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Beatty NL, Arango-Ferreira C, Gual-Gonzalez L, Zuluaga S, Nolan MS, Cantillo-Barraza O. Oral Chagas Disease in Colombia-Confirmed and Suspected Routes of Transmission. Trop Med Infect Dis 2024; 9:14. [PMID: 38251211 PMCID: PMC10819552 DOI: 10.3390/tropicalmed9010014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/21/2023] [Accepted: 12/28/2023] [Indexed: 01/23/2024] Open
Abstract
Chagas disease (CD) remains endemic throughout many regions of Colombia despite implementing decades of vector control strategies in several departments. Some regions have had a significant decrease in vectorial transmission, but the oral ingestion of Trypanosoma cruzi through consumption of contaminated food and drink products is increasingly described. This form of transmission has important public health relevance in Colombia due to an increase in reported acute CD cases and clinical manifestations that often lead to significant morbidity and mortality. Oral CD in Colombia has been associated with the consumption of contaminated fruit juices, such as palm wine, sugar cane, or tangerine juice and water for consumption, or contaminated surfaces where food has been prepared. Another interesting route of oral transmission includes ingestion of unbeknownst infected armadillos' blood, which is related to a traditional medicine practice in Colombia. Some earlier reports have also implemented consumption of infected bush meat as a source, but this is still being debated. Within the Amazon Basin, oral transmission is now considered the principal cause of acute CD in these regions. Furthermore, new cases of acute CD are now being seen in departments where CD has not been documented, and triatomine vectors are not naturally found, thus raising suspicion for oral transmission. The oral CD could also be considered a food-borne zoonosis, and odoriferous didelphid secretions have been implemented in contaminating the human dwelling environment, increasing the risk of consumption of infectious metacyclic trypomastigotes. In this article, we will discuss the complex transmission dynamics of oral CD in Colombia and further examine the unique clinical manifestations of this route of infection. New insights into the oral transmission of Trypanosoma cruzi are being discovered in Colombia, which can help bring increased awareness and a better understanding of this neglected tropical disease to reduce the burden of CD throughout Latin America.
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Affiliation(s)
- Norman L. Beatty
- Division of Infectious Diseases and Global Medicine, Department of Medicine, University of Florida College of Medicine, Gainesville, FL 32610, USA;
- Emerging Pathogens Institute, University of Florida, Gainesville, FL 32610, USA
| | - Catalina Arango-Ferreira
- Departamento de Pediatría, Hospital San Vicente Fundación, Medellín 050010, Colombia;
- Departamento de Pediatría, Facultad de Medicina, Universidad de Antioquia, Medellín 050010, Colombia
| | - Lídia Gual-Gonzalez
- Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (L.G.-G.); (M.S.N.)
| | - Sara Zuluaga
- Grupo Biología y Control de Enfermedades Infecciosas, Universidad de Antioquia, Medellín 050010, Colombia;
| | - Melissa S. Nolan
- Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (L.G.-G.); (M.S.N.)
| | - Omar Cantillo-Barraza
- Grupo Biología y Control de Enfermedades Infecciosas, Universidad de Antioquia, Medellín 050010, Colombia;
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Testai R, Ferreira de Siqueira M, Rocha DSB, Roque ALR, Jansen AM, Xavier SCDC. Space-environment relationship in the identification of potential areas of expansion of Trypanosoma cruzi infection in Didelphis aurita in the Atlantic Rainforest. PLoS One 2023; 18:e0288595. [PMID: 37506103 PMCID: PMC10381050 DOI: 10.1371/journal.pone.0288595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/29/2023] [Indexed: 07/30/2023] Open
Abstract
Ecological Niche Modeling is widely used for animals, but rarely for understanding the parasite ecology. Trypanosoma cruzi is a heterogeneous and widely dispersed multi-host parasite. Didelphis aurita is a generalist species, both in terms of diet and environments. We modeled the D. aurita niche and T. cruzi infection in the Brazilian Atlantic Rainforest, using the models of two common vector species (Triatoma vitticeps and Panstrongylus megistus) as biotic variables, predicting their occurrence. Records of T. cruzi infected and non-infected D. aurita were analyzed through climate and landscape approaches by the Ecoland method. Models for each triatomine species and infected and noninfected D. aurita were produced considering climate and landscape: resolution of ~1km2 selected by Pearson's correlation [-0.7≤α≤0.7]. For modeling, seven algorithms available in ModleR package were used. True Skill Statistic was used to evaluate the models' performance (≥ 0.7). T. vitticeps indicates that there is a spatial dependence with warm areas in the southeastern region while P. megistus presented a distribution with high environmental suitability concentrated in the Southeast. High values of climatic suitability, landscape and potential presence of T. vitticeps and P. megistus were considered necessary, but not sufficient for the presence of D. aurita infected by T. cruzi. Climate models showed an ecological niche with suitability variations homogeneous, and landscape models showed a distribution of habitat conditions along the biome, with a fragmented profile and heterogeneous between locations. Ecoland demonstrated that D. aurita has different degrees of impact on its role in the enzootic cycle in different locations of the Atlantic Rainforest. Associating the models with the Ecoland method allowed the recognition of areas where D. aurita are important T. cruzi reservoirs. Areas of high suitability for the presence of marsupials are a necessary, but not sufficient for D. aurita to act as a reservoir for T. cruzi.
