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Ferrer E, Aguilar CM, Viettri M, Torrellas A, Lares M, Diaz M, Delgado O, Feliciangeli MD, Herrera L. Chagas Disease and Leishmaniasis, Sympatric Zoonoses Present in Human from Rural Communities of Venezuela. Acta Parasitol 2024; 69:616-627. [PMID: 38294711 DOI: 10.1007/s11686-023-00786-8] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 12/21/2023] [Indexed: 02/01/2024]
Abstract
PURPOSE Trypanosoma cruzi and Leishmania spp. coexist in several endemic areas, and there are few studies of Chagas disease and leishmaniasis coinfection worldwide; for this reason, the objective of this work was to determine the Chagas disease and leishmaniasis coinfection in several rural communities co-endemic for these diseases. METHODS A total of 1107 human samples from six co-endemic rural communities of Cojedes state, Venezuela, were analyzed. Serum samples were evaluated by ELISA, indirect hemagglutination, and indirect immunofluorescence for Chagas disease diagnosis, and individuals were evaluated for leishmaniasis by leishmanin skin test (LST). Approximately, 30% of the individuals were also analyzed by PCR (blood clot samples) for T. cruzi and for Leishmania spp. RESULTS The 14.7% of the individuals were positive to Trypanosoma cruzi infection by serology, and 25.8% were positive to Leishmania spp. current or past infection by LST. Among the group with PCR results, 7.8% were positive for T. cruzi, and 9.4% for Leishmania spp. The coinfection T. cruzi/Leishmania spp. was 6.5%. The T. cruzi DTUs of the positive blood clot samples were TcI, revealed using the molecular markers: (i) intergenic region of the miniexon, (ii) D7 divergent domain of the 24Sα rDNA, (iii) size-variable domain of the 18S rDNA, and (iv) hsp60-PCR-RFLP (EcoRV). The Leishmania species identified were L. (Leishmania) mexicana and L. (Viannia) braziliensis. CONCLUSION A high prevalence was found for T. cruzi and Leishmania spp. single and coinfections in almost all communities studied, being these results of relevance for the implementation of control programs in co-endemic areas.
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Affiliation(s)
- Elizabeth Ferrer
- Instituto de Investigaciones Biomédicas "Dr. Francisco J. Triana Alonso" (BIOMED), Universidad de Carabobo Sede Aragua, calle Cecilio Acosta, Urb. La Rinconada, Las Delicias, Maracay, estado Aragua, Venezuela.
- Departamento de Parasitología, Facultad de Ciencias de la Salud, Universidad de Carabobo Sede Aragua, Maracay, estado Aragua, Venezuela.
| | - Cruz M Aguilar
- Centro de Investigaciones en Enfermedades Tropicales (CIET-UC), Facultad de Ciencias de la Salud, Universidad de Carabobo, San Carlos, Cojedes, Venezuela
| | - Mercedes Viettri
- Instituto de Investigaciones Biomédicas "Dr. Francisco J. Triana Alonso" (BIOMED), Universidad de Carabobo Sede Aragua, calle Cecilio Acosta, Urb. La Rinconada, Las Delicias, Maracay, estado Aragua, Venezuela
| | - Annhymariet Torrellas
- Instituto de Investigaciones Biomédicas "Dr. Francisco J. Triana Alonso" (BIOMED), Universidad de Carabobo Sede Aragua, calle Cecilio Acosta, Urb. La Rinconada, Las Delicias, Maracay, estado Aragua, Venezuela
| | - María Lares
- Instituto de Investigaciones Biomédicas "Dr. Francisco J. Triana Alonso" (BIOMED), Universidad de Carabobo Sede Aragua, calle Cecilio Acosta, Urb. La Rinconada, Las Delicias, Maracay, estado Aragua, Venezuela
| | - Marietta Diaz
- Centro de Investigaciones en Enfermedades Tropicales (CIET-UC), Facultad de Ciencias de la Salud, Universidad de Carabobo, San Carlos, Cojedes, Venezuela
| | - Olinda Delgado
- Instituto de Medicina Tropical (IMT), Facultad de Medicina, Universidad Central de Venezuela (UCV), Caracas, Venezuela
| | - María D Feliciangeli
- Instituto de Investigaciones Biomédicas "Dr. Francisco J. Triana Alonso" (BIOMED), Universidad de Carabobo Sede Aragua, calle Cecilio Acosta, Urb. La Rinconada, Las Delicias, Maracay, estado Aragua, Venezuela
| | - Leidi Herrera
- Instituto de Zoología y Ecología Tropical (IZET), Facultad de Ciencias, Universidad Central de Venezuela (UCV), Caracas, Venezuela
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Fleitas PE, Floridia-Yapur N, Nieves EE, Echazu A, Vargas PA, Caro NR, Aveldaño R, Lopez W, Fernandez M, Crudo F, Cimino RO, Krolewiecki AJ. Strongyloides stercoralis and Trypanosoma cruzi coinfections in a highly endemic area in Argentina. PLoS Negl Trop Dis 2022; 16:e0010179. [PMID: 35120117 PMCID: PMC8865657 DOI: 10.1371/journal.pntd.0010179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 02/23/2022] [Accepted: 01/19/2022] [Indexed: 11/18/2022] Open
Abstract
Background Strongyloidiasis and Chagas disease are endemic in northern Argentina. In this study we evaluate the association between S. stercoralis and T. cruzi infections in villages with diverse prevalence levels for these parasites. Further understanding in the relationship between these Neglected Tropical Diseases of South America is relevant for the design of integrated control measures as well as exploring potential biologic interactions. Methodology Community based cross-sectional studies were carried in different villages of the Chaco and Yungas regions in Argentina. Individuals were diagnosed by serology for S. stercoralis and T. cruzi. The association between S. stercoralis and T. cruzi, and between anemia and the two parasites was evaluated using two approaches: marginal (Ma) and multilevel regression (Mu). Results A total of 706 individuals from six villages of northern Argentina were included. A total of 37% were positive for S. stercoralis, 14% were positive for T. cruzi and 5% were positive for both. No association was found between infection with S. stercoralis and T. cruzi in any of the models, but we found a negative correlation between the prevalence of these species in the different villages (r = -0.91). Adults (> 15 years) presented association with S. stercoralis (Ma OR = 2.72; Mu OR = 2.84) and T. cruzi (Ma OR = 5.12; Mu OR = 5.48). Also, 12% and 2% of the variance of infection with S. stercoralis and T. cruzi, respectively, could be explained by differences among villages. On the other hand, anemia was associated with infection with S. stercoralis (Ma OR = 1.73; Mu OR = 1.78) and was more prevalent in adults (Ma OR = 2.59; Mu OR = 2.69). Conclusion We found that coinfection between S. stercoralis and T. cruzi is not more frequent than chance in endemic areas. However, the high prevalence for both parasites, raises the need for an integrated strategy for the control of STH and Chagas disease. Infections with S. stercoralis and T. cruzi belong to the group of neglected tropical diseases (NTDs). NTDs are influenced by climate and the presence of their vectors and host reservoirs in areas with structural poverty. S. stercoralis and T. cruzi have high prevalence in northern Argentina. Due to the high prevalence and chronicity of infections by these parasites, coinfection with both is possible. We conducted a cross sectional study in six villages in the north of Argentina. These villages have different prevalence for the two parasites and are located in different ecoregions (Chaco, Yungas and the border between these two). We found that coinfection between S. stercoralis and T. cruzi occurs only by chance; and the most affected groups for S. stercoralis and T. cruzi infection are adults. We also found that adults or individual with infection with S. stercoralis were more likely to have anemia. In addition, each village represents a different setting for infection with S. stercoralis and T. cruzi, and individuals in different villages presented differences in the probability of infection.
