| | - Tarub S Mabud
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Katelyn Levy
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Corentin M Barbu
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA Universidad Peruana Cayetano Heredia/University of Pennsylvania Chagas Disease Field Laboratory, Arequipa, Peru
| | - Victor R Quispe-Machaca
- Universidad Peruana Cayetano Heredia/University of Pennsylvania Chagas Disease Field Laboratory, Arequipa, Peru
| | - Jenny Ancca-Juarez
- Universidad Peruana Cayetano Heredia/University of Pennsylvania Chagas Disease Field Laboratory, Arequipa, Peru
| | - Katty Borrini-Mayori
- Universidad Peruana Cayetano Heredia/University of Pennsylvania Chagas Disease Field Laboratory, Arequipa, Peru
| | - Cesar Naquira-Velarde
- Universidad Peruana Cayetano Heredia/University of Pennsylvania Chagas Disease Field Laboratory, Arequipa, Peru
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