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Gual-Gonzalez L, Arango-Ferreira C, Lopera-Restrepo LC, Cantillo-Barraza O, Marín DV, Bustamante NR, Triana-Chavez O, Nolan MS. Acute Pediatric Chagas Disease in Antioquia, Colombia: A Geographic Location of Suspected Oral Transmission. Microorganisms 2021; 10:8. [PMID: 35056459 PMCID: PMC8781947 DOI: 10.3390/microorganisms10010008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/17/2021] [Accepted: 12/18/2021] [Indexed: 11/16/2022] Open
Abstract
Chagas disease, Trypanosoma cruzi infection, is an insidious cause of heart failure in Latin America. Early diagnosis and treatment are critical to prevent irreversible myocardial damage that progressively accumulates over decades. Several structural barriers account for the less than 1% of cases in Colombia being treated, including poor physician knowledge, especially considering that some regions are considered non-endemic. The two cases reported here represent an emerging epidemiologic scenario associated with pediatric Chagas disease. Both cases are suspected oral transmitted parasitic infection in a geographic region of Colombia (Andean region of Antioquia) where no previous oral transmission of Chagas disease had been reported. Their clinical histories and course of disease are presented here to increase physician awareness of the epidemiologic risk factors and clinical manifestations associated with pediatric oral Chagas disease in Antioquia department, Colombia.
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Affiliation(s)
- Lídia Gual-Gonzalez
- Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Catalina Arango-Ferreira
- Departamento de Pediatría Hospital San Vicente Fundación, Medellin 050010, Colombia;
- Departamento de Pediatría, Facultad de Medicina, Universidad de Antioquia, MMedellin 050010, Colombia; (D.V.M.); (N.R.B.)
| | | | - Omar Cantillo-Barraza
- Grupo Biología y Control de Enfermedades Infecciosas, Universidad de Antioquia, Medellin 050010, Colombia; (O.C.-B.); (O.T.-C.)
| | - Daniela Velásquez Marín
- Departamento de Pediatría, Facultad de Medicina, Universidad de Antioquia, MMedellin 050010, Colombia; (D.V.M.); (N.R.B.)
| | - Natalia Restrepo Bustamante
- Departamento de Pediatría, Facultad de Medicina, Universidad de Antioquia, MMedellin 050010, Colombia; (D.V.M.); (N.R.B.)
| | - Omar Triana-Chavez
- Grupo Biología y Control de Enfermedades Infecciosas, Universidad de Antioquia, Medellin 050010, Colombia; (O.C.-B.); (O.T.-C.)
| | - Melissa S. Nolan
- Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
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2
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Medina-Rincón GJ, Gallo-Bernal S, Jiménez PA, Cruz-Saavedra L, Ramírez JD, Rodríguez MJ, Medina-Mur R, Díaz-Nassif G, Valderrama-Achury MD, Medina HM. Molecular and Clinical Aspects of Chronic Manifestations in Chagas Disease: A State-of-the-Art Review. Pathogens 2021; 10:pathogens10111493. [PMID: 34832648 PMCID: PMC8619182 DOI: 10.3390/pathogens10111493] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 11/03/2021] [Accepted: 11/08/2021] [Indexed: 12/11/2022] Open
Abstract
Chronic manifestations of Chagas disease present as disabling and life-threatening conditions affecting mainly the cardiovascular and gastrointestinal systems. Although meaningful research has outlined the different molecular mechanisms underlying Trypanosoma cruzi’s infection and the host-parasite interactions that follow, prompt diagnosis and treatment remain a challenge, particularly in developing countries and also in those where the disease is considered non-endemic. This review intends to present an up-to-date review of the parasite’s life cycle, genetic diversity, virulence factors, and infective mechanisms, as well as the epidemiology, clinical presentation, diagnosis, and treatment options of the main chronic complications of Chagas disease.
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Affiliation(s)
- Germán J. Medina-Rincón
- School of Medicine and Health Sciences, Universidad del Rosario, Bogotá 111221, Colombia; (S.G.-B.); (M.D.V.-A.); (H.M.M.)
- Correspondence: ; Tel.: +57-310-817-2369
| | - Sebastián Gallo-Bernal
- School of Medicine and Health Sciences, Universidad del Rosario, Bogotá 111221, Colombia; (S.G.-B.); (M.D.V.-A.); (H.M.M.)
- Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Radiology, Harvard Medical School, Boston, MA 02114, USA
| | - Paula A. Jiménez
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá 111221, Colombia; (P.A.J.); (L.C.-S.); (J.D.R.)
| | - Lissa Cruz-Saavedra
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá 111221, Colombia; (P.A.J.); (L.C.-S.); (J.D.R.)
| | - Juan David Ramírez
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá 111221, Colombia; (P.A.J.); (L.C.-S.); (J.D.R.)
| | - María Juliana Rodríguez
- Division of Cardiology, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá 110131, Colombia; (M.J.R.); (R.M.-M.)
| | - Ramón Medina-Mur
- Division of Cardiology, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá 110131, Colombia; (M.J.R.); (R.M.-M.)
| | - Gustavo Díaz-Nassif
- Division of Gastroenterology and Liver Diseases, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá 111221, Colombia;
| | | | - Héctor M. Medina
- School of Medicine and Health Sciences, Universidad del Rosario, Bogotá 111221, Colombia; (S.G.-B.); (M.D.V.-A.); (H.M.M.)
- Division of Cardiology, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá 110131, Colombia; (M.J.R.); (R.M.-M.)
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Cantillo-Barraza O, Torres J, Hernández C, Romero Y, Zuluaga S, Correa-Cárdenas CA, Herrera G, Rodríguez O, Alvarado MT, Ramírez JD, Méndez C. The potential risk of enzootic Trypanosoma cruzi transmission inside four training and re-training military battalions (BITER) in Colombia. Parasit Vectors 2021; 14:519. [PMID: 34625109 PMCID: PMC8501693 DOI: 10.1186/s13071-021-05018-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 09/14/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Colombia's National Army is one of the largest military institutions in the country based on the number of serving members and its presence throughout the country. There have been reports of cases of acute or chronic cases of Chagas disease among active military personnel. These may be the result of military-associated activities performed in jungles and other endemic areas or the consequence of exposure to Trypanosoma cruzi inside military establishments/facilities located in endemic areas. The aim of the present study was to describe the circulation of T. cruzi inside facilities housing four training and re-training battalions [Battalions of Instruction, Training en Re-training (BITERs)] located in municipalities with historical reports of triatomine bugs and Chagas disease cases. An entomological and faunal survey of domestic and sylvatic environments was conducted inside each of these military facilities. METHODS Infection in working and stray dogs present in each BITER location was determined using serological and molecular tools, and T. cruzi in mammal and triatomine bug samples was determined by PCR assay. The PCR products of the vertebrate 12S rRNA gene were also obtained and subjected to Sanger sequencing to identify blood-feeding sources. Finally, we performed a geospatial analysis to evaluate the coexistence of infected triatomines and mammals with the military personal inside of each BITER installation. RESULTS In total, 86 specimens were collected: 82 Rhodnius pallescens, two Rhodnius prolixus, one Triatoma dimidiata and one Triatoma maculata. The overall T. cruzi infection rate for R. pallescens and R. prolixus was 56.1 and 100% respectively, while T. dimidiata and T. maculata were not infected. Eight feeding sources were found for the infected triatomines, with opossum and humans being the most frequent sources of feeding (85.7%). Infection was most common in the common opossum Didelphis marsupialis, with infection levels of 77.7%. Sylvatic TcI was the most frequent genotype, found in 80% of triatomines and 75% of D. marsupialis. Of the samples collected from dogs (n = 52), five (9.6%; 95% confidence interval: 3.20-21.03) were seropositive based on two independent tests. Four of these dogs were creole and one was a working dog. The spatial analysis revealed a sympatry between infected vectors and mammals with the military population. CONCLUSIONS We have shown a potential risk of spillover of sylvatic T. cruzi transmission to humans by oral and vectorial transmission in two BITER installations in Colombia. The results indicate that installations where 100,000 active military personnel carry out training activities should be prioritized for epidemiological surveillance of Chagas disease.