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Affiliation(s)
- Raphael Testai
- Laboratory of Tripanosomatid Biology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
- The Graduate Program in Computational and Systems Biology of the Instituto Oswaldo Cruz (PGBCS/IOC/Fiocruz), Rio de Janeiro/RJ, Brazil
| | | | | | - Andre Luiz Rodrigues Roque
- Laboratory of Tripanosomatid Biology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Ana Maria Jansen
- Laboratory of Tripanosomatid Biology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
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Rezende MDAR, Lana MD, Diotaiuti L, Machado-de-Assis GF. Entomological surveillance of Chagas disease in the East of Minas Gerais region, Brazil. Rev Soc Bras Med Trop 2022; 55:e0065. [PMID: 36134858 DOI: 10.1590/0037-8682-0065-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 06/01/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND After decentralizing the actions of the Chagas Disease Control Program (CDCP) in Brazil, municipalities were now responsible for control measures against this endemic, supervised by the Regional Health Superintendencies (RHS). We aimed to evaluate the recent entomological surveillance of Chagas disease in the Regional Health Superintendence of Governador Valadares (RHS/GV) from 2014 to 2019. METHODS Triatomines captured by residents during entomological surveillance were sent to the reference laboratory, where the species and evolutionary stages were identified, place of capture, and presence of Trypanosoma cruzi. A database was created, and the following were calculated: the rate of infection by T. cruzi (overall rate and rate by species), monthly seasonality, spatial distribution of species, number of captures, and infected triatomines/health microregions. RESULTS We identified 1,708 insects; 1,506 (88.2%) were triatomines, most were adult instars (n=1,469), and few were nymphs (n=37). The identified species were Triatoma vitticeps, Panstrongylus megistus, Panstrongylus diasi, Rhodnius neglectus, and Panstrongylus geniculatus. The first three were most frequently captured and distributed throughout the study area. Most bugs were captured intradomicile (72.5%), mainly in the second semester, between September and November, with an average infection rate of 41.5% (predominantly T. vitticeps, 49.2%). All municipalities sent triatomines, especially in the microregions of Governador Valadares. CONCLUSIONS These data reinforce the need and importance of improving Chagas disease control measures in the region to establish active and participatory entomological surveillance.
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Affiliation(s)
- Mariana de Almeida Rosa Rezende
- Universidade Federal de Juiz de Fora, Campus Governador Valadares, Programa de Pós-Graduação em Ciências Aplicadas à Saúde, Governador Valadares, MG, Brasil
| | - Marta de Lana
- Universidade Federal de Ouro Preto, Programa de Pós-Graduação em Ciências Biológicas e Programa de Pós-Graduação em Ciências Farmacêuticas, Ouro Preto, MG, Brasil
| | - Liléia Diotaiuti
- Centro de Pesquisas René Rachou, Laboratório de Triatomíneos e Epidemiologia da Doença de Chagas, Belo Horizonte, MG, Brasil
| | - Girley Francisco Machado-de-Assis
- Universidade Federal de Juiz de Fora, Campus Governador Valadares, Programa de Pós-Graduação em Ciências Aplicadas à Saúde, Laboratório de Parasitologia, Governador Valadares, MG, Brasil
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Santos F, Magalhães-Junior JT, Carneiro IDO, Santos FLN, Silva ÂAO, Novais JMCB, Santos JSS, Ribeiro-Jr G, Reis MG, Franke CR. Eco-epidemiology of vectorial Trypanosoma cruzi transmission in a region of northeast Brazil. Acta Trop 2022; 225:106184. [PMID: 34637752 DOI: 10.1016/j.actatropica.2021.106184] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 08/12/2021] [Accepted: 09/26/2021] [Indexed: 12/20/2022]
Abstract
Chagas disease (CD) is a parasitic zoonosis endemic in Brazil. Despite virtual control of Triatoma infestans, the main domesticated vector of Trypanosoma cruzi, vectorial transmission by other triatomine species persists in some rural communities. This study aims to characterize triatomines role in transmitting T. cruzi to dogs and humans in the district of Santo Inácio, located in the northwest region of the state of Bahia, Brazil. It also describes environmental factors in housings associated with insect occurrence and assesses the perception, knowledge, and preventive practices adopted by the population regarding CD. Blood samples of humans and dogs, and biological samples of triatomines, were collected between November 2018 and February 2019 and subjected to the detection of T. cruzi by serological and molecular biology tests. Also, we applied a questionnaire to research the perception, knowledge, and local practices of people related to CD. The capture of triatomines in households was associated with exploratory variables of the questionnaires using multivariate logistic regression (p < 0.05). The 155 triatomines captured in the wild and domestic environment