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Affiliation(s)
- Pedro E Fleitas
- Universidad Nacional de Salta. Sede Regional Orán. Instituto de Investigación de Enfermedades Tropicales (IIET), Salta, Argentina
- Universidad Nacional de Salta, Facultad de Ciencias Naturales, Cátedra de Química Biológica, Salta, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Noelia Floridia-Yapur
- Universidad Nacional de Salta, Facultad de Ciencias Naturales, Cátedra de Química Biológica, Salta, Argentina
- Instituto de Patología Experimental, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Salta, Argentina
| | - Elvia E Nieves
- Universidad Nacional de Salta. Sede Regional Orán. Instituto de Investigación de Enfermedades Tropicales (IIET), Salta, Argentina
| | - Adriana Echazu
- Universidad Nacional de Salta. Sede Regional Orán. Instituto de Investigación de Enfermedades Tropicales (IIET), Salta, Argentina
- Universidad Nacional de Salta, Facultad de Ciencias de la Salud, Cátedra de Parasitología, Salta, Argentina
| | - Paola A Vargas
- Universidad Nacional de Salta. Sede Regional Orán. Instituto de Investigación de Enfermedades Tropicales (IIET), Salta, Argentina
- Biotecnología, Universidad Católica de Boliviana San Pablo, Santa Cruz, Bolivia
| | - Nicolás R Caro
- Universidad Nacional de Salta. Sede Regional Orán. Instituto de Investigación de Enfermedades Tropicales (IIET), Salta, Argentina
| | - Ramiro Aveldaño
- Universidad Nacional de Salta. Sede Regional Orán. Instituto de Investigación de Enfermedades Tropicales (IIET), Salta, Argentina
| | - Walter Lopez
- Universidad Nacional de Salta. Sede Regional Orán. Instituto de Investigación de Enfermedades Tropicales (IIET), Salta, Argentina
| | - Mariana Fernandez
- Asociación para el Desarrollo Sanitario Regional (ADESAR), San Antonio de Areco, Buenos Aires, Argentina
- Fundación Mundo Sano, Buenos Aires, Argentina
| | - Favio Crudo
- Asociación para el Desarrollo Sanitario Regional (ADESAR), San Antonio de Areco, Buenos Aires, Argentina
- Fundación Mundo Sano, Buenos Aires, Argentina
- Universidad Nacional de San Antonio de Areco, San Antonio de Areco, Buenos Aires, Argentina
| | - Rubén O Cimino
- Universidad Nacional de Salta. Sede Regional Orán. Instituto de Investigación de Enfermedades Tropicales (IIET), Salta, Argentina
- Universidad Nacional de Salta, Facultad de Ciencias Naturales, Cátedra de Química Biológica, Salta, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Alejandro J Krolewiecki
- Universidad Nacional de Salta. Sede Regional Orán. Instituto de Investigación de Enfermedades Tropicales (IIET), Salta, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
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Enriquez GF, Bua J, Orozco MM, Macchiaverna NP, Otegui JAA, Argibay HD, Fernández MDP, Gürtler RE, Cardinal MV. Over-dispersed Trypanosoma cruzi parasite load in sylvatic and domestic mammals and humans from northeastern Argentina. Parasit Vectors 2022; 15:37. [PMID: 35073983 PMCID: PMC8785451 DOI: 10.1186/s13071-022-05152-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 09/27/2021] [Accepted: 01/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The distribution of parasite load across hosts may modify the transmission dynamics of infectious diseases. Chagas disease is caused by a multi-host protozoan, Trypanosoma cruzi, but the association between host parasitemia and infectiousness to the vector has not been studied in sylvatic mammalian hosts. We quantified T. cruzi parasite load in sylvatic mammals, modeled the association of the parasite load with infectiousness to the vector and compared these results with previous ones for local domestic hosts. METHODS The bloodstream parasite load in each of 28 naturally infected sylvatic mammals from six species captured in northern Argentina was assessed by quantitative PCR, and its association with infectiousness to the triatomine Triatoma infestans was evaluated, as determined by natural or artificial xenodiagnosis. These results were compared with our previous results for 88 humans, 70 dogs and 13 cats, and the degree of parasite over-dispersion was quantified and non-linear models fitted to data on host infectiousness and bloodstream parasite load. RESULTS The parasite loads of Didelphis albiventris (white-eared opossum) and Dasypus novemcinctus (nine-banded armadillo) were directly and significantly associated with infectiousness of the host and were up to 190-fold higher than those in domestic hosts. Parasite load was aggregated across host species, as measured by the negative binomial parameter, k, and found to be substantially higher in white-eared opossums, cats, dogs and nine-banded armadillos (range: k = 0.3-0.5) than in humans (k = 5.1). The distribution of bloodstream parasite load closely followed the "80-20 rule" in every host species examined. However, the 20% of human hosts, domestic mammals or sylvatic mammals exhibiting the highest parasite load accounted for 49, 25 and 33% of the infected triatomines, respectively. CONCLUSIONS Our results support the use of bloodstream parasite load as a proxy of reservoir host competence and individual transmissibility. The over-dispersed distribution of T. cruzi bloodstream load implies the existence of a fraction of highly infectious hosts that could be targeted to improve vector-borne transmission control efforts toward interruption transmission. Combined strategies that decrease the parasitemia and/or host-vector contact with these hosts would disproportionally contribute to T. cruzi transmission control.
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Affiliation(s)
- Gustavo Fabián Enriquez
- Laboratorio de Eco-Epidemiología, Departamento de Ecología, Genética y Evolución, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Intendente Güiraldes 2160, Piso 2, Ciudad Universitaria, Buenos Aires, Argentina.
- Instituto de Ecología, Genética y Evolución (IEGEBA), CONICET-Universidad de Buenos Aires, Buenos Aires, Argentina.