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Affiliation(s)
- Omar Cantillo-Barraza
- Grupo de Investigación en Enfermedades Tropicales del Ejército (GINETEJ), Laboratorio de Referencia E Investigación, Dirección de Sanidad Ejército, Bogotaá, Colombia
| | - Jeffer Torres
- Grupo de Investigación en Enfermedades Tropicales del Ejército (GINETEJ), Laboratorio de Referencia E Investigación, Dirección de Sanidad Ejército, Bogotaá, Colombia
| | - Carolina Hernández
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia.,Centro de Tecnología en Salud (CETESA), Innovaseq SAS, Bogotá, Colombia
| | - Yanira Romero
- Grupo de Investigación en Enfermedades Tropicales del Ejército (GINETEJ), Laboratorio de Referencia E Investigación, Dirección de Sanidad Ejército, Bogotaá, Colombia
| | - Sara Zuluaga
- Grupo Biología Y Control de Enfermedades Infecciosas (BCEI), Universidad de Antioquia, Calle 70 No. 52-21, Medellín, Colombia
| | - Camilo A Correa-Cárdenas
- Grupo de Investigación en Enfermedades Tropicales del Ejército (GINETEJ), Laboratorio de Referencia E Investigación, Dirección de Sanidad Ejército, Bogotaá, Colombia
| | - Giovanny Herrera
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Omaira Rodríguez
- Grupo de Investigación en Enfermedades Tropicales del Ejército (GINETEJ), Laboratorio de Referencia E Investigación, Dirección de Sanidad Ejército, Bogotaá, Colombia
| | - María Teresa Alvarado
- Grupo de Investigación en Enfermedades Tropicales del Ejército (GINETEJ), Laboratorio de Referencia E Investigación, Dirección de Sanidad Ejército, Bogotaá, Colombia
| | - Juan David Ramírez
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Claudia Méndez
- Grupo de Investigación en Enfermedades Tropicales del Ejército (GINETEJ), Laboratorio de Referencia E Investigación, Dirección de Sanidad Ejército, Bogotaá, Colombia.
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Rincón-Acevedo CY, Parada-García AS, Olivera MJ, Torres-Torres F, Zuleta-Dueñas LP, Hernández C, Ramírez JD. Clinical and Epidemiological Characterization of Acute Chagas Disease in Casanare, Eastern Colombia, 2012-2020. Front Med (Lausanne) 2021; 8:681635. [PMID: 34368188 PMCID: PMC8343227 DOI: 10.3389/fmed.2021.681635] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 06/29/2021] [Indexed: 12/29/2022] Open
Abstract
Background: Chagas disease (CD), caused by the protozoan Trypanosoma cruzi, is considered a public health problem in Latin America. In Colombia, it affects more than 437,000 inhabitants, mainly in Casanare, an endemic region with eco-epidemiological characteristics that favor its transmission. The objective of this study was to describe the clinical and epidemiological characteristics of the cases of acute CD in Casanare, eastern Colombia, in the period 2012–2020. Methods: In the present study, 103 medical records of confirmed cases of acute CD were reviewed. The departmental/national incidence and fatality were compared by year; the climatological data of mean temperature, relative humidity, and precipitation per year were reviewed and plotted at IDEAM (Colombian Meteorology Institute) concerning the number of cases of acute CD per month, and it was compared with the frequency of triatomines collected in infested houses by community surveillance. Univariate, bivariate, and multivariate analyses were performed, comparing symptoms and signs according to transmission routes, complications, and age groups. Results: The incidence was 3.16 cases per 100,000 inhabitants, and the fatality rate was 20% in the study period. The most frequent symptoms included: fever 98.1%, myalgia 62.1%, arthralgia 60.2%, and headache 49.5%. There were significant differences in the frequency of myalgia, abdominal pain, and periorbital edema in oral transmission. The main complications were pericardial effusion, myocarditis, and heart failure in the group over 18 years of age. In Casanare, TcI Discrete Typing Unit (DTU) has mainly been identified in humans, triatomines, and reservoirs such as opossums and dogs and TcBat in bats. An increase in the number of acute CD cases was evidenced in March, a period when precipitation increases due to the beginning of the rainy season. Conclusions: The results corroborate the symptomatic heterogeneity of the acute phase of CD, which delays treatment, triggering possible clinical complications. In endemic regions, clinical suspicion, diagnostic capacity, detection, and surveillance programs should be strengthened, including intersectoral public health policies for their prevention and control.
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Affiliation(s)
- Claudia Yaneth Rincón-Acevedo
- Centro de Investigaciones en Microbiología y Biotecnología-UR, Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia.,Maestría en Salud Pública, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | - Andrea Stella Parada-García
- Centro de Investigaciones en Microbiología y Biotecnología-UR, Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia.,Maestría en Salud Pública, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | | | | | | | - Carolina Hernández
- Centro de Investigaciones en Microbiología y Biotecnología-UR, Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Juan David Ramírez
- Centro de Investigaciones en Microbiología y Biotecnología-UR, Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
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Quintero WL, Moreno EM, Pinto SML, Sanabria SM, Stashenko E, García LT. Immunomodulatory, trypanocide, and antioxidant properties of essential oil fractions of Lippia alba (Verbenaceae). BMC Complement Med Ther 2021; 21:187. [PMID: 34215249 PMCID: PMC8254251 DOI: 10.1186/s12906-021-03347-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 06/07/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Parasite persistence, exacerbated and sustained immune response, and continuous oxidative stress have been described to contribute to the development of the cardiac manifestations in Chronic Chagas Disease. Nevertheless, there are no efficient therapies to resolve the Trypanosoma cruzi infection and prevent the disease progression. Interestingly, trypanocide, antioxidant, and immunodulatory properties have been reported separately for some major terpenes, as citral (neral plus geranial), limonene, and caryophyllene oxide, presents in essential oils (EO) extracted from two chemotypes (Citral and Carvone) of Lippia alba. The aim of this study was to obtain L. alba essential oil fractions enriched with the aforementioned bioactive terpenes and to evaluate the impact of these therapies on trypanocide, oxidative stress, mitochondrial bioenergetics, genotoxicity, and inflammatory markers on T. cruzi-infected macrophages. METHODS T. cruzi-infected J774A.1 macrophage were treated with limonene-enriched (ACT1) and citral/caryophyllene oxide-enriched (ACT2) essential oils fractions derived from Carvone and Citral-L. alba chemotypes, respectively. RESULTS ACT1 (IC50 = 45 ± 1.7 μg/mL) and ACT2 (IC50 = 80 ± 1.9 μg/mL) exhibit similar trypanocidal effects to Benznidazole (BZN) (IC50 = 48 ± 2.5 μg/mL), against amastigotes. Synergistic antiparasitic activity was observed when ACT1 was combined with BZN (∑FIC = 0.52 ± 0.13 μg/mL) or ACT2 (∑FIC = 0.46 ± 1.7 μg/mL). ACT1 also decreased the oxidative stress, mitochondrial metabolism, and genotoxicity of the therapies. The ACT1 + ACT2 and ACT1 + BZN experimental treatments reduced the pro-inflammatory cytokines (IFN-γ, IL-2, and TNF-α) and increased the anti-inflammatory cytokines (IL-4 and IL-10). CONCLUSION Due to its highly trypanocidal and immunomodulatory properties, ACT1 (whether alone or in combination with BZN or ACT2) represents a promising L. alba essential oil fraction for further studies in drug development towards the Chagas disease control.