were of the species Triatoma sherlocki (n = 151), Panstrongylus sherlocki (n = 1) and Triatoma sordida (n = 3), and had a natural infection rate for T. cruzi by PCR of 18.5%, 100% and 0%, respectively. District residents (n = 126) were seronegative for T. cruzi, while 17.5% (7/40) of the dogs were seropositive. The fact that residents are aware that triatomines can "cause" CD was configured as a protection factor for residents according to the fitted logistic regression model (p = 0.04). However, respondents have limited perception and knowledge about the CD, prevention and control practices for triatomines in a household. The results suggest the existence of a domestic cycle of transmission of T. cruzi between triatomines and dogs, configuring a latent risk of infection to the human population of Santo Inácio. Studies that clarify the potential for the establishing of intrusive triatomines in households, surveillance actions for triatomines, and health education in rural communities are indispensable to prevent the reemergence of CD in vulnerable regions of Brazil and other American countries with similar epidemiological characteristics.
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Bezerra-Santos MA, Ramos RAN, Campos AK, Dantas-Torres F, Otranto D. Didelphis spp. opossums and their parasites in the Americas: A One Health perspective. Parasitol Res 2021. [PMID: 33788021 DOI: 10.1007/s00436-021-07072-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 01/26/2021] [Indexed: 12/16/2022]
Abstract
Medium sized opossums (Didelphis spp.) are among the most fascinating mammals of the Americas, playing important ecological roles (e.g., dispersal of seeds and control of insect populations) in the environment they inhabit. Nevertheless, as synanthropic animals, they are well adapted to human dwellings, occupying shelters within the cities, peripheral areas, and rural settings. These marsupials can harbor numerous pathogens, which may affect people, pets, and livestock. Among those, some protozoa (e.g., Leishmania infantum, Trypanosoma cruzi, Toxoplasma gondii), helminths (e.g., Ancylostoma caninum, Trichinella spiralis, Alaria marcianae, Paragonimus spp.) and arthropods (e.g., ticks, fleas) present substantial public health and veterinary importance, due to their capacity to cause disease in humans, domestic animals, and wildlife. Here, we reviewed the role played by opossums on the spreading of zoonotic parasites, vectors, and vector-borne pathogens, highlighting the risks of pathogens transmission due to the direct and indirect interaction of humans and domestic animals with Didelphis spp. in the Americas.
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Nielebock MAP, Moreira OC, Xavier SCDC, Miranda LDFC, de Lima ACB, Pereira TODJS, Hasslocher-Moreno AM, Britto C, Sangenis LHC, Saraiva RM. Association between Trypanosoma cruzi DTU TcII and chronic Chagas disease clinical presentation and outcome in an urban cohort in Brazil. PLoS One 2020; 15:e0243008. [PMID: 33264350 PMCID: PMC7710061 DOI: 10.1371/journal.pone.0243008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 11/12/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The specific roles of parasite characteristics and immunological factors of the host in Chagas disease progression and prognosis are still under debate. Trypanosoma cruzi genotype may be an important determinant of the clinical chronic Chagas disease form and prognosis. This study aimed to identify the potential association between T. cruzi genotypes and the clinical presentations of chronic Chagas disease. METHODOLOGY/PRINCIPAL FINDINGS This is a retrospective study using T. cruzi isolated from blood culture samples of 43 patients with chronic Chagas disease. From 43 patients, 42 were born in Brazil, mainly in Southeast and Northeast Brazilian regions, and one patient was born in Bolivia. Their mean age at the time of blood collection was 52.4±13.2 years. The clinical presentation was as follows 51.1% cardiac form, 25.6% indeterminate form, and 23.3% cardiodigestive form. Discrete typing unit (DTU) was determined by multilocus conventional PCR. TcII (n = 40) and TcVI (n = 2) were the DTUs identified. DTU was unidentifiable in one patient. The average follow-up time after blood culture was 5.7±4.4 years. A total of 14 patients (32.5%) died and one patient underwent heart transplantation. The cause of death was sudden cardiac arrest in six patients, heart failure in five patients, not related to Chagas disease in one patient, and ignored in two patients. A total of 8 patients (18.6%) progressed, all of them within the cardiac or cardiodigestive forms. CONCLUSIONS/SIGNIFICANCE TcII was the main T. cruzi DTU identified in chronic Chagas disease Brazilian patients (92.9%) with either cardiac, indeterminate or cardiodigestive forms, born at Southeast and Northeast regions. Other DTU found in much less frequency was TcVI (4.8%). TcII was also associated to patients that evolved with heart failure or sudden cardiac arrest, the two most common and ominous consequences of the cardiac form of Chagas disease.