| | - Jacqueline Bua
- Instituto Nacional de Parasitología Dr. M. Fatala Chabén, Administración Nacional de Laboratorios e Institutos de Salud Dr. C.G. Malbrán, Buenos Aires, Argentina
| | - María Marcela Orozco
- Instituto de Ecología, Genética y Evolución (IEGEBA), CONICET-Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Natalia Paula Macchiaverna
- Laboratorio de Eco-Epidemiología, Departamento de Ecología, Genética y Evolución, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Intendente Güiraldes 2160, Piso 2, Ciudad Universitaria, Buenos Aires, Argentina
- Instituto de Ecología, Genética y Evolución (IEGEBA), CONICET-Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Julián Antonio Alvarado Otegui
- Laboratorio de Eco-Epidemiología, Departamento de Ecología, Genética y Evolución, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Intendente Güiraldes 2160, Piso 2, Ciudad Universitaria, Buenos Aires, Argentina
- Instituto de Ecología, Genética y Evolución (IEGEBA), CONICET-Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Hernán Darío Argibay
- Laboratorio de Patologia e Biologia Molecular, Instituto Gonçalo Moniz/Fiocruz Bahia, Salvador, Brazil
| | | | - Ricardo Esteban Gürtler
- Laboratorio de Eco-Epidemiología, Departamento de Ecología, Genética y Evolución, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Intendente Güiraldes 2160, Piso 2, Ciudad Universitaria, Buenos Aires, Argentina
- Instituto de Ecología, Genética y Evolución (IEGEBA), CONICET-Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Marta Victoria Cardinal
- Laboratorio de Eco-Epidemiología, Departamento de Ecología, Genética y Evolución, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Intendente Güiraldes 2160, Piso 2, Ciudad Universitaria, Buenos Aires, Argentina
- Instituto de Ecología, Genética y Evolución (IEGEBA), CONICET-Universidad de Buenos Aires, Buenos Aires, Argentina
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Flores-López CA, Rivas-García L, Romero-Figueroa G, Guevara-Carrizales A, Peiro-Nuño H, López-Ordoñez T, Bello-Bedoy R. Infection Rate of Trypanosoma cruzi (Trypanosomatida: Trypanosomatidae) in Dipetalogaster maxima (Hemiptera: Reduviidae). J Med Entomol 2022; 59:394-399. [PMID: 34448006 DOI: 10.1093/jme/tjab147] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Indexed: 06/13/2023]
Abstract
Chagas disease is caused by the infection of the parasite Trypanosoma cruzi (Chagas, 1909). Mexico is estimated to be among the countries with the highest rates of human infections. The southernmost region of the Baja California peninsula is home to the endemic, highly aggressive, and largest Triatominae vector, thus far described: Dipetalogaster maxima (Uhler 1894). Previous single-year studies have attempted to estimate the natural infection rate of T. cruzi in this species, none encompassing a multiyear sampling design nor a species-specific diagnostic tool. We report the infection rate based on more than 717 individuals examined via a PCR species-specific diagnosis. The infection rate of T. cruzi was of 4.4% (n = 5/112), 0.9% (n = 4/411), and 4.6% (n = 9/194) for 2016, 2017, and 2018, respectively, resulting in an infection rate of 2% across all sites and years (n = 18/717).
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Affiliation(s)
- Carlos Alberto Flores-López
- Facultad de Ciencias, Universidad Autónoma de Baja California, Carretera Transpeninsular, Ensenada-Tijuana, 3917, Playitas, Baja California, Mexico
| | - Lynneth Rivas-García
- Facultad de Ciencias, Universidad Autónoma de Baja California, Carretera Transpeninsular, Ensenada-Tijuana, 3917, Playitas, Baja California, Mexico
| | - Guillermo Romero-Figueroa
- Facultad de Ciencias, Universidad Autónoma de Baja California, Carretera Transpeninsular, Ensenada-Tijuana, 3917, Playitas, Baja California, Mexico
| | - Aldo Guevara-Carrizales
- Facultad de Ciencias, Universidad Autónoma de Baja California, Carretera Transpeninsular, Ensenada-Tijuana, 3917, Playitas, Baja California, Mexico
| | - Haran Peiro-Nuño
- Facultad de Ciencias, Universidad Autónoma de Baja California, Carretera Transpeninsular, Ensenada-Tijuana, 3917, Playitas, Baja California, Mexico
| | - Teresa López-Ordoñez
- Centro Regional de Investigación en Salud Pública (CRISP), Instituto Nacional de Salud Pública (INSP), Tapachula, Chiapas, Mexico
| | - Rafael Bello-Bedoy
- Facultad de Ciencias, Universidad Autónoma de Baja California, Carretera Transpeninsular, Ensenada-Tijuana, 3917, Playitas, Baja California, Mexico
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Tátila-Ferreira A, Garcia GA, Dos Santos LMB, Pavan MG, de C Moreira CJ, Victoriano JC, da Silva-Junior R, Dos Santos-Mallet JR, Verly T, Britto C, Sikulu-Lord MT, Maciel-de-Freitas R. Near infrared spectroscopy accurately detects Trypanosoma cruzi non-destructively in midguts, rectum and excreta samples of Triatoma infestans. Sci Rep 2021; 11:23884. [PMID: 34903840 PMCID: PMC8668913 DOI: 10.1038/s41598-021-03465-8] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 11/29/2021] [Indexed: 11/09/2022] Open
Abstract
Chagas disease is a neglected tropical disease caused by Trypanosoma cruzi parasite with an estimated 70 million people at risk. Traditionally, parasite presence in triatomine vectors is detected through optical microscopy which can be low in sensitivity or molecular techniques which can be costly in endemic countries. The aim of this study was to evaluate the ability of a reagent-free technique, the Near Infrared Spectroscopy (NIRS) for rapid and non-invasive detection of T. cruzi in Triatoma infestans body parts and in wet/dry excreta samples of the insect. NIRS was 100% accurate for predicting the presence of T. cruzi infection Dm28c strain (TcI) in either the midgut or the rectum and models developed from either body part could predict infection in the other part. Models developed to predict infection in excreta samples were 100% accurate for predicting infection in both wet and dry samples. However, models developed using dry excreta could not predict infection in wet samples and vice versa. This is the first study to report on the potential application of NIRS for rapid and non-invasive detection of T. cruzi infection in T. infestans in the laboratory. Future work should demonstrate the capacity of NIRS to detect T. cruzi in triatomines originating from the field.
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Affiliation(s)
- Aline Tátila-Ferreira
- Laboratório de Transmissores de Hematozoários, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Gabriela A Garcia
- Laboratório de Transmissores de Hematozoários, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Lilha M B Dos Santos
- Laboratório de Transmissores de Hematozoários, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Márcio G Pavan
- Laboratório de Transmissores de Hematozoários, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Carlos José de C Moreira
- Laboratório de Doenças Parasitárias, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Juliana C Victoriano
- Laboratório Interdisciplinar de Vigilância Entomológica de Diptera E Hemiptera, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Renato da Silva-Junior
- Laboratório Interdisciplinar de Vigilância Entomológica de Diptera E Hemiptera, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- Universidade Iguaçu - UNIG, Rio de Janeiro, Brazil
| | - Jacenir R Dos Santos-Mallet
- Laboratório Interdisciplinar de Vigilância Entomológica de Diptera E Hemiptera, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- Universidade Iguaçu - UNIG, Rio de Janeiro, Brazil
| | - Thaiane Verly
- Laboratório de Biologia Molecular e Doenças Endêmicas, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Constança Britto
- Laboratório de Biologia Molecular e Doenças Endêmicas, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Maggy T Sikulu-Lord
- The School of Public Health, The University of Queensland, Herston, QLD, 4006, Australia
| | - Rafael Maciel-de-Freitas
- Laboratório de Transmissores de Hematozoários, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
- Instituto Nacional de Ciência e Tecnologia em Entomologia Molecular, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
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Lima-Neiva V, Toma HK, Abrantes Aguiar LM, Lopes CM, Dias LP, Monte Gonçalves TC, Costa J. The connection between Trypanosoma cruzi transmission cycles by Triatoma brasiliensis brasiliensis: A threat to human health in an area susceptible to desertification in the Seridó, Rio Grande do Norte, Brazil. PLoS Negl Trop Dis 2021; 15:e0009919. [PMID: 34752464 PMCID: PMC8577756 DOI: 10.1371/journal.pntd.0009919] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 03/27/2021] [Accepted: 10/17/2021] [Indexed: 11/21/2022] Open
Abstract
An outbreak of Chagas disease, possibly involving its vector Triatoma brasiliensis brasiliensis, was identified in the state of Rio Grande do Norte (RN). Given the historical significance of this vector in public health, the study aimed to evaluate its role in the transmission dynamics of the protozoan Trypanosoma cruzi in an area undergoing desertification in the Seridó region, RN, Brazil. We captured triatomines in sylvatic and anthropic ecotopes. Natural vector infection was determined using parasitological and molecular methods and we identified discrete typing units (DTUs) of T. cruzi by analyzing the COII gene of mtDNA, 24Sα rDNA, and mini-exon gene. Their blood meals sources were identified by amplification and sequencing of the mtDNA cytochrome b gene. A total of 952 T. b. brasiliensis were captured in peridomestic (69.9%) and sylvatic ecotopes (30.4%). A wide range of natural infection rates were observed in peridomestic (36.0% - 71.1%) and sylvatic populations (28.6% - 100.0%). We observed the circulation of TcI and TcII DTUs with a predominance of Tcl in sylvatic and peridomestic environments. Kerodon rupestris, rocky cavy (13/39), Homo sapiens, human (8/39), and Bos taurus, ox (6/39) were the most frequently detected blood meals sources. Thus, Triatoma b. brasiliensis is invading and colonizing the human dwellings. Furthermore, high levels of natural infection, coupled with the detection of TcI and TcII DTUs, and also the detection of K. rupestris and H. sapiens as blood meals sources of infected T. b. brasiliensis indicate a risk of T. cruzi transmission to human populations in areas undergoing desertification. Chagas disease currently affects about six to seven million people worldwide, resulting in high morbidity, mortality, and economic burden in endemic countries of Latin America. Its etiological agent, Trypanosoma cruzi, circulates among a wide variety of mammalian and insect vectors. Triatoma brasiliensis brasiliensis is adapted to the dry and warm climate of the Caatinga biome, and is considered the main vector in the semi-arid areas of northeastern Brazil. Information on the infestation, natural infection rates, T. cruzi strains, and blood meals sources of this vector is crucial for understanding the dynamics of T. cruzi transmission in areas susceptible to desertification. Triatoma b. brasiliensis colonizes peridomestic structures, particularly in the stone walls of cattle corrals that emerge as a refuge for sylvatic populations where they access a variety of blood meals sources. The predominance of the TcI strain in the sylvatic and peridomestic environments shows an overlap of transmission cycles by T. cruzi mediated by T. b. brasiliensis. The high rates of natural infection and the evidence of their feeding on humans and the rodent K. rupestris are worrisome and indicate the threat this vector poses to human health in the area studied.