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Affiliation(s)
- Wendy Lorena Quintero
- Infectious Disease Research Program, Universidad de Santander, Bucaramanga, Santander Colombia 680006
| | - Erika Marcela Moreno
- Infectious Disease Research Program, Universidad de Santander, Bucaramanga, Santander Colombia 680006
| | - Sandra Milena Leal Pinto
- Infectious Disease Research Program, Universidad de Santander, Bucaramanga, Santander Colombia 680006
| | | | - Elena Stashenko
- National Research Center for the Agroindustrialization of Aromatic and Medicinal Tropical Species (CENIVAM), Universidad Industrial de Santander, Bucaramanga, Colombia 680002
| | - Liliana Torcoroma García
- Infectious Disease Research Program, Universidad de Santander, Bucaramanga, Santander Colombia 680006
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Rodriguez-Morales AJ, Paniz-Mondolfi AE, Faccini-Martínez ÁA, Henao-Martínez AF, Ruiz-Saenz J, Martinez-Gutierrez M, Alvarado-Arnez LE, Gomez-Marin JE, Bueno-Marí R, Carrero Y, Villamil-Gomez WE, Bonilla-Aldana DK, Haque U, Ramirez JD, Navarro JC, Lloveras S, Arteaga-Livias K, Casalone C, Maguiña JL, Escobedo AA, Hidalgo M, Bandeira AC, Mattar S, Cardona-Ospina JA, Suárez JA. The Constant Threat of Zoonotic and Vector-Borne Emerging Tropical Diseases: Living on the Edge. Front Trop Dis 2021; 2:676905. [PMID: 34010366 PMCID: PMC8132189 DOI: 10.3389/fitd.2021.676905] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 04/06/2021] [Indexed: 12/20/2022] Open
Affiliation(s)
- Alfonso J. Rodriguez-Morales
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundacion Universitaria Autonoma de las Americas, Pereira, Colombia
- Emerging Infectious Diseases and Tropical Medicine Research Group, Instituto para la Investigación en Ciencias Biomédicas - Sci-Help, Pereira, Colombia
- Coordinación Nacional de Investigación, Universidad Privada Franz Tamayo (UNIFRANZ), Cochabamba, Bolivia
- Master Program on Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru
| | - Alberto E. Paniz-Mondolfi
- Department of Pathology, Molecular and Cell-Based Medicine, Laboratory of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Instituto de Investigaciones Biomédicas IDB/Incubadora Venezolana de la Ciencia, Barquisimeto, Venezuela
| | | | - Andrés F. Henao-Martínez
- Department of Medicine, Division of Infectious Diseases, School of Medicine, University of Colorado Denver, Aurora, CO, United States
| | - Julian Ruiz-Saenz
- Grupo de Investigación en Ciencias Animales - GRICA, Facultad de Medicina Veterinaria y Zootecnia, Universidad Cooperativa de Colombia, Bucaramanga, Colombia
| | - Marlen Martinez-Gutierrez
- Grupo de Investigación en Ciencias Animales - GRICA, Facultad de Medicina Veterinaria y Zootecnia, Universidad Cooperativa de Colombia, Bucaramanga, Colombia
- Infettare, Facultad de Medicina, Universidad Cooperativa de Colombia, Medellín, Colombia
| | - Lucia E. Alvarado-Arnez
- Coordinación Nacional de Investigación, Universidad Privada Franz Tamayo (UNIFRANZ), Cochabamba, Bolivia
| | - Jorge E. Gomez-Marin
- Grupo de Estudio en Parasitologia Molecular (GEPAMOL) Group, Facultad de Ciencias de la Salud, Universidad del Quindío, Armenia, Colombia
| | - Ruben Bueno-Marí
- Departamento de Investigación y Desarrollo (I+D), Laboratorios Lokímica, Paterna, Spain
- Área de Parasitología, Departamento de Farmacia y Tecnología Farmaceútica y Parasitología, Universidad de Valencia, Burjasot, Spain
| | - Yenddy Carrero
- Facultad de Ciencias de la Salud, Carrera de Medicina, Universidad Técnica de Ambato, Ambato, Ecuador
| | - Wilmer E. Villamil-Gomez
- Infectious Diseases and Infection Control Research Group, Hospital Universitario de Sincelejo, Sincelejo, Colombia
- Programa Del Doctorado de Medicina Tropical, SUE Caribe, Universidad Del Atlántico, Barranquilla, Colombia
| | - D. Katterine Bonilla-Aldana
- Semillero de Investigación en Zoonosis (SIZOO), Grupo de Investigación BIOECOS, Fundacion Universitaria Autonoma de las Americas, Pereira, Colombia
| | - Ubydul Haque
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Juan D. Ramirez
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Juan-Carlos Navarro
- Research Group of Emerging Diseases, Ecoepidemiology and Biodiversity, Health Sciences Faculty, Universidad Internacional SEK, Quito, Ecuador
| | - Susana Lloveras
- Sección Zoopatología Médica, Hospital de Infecciosas FJ Muñiz, Buenos Aires, Argentina
| | - Kovy Arteaga-Livias
- Master Program on Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru
- Faculty of Medicine, Universidad Nacional Hermilio Valdizán, Huánuco, Peru
| | | | - Jorge L. Maguiña
- Master Program on Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru
| | - Angel A. Escobedo
- Department of Epidemiology, Institute of Gastroenterology, Havana, Cuba
| | - Marylin Hidalgo
- Infectious Diseases Group, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | - Salim Mattar
- Instituto de Investigaciones Biologicas del Tropico, Universidad de Cordoba, Monteria, Colombia
| | - Jaime A. Cardona-Ospina
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundacion Universitaria Autonoma de las Americas, Pereira, Colombia
- Emerging Infectious Diseases and Tropical Medicine Research Group, Instituto para la Investigación en Ciencias Biomédicas - Sci-Help, Pereira, Colombia
| | - Jose A. Suárez
- Investigador SNI Senacyt Panamá, Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama, Panama
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Muñoz-Calderón A, Díaz-Bello Z, Alarcón de Noya B, Noya-González OO, Schijman AG. Characterization and Follow-Up of Trypanosoma cruzi Natural Populations Refractory to Etiological Chemotherapy in Oral Chagas Disease Patients. Front Cell Infect Microbiol 2021; 11:665063. [PMID: 33996636 PMCID: PMC8121101 DOI: 10.3389/fcimb.2021.665063] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 04/12/2021] [Indexed: 11/13/2022] Open
Abstract
We aimed to characterize the genetic constitution of natural T. cruzi populations involved in an Oral Chagas Disease (OCD) outbreak at a rural school of the community of Chichiriviche de la Costa, Venezuela, which affected patients did not respond to the etiological treatment. Peripheral blood samples and/or hemocultures were obtained from twenty-nine OCD patients at time of diagnosis or along nine years of Post-treatment (Tx) follow-up. The IgG serology, T. cruzi discrete typing units (DTU), satellite DNA-qPCR parasitic loads, and minicircle signatures were determined at Pre-Tx and after Tx. The serological titles and parasitic loads changed after treatment, with a significant decrease of IgG titers (Spearman’s r value= -0.961) and median parasite loads from 2.869 [IQR = 2.113 to 3.720] to 0.105 [IQR = -1.147 to 1.761] log10 par eq. /mL at Pre-Tx and Post-Tx, respectively, suggesting infection evolution from acute to chronic phase, without seroconversion or parasitological eradication, which was indicative of treatment failure. All patients were infected with T. cruzi DTU I populations. At Pre-Tx their median Jaccard genetic distances were 0.775 [IQR = 0.708 to 0.882], decreasing in genetic variability towards the end of follow-up (Mann-Whitney U test p= 0.0031). Interestingly, no Post-Tx minicircle signature was identical to its Pre-Tx counterpart population in a same patient, revealing selection of parasite subpopulations between the primary infection and Post-Tx. The parasitic populations isolated from hemocultures showed a lower number of bands in the minicircle signatures with respect to the signatures obtained directly from the patients’ blood samples, demonstrating a process of parasitic selection and reduction of the population variability that initially infected the patients. Decrease of parasitic loads after treatment as well as Pre- and Post-Tx intra-TcI diversity might be a consequence of both, natural evolution of the acute infection to the chronic phase and persistence of refractory populations due to Tx selection.