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Affiliation(s)
- Marco Antonio Prates Nielebock
- Clinical Research Laboratory in Chagas Disease, Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
| | - Otacílio C. Moreira
- Molecular Biology and Endemic Diseases Laboratory, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil
| | | | | | | | | | - Alejandro Marcel Hasslocher-Moreno
- Clinical Research Laboratory in Chagas Disease, Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
| | - Constança Britto
- Molecular Biology and Endemic Diseases Laboratory, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil
| | - Luiz Henrique Conde Sangenis
- Clinical Research Laboratory in Chagas Disease, Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
| | - Roberto Magalhães Saraiva
- Clinical Research Laboratory in Chagas Disease, Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
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Santos JPD, Guimarães LM, Lima IP, Batista FMDA, Carvalho-Costa FA, Santos-Mallet JRD. Spatial distribution of synanthropic triatomines in Piaui State, Northeastern Brazil. Rev Inst Med Trop Sao Paulo 2020; 62:e57. [PMID: 32844905 PMCID: PMC7447235 DOI: 10.1590/s1678-9946202062057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 07/21/2020] [Indexed: 12/02/2022] Open
Abstract
This study aimed to describe the spatial distribution and assess entomological indicators of synanthropic triatomines in Piaui State, Northeastern Brazil. We used surveillance data on the detection, identification and assessment of natural infection with trypanosomatids from triatomines in the State from 2014 to 2017. The State was divided into four macroregions. In relation to the dispersion rates of triatomines, they were much lower in the North, when compared to Southwest, Southeast and Central North macroregions. Infestation rates were higher in the Southwest and Southeast and intradomicile infestation rates varied during the study period, reaching high values in all regions. Insects belonging to the species Triatoma brasiliensis complex, Triatoma pseudomaculata, Triatoma sordida, and to the genus Panstrongylus spp. and Rhodnius spp. were collected during this period. T. brasiliensis was collected from all four regions of the State, but more frequently in those located in the Southeast. A similar pattern was observed for T. pseudomaculata. T. sordida was detected in the municipalities in the Southeast and Southwest regions, and less frequently in the Central North municipalities. Rhodnius spp. was detected in the Central North and North regions, and Panstrongylus spp. in the Central North and Southeast regions. The highest trypanosomatid-positivity rate of T. brasiliensis and Panstrongylus spp. was in the Southeast region. A significant proportion of the municipalities of Piaui State presents entomological parameters that indicate a risk of Chagas disease by vector transmission.
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Affiliation(s)
| | - Lucas Melo Guimarães
- Departamento de Epidemiologia em Saúde Pública, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - Filipe Anibal Carvalho-Costa
- Escritório Técnico Regional, Fundação Oswaldo Cruz, Teresina, Piauí, Brazil.,Laboratório de Epidemiologia e Sistemática Molecular, Fundação Oswaldo Cruz, Instituto Oswaldo Cruz,nRio de Janeiro, Rio de Janeiro, Brazil
| | - Jacenir Reis Dos Santos-Mallet
- Escritório Técnico Regional, Fundação Oswaldo Cruz, Teresina, Piauí, Brazil.,Laboratório Interdisciplinar de Vigilância Entomológica em Diptera e Hemiptera, Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil.,Universidade Iguaçu, Nova Iguaçu, Rio de Janeiro, Brazil
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Dario MA, Andrade TES, Dos Santos CB, Fux B, Brandão AA, Falqueto A. Molecular characterization of Trypanosoma cruzi samples derived from Triatoma vitticeps and Panstrongylus geniculatus of the Atlantic rainforest, southeast Brazil. ACTA ACUST UNITED AC 2018; 25:59. [PMID: 30474600 PMCID: PMC6254102 DOI: 10.1051/parasite/2018060] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Accepted: 11/06/2018] [Indexed: 01/04/2023]
Abstract
Background: In rural areas of Espírito Santo state, southeast Brazil, triatomine species attracted by light frequently invade residences. The aim of this study was to investigate the Trypanosoma cruzi discrete typing units (DTUs) harbored by these triatomines. Methods: Triatomine’s intestinal contents were examined, inoculated in mice, and the positive samples were cultivated. Flagellates obtained from infected mice hemoculture were submitted to DNA extraction using a salting-out method and to TcSC5D gene amplification. The amplified samples were sequenced, and polymorphism was analyzed for DTU identification. Results: Three hundred and ninety-four triatomines were identified: Triatoma vitticeps (90.03%), Panstrongylus geniculatus (8.89%), Panstrongylus megistus (0.54%), Panstrongylus diasi (0.27%), and Triatoma tibiamaculata (0.27%). Among the specimens, 251/394 (67.65%) presented flagellated forms similar to T. cruzi. After triatomine intestinal content inoculation into mice, 134 mice presented T. cruzi-like trypomastigotes from Tr. vitticeps and P. geniculatus and 89 samples were positive in hemoculture. Sixty-two samples were analyzed for the TcSC5D gene and TcI, TcII, TcIII, and TcIV DTUs were identified. Conclusions: We observed T. cruzi DTU diversity in Tr. vitticeps and P. geniculatus, which showed the predominance of TcII and occurrence of TcI, TcIII and TcIV. Triatomines presented high T. cruzi infection rates. Since little is known regarding the possible mammalian hosts that maintain the T. cruzi cycle, further studies are necessary to obtain a better understanding of the parasite transmission cycle in this region.