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Affiliation(s)
- Vanessa Lima-Neiva
- Laboratório de Biodiversidade Entomológica, Instituto Oswaldo Cruz/FIOCRUZ, Rio de Janeiro, Rio de Janeiro, Brazil
- * E-mail:
| | - Helena Keiko Toma
- Laboratório de Diagnóstico Molecular e Hematologia, Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Catarina Macedo Lopes
- Laboratório Interdisciplinar de Vigilância Entomológica em Diptera e Hemiptera, Instituto Oswaldo Cruz /FIOCRUZ, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Letícia Paschoaletto Dias
- Laboratório de Biodiversidade Entomológica, Instituto Oswaldo Cruz/FIOCRUZ, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Teresa Cristina Monte Gonçalves
- Laboratório Interdisciplinar de Vigilância Entomológica em Diptera e Hemiptera, Instituto Oswaldo Cruz /FIOCRUZ, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jane Costa
- Laboratório de Biodiversidade Entomológica, Instituto Oswaldo Cruz/FIOCRUZ, Rio de Janeiro, Rio de Janeiro, Brazil
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Nielsen DH, Koch K, Roachell W, Delgado B, Bast J. First Record of an Established Population of Triatoma sanguisuga (Hemiptera: Reduviidae) in Richardson County, Nebraska. J Med Entomol 2021; 58:2519-2523. [PMID: 34283239 DOI: 10.1093/jme/tjab122] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Indexed: 06/13/2023]
Abstract
In 2017, a single adult Triatoma sanguisuga (LeConte) (Hemiptera: Reduviidae) was identified from Indian Cave State Park in Nemaha County, NE. The following summer, a single adult specimen was found in a 4-H insect collection at the Nebraska State Fair from Richardson County. A subsequent investigation found that these were collected from a residence in Richardson County and three more adults were collected in 2019. In 2020, the latter three kissing bugs were submitted to Public Health Command-Central's DoD Food Analysis and Diagnostic Laboratory (DOD FADL) for confirmatory species identification and diagnostic testing for Trypanosoma cruzi, the causative agent of Chagas disease. One specimen tested positive for T. cruzi using a real-time dual-target PCR screen followed by confirmatory dual-target traditional PCR. Based on these findings, a survey plan was developed for Richardson and surrounding counties in southeast Nebraska. In July of 2020, two adult and seven nymphs (multiple instars) of T. sanguisuga were collected in Richardson County, one of which tested positive for T. cruzi. This is the first record of an established population of T. sanguisuga and T. cruzi-infected kissing bugs in Nebraska.
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Affiliation(s)
- David H Nielsen
- Entomological Sciences Division, Public Health Command-Central, Ft. Sam Houston, TX 78234, USA
- Entomolgy Program, Nebraska Department of Agriculture, 301 Centennial Mall South, Lincoln, NE 68509-4756, USA
| | - Kyle Koch
- Entomology Department, University of Nebraska-Lincoln, Lincoln, NE 68583-0816, USA
| | - Walter Roachell
- Entomological Sciences Division, Public Health Command-Central, Ft. Sam Houston, TX 78234, USA
| | - Bernardo Delgado
- Entomological Sciences Division, Public Health Command-Central, Ft. Sam Houston, TX 78234, USA
| | - Joshua Bast
- Entomological Sciences Division, Public Health Command-Central, Ft. Sam Houston, TX 78234, USA
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Ramos-Sesma V, Navarro M, Llenas-García J, Gil-Anguita C, Torrus-Tendero D, Wikman-Jorgensen P, García-López M, Amador-Prous C, Ventero-Martín MP, Guevara-Hernández P, Garijo-Saiz A, Sanchez-Sanchez A, Bernal-Alcaraz C, Pujades-Tarraga AI, Muñoz-Perez R, Flores-Chávez M, Ramos-Rincón JM. Community-based screening of Chagas disease among Latin American migrants in a non-endemic country: an observational study. Infect Dis Poverty 2021; 10:117. [PMID: 34526137 PMCID: PMC8441044 DOI: 10.1186/s40249-021-00897-2] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 08/24/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Chagas disease is a parasitic disease endemic to Latin America, but it has become a disease of global concern due to migration flows. Asymptomatic carriers may host the parasite for years, without knowing they are infected. The aim of this study is to assess prevalence of Chagas disease and evaluate the participants' level of knowledge between Latin American migrants attending a community-based screening campaign. METHODS Three community-based campaigns were performed in Alicante (Spain) in 2016, 2017 and 2018, including educational chats and blood tests for Trypanosoma cruzi serology. Participants completed a questionnaire assessing knowledge about the mechanisms of transmission, disease presentation, diagnosis, and treatment. People seropositive for T. cruzi underwent diagnostic confirmation by two different tests. Results were analyzed by multivariable logistic regression and expressed as adjusted odds ratios (aORs), adjusting for age, sex, and time in Spain. RESULTS A total of 596 participants were included in the study; 17% were aged under 18 years. Prevalence in adults was 11% [54/496; 95% confidence interval (CI): 8.3-14.5%] versus 0% among children. All but one case were in Bolivians. Diagnosis was independently associated with having been born in Bolivia (aOR: 102, 95% CI: 13-781) and a primary school-level education (aOR: 2.40, 95% CI: 1.14-5.06). Of 54 people diagnosed with Chagas disease (most of whom were asymptomatic), 42 (77.7%) returned to the clinic at least once, and 24 (44.4%) received treatment. Multivariable analysis showed that coming from Argentina (aOR: 13, 95% CI: 1.61-1188) or Bolivia (aOR: 1.90, 95% CI: 1.19-3.39) and having received information about Chagas disease in Spain (aOR: 4.63, 95% CI: 2.54-8.97) were associated with a good level of knowledge on the disease. Having primary level studies (aOR: 0.59, 95% CI: 0.34-0.98) and coming from Ecuador (aOR: 4.63, 95% CI: 2.52-847) were independently associated with a lower level of knowledge. CONCLUSIONS Community-based interventions are a good strategy for diagnosing neglected diseases such as Chagas disease in non-endemic countries and for identifying and treating infected, asymptomatic individuals.