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Affiliation(s)
- Arturo Muñoz-Calderón
- Laboratorio de Biología Molecular de la Enfermedad de Chagas, Instituto de Investigaciones en Ingeniería Genética y Biología Molecular (INGEBI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Zoraida Díaz-Bello
- Instituto de Medicina Tropical "Dr Félix Pifano", Universidad Central de Venezuela, Caracas, Venezuela
| | | | - Oscar O Noya-González
- Instituto de Medicina Tropical "Dr Félix Pifano", Universidad Central de Venezuela, Caracas, Venezuela
| | - Alejandro G Schijman
- Laboratorio de Biología Molecular de la Enfermedad de Chagas, Instituto de Investigaciones en Ingeniería Genética y Biología Molecular (INGEBI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
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8
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Díaz ALM, Pregonero Sigua F, Otálora AS, Pedraza Bernal AM. Trypanosoma cruzi seroprevalence and associated factors in women in Casanare-Colombia. J Parasit Dis 2021; 45:89-95. [PMID: 33746391 DOI: 10.1007/s12639-020-01280-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 09/22/2020] [Indexed: 10/23/2022] Open
Abstract
Chagas disease is caused by the parasite Trypanosoma cruzi and transmitted mainly by triatomines and from mothers to children. In Colombia, this disease is a public health problem and due to its high endemicity and vertical transmission, women are susceptible populations that must be evaluated. Our objective was to determinate the Trypanosoma cruzi seroprevalence and factors associated with women in Pore (Municipality), Casanare, Colombia. Cross-sectional study. A sample of 230 healthy volunteer women, 15 years or older, without previous diagnosis of Chagas disease was taken; the serological analysis was done using the Chagas ELISA IgG and IgM and indirect Hemagglutination (HAI) technique. In addition, a survey was applied to each participant in order to explore the presence of factors that could be associated with a positive test result. The seropostitivity found in Pore Casanare's women was 16.9% (39/230, 95% CI 12.1-21.7), additionally it was found that rural origin, the coexistence with animals, especially chickens, age, low level schooling and housing material are factors associated with T. cruzi infection in this population. The results of this study indicate the importance of conducting extensive seroepidemiological studies in populations of endemic areas, due to the difficulty in detecting cases in the acute phase; therefore, screening allows the establishment of a follow-up and treatment time line that contributes to the interruption of the transmission vertical.
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9
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Vivas RJ, García JE, Guhl F, Hernández C, Velásquez N, Ramírez JD, Carranza JC, Vallejo GA. Systematic review on the biology, ecology, genetic diversity and parasite transmission potential of Panstrongylus geniculatus (Latreille 1811) in Latin America. Mem Inst Oswaldo Cruz 2021; 116:e200528. [PMID: 33656141 PMCID: PMC7919531 DOI: 10.1590/0074-02760200528] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 01/26/2021] [Indexed: 11/21/2022] Open
Abstract
Panstrongylus geniculatus (Latreille, 1811) is the triatomine with the largest geographic distribution in Latin America. It has been reported in 18 countries from southern Mexico to northern Argentina, including the Caribbean islands. Although most reports indicate that P. geniculatus has wild habitats, this species has intrusive habits regarding human dwellings mainly located in intermediate deforested areas. It is attracted by artificial light from urban and rural buildings, raising the risk of transmission of Trypanosoma cruzi. Despite the wide body of published information on P. geniculatus, many knowledge gaps exist about its biology and epidemiological potential. For this reason, we analysed the literature for P. geniculatus in Scopus, PubMed, Scielo, Google Scholar and the BibTriv3.0 databases to update existing knowledge and provide better information on its geographic distribution, life cycle, genetic diversity, evidence of intrusion and domiciliation, vector-related circulating discrete taxonomic units, possible role in oral T. cruzi transmission, and the effect of climate change on its biology and epidemiology.
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Affiliation(s)
- Ricardo José Vivas
- Universidad del Tolima, Laboratorio de Investigaciones en Parasitología Tropical, Ibagué, Colombia
| | - Jorge Enrique García
- Universidad de Ibagué, Facultad de Ciencias Naturales y Matemáticas, Ibagué, Colombia
| | - Felipe Guhl
- Universidad de los Andes, Centro de Investigaciones en Microbiología y Parasitología Tropical, Bogotá, Colombia
| | - Carolina Hernández
- Universidad del Rosario, Facultad de Ciencias Naturales y Matemáticas, Departamento de Biología, Grupo de Investigaciones Microbiológicas, Bogotá, Colombia
| | - Natalia Velásquez
- Universidad del Rosario, Facultad de Ciencias Naturales y Matemáticas, Departamento de Biología, Grupo de Investigaciones Microbiológicas, Bogotá, Colombia
| | - Juan David Ramírez
- Universidad del Rosario, Facultad de Ciencias Naturales y Matemáticas, Departamento de Biología, Grupo de Investigaciones Microbiológicas, Bogotá, Colombia
| | - Julio César Carranza
- Universidad del Tolima, Laboratorio de Investigaciones en Parasitología Tropical, Ibagué, Colombia
| | - Gustavo Adolfo Vallejo
- Universidad del Tolima, Laboratorio de Investigaciones en Parasitología Tropical, Ibagué, Colombia
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10
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Domingues CS, Cardoso FDO, Hardoim DDJ, Pelajo-Machado M, Bertho AL, Calabrese KDS. Host Genetics Background Influence in the Intragastric Trypanosoma cruzi Infection. Front Immunol 2020; 11:566476. [PMID: 33329529 PMCID: PMC7732431 DOI: 10.3389/fimmu.2020.566476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 10/23/2020] [Indexed: 01/21/2023] Open
Abstract
Background Considering the complexity of the factors involved in the immunopathology of Chagas disease, which influence the Chagas' disease pathogenesis, anti-T. cruzi immune response, and chemotherapy outcome, further studies are needed to improve our understanding about these relationships. On this way, in this article we analyzed the host genetic influence on hematological, histopathological and immunological aspects after T. cruzi infection. Methods BALB/c and A mice were intragastrically infected with T. cruzi SC2005 strain, isolated from a patient of an outbreak of Chagas disease. Parameters such as parasite load, survival rates, cytokines production, macrophages, T and B cell frequencies, and histopathology analysis were carried out. Results BALB/c mice presented higher parasitemia and mortality rates than A mice. Both mouse lineages exhibited hematological alterations suggestive of microcytic hypochromic anemia and histopathological alterations in stomach, heart and liver. The increase of CD8+ T cells, in heart, liver and blood, and the increase of CD19+ B cells, in liver, associated with a high level of proinflammatory cytokines (IL-6, TNF-α, IFN-γ), confer a resistance profile to the host. Although BALB/c animals exhibited the same findings observed in A mice, the response to infection occurred later, after a considerable parasitemia increase. By developing an early response to the infection, A mice were found to be less susceptible to T. cruzi SC2005 infection. Conclusions Host genetics background shaping the response to infection. The early development of a cytotoxic cellular response profile with the production of proinflammatory cytokines is important to lead a less severe manifestation of Chagas disease.
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Affiliation(s)
- Carolina Salles Domingues
- Laboratório de Imunomodulação e Protozoologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Flávia de Oliveira Cardoso
- Laboratório de Imunomodulação e Protozoologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Daiana de Jesus Hardoim
- Laboratório de Imunomodulação e Protozoologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Marcelo Pelajo-Machado
- Laboratório de Patologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Alvaro Luiz Bertho
- Laboratório de Imunoparasitologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- Plataforma de Citometria de Fluxo, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Kátia da Silva Calabrese
- Laboratório de Imunomodulação e Protozoologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
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11
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Cantillo-Barraza O, Bedoya SC, Xavier SC, Zuluaga S, Salazar B, Vélez-Mira A, Carrillo LM, Triana-Chávez O. Trypanosoma cruzi infection in domestic and synanthropic mammals such as potential risk of sylvatic transmission in a rural area from north of Antioquia, Colombia. Parasite Epidemiol Control 2020; 11:e00171. [PMID: 32875129 PMCID: PMC7452044 DOI: 10.1016/j.parepi.2020.e00171] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/25/2020] [Accepted: 07/26/2020] [Indexed: 12/11/2022] Open
Abstract
In Colombia, dogs and opossum are the most important mammals in domestic and sylvatic T. cruzi transmission. However, the role of both species has not been evaluated in areas where both species converge in the peridomestic area. To evaluate the infection status of domestic and wild mammals in peridomestic habitats of Puerto Valdivia, Antioquia Department. The infection of domestic dogs and small wild mammals was performed by hemoculture, molecular and serological methods. Additionally, the infection in children under 15 years old and triatomine searches was carried out. We found that 16.07% and 34% dogs, and 59.1% and 61.1% Didelphis marsupialis were found positive by molecular and serological methods respectively. Moreover, in 25% and 75% of the infected dogs were detected TcIDom and TcI sylvatic, respectively, while all the D. marsupialis were infected with TcI. Six Rattus rattus and three Proechimys semispinosus were captured but without T. cruzi infection. Finally, none of the 82 children were positive and no triatomine bugs were captured. D. marsupialis and domestics dogs have an important role in the transmission of T. cruzi suggesting a potential risk in T. cruzi transitions areas.