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Affiliation(s)
- Maria Augusta Dario
- Unidade de Medicina Tropical, Universidade Federal do Espírito Santo (UFES), Av. Marechal Campos, 1468, Vitória, ES 29043-900, Brazil
| | | | - Claudiney Biral Dos Santos
- Núcleo de Entomologia e Malacologia, Secretaria de estado da Saúde (SESA/ES), Rua Pedro Zangradini, 320, Serra, ES 29164-020, Brazil
| | - Blima Fux
- Unidade de Medicina Tropical, Universidade Federal do Espírito Santo (UFES), Av. Marechal Campos, 1468, Vitória, ES 29043-900, Brazil
| | - Adeilton Alves Brandão
- Laboratório Interdisciplinar em Pesquisas Médicas, Instituto Oswaldo Cruz/Fiocruz, Av. Brasil, 4365, Rio de Janeiro, RJ 21040-900, Brazil
| | - Aloísio Falqueto
- Unidade de Medicina Tropical, Universidade Federal do Espírito Santo (UFES), Av. Marechal Campos, 1468, Vitória, ES 29043-900, Brazil
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Vizzoni AG, Varela MC, Sangenis LHC, Hasslocher-Moreno AM, do Brasil PEAA, Saraiva RM. Ageing with Chagas disease: an overview of an urban Brazilian cohort in Rio de Janeiro. Parasit Vectors 2018; 11:354. [PMID: 29914550 PMCID: PMC6006711 DOI: 10.1186/s13071-018-2929-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 06/01/2018] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Chagas disease control programmes have decreased the prevalence of Chagas disease in Latin America. Together with migration to urban areas and increase in life expectancy, a new scenario for Chagas disease has emerged in Brazil with most patients currently elderly individuals living in urban areas. However, acute Chagas disease cases still occur due to vector transmission by sylvatic vectors and oral transmission by contaminated food. Therefore, we characterized the clinical and epidemiological profile of the patients followed at Evandro Chagas National Institute of Infectious Diseases in Rio de Janeiro, Brazil. We aimed to identify the clinical forms, associated co-morbidities, and geographical areas where younger patients originate from. This will aid in the identification of potential challenges to be currently faced. RESULTS This is a cross-sectional study. Adult patients with chronic Chagas disease were recruited between March 2013 and April 2016. Clinical and epidemiological data were obtained from electronic medical records and interviews. The clinical form of the Chagas disease presented by the patients was determined following the Brazilian Consensus on Chagas disease. Six hundred and nineteen patients (mean age 60 ± 12 years; 56.9% women) were included in this study. Patients' clinical forms were classified as follows: indeterminate 29.1%; cardiac 55.4%; digestive 5.5%; and mixed 10.0%. Patients aged over 65 years comprised 38% of the population. Hypertension was present in 347 (56%) patients, dyslipidemia in 261 patients (42%) and diabetes mellitus in 185 patients (30%). There were no differences regarding gender, race, comorbidities frequency or place of origin across Chagas disease clinical forms. Most of the elderly population originated from Bahia, Minas Gerais and Pernambuco states, while most of the younger patients were born in Ceará, Paraíba and Rio de Janeiro states. CONCLUSIONS We described a great proportion of elderly patients in the composition of an urban Brazilian Chagas disease patient cohort with a high prevalence of comorbidities. We also identified a change in the pattern of the place of origin among younger patients.