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Affiliation(s)
| | - Miriam Navarro
- Public Health, Science History and Gynecology Department, Universidad Miguel Hernández de Elche, Alicante, Spain
- Epidemiology Unit Public Health Center of Elche, Alicante, Spain
| | - Jara Llenas-García
- Internal Medicine Department, Hospital Vega Baja de Orihuela (Alicante, Spain)-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO), Alicante, Spain
- Clinical Medicine Department, University Miguel Hernández of Elche, Sant Joan d'Alacant, Spain
| | - Concepción Gil-Anguita
- Internal Medicine Department, Hospital Marina BaixaLa Vila Joiosa (Alicante, Spain)-FISABIO, Alicante, Spain
| | - Diego Torrus-Tendero
- Internal Medicine Department, General University Hospital of Alicante-Biomedical and Health Research Institute of Alicante (ISABIAL), Alicante, Spain
- Parasitology Area, University Miguel Hernández of Elche, Sant Joan d'Alacant, Spain
| | - Philip Wikman-Jorgensen
- Internal Medicine Department, University Hospital of Sant Joan, (Sant Joan d'Alacant, Spain)- FISABIO, Alicante, Spain
| | - María García-López
- Internal Medicine Department, Hospital Vega Baja de Orihuela (Alicante, Spain)-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO), Alicante, Spain
| | - Concepción Amador-Prous
- Internal Medicine Department, Hospital Marina BaixaLa Vila Joiosa (Alicante, Spain)-FISABIO, Alicante, Spain
| | | | - Pedro Guevara-Hernández
- Internal Medicine Department, Hospital Vega Baja de Orihuela (Alicante, Spain)-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO), Alicante, Spain
| | - Ana Garijo-Saiz
- Internal Medicine Department, Hospital Marina BaixaLa Vila Joiosa (Alicante, Spain)-FISABIO, Alicante, Spain
| | - Ares Sanchez-Sanchez
- Pediatric Department, General University Hospital of Alicante-ISABIAL, Alicante, Spain
| | - Cristina Bernal-Alcaraz
- Internal Medicine Department, Hospital Vega Baja de Orihuela (Alicante, Spain)-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO), Alicante, Spain
| | - Ana-Isabel Pujades-Tarraga
- Internal Medicine Department, Hospital Marina BaixaLa Vila Joiosa (Alicante, Spain)-FISABIO, Alicante, Spain
| | - Roser Muñoz-Perez
- Digestive Service, General University Hospital of Alicante-ISABIAL, Alicante, Spain
| | - María Flores-Chávez
- Reference and Research Laboratory in Parasitology, National Center of Microbiology/Mundo Sano Foundation, Madrid, Spain
| | - José-Manuel Ramos-Rincón
- Clinical Medicine Department, University Miguel Hernández of Elche, Sant Joan d'Alacant, Spain.
- Internal Medicine Department, General University Hospital of Alicante-Biomedical and Health Research Institute of Alicante (ISABIAL), Alicante, Spain.
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Berná L, Greif G, Pita S, Faral-Tello P, Díaz-Viraqué F, Souza RDCMD, Vallejo GA, Alvarez-Valin F, Robello C. Maxicircle architecture and evolutionary insights into Trypanosoma cruzi complex. PLoS Negl Trop Dis 2021; 15:e0009719. [PMID: 34437557 PMCID: PMC8425572 DOI: 10.1371/journal.pntd.0009719] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 09/08/2021] [Accepted: 08/10/2021] [Indexed: 12/13/2022] Open
Abstract
We sequenced maxicircles from T. cruzi strains representative of the species evolutionary diversity by using long-read sequencing, which allowed us to uncollapse their repetitive regions, finding that their real lengths range from 35 to 50 kb. T. cruzi maxicircles have a common architecture composed of four regions: coding region (CR), AT-rich region, short (SR) and long repeats (LR). Distribution of genes, both in order and in strand orientation are conserved, being the main differences the presence of deletions affecting genes coding for NADH dehydrogenase subunits, reinforcing biochemical findings that indicate that complex I is not functional in T. cruzi. Moreover, the presence of complete minicircles into maxicircles of some strains lead us to think about the origin of minicircles. Finally, a careful phylogenetic analysis was conducted using coding regions of maxicircles from up to 29 strains, and 1108 single copy nuclear genes from all of the DTUs, clearly establishing that taxonomically T. cruzi is a complex of species composed by group 1 that contains clades A (TcI), B (TcIII) and D (TcIV), and group 2 (1 and 2 do not coincide with groups I and II described decades ago) containing clade C (TcII), being all hybrid strains of the BC type. Three variants of maxicircles exist in T. cruzi: a, b and c, in correspondence with clades A, B, and C from mitochondrial phylogenies. While A and C carry maxicircles a and c respectively, both clades B and D carry b maxicircle variant; hybrid strains also carry the b- variant. We then propose a new nomenclature that is self-descriptive and makes use of both the phylogenetic relationships and the maxicircle variants present in T. cruzi.
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Affiliation(s)
- Luisa Berná
- Laboratorio de Interacciones Hospedero-Patógeno, Unidad de Biología Molecular, Institut Pasteur de Montevideo, Montevideo, Uruguay
- Sección Biomatemática—Unidad de Genómica Evolutiva, Facultad de Ciencias, Universidad de la República, Montevideo, Uruguay
| | - Gonzalo Greif
- Laboratorio de Interacciones Hospedero-Patógeno, Unidad de Biología Molecular, Institut Pasteur de Montevideo, Montevideo, Uruguay
| | - Sebastián Pita
- Laboratorio de Interacciones Hospedero-Patógeno, Unidad de Biología Molecular, Institut Pasteur de Montevideo, Montevideo, Uruguay
- Sección Genética, Facultad de Ciencias, Universidad de la República, Montevideo, Uruguay
| | - Paula Faral-Tello
- Laboratorio de Interacciones Hospedero-Patógeno, Unidad de Biología Molecular, Institut Pasteur de Montevideo, Montevideo, Uruguay
| | - Florencia Díaz-Viraqué
- Laboratorio de Interacciones Hospedero-Patógeno, Unidad de Biología Molecular, Institut Pasteur de Montevideo, Montevideo, Uruguay
| | | | - Gustavo Adolfo Vallejo
- Laboratorio de investigaciones en Parasitología Tropical (LIPT), Facultad de Ciencias, Universidad del Tolima, Tolima, Colombia
| | - Fernando Alvarez-Valin
- Sección Biomatemática—Unidad de Genómica Evolutiva, Facultad de Ciencias, Universidad de la República, Montevideo, Uruguay
| | - Carlos Robello
- Laboratorio de Interacciones Hospedero-Patógeno, Unidad de Biología Molecular, Institut Pasteur de Montevideo, Montevideo, Uruguay
- Departamento de Bioquímica, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
- * E-mail:
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Hernández-Cuevas NA, Marín-Cervera A, Garcia-Polanco S, Martínez-Vega P, Rosado-Vallado M, Dumonteil E. Fibronectin degradation as biomarker for Trypanosoma cruzi infection and treatment monitoring in mice. Parasitology 2021; 148:1067-1073. [PMID: 34024298 PMCID: PMC11010125 DOI: 10.1017/s0031182021000809] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 05/13/2021] [Accepted: 05/19/2021] [Indexed: 11/06/2022]
Abstract
Biomarkers (coming from host or parasite) to monitor Chagas disease (CD) progression as well as the therapeutic response in chronic CD are critically needed, since seronegativization, which may be considered the best indicator of therapeutic cure, takes several years to be observed in adults. Several molecules have been suggested as biomarkers for CD, however, they have to be validated. Taking advantage of mouse models of Trypanosoma cruzi infection, we investigated changes in the degradation profile of fibronectin in plasma. The degradation profile of fibronectin was different in the acute phase compared to the chronic phase of the infection. Fibronectin fragments of approximately 150, 100, 40 and 30 kDa were identified. Furthermore, those degradation profiles correlated with acute parasitaemia as well as with cardiac parasite burden and tissue damage during the infection. The usefulness of fibronectin degradation as a biomarker for therapeutic response following drug treatment and immunotherapeutic vaccination also was evaluated and a decreased fibronectin degradation profile was observed upon benznidazole or a vaccine candidate treatment.