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Affiliation(s)
- Omar Cantillo-Barraza
- Grupo Biología y Control de Enfermedades Infecciosas BCEI, Universidad de Antioquia, Calle 70 No. 52-21, Medellín, Colombia
- Corresponding author at: Sede de Investigación Universitaria (SIU), Calle 70 No. 52-21, Medellín, Colombia.
| | - Sindy Carolina Bedoya
- Grupo Biología y Control de Enfermedades Infecciosas BCEI, Universidad de Antioquia, Calle 70 No. 52-21, Medellín, Colombia
| | - Samanta C.C. Xavier
- Laboratory of Trypanosomatid Biology, Oswaldo Cruz Institute, FIOCRUZ., Fundaçao Oswaldo Cruz (FIOCRUZ), Av. Brasil 4365, 21040-360 Rio de Janeiro, RJ, Brazil
| | - Sara Zuluaga
- Grupo Biología y Control de Enfermedades Infecciosas BCEI, Universidad de Antioquia, Calle 70 No. 52-21, Medellín, Colombia
| | - Bibiana Salazar
- Grupo Biología y Control de Enfermedades Infecciosas BCEI, Universidad de Antioquia, Calle 70 No. 52-21, Medellín, Colombia
| | - Andrés Vélez-Mira
- Programa para el Estudio y Control de Enfermedades Tropicales PECET, Universidad de Antioquia, Calle 70 No. 52-21, Medellín, Colombia
| | - Lina María Carrillo
- Programa para el Estudio y Control de Enfermedades Tropicales PECET, Universidad de Antioquia, Calle 70 No. 52-21, Medellín, Colombia
| | - Omar Triana-Chávez
- Grupo Biología y Control de Enfermedades Infecciosas BCEI, Universidad de Antioquia, Calle 70 No. 52-21, Medellín, Colombia
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12
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Echeverría LE, González CI, Hernandez JCM, Díaz ML, Eduardo Nieto J, López-Romero LA, Rivera JD, Suárez EU, Ochoa SAG, Rojas LZ, Morillo CA. Efficacy of the Benznidazole+Posaconazole combination therapy in parasitemia reduction: An experimental murine model of acute Chagas. Rev Soc Bras Med Trop 2020; 53:e20190477. [PMID: 32049205 PMCID: PMC7083359 DOI: 10.1590/0037-8682-0477-2019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 10/11/2019] [Accepted: 12/12/2019] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION: Benznidazole (BZL) and Nifurtimox (NFX) are the pharmacological treatment
for acute phase Chagas Disease (CD); however, therapy resistance and
residual mortality development remain important unresolved issues.
Posaconazole (POS) has shown a trypanocidal effect in vivo and in vitro.
Thus, this study aimed at comparing the T. Cruzi parasitic
load-reducing effect of the combination of BZL+POS against that of
monotherapy with either, during acute phase CD, in an experimental murine
model. METHODS Nineteen Wistar rats were randomly allocated to four groups
and inoculated with the trypomastigotes of T. cruzi
strain´s JChVcl1. The rats were administered anti-parasites from day 20-29
post-infection. The Pizzi and Brener method was used for parasitemia
measurement. Longitudinal data analysis for the continuous outcome of
repeated measures was performed using parasitemia as the outcome measured at
days 20, 22, 24, 27, and 29 post-infection. RESULTS All four groups had similar parasitic loads (p=0.143) prior to therapy
initiation. Among the three treatment groups, the BZL+POS (n=5) group showed
the highest mean parasitic load reduction (p=0.000) compared with the
control group. Likewise, the BZL+POS group rats showed an earlier
therapeutic effect and were the only ones without parasites in their
myocardial samples. CONCLUSIONS: Treatment of acute phase CD with BZL+POS was more efficacious at parasitemia
and myocardial injury reduction, compared with monotherapy with either.
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Affiliation(s)
- Luis Eduardo Echeverría
- Grupo de Estudios Epidemiológicos y Salud Pública-FCV, Fundación Cardiovascular de Colombia, Floridablanca, Colombia.,Heart Failure and Heart Transplant Clinic, Fundación Cardiovascular de Colombia, Floridablanca, Colombia
| | - Clara Isabel González
- Basic Sciences Department, Faculty of Medicine. Universidad Industrial de Santander. Grupo de Inmunología y Epidemiología Molecular GIEM, Santander, Bucaramanga, Colombia
| | - Julio Cesar Mantilla Hernandez
- Basic Sciences Department, Faculty of Medicine. Universidad Industrial de Santander. Grupo de Inmunología y Epidemiología Molecular GIEM, Santander, Bucaramanga, Colombia
| | - Martha Lucia Díaz
- Basic Sciences Department, Faculty of Medicine. Universidad Industrial de Santander. Grupo de Inmunología y Epidemiología Molecular GIEM, Santander, Bucaramanga, Colombia
| | - Javier Eduardo Nieto
- Veterinary Department. Universidad Cooperativa de Colombia, Bucaramanga, Santander, Colombia
| | - Luis Alberto López-Romero
- Research Group and Development of Nursing Knowledge (GIDCEN-FCV), Research Institute, Fundación Cardiovascular de Colombia, Floridablanca, Santander, Colombia
| | - Julián David Rivera
- Heart Failure and Heart Transplant Clinic, Fundación Cardiovascular de Colombia, Floridablanca, Colombia
| | - Edwin Uriel Suárez
- Heart Failure and Heart Transplant Clinic, Fundación Cardiovascular de Colombia, Floridablanca, Colombia
| | - Sergio Alejandro Gómez Ochoa
- Grupo de Estudios Epidemiológicos y Salud Pública-FCV, Fundación Cardiovascular de Colombia, Floridablanca, Colombia
| | - Lyda Z Rojas
- Research Group and Development of Nursing Knowledge (GIDCEN-FCV), Research Institute, Fundación Cardiovascular de Colombia, Floridablanca, Santander, Colombia
| | - Carlos A Morillo
- Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada.,Department of Medicine, Cardiology Division, McMaster University, PHRI-HHSC, Hamilton, Ontario, Canada
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13
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Batista C, Forsyth CJ, Herazo R, Certo MP, Marchiol A. A four-step process for building sustainable access to diagnosis and treatment of Chagas disease. Rev Panam Salud Publica 2019; 43:e74. [PMID: 31582959 PMCID: PMC6758842 DOI: 10.26633/rpsp.2019.74] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 07/16/2019] [Indexed: 02/04/2023] Open
Abstract
The vast majority of people with Chagas disease (CD) are undiagnosed and untreated. Improving access to diagnosis and treatment for CD involves confronting a wide range of barriers. This report discusses a collaborative approach to eliminate barriers and increase the availability of CD testing and treatment. Potential areas for intervention are selected based on burden of disease, support of local champions, and commitment from national and local authorities. A 4D approach (diagnose, design, deliver, and demonstrate impact) is then implemented. The diagnose step involves gathering key stakeholders at a seminar to collaboratively identify important barriers and propose solutions. The design step creates a specific plan to act upon the seminar’s conclusions with consensus on core indicators. The deliver step entails implementing the plan at pilot locations, while simultaneously strengthening health system capacity for CD testing and treatment. Lastly, the demonstrate impact step compares baseline data with annual post-implementation data to measure progress. In Colombia, this approach has helped simplify testing procedures and increase CD testing and treatment access in pilot communities, though challenges remain. The 4D approach represents one of several pathways toward ensuring that the best therapeutic and diagnostic products reach people affected by neglected tropical diseases.