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Affiliation(s)
- Alexandre Gomes Vizzoni
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Margareth Catoia Varela
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | | | | | - Roberto Magalhães Saraiva
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Moreira OC, Verly T, Finamore-Araujo P, Gomes SAO, Lopes CM, de Sousa DM, Azevedo LR, da Mota FF, d'Avila-Levy CM, Santos-Mallet JR, Britto C. Development of conventional and real-time multiplex PCR-based assays for estimation of natural infection rates and Trypanosoma cruzi load in triatomine vectors. Parasit Vectors 2017; 10:404. [PMID: 28851417 DOI: 10.1186/s13071-017-2343-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 08/22/2017] [Indexed: 11/30/2022] Open
Abstract
Background Chagas disease is a complex anthropozoonosis with distinct domestic and sylvatic mammal species acting as potential reservoirs. The diversity of vector species and their habitats are among the factors that hinder the control of the disease. Control programs periodically monitor the prevalence of T. cruzi infection in insect bugs through microscopical observation of diluted feces. However, microscopy presents limited sensitivity in samples with low parasite numbers, difficulties in examining all evolutionary stages of the insect and may in turn be limited to differentiate T. cruzi from other morphologically similar trypanosomatids. Here, we report two highly sensitive and accurate methodologies to infer T. cruzi infection rates and to quantify parasite load in the gut of field-collected triatomines. Methods Triatomines were manually collected in the period 2011–2012 and 2014–2015, in domestic, peridomestic or sylvatic habitats in rural areas of 26 municipalities, encompassing three distinct Brazilian biomes: Caatinga, Cerrado and Atlantic Rainforest. Following morphological and taxonomical identification, the search for flagellated protozoa was performed by optical microscopy. A conventional PCR targeting T. cruzi kDNA and a TaqMan qPCR directed to the parasite nuclear satellite DNA (SAT) were developed, both in multiplex, with the triatomine 12S subunit ribosomal RNA gene, used as internal amplification control. Both methods were used for detection (kDNA-PCR) and parasite load quantification (SAT-DNA-qPCR), to investigate T. cruzi infection in captured triatomines. Results The combined methods were assayed on a panel of 205 field-collected triatomine samples. Diagnostic analysis revealed 21% positivity for the kDNA-PCR, whereas microscopic examination enabled identification of T. cruzi in only 7.0% of the PCR-positive samples. Negative PCR results were confirmed by the absence of T. cruzi flagellates using microscopy. Caatinga biome yielded the highest T. cruzi infection rate (60%), followed by the Atlantic Rainforest and Cerrado with 7.1 and 6.1%, respectively. In addition, a wide range distribution of parasite load, varying from 8.05 × 10-2 to 6.31 × 1010 was observed with a median of 2.29 × 103 T. cruzi/intestine units. When parasite load was analyzed by triatomine species, a significantly higher median was found for Panstrongylus lutzi in comparison with Triatoma brasiliensis. Conclusions Our results demonstrate highly sensitive PCR-based methodologies to monitor T. cruzi infection in triatomines. In addition, the qPCR assay offers the possibility of further evaluation parasite load, as a promising biomarker of the vectorial capacity of triatomines in Chagas disease endemic areas. Electronic supplementary material The online version of this article (10.1186/s13071-017-2343-x) contains supplementary material, which is available to authorized users.
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Faria CP, Zanini GM, Dias GS, Sousa MDC. Associations of Giardia lamblia assemblages with HIV infections and symptomatology: HIV virus and assemblage B were they born to each other? Acta Trop 2017; 172:80-85. [PMID: 28456597 DOI: 10.1016/j.actatropica.2017.04.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 04/20/2017] [Accepted: 04/22/2017] [Indexed: 12/13/2022]
Abstract
Giardia lamblia is an intestinal parasite that has an extensive genetic variation among isolates. This species is divided into eight different assemblages (A-H), but only assemblages A and B have been associated with human infections. Studies on the associations of G. lamblia assemblages and symptoms have been done but were inconclusive. The aim of this study was to correlate G. lamblia assemblages with symptoms in patients with and without HIV/AIDS and its association with the CD4T cell count. The cross-sectional survey was conducted among patients attending the Evandro Chagas National Institute of Infectious Diseases (INI/FIOCRUZ) in Rio de Janeiro from January 2011 to February 2015. Thirty-eight of 65 microscopically positive stool samples for G. lamblia were from HIV positive patients and 27 were from HIV negative patients. Of the HIV infected patients, 19 (55.9%) were genotyped as assemblage B of which 9 (47.4%) had a CD4Tcell count below 200cells/mm3. In addition, we found a greater number of samples belonging to assemblage B in symptomatic cases (11 of 19; 57.9%). Our data suggest that assemblage B is very likely to be found in HIV infected patients and probably the lower CD4T count gives advantages for assemblage B replication. Furthermore, assemblage B seems to be associated with symptomatology, particularly abdominal pain, asthenia, diarrhea, fever, headache and myalgia. This study provides information on G. lamblia assemblages and symptoms in patients with and without HIV/AIDS virus and their association with CD4Tcell counts.