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Affiliation(s)
- Nora Adriana Hernández-Cuevas
- Laboratorio de Parasitología, Centro de Investigaciones Regionales ‘Dr. Hideyo Noguchi’, Universidad Autónoma de Yucatán, Mérida, México
| | - Andrea Marín-Cervera
- Laboratorio de Parasitología, Centro de Investigaciones Regionales ‘Dr. Hideyo Noguchi’, Universidad Autónoma de Yucatán, Mérida, México
| | - Shineily Garcia-Polanco
- Laboratorio de Parasitología, Centro de Investigaciones Regionales ‘Dr. Hideyo Noguchi’, Universidad Autónoma de Yucatán, Mérida, México
| | - Pedro Martínez-Vega
- Laboratorio de Parasitología, Centro de Investigaciones Regionales ‘Dr. Hideyo Noguchi’, Universidad Autónoma de Yucatán, Mérida, México
| | - Miguel Rosado-Vallado
- Laboratorio de Parasitología, Centro de Investigaciones Regionales ‘Dr. Hideyo Noguchi’, Universidad Autónoma de Yucatán, Mérida, México
| | - Eric Dumonteil
- Department of Tropical Medicine, School of Public Health and Tropical Medicine, and Vector-Borne and Infectious Disease Research Center, Tulane University, New Orleans, LA, USA
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11
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Suescún-Carrero SH, Salamanca-Cardozo LP, Pinazo MJ, Armadans-Gil L. Sensitivity and Specificity of two rapid tests for the diagnosis of infection by Trypanosoma cruzi in a Colombian population. PLoS Negl Trop Dis 2021; 15:e0009483. [PMID: 34077424 PMCID: PMC8202949 DOI: 10.1371/journal.pntd.0009483] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 06/14/2021] [Accepted: 05/17/2021] [Indexed: 01/22/2023] Open
Abstract
Objective To evaluate diagnostic precision of two rapid diagnostic tests (RDT’s) on patients with chronic Chagas disease. Methodology Prospective study with the following inclusion criteria: subjects older than 3 years, signed informed consent. Exclusion criterion: subjects could not have previously received treatment for infection with T. cruzi. The study population were participants in a screening process undertaken in rural and urban zones of the department Boyacá, Colombia. Two RDT’s were performed to all participants: the Chagas Detect Plus InBios (CDP) and the Chagas Stat-Pak (CSP) and as a reference standard the ELISA Chagas III GrupoBios and the Chagas ELISA IgG+IgM I Vircell tests were used. In the case of discordant results between the two ELISA tests, an indirect immunofluorescence was done. Results Three hundred-five (305) subjects were included in the study (38 patients with leishmaniasis), of which 215 tested negative for T cruzi and 90 tested positive according to the reference standard. The sensitivity of the RDT’s were 100% (CI 95% 95.9–100), and the specificity of the CDP was 99.1% (CI 95% 96.6–99.8) and for CSP was 100% (CI 95% 98.3–100). The agreement of CDP was 99.5% and for CSP was 100% with Kappa values of (k = 99.1; CI 95% 92.6–99.8%) and (k = 100; CI 95% 94.3–100), respectively. RDT’s did not present cross-reactions with samples from patients who were positive for leishmaniasis. Conclusions The findings demonstrate excellent results from the RDT’s in terms of validity, safety, and reproducibility. The results obtained provide evidence for the recommendation for using these tests in a Colombian epidemiological context principally in endemic areas in which laboratory installations necessary to perform conventional tests are not available, or they are scarce and to help in diagnosing chronic Chagas disease in order to provide access to treatment as soon as possible. Chagas is a disease caused by the parasite Trypanosoma cruzi, and is one of the most important public health concerns affecting the population of Latin America. This disease presents an acute phase that generally goes undiagnosed and a chronic phase with cardiac manifests principally, is diagnosed through serological tests that are not available in the majority of regions endemic for Chagas disease (CD), the results may take weeks to be returned due to logistical and operational reasons that comprise the main obstacles in initiating treatment of the disease. In the present article, quality indices of two RDT’s were evaluated during a field study in the department of Boyacá Colombia, these tests are easy to administer, require only minimal quantities of sample, provide rapid results and do not require electrical equipment or refrigeration. The sensitivity of the two RDT’s was 100% and the specificity of CDP was 99.1% and for CSP was 100% according to reference tests. The results obtained support the recommendation of using RDT’s in order to help diagnose chronic Chagas disease and thus to improve access to treatment for the populations studied as soon as possible.
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Affiliation(s)
- Sandra Helena Suescún-Carrero
- Grupo de Investigación del Laboratorio de Salud Pública de Boyacá, Secretaria de Salud de Boyacá, Tunja, Colombia, Doctorado en Metodología de la Investigación Biomédica y Salud Pública, Universitat Autònoma de Barcelona, Barcelona, Spain
- * E-mail:
| | - Lyda Pilar Salamanca-Cardozo
- Grupo de Investigación del Laboratorio de Salud Pública de Boyacá, Secretaria de Salud de Boyacá, Tunja, Colombia
| | - María-Jesus Pinazo
- Barcelona Institute for Global Health (ISGlobal), Hospital Clinic—University of Barcelona, Barcelona, Spain
| | - Lluis Armadans-Gil
- Servicio de Medicina Preventiva y Epidemiología, Hospital Universitari Vall d’Hebron—Universitat Autònoma de Barcelona, Barcelona, Spain
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Padilla AM, Yao PY, Landry TJ, Cooley GM, Mahaney SM, Ribeiro I, VandeBerg JL, Tarleton RL. High variation in immune responses and parasite phenotypes in naturally acquired Trypanosoma cruzi infection in a captive non-human primate breeding colony in Texas, USA. PLoS Negl Trop Dis 2021; 15:e0009141. [PMID: 33788859 PMCID: PMC8041201 DOI: 10.1371/journal.pntd.0009141] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 04/12/2021] [Accepted: 03/22/2021] [Indexed: 11/18/2022] Open
Abstract
Trypanosoma cruzi, the causative agent of human Chagas disease, is endemic to the southern region of the United States where it routinely infects many host species. The indoor/outdoor housing configuration used in many non-human primate research and breeding facilities in the southern of the USA provides the opportunity for infection by T. cruzi and thus provides source material for in-depth investigation of host and parasite dynamics in a natural host species under highly controlled and restricted conditions. For cynomolgus macaques housed at such a facility, we used a combination of serial blood quantitative PCR (qPCR) and hemoculture to confirm infection in >92% of seropositive animals, although each method alone failed to detect infection in >20% of cases. Parasite isolates obtained from 43 of the 64 seropositive macaques were of 2 broad genetic types (discrete typing units, (DTU's) I and IV); both within and between these DTU groupings, isolates displayed a wide variation in growth characteristics and virulence, elicited host immune responses, and susceptibility to drug treatment in a mouse model. Likewise, the macaques displayed a diversity in T cell and antibody response profiles that rarely correlated with parasite DTU type, minimum length of infection, or age of the primate. This study reveals the complexity of infection dynamics, parasite phenotypes, and immune response patterns that can occur in a primate group, despite being housed in a uniform environment at a single location, and the limited time period over which the T. cruzi infections were established.