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Affiliation(s)
- Carolina Batista
- Drugs for Neglected Diseases initiative, Chagas Treatment Access Project Drugs for Neglected Diseases initiative, Chagas Treatment Access Project Geneva Switzerland Drugs for Neglected Diseases initiative, Chagas Treatment Access Project, Geneva, Switzerland
| | - Colin J Forsyth
- Drugs for Neglected Diseases initiative, Chagas Treatment Access Project Drugs for Neglected Diseases initiative, Chagas Treatment Access Project Geneva Switzerland Drugs for Neglected Diseases initiative, Chagas Treatment Access Project, Geneva, Switzerland
| | - Rafael Herazo
- Drugs for Neglected Diseases initiative, Chagas Treatment Access Project Drugs for Neglected Diseases initiative, Chagas Treatment Access Project Geneva Switzerland Drugs for Neglected Diseases initiative, Chagas Treatment Access Project, Geneva, Switzerland
| | - Marina Pereira Certo
- Drugs for Neglected Diseases initiative, Chagas Treatment Access Project Drugs for Neglected Diseases initiative, Chagas Treatment Access Project Geneva Switzerland Drugs for Neglected Diseases initiative, Chagas Treatment Access Project, Geneva, Switzerland
| | - Andrea Marchiol
- Drugs for Neglected Diseases initiative, Chagas Treatment Access Project Drugs for Neglected Diseases initiative, Chagas Treatment Access Project Geneva Switzerland Drugs for Neglected Diseases initiative, Chagas Treatment Access Project, Geneva, Switzerland
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14
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Abstract
Chagas disease (CD) persists as one of the neglected tropical diseases (NTDs) with a particularly large impact in the Americas. The World Health Organization (WHO) recently proposed goals for CD elimination as a public health problem to be reached by 2030 by means of achieving intradomiciliary transmission interruption (IDTI), blood transfusion and transplant transmission interruption, diagnostic and treatment scaling-up and prevention and control of congenital transmission. The NTD Modelling Consortium has developed mathematical models to study
Trypanosoma cruzi transmission dynamics and the potential impact of control measures. Modelling insights have shown that IDTI is feasible in areas with sustained vector control programmes and no presence of native triatomine vector populations. However, IDTI in areas with native vectors it is not feasible in a sustainable manner. Combining vector control with trypanocidal treatment can reduce the timeframes necessary to reach operational thresholds for IDTI (<2% seroprevalence in children aged <5 years), but the most informative age groups for serological monitoring are yet to be identified. Measuring progress towards the 2030 goals will require availability of vector surveillance and seroprevalence data at a fine scale, and a more active surveillance system, as well as a better understanding of the risks of vector re-colonization and disease resurgence after vector control cessation. Also, achieving scaling-up in terms of access to treatment to the expected levels (75%) will require a substantial increase in screening asymptomatic populations, which is anticipated to become very costly as CD prevalence decreases. Further modelling work includes refining and extending mathematical models (including transmission dynamics and statistical frameworks) to predict transmission at a sub-national scale, and developing quantitative tools to inform IDTI certification, post-certification and re-certification protocols. Potential perverse incentives associated with operational thresholds are discussed. These modelling insights aim to inform discussions on the goals and treatment guidelines for CD.
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15
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Gómez Marín JE, El Bissati K. Editorial: Innovative Therapeutic and Immunomodulatory Strategies for Protozoan Infections. Front Cell Infect Microbiol 2019; 9:293. [PMID: 31448246 PMCID: PMC6695569 DOI: 10.3389/fcimb.2019.00293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 07/30/2019] [Indexed: 11/13/2022] Open
Affiliation(s)
- Jorge Enrique Gómez Marín
- Grupo GEPAMOL, Centro Investigaciones Biomédicas, Facultad de Ciencias de la Salud, Universidad del Quindío, Armenia, Colombia
| | - Kamal El Bissati
- Institute for Molecular Engineering, University of Chicago Medical Center, Chicago, IL, United States
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16
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Mateus J, Guerrero P, Lasso P, Cuervo C, González JM, Puerta CJ, Cuéllar A. An Animal Model of Acute and Chronic Chagas Disease With the Reticulotropic Y Strain of Trypanosoma cruzi That Depicts the Multifunctionality and Dysfunctionality of T Cells. Front Immunol 2019; 10:918. [PMID: 31105709 PMCID: PMC6499084 DOI: 10.3389/fimmu.2019.00918] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 04/09/2019] [Indexed: 12/15/2022] Open
Abstract
Chagas disease (ChD), a complex and persistent parasitosis caused by Trypanosoma cruzi, represents a natural model of chronic infection, in which some people exhibit cardiac or digestive complications that can result in death 20–40 years after the initial infection. Nonetheless, due to unknown mechanisms, some T. cruzi-infected individuals remain asymptomatic throughout their lives. Actually, no vaccine is available to prevent ChD, and treatments for chronic ChD patients are controversial. Chronically T. cruzi-infected individuals exhibit a deterioration of T cell function, an exhaustion state characterized by poor cytokine production and increased inhibitory receptor co-expression, suggesting that these changes are potentially related to ChD progression. Moreover, an effective anti-parasitic treatment appears to reverse this state and improve the T cell response. Taking into account these findings, the functionality state of T cells might provide a potential correlate of protection to detect individuals who will or will not develop the severe forms of ChD. Consequently, we investigated the T cell response, analyzed by flow cytometry with two multicolor immunofluorescence panels, to assess cytokines/cytotoxic molecules and the expression of inhibitory receptors, in a murine model of acute (10 and 30 days) and chronic (100 and 260 days) ChD, characterized by parasite persistence for up to 260 days post-infection and moderate inflammation of the colon and liver of T. cruzi-infected mice. Acute ChD induced a high antigen-specific multifunctional T cell response by producing IFN-γ, TNF-α, IL-2, granzyme B, and perforin; and a high frequency of T cells co-expressed 2B4, CD160, CTLA-4, and PD-1. In contrast, chronically infected mice with moderate inflammatory infiltrate in liver tissue exhibited monofunctional antigen-specific cells, high cytotoxic activity (granzyme B and perforin), and elevated levels of inhibitory receptors (predominantly CTLA-4 and PD-1) co-expressed on T cells. Taken together, these data support our previous results showing that similar to humans, the T. cruzi persistence in mice promotes the dysfunctionality of T cells, and these changes might correlate with ChD progression. Thus, these results constitute a model that will facilitate an in-depth search for immune markers and correlates of protection, as well as long-term studies of new immunotherapy strategies for ChD.
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Affiliation(s)
- Jose Mateus
- Grupo Inmunobiología y Biología Celular, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia.,Grupo de Enfermedades Infecciosas, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Paula Guerrero
- Grupo Inmunobiología y Biología Celular, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Paola Lasso
- Grupo Inmunobiología y Biología Celular, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia.,Grupo de Enfermedades Infecciosas, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Claudia Cuervo
- Grupo de Enfermedades Infecciosas, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - John Mario González
- Grupo de Ciencias Básicas Médicas, Facultad de Medicina, Universidad de los Andes, Bogotá, Colombia
| | - Concepción J Puerta
- Grupo de Enfermedades Infecciosas, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Adriana Cuéllar
- Grupo Inmunobiología y Biología Celular, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
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17
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Villena FE, Gomez-Puerta LA, Jhonston EJ, Del Alcazar OM, Maguiña JL, Albujar C, Laguna-Torres VA, Recuenco SE, Ballard SB, Ampuero JS. First Report of Trypanosoma cruzi Infection in Salivary Gland of Bats from the Peruvian Amazon. Am J Trop Med Hyg 2018; 99:723-728. [PMID: 30014825 PMCID: PMC6169177 DOI: 10.4269/ajtmh.17-0816] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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] [Indexed: 11/07/2022] Open
Abstract
In the Americas, 8 million people are infected with Chagas disease, and an additional 90 million people are at risk for infection. Little is known about the role bats play in the sylvatic transmission cycle of Trypanosoma cruzi, the parasite causing Chagas disease. Here, we captured bats in the villages of Palmiche, Pachacutec, Nuevo San Martin, and Mayuriaga located in the Datem del Marañon Province in Loreto, Peru. Venous blood samples were collected by cardiac puncture or from the upper extremities, and trypanosomatids were identified by microscopy and molecularly. We collected blood samples from 121 bats on filter paper for molecular studies and 111 slides for microscopic examination of thin and thick blood smears from 16 different bat species. The prevalence of trypanosomatids in all bats species was 34.7% (42/121) and the prevalence of T. cruzi was 4.1% (5/121). In hematophagous bat species, the prevalence of trypanosomatids and T. cruzi was 36.9% (27/73) and 2.7% (2/73), respectively. In non-hematophagous bats, the prevalences of trypanosomatids and T. cruzi were 31.2% (15/48) and 6.2% (3/48), respectively. Also, we confirm the presence of T. cruzi in salivary glands of hematophagous bats Diaemus youngi. These results suggest a sylvatic cycle of trypanosomatid transmission in which bats may harbor infectious T. cruzi parasites that could be transmitted to humans via hematophagous bat bites or salivary contamination by non-hematophagous bats of vegetables consumed by humans.