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Affiliation(s)
- Clarissa Perez Faria
- CNC - Center for Neurosciences and Cell Biology, University of Coimbra, 3030-548 Coimbra, Portugal; Faculty of Pharmacy, University of Coimbra, 3030-548 Coimbra, Portugal; Laboratory of Parasitology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, 21040-900, Brazil
| | - Graziela Maria Zanini
- Laboratory of Parasitology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, 21040-900, Brazil
| | - Gisele Silva Dias
- Laboratory of Parasitology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, 21040-900, Brazil
| | - Maria do Céu Sousa
- CNC - Center for Neurosciences and Cell Biology, University of Coimbra, 3030-548 Coimbra, Portugal; Faculty of Pharmacy, University of Coimbra, 3030-548 Coimbra, Portugal.
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Oliveira TDSFD, Santos BND, Galdino TS, Hasslocher-Moreno AM, Bastos OMP, Sousa MAD. Trypanosoma cruzi I genotype among isolates from patients with chronic Chagas disease followed at the Evandro Chagas National Institute of Infectious Diseases (FIOCRUZ, Brazil). Rev Soc Bras Med Trop 2017; 50:35-43. [PMID: 28327800 DOI: 10.1590/0037-8682-0406-2016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 12/02/2016] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION: Trypanosoma cruzi is the etiologic agent of Chagas disease in humans, mainly in Latin America. Trypanosome stocks were isolated by hemoculture from patients followed at Evandro Chagas National Institute of Infectious Diseases (FIOCRUZ) and studied using different approaches. METHODS: For species and genotype identification, the stocks were analyzed by parasitological techniques, polymerase chain reaction assays targeted to specific DNA sequences, isoenzyme patterns, besides sequencing of a polymorphic locus of TcSC5D gene (one stock). RESULTS: The isolates presented typical T. cruzi morphology and usually grew well in routine culture media. Metacyclic trypomastigotes were found in cultures or experimentally infected Triatoma infestans. All isolates were pure T. cruzi cultures, presenting typical 330-bp products from kinetoplast DNA minicircles, and 250 or 200-bp amplicons from the mini-exon non-transcribed spacer. Their genetic type assignment was resolved by their isoenzyme profiles. The finding of TcI in one asymptomatic patient from Paraíba was confirmed by the sequencing assay. TcVI was found in two asymptomatic individuals from Bahia and Rio Grande do Sul. TcII was identified in six patients from Pernambuco, Bahia and Minas Gerais, who presented different clinical forms: cardiac (2), digestive with megaesophagus (1), and indeterminate (3). CONCLUSIONS: The main T. cruzi genotypes found in Brazilian chronic patients were identified in this work, including TcI, which is less frequent and usually causes asymptomatic disease, unlike that in other American countries. This study emphasizes the importance of T. cruzi genotyping for possible correlations between the parasite and patient' responses to therapeutic treatment or disease clinical manifestations.
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Affiliation(s)
| | | | - Tainah Silva Galdino
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | | | - Otilio Machado Pereira Bastos
- Departamento de Microbiologia e Parasitologia, Instituto Biomédico, Universidade Federal Fluminense, Niterói, RJ, Brasil
| | - Maria Auxiliadora de Sousa
- Coleção de Tripanossomatídeos, Instituto Oswaldo Cruz, Rio de Janeiro, RJ, Brasil.,Laboratório de Toxoplasmose e Outras Protozooses, Instituto Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
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Sangenis LHC, Nielebock MAP, Santos CDS, Silva MCCD, Bento GMR. Transmissão da doença de Chagas por consumo de carne de caça: revisão sistemática. Rev bras epidemiol 2016; 19:803-811. [DOI: 10.1590/1980-5497201600040010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 09/08/2016] [Indexed: 11/22/2022] Open
Abstract
RESUMO: Objetivo: Avaliar a influência do consumo de carne de caça na transmissão da doença de Chagas (DC), assim como as condições em que ela ocorre e a frequência de relatos na literatura. Métodos: Mediante revisão sistemática, foram consultadas as bases PubMed, LILACS, MEDLINE e SciELO, sendo incluídos artigos escritos em português, inglês e espanhol, sem limitação do ano de publicação. Os descritores utilizados foram: oral, transmission, meat, wild animals, hunt, carnivory e Chagas disease, sendo inseridos na análise os artigos que mencionavam o consumo de carne de animais como forma de transmissão humana da DC. Foram utilizados critérios de evidência epidemiológico, clínico e laboratorial. Resultados: Entre os 298 artigos identificados, apenas seis preencheram os critérios de elegibilidade. Foram identificados somente cinco episódios de transmissão oral por consumo de carne ou sangue de animais silvestres, porém em dois deles não foi possível afastar a possibilidade de transmissão vetorial. A maior parte dos relatos preencheu os critérios de evidência epidemiológico, clínico e laboratorial, estabelecidos para sustentar a transmissão. Conclusão: Apesar da transmissão de DC ser incomum, a caça e o consumo de mamíferos silvestres reservatórios devem ser desestimulados nos países endêmicos em função dos riscos inerentes a essas práticas.