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Affiliation(s)
- Angel M. Padilla
- Center for Tropical and Emerging Global Diseases and Department of Cellular Biology, University of Georgia, Athens, Georgia, United States of America
| | - Phil Y. Yao
- Center for Tropical and Emerging Global Diseases and Department of Cellular Biology, University of Georgia, Athens, Georgia, United States of America
| | - Tre J. Landry
- Center for Tropical and Emerging Global Diseases and Department of Cellular Biology, University of Georgia, Athens, Georgia, United States of America
| | - Gretchen M. Cooley
- Center for Tropical and Emerging Global Diseases and Department of Cellular Biology, University of Georgia, Athens, Georgia, United States of America
| | - Susan M. Mahaney
- Department of Human Genetics, South Texas Diabetes and Obesity Institute, and Center for Vector-Borne Diseases, The University of Texas Rio Grande Valley, Brownsville/Edinburg/Harlingen, Texas, United States of America
| | - Isabela Ribeiro
- Drugs for Neglected Diseases initiative, Geneva, Switzerland
| | - John L. VandeBerg
- Department of Human Genetics, South Texas Diabetes and Obesity Institute, and Center for Vector-Borne Diseases, The University of Texas Rio Grande Valley, Brownsville/Edinburg/Harlingen, Texas, United States of America
| | - Rick L. Tarleton
- Center for Tropical and Emerging Global Diseases and Department of Cellular Biology, University of Georgia, Athens, Georgia, United States of America
- * E-mail:
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Llenas-García J, Wikman-Jorgensen P, Gil-Anguita C, Ramos- Sesma V, Torrús-Tendero D, Martínez-Goñi R, Romero-Nieto M, García-Abellán J, Esteban-Giner MJ, Antelo K, Navarro-Cots M, Buñuel F, Amador C, García-García J, Gascón I, Telenti G, Fuentes-Campos E, Torres I, Gimeno-Gascón A, Ruíz-García MM, Navarro M, Ramos-Rincón JM. Chagas disease screening in pregnant Latin American women: Adherence to a systematic screening protocol in a non-endemic country. PLoS Negl Trop Dis 2021; 15:e0009281. [PMID: 33760816 PMCID: PMC8021187 DOI: 10.1371/journal.pntd.0009281] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 04/05/2021] [Accepted: 03/01/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Chagas disease (CD) is a chronic parasitic disease caused by Trypanosoma cruzi and is endemic to continental Latin America. In Spain, the main transmission route is congenital. We aimed to assess adherence to regional recommendations of universal screening for CD during pregnancy in Latin American women in the province of Alicante from 2014 to 2018. METHODOLOGY/PRINCIPAL FINDINGS Retrospective quality study using two data sources: 1) delivery records of Latin American women that gave birth in the 10 public hospitals of Alicante between January 2014 and December 2018; and 2) records of Chagas serologies carried out in those centers between May 2013 and December 2018. There were 3026 deliveries in Latin American women during the study period; 1178 (38.9%) underwent CD serology. Screening adherence ranged from 17.2% to 59.3% in the different health departments and was higher in Bolivian women (48.3%). Twenty-six deliveries (2.2%) had a positive screening; CD was confirmed in 23 (2%) deliveries of 21 women. Bolivians had the highest seroprevalence (21/112; 18.7%), followed by Colombians (1/333; 0.3%) and Ecuadorians (1/348; 0.3%). Of 21 CD-positive women (19 Bolivians, 1 Colombian, 1 Ecuadorian), infection was already known in 12 (57.1%), and 9 (42.9%) had already been treated. Only 1 of the 12 untreated women (8.3%) was treated postpartum. Follow-up started in 20 of the 23 (87.0%) neonates but was completed only in 11 (47.8%); no cases of congenital transmission were detected. Among the 1848 unscreened deliveries, we estimate 43 undiagnosed cases of CD and 1 to 2 undetected cases of congenital transmission. CONCLUSIONS/SIGNIFICANCE Adherence to recommendations of systematic screening for CD in Latin American pregnant women in Alicante can be improved. Strategies to strengthen treatment of postpartum women and monitoring of exposed newborns are needed. Currently, there may be undetected cases of congenital transmission in our province.
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Affiliation(s)
- Jara Llenas-García
- Internal Medicine Department, Hospital Vega Baja, Orihuela, Spain
- Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO), Valencia, Spain
- Clinical Medicine Department, University Miguel Hernández, Elche, Spain
- * E-mail:
| | - Philip Wikman-Jorgensen
- Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO), Valencia, Spain
- Internal Medicine Department, University Hospital San Juan de Alicante, San Juan de Alicante, Spain
| | | | | | - Diego Torrús-Tendero
- Reference Unit of Imported Diseases and International Health, Alicante General University Hospital, Alicante, Spain
- Biomedical and Health Research Institute of Alicante (ISABIAL), Alicante, Spain
- Parasitology Area, University Miguel Hernández, Elche, Spain
| | | | - Mónica Romero-Nieto
- Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO), Valencia, Spain
- Clinical Medicine Department, University Miguel Hernández, Elche, Spain
- Internal Medicine Department, Elda General University Hospital, Elda, Spain
| | - Javier García-Abellán
- Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO), Valencia, Spain
- Infectious Diseases Unit. Elche General University Hospital, Elche, Spain
| | | | | | - María Navarro-Cots
- Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO), Valencia, Spain
- Microbiology Department, Hospital Vega Baja, Orihuela, Spain
| | - Fernando Buñuel
- Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO), Valencia, Spain
- Microbiology Department, University Hospital San Juan de Alicante, San Juan de Alicante, Spain
| | - Concepción Amador
- Internal Medicine Department, Hospital Marina Baixa, Villajoyosa, Spain
| | | | - Isabel Gascón
- Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO), Valencia, Spain
- Microbiology Department, Elda General University Hospital, Elda, Spain
| | - Guillermo Telenti
- Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO), Valencia, Spain
- Infectious Diseases Unit. Elche General University Hospital, Elche, Spain
| | | | | | - Adelina Gimeno-Gascón
- Biomedical and Health Research Institute of Alicante (ISABIAL), Alicante, Spain
- Microbiology Department, Alicante General University Hospital, Alicante, Spain
| | - María Montserrat Ruíz-García
- Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO), Valencia, Spain
- Microbiology Department, Elche General University Hospital, Elche, Spain
| | - Miriam Navarro
- Department of Public Health, Science History and Gynaecology, University Miguel Hernández, Elche, Spain
| | - José-Manuel Ramos-Rincón
- Clinical Medicine Department, University Miguel Hernández, Elche, Spain
- Reference Unit of Imported Diseases and International Health, Alicante General University Hospital, Alicante, Spain
- Biomedical and Health Research Institute of Alicante (ISABIAL), Alicante, Spain
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Waniek PJ, Araújo CAC, Jansen AM, Costa J. First genotyping of Trypanosoma cruzi from naturally infected Triatoma juazeirensis, Triatoma melanica and Triatoma sherlocki from Bahia State, Brazil. Med Vet Entomol 2021; 35:134-140. [PMID: 32648329 DOI: 10.1111/mve.12459] [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] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 05/04/2020] [Accepted: 05/27/2020] [Indexed: 06/11/2023]
Abstract
Many previous studies have shown a great phylogenetic and biological variability of Trypanosoma cruzi using different molecular and biochemical methods. Populations of T. cruzi were initially clustered into two main lineages called TcI and TcII by the size of the mini-exon PCR product. In the present study, 33 isolates derived from three triatomine taxa, which belong to the Triatoma brasiliensis species complex (Triatoma juazeirensis, Triatoma melanica and Triatoma sherlocki); collected in three distinct areas of Bahia state were characterized by PCR. The isolates were identified by the size of the mini-exon gene, 18S rRNA and 24Sα rRNA amplicons. T. cruzi isolates obtained in sylvatic and intradomiciliar ecotopes, derived from T. juazeirensis and T. melanica, were identified as TcI while the parasites originated from T. sherlocki were characterized as TcI and TcII genotypes, respectively. Those species are present in sylvatic ecotopes but are able to infest intradomiciliar areas. Therefore, it would be important to maintain studies in those localities of Bahia and further investigate the possibilities of Chagas disease transmission. Human disease may occur by any T. cruzi genotype and not only by TcII as it is the case in Amazonia.