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Affiliation(s)
- Fredy E Villena
- U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru
| | - Luis A Gomez-Puerta
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru.,U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru
| | - Erik J Jhonston
- Facultad de Medicina de la Universidad Nacional de la Amazonia Peruana, Loreto, Peru
| | - O Melisa Del Alcazar
- Departamento de Mastozoología, Museo de Historia Natural, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Jorge L Maguiña
- U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru
| | | | - V Alberto Laguna-Torres
- Instituto de Medicina Tropical Daniel A. Carrión, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Sergio E Recuenco
- Departamento de Medicina Preventiva y Salud Pública, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | | | - Julia S Ampuero
- U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru
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Marchiol A, Forsyth C, Bernal O, Valencia Hernández C, Cucunubá Z, Pachón Abril E, Vera Soto MJ, Batista C. Increasing access to comprehensive care for Chagas disease: development of a patient-centered model in Colombia. Rev Panam Salud Publica 2017; 41:e153. [PMID: 31384272 PMCID: PMC6645187 DOI: 10.26633/rpsp.2017.153] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 08/16/2017] [Indexed: 12/28/2022] Open
Abstract
Worldwide, over 6 million people are infected with Trypanosoma cruzi, the pathogen that causes Chagas disease (CD). In the Americas, CD creates the greatest burden in disability-adjusted life years of any parasitic infection. In Colombia, 437 000 people are infected with T. cruzi, of whom 131 000 suffer from cardiomyopathy. Colombia's annual costs for treating patients with advanced CD reach US$ 175 016 000. Although timely etiological treatment can significantly delay or prevent development of cardiomyopathy-and costs just US$ 30 per patient-fewer than 1% of people with CD in Colombia and elsewhere receive it. This represents a missed opportunity for increasing patients' healthy, productive years of life while significantly reducing the economic burden on the health care system. Key barriers are complexities and delays in the diagnosis and treatment process, lack of awareness of CD among both patients and health care professionals, and administrative barriers at the primary care level. In 2015, stakeholders from government, academia, nongovernmental organizations, and patient associations participated in a seminar in the city of Bogotá on eliminating barriers to diagnosis and treatment for CD. The seminar gave birth to a model of care for increasing patient access, including a patient road map that simplifies diagnostic and treatment processes, shifting them from specialists to primary care facilities. The patient road map was implemented in a pilot project in four endemic communities beginning in 2016, with the goal of testing and refining the model so it can be implemented nationally. This article describes key components in the development of a new, recently implemented model of care for CD in Colombia.
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Affiliation(s)
- Andrea Marchiol
- Drugs for Neglected Diseases initiative Latin America Drugs for Neglected Diseases initiative Latin America Rio de Janeiro Brazil Drugs for Neglected Diseases initiative Latin America, Rio de Janeiro, Brazil
| | - Colin Forsyth
- Drugs for Neglected Diseases initiative Latin America Drugs for Neglected Diseases initiative Latin America Rio de Janeiro Brazil Drugs for Neglected Diseases initiative Latin America, Rio de Janeiro, Brazil
| | - Oscar Bernal
- Drugs for Neglected Diseases initiative Latin America Drugs for Neglected Diseases initiative Latin America Rio de Janeiro Brazil Drugs for Neglected Diseases initiative Latin America, Rio de Janeiro, Brazil
| | - Carlos Valencia Hernández
- Drugs for Neglected Diseases initiative Latin America Drugs for Neglected Diseases initiative Latin America Rio de Janeiro Brazil Drugs for Neglected Diseases initiative Latin America, Rio de Janeiro, Brazil
| | - Zulma Cucunubá
- Red Chagas, Grupo de Parasitología Red Chagas, Grupo de Parasitología Bogotá Colombia Red Chagas, Grupo de Parasitología, Instituto Nacional de Salud, Bogotá, Colombia
| | - Eduin Pachón Abril
- Ministry of Health and Social Protection Republic of Colombia Bogotá Colombia Ministry of Health and Social Protection, Republic of Colombia, Bogotá, Colombia
| | - Mauricio Javier Vera Soto
- Drugs for Neglected Diseases initiative Latin America Drugs for Neglected Diseases initiative Latin America Rio de Janeiro Brazil Drugs for Neglected Diseases initiative Latin America, Rio de Janeiro, Brazil
| | - Carolina Batista
- Drugs for Neglected Diseases initiative Latin America Drugs for Neglected Diseases initiative Latin America Rio de Janeiro Brazil Drugs for Neglected Diseases initiative Latin America, Rio de Janeiro, Brazil
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Dario MA, Rodrigues MS, Barros JHDS, Xavier SCDC, D’Andrea PS, Roque ALR, Jansen AM. Ecological scenario and Trypanosoma cruzi DTU characterization of a fatal acute Chagas disease case transmitted orally (Espírito Santo state, Brazil). Parasit Vectors 2016; 9:477. [PMID: 27580853 PMCID: PMC5006519 DOI: 10.1186/s13071-016-1754-4] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 08/12/2016] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Trypanosoma cruzi infection via oral route results in outbreaks or cases of acute Chagas disease (ACD) in different Brazilian regions and poses a novel epidemiological scenario. In the Espírito Santo state (southeastern Brazil), a fatal case of a patient with ACD led us to investigate the enzootic scenario to avoid the development of new cases. At the studied locality, Triatoma vitticeps exhibited high T. cruzi infection rates and frequently invaded residences. METHODS Sylvatic and domestic mammals in the Rio da Prata locality, where the ACD case occurred, and in four surrounding areas (Baia Nova, Buenos Aires, Santa Rita and Todos os Santos) were examined and underwent parasitological and serological tests. Triatomines were collected for a fecal material exam, culturing and mini-exon gene molecular characterization, followed by RFLP-PCR of H3/Alul. Paraffin-embedded cardiac tissue of a patient was washed with xylene to remove paraffin and DNA was extracted using the phenol-chloroform method. For genotype characterization, PCR was performed to amplify the 1f8, GPI and 18S rRNA genes. In the case of V7V8 SSU rRNA, the PCR products were molecularly cloned. PCR products were sequenced and compared to sequences in GenBank. Phylogenetic analysis using maximum likelihood method with 1000 bootstrap replicates was performed. RESULTS None of the animals showed positive hemocultures. Three rodents and two dogs showed signs of infection, as inferred from borderline serological titers. T. vitticeps was the only triatomine species identified and showed T. cruzi infection by DTUs TcI and TcIV. The analysis of cardiac tissue DNA showed mixed infection by T. cruzi (DTUs I, II, III and IV) and Trypanosoma dionisii. CONCLUSIONS Each case or outbreak of ACD should be analyzed as a particular epidemiological occurrence. The results indicated that mixed infections in humans may play a role in pathogenicity and may be more common than is currently recognized. Direct molecular characterization from biological samples is essential because this procedure avoids parasite selection. T. dionisii may under certain and unknown circumstances infect humans. The distribution of T. cruzi DTUS TcIII and TcIV in Brazilian biomes is broader than has been assumed to date.