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Dias JCP, Ramos Jr. AN, Gontijo ED, Luquetti A, Shikanai-Yasuda MA, Coura JR, Torres RM, Melo JRDC, Almeida EAD, Oliveira Jr. WD, Silveira AC, Rezende JMD, Pinto FS, Ferreira AW, Rassi A, Fragata Filho AA, Sousa ASD, Correia D, Jansen AM, Andrade GMQ, Britto CFDPDC, Pinto AYDN, Rassi Jr. A, Campos DE, Abad-Franch F, Santos SE, Chiari E, Hasslocher-Moreno AM, Moreira EF, Marques DSDO, Silva EL, Marin-Neto JA, Galvão LMDC, Xavier SS, Valente SADS, Carvalho NB, Cardoso AV, Silva RAE, Costa VMD, Vivaldini SM, Oliveira SM, Valente VDC, Lima MM, Alves RV. 2 nd Brazilian Consensus on Chagas Disease, 2015. Rev Soc Bras Med Trop 2016; 49Suppl 1:3-60. [DOI: 10.1590/0037-8682-0505-2016] [Citation(s) in RCA: 179] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 12/05/2016] [Indexed: 11/22/2022] Open
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Dias JVL, Queiroz DRM, Martins HR, Gorla DE, Pires HHR, Diotaiuti L. Spatial distribution of triatomines in domiciles of an urban area of the Brazilian Southeast Region. Mem Inst Oswaldo Cruz 2016; 111:43-50. [PMID: 26814643 PMCID: PMC4727435 DOI: 10.1590/0074-02760150352] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 12/08/2015] [Indexed: 11/25/2022] Open
Abstract
Reports of triatomine infestation in urban areas have increased. We analysed the
spatial distribution of infestation by triatomines in the urban area of Diamantina,
in the state of Minas Gerais, Brazil. Triatomines were obtained by community-based
entomological surveillance. Spatial patterns of infestation were analysed by Ripley’s
K function and Kernel density estimator. Normalised difference vegetation index
(NDVI) and land cover derived from satellite imagery were compared between infested
and uninfested areas. A total of 140 adults of four species were captured (100
Triatoma vitticeps, 25Panstrongylus geniculatus,
8 Panstrongylus megistus, and 7 Triatoma
arthurneivai specimens). In total, 87.9% were captured within domiciles.
Infection by trypanosomes was observed in 19.6% of 107 examined insects. The spatial
distributions ofT. vitticeps, P. geniculatus,
T. arthurneivai, and trypanosome-positive triatomines were
clustered, occurring mainly in peripheral areas. NDVI values were statistically
higher in areas infested by T. vitticeps and P.
geniculatus. Buildings infested by these species were located closer to
open fields, whereas infestations of P. megistus andT.
arthurneivai were closer to bare soil. Human occupation and modification
of natural areas may be involved in triatomine invasion, exposing the population to
these vectors.
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Affiliation(s)
- João Victor Leite Dias
- Laboratório de Triatomíneos e Epidemiologia da Doença de Chagas, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, MG, Brasil
| | - Dimas Ramon Mota Queiroz
- Laboratório de Doenças Parasitárias, Departamento de Farmácia, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brasil
| | - Helen Rodrigues Martins
- Laboratório de Doenças Parasitárias, Departamento de Farmácia, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brasil
| | - David Eladio Gorla
- Instituto Multidisciplinario de Biología Vegetal, Consejo Nacional de Investigaciones Científicas y Técnicas, Córdoba, Argentina
| | - Herton Helder Rocha Pires
- Laboratório de Doenças Parasitárias, Departamento de Farmácia, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brasil
| | - Liléia Diotaiuti
- Laboratório de Triatomíneos e Epidemiologia da Doença de Chagas, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, MG, Brasil
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