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Affiliation(s)
- P J Waniek
- Laboratório de Biologia de Insetos, Departamento de Biologia Geral, Universidade Federal Fluminense, Rio de Janeiro, Brazil
- Laboratório de Biologia de Tripanosomatídeos, Instituto Oswaldo Cruz-FIOCRUZ, Rio de Janeiro, Brazil
| | - C A C Araújo
- Laboratório de Biologia de Insetos, Departamento de Biologia Geral, Universidade Federal Fluminense, Rio de Janeiro, Brazil
- Laboratório de Biodiversidade Entomológica, Instituto Oswaldo Cruz-FIOCRUZ, Rio de Janeiro, Brazil
| | - A M Jansen
- Laboratório de Biologia de Tripanosomatídeos, Instituto Oswaldo Cruz-FIOCRUZ, Rio de Janeiro, Brazil
| | - J Costa
- Laboratório de Biodiversidade Entomológica, Instituto Oswaldo Cruz-FIOCRUZ, Rio de Janeiro, Brazil
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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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Finamore-Araujo P, Faier-Pereira A, Ramon do Nascimento Brito C, Gomes Peres E, Kazumy de Lima Yamaguchi K, Trotta Barroso Ferreira R, Moreira OC. Validation of a novel multiplex real-time PCR assay for Trypanosoma cruzi detection and quantification in açai pulp. PLoS One 2021; 16:e0246435. [PMID: 33529258 PMCID: PMC7853518 DOI: 10.1371/journal.pone.0246435] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 01/19/2021] [Indexed: 11/19/2022] Open
Abstract
In Brazil, orally acquired T. cruzi infection has become the most relevant transmission mechanisms from public health perspective. Around 70% of new Chagas disease cases have been associated with consumption of contaminated food or beverages. Açai (Euterpe oleracea and Euterpe precatoria) is currently one of the most commercialized Amazonian fruits in the Brazilian and international markets. Therefore, it has become important to incorporate in the production process some procedures to measure out effective hygiene and product quality control required by global market. Molecular methods have been developed for rapid detection and quantification of T. cruzi DNA in several biological samples, including food matrices, for epidemiological investigation of Chagas disease and food quality control. However, a high-performance molecular methodology since DNA extraction until detection and quantification of T. cruzi DNA in açai berry pulp is still needed. Herein, a simple DNA extraction methodology was standardized from the supernatant of açai berry pulp stabilized in a 6M Guanidine-HCl/0.2M EDTA buffer. In addition, a multiplex real time qPCR assay, targeting T. cruzi DNA and an Exogenous Internal Positive Control was developed and validated, using reference from all T. cruzi DTUs and commercial samples of açai pulp, from an endemic municipality with previous history of oral Chagas disease outbreak. Thus, a high-sensitivity qPCR assay, that could detect up to 0.01 parasite equivalents/mL in açai, was reached. As of the 45 commercial samples analyzed, 9 (20%) were positive for T. cruzi. This high-sensitive, fast, and easy-to-use molecular assay is compatible with most of the laboratories involved in the investigations of oral Chagas disease outbreaks, representing an important tool to the epidemiology, control, and surveillance of Chagas disease.
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Affiliation(s)
- Paula Finamore-Araujo
- Plataforma Fiocruz de PCR em Tempo Real RPT09A –Laboratório de Biologia Molecular e Doenças Endêmicas, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Amanda Faier-Pereira
- Plataforma Fiocruz de PCR em Tempo Real RPT09A –Laboratório de Biologia Molecular e Doenças Endêmicas, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Carlos Ramon do Nascimento Brito
- Departamento de Análises Clínicas e Toxicológicas, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
| | | | | | | | - Otacilio Cruz Moreira
- Plataforma Fiocruz de PCR em Tempo Real RPT09A –Laboratório de Biologia Molecular e Doenças Endêmicas, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
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Affiliation(s)
- Alba Valdez-Tah
- Department of Anthropology, University of California–Irvine, City of Irvine, California, United States of America
| | - Carlos N. Ibarra-Cerdeña
- Departamento de Ecología Humana, Centro de Investigaciones y Estudios Avanzados del IPN (Cinvestav) Unidad Mérida. Mérida, Yucatán, México
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Ghersi BM, Peterson AC, Gibson NL, Dash A, Elmayan A, Schwartzenburg H, Tu W, Riegel C, Herrera C, Blum MJ. In the heart of the city: Trypanosoma cruzi infection prevalence in rodents across New Orleans. Parasit Vectors 2020; 13:577. [PMID: 33189151 PMCID: PMC7666460 DOI: 10.1186/s13071-020-04446-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 07/07/2020] [Accepted: 10/30/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Trypanosoma cruzi - the causative agent of Chagas disease - is known to circulate in commensal pests, but its occurrence in urban environments is not well understood. We addressed this deficit by determining the distribution and prevalence of T. cruzi infection in urban populations of commensal and wild rodents across New Orleans (Louisiana, USA). We assessed whether T. cruzi prevalence varies according to host species identity and species co-occurrences, and whether T. cruzi prevalence varies across mosaics of abandonment that shape urban rodent demography and assemblage structure in the city. METHODS Leveraging city-wide population and assemblage surveys, we tested 1428 rodents comprising 5 species (cotton rats, house mice, Norway rats, rice rats and roof rats) captured at 98 trapping sites in 11 study areas across New Orleans including nine residential neighborhoods and a natural area in Orleans Parish and a neighborhood in St. Bernard Parish. We also assayed Norway rats at one site in Baton Rouge (Louisiana, USA). We used chi-square tests to determine whether infection