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Affiliation(s)
- Maria Augusta Dario
- Laboratory of Trypanosomatid Biology, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Rio de Janeiro Brazil
| | - Marina Silva Rodrigues
- Laboratory of Trypanosomatid Biology, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Rio de Janeiro Brazil
| | | | | | - Paulo Sérgio D’Andrea
- Laboratory of Biology and Parasitology of Wild Reservoir Mammals, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Rio de Janeiro Brazil
| | - André Luiz Rodrigues Roque
- Laboratory of Trypanosomatid Biology, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Rio de Janeiro Brazil
| | - Ana Maria Jansen
- Laboratory of Trypanosomatid Biology, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Rio de Janeiro Brazil
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Hernández C, Vera MJ, Cucunubá Z, Flórez C, Cantillo O, Buitrago LS, González MS, Ardila S, Dueñas LZ, Tovar R, Forero LF, Ramírez JD. High-Resolution Molecular Typing of Trypanosoma cruzi in 2 Large Outbreaks of Acute Chagas Disease in Colombia. J Infect Dis 2016; 214:1252-5. [PMID: 27511897 DOI: 10.1093/infdis/jiw360] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [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: 05/25/2016] [Accepted: 08/03/2016] [Indexed: 12/11/2022] Open
Abstract
Oral transmission of Trypanosoma cruzi has gained relevance because of its association with high morbidity and lethality rates. This transmission route is responsible for maintaining the infection of the parasite in sylvatic cycles, and human cases have been associated mainly with the consumption of food contaminated with triatomine feces or didelphid secretions. Several ecological changes allow the intrusion of sylvatic reservoirs and triatomines to the domestic environments with subsequent food contamination. Here, high-resolution molecular tools were used to detect and genotype T. cruzi across humans, reservoirs, and insect vectors in 2 acute outbreaks of presumptive oral transmission in eastern Colombia.
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Affiliation(s)
- Carolina Hernández
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Programa de Biología, Facultad de Ciencias Naturales y Matemáticas, Universidad el Rosario Red Chagas Colombia Grupo de Parasitología, Instituto Nacional de Salud
| | | | - Zulma Cucunubá
- Red Chagas Colombia Grupo de Parasitología, Instituto Nacional de Salud Department of Infectious Disease Epidemiology, Imperial College London, United Kingdom
| | | | - Omar Cantillo
- Red Chagas Colombia Laboratorio Biología y Control de Enfermedades Infecciosas (BCEI), Universidad de Antioquia, Medellín
| | | | | | - Susanne Ardila
- Grupo de Entomología, Instituto Nacional de Salud, Bogotá
| | | | - Rubén Tovar
- Ministerio de Salud y protección Social, Bogotá, Colombia
| | | | - Juan David Ramírez
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Programa de Biología, Facultad de Ciencias Naturales y Matemáticas, Universidad el Rosario
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Alarcón de Noya B, Colmenares C, Díaz-Bello Z, Ruiz-Guevara R, Medina K, Muñoz-Calderón A, Mauriello L, Cabrera E, Montiel L, Losada S, Martínez J, Espinosa R, Abate T. Orally-transmitted Chagas disease: Epidemiological, clinical, serological and molecular outcomes of a school microepidemic in Chichiriviche de la Costa, Venezuela. Parasite Epidemiol Control 2016; 1:188-198. [PMID: 29988179 PMCID: PMC5991850 DOI: 10.1016/j.parepi.2016.02.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 02/23/2016] [Accepted: 02/23/2016] [Indexed: 11/15/2022] Open
Abstract
Oral transmission of Trypanosoma cruzi is a frequent cause of acute Chagas disease (ChD). In the present cross-sectional study, we report the epidemiological, clinical, serological and molecular outcomes of the second largest outbreak of oral ChD described in the literature. It occurred in March 2009 in Chichiriviche de la Costa, a rural seashore community at the central littoral in Venezuela. The vehicle was an artisanal guava juice prepared at the local school and Panstrongylus geniculatus was the vector involved. TcI genotype was isolated from patients and vector; some showed a mixture of haplotypes. Using molecular markers, parasitic loads were high. Eighty-nine cases were diagnosed, the majority (87.5%) in school children 6-15 years of age. Frequency of symptomatic patients was high (89.9%) with long-standing fever in 87.5%; 82.3% had pericardial effusion detected by echocardiogram and 41% had EKG abnormalities. Three children, a pregnant woman and her stillborn child died (5.6% mortality). The community was addressed by simultaneous determination of specific IgG and IgM, confirmed with indirect hemagglutination and lytic antibodies. Determination of IgG and IgA in saliva had low sensitivity. No individual parasitological or serological technique diagnosed 100% of cases. Culture and PCR detected T. cruzi in 95.5% of examined individuals. Based on the increasing incidence of oral acute cases of ChD, it appears that food is becoming one of the most important modes of transmission in the Amazon, Caribbean and Andes regions of America.
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Affiliation(s)
- Belkisyolé Alarcón de Noya
- Sección de Inmunología Instituto de Medicina Tropical, Facultad de Medicina, Universidad Central de Venezuela, Venezuela
- Cátedra de Parasitología, Escuela de Medicina “Luis Razetti”, Universidad Central de Venezuela, Venezuela
| | - Cecilia Colmenares
- Sección de Inmunología Instituto de Medicina Tropical, Facultad de Medicina, Universidad Central de Venezuela, Venezuela
- Cátedra de Parasitología, Escuela de Medicina “Luis Razetti”, Universidad Central de Venezuela, Venezuela
| | - Zoraida Díaz-Bello
- Sección de Inmunología Instituto de Medicina Tropical, Facultad de Medicina, Universidad Central de Venezuela, Venezuela
| | - Raiza Ruiz-Guevara
- Cátedra de Parasitología, Escuela de Medicina “Luis Razetti”, Universidad Central de Venezuela, Venezuela
| | - Karen Medina
- Postgrado Nacional de Parasitología, Facultad de Medicina, Universidad Central de Venezuela, Venezuela
| | - Arturo Muñoz-Calderón
- Sección de Inmunología Instituto de Medicina Tropical, Facultad de Medicina, Universidad Central de Venezuela, Venezuela
| | - Luciano Mauriello
- Sección de Inmunología Instituto de Medicina Tropical, Facultad de Medicina, Universidad Central de Venezuela, Venezuela
| | - Elida Cabrera
- Servicio de Cardiología Infantil, Hospital Militar “Dr. Carlos Arvelo”, Venezuela
| | - Luís Montiel
- Dirección de Epidemiología, Ministerio del Poder Popular para la Salud, Venezuela
| | - Sandra Losada
- Sección de Biohelmintiasis, Instituto de Medicina Tropical, Facultad de Medicina, Universidad Central de Venezuela, Venezuela
| | - Jetzi Martínez
- Dirección de Epidemiología, Estado Vargas, Ministerio del Poder Popular para la Salud, Venezuela
| | - Raúl Espinosa
- Servicio de Cardiología, Hospital “Miguel Pérez Carreño”, Venezuela
| | - Teresa Abate
- Sección de Biología Molecular, Instituto de Medicina Tropical, Facultad de Medicina, Universidad Central de Venezuela, Venezuela
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Liu Q, Zhou XN. Preventing the transmission of American trypanosomiasis and its spread into non-endemic countries. Infect Dis Poverty 2015; 4:60. [PMID: 26715535 PMCID: PMC4693433 DOI: 10.1186/s40249-015-0092-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [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: 12/31/2014] [Accepted: 12/11/2015] [Indexed: 11/10/2022] Open
Abstract
American trypanosomiasis, commonly known as Chagas disease, is caused by the flagellate protozoan parasite Trypanosoma cruzi. An estimated eight million people infected with T. cruzi currently reside in the endemic regions of Latin America. However, as the disease has now been imported into many non-endemic countries outside of Latin America, it has become a global health issue. We reviewed the transmission patterns and current status of disease spread pertaining to American trypanosomiasis at the global level, as well as recent advances in research. Based on an analysis of the gaps in American trypanosomiasis control, we put forward future research priorities that must be implemented to stop the global spread of the disease.
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Affiliation(s)
- Qin Liu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Key Laboratory of Parasite and Vector Biology, Ministry of Health;, WHO Collaborating Center for Tropical Diseases, Shanghai, 200025, P. R. China
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Key Laboratory of Parasite and Vector Biology, Ministry of Health;, WHO Collaborating Center for Tropical Diseases, Shanghai, 200025, P. R. China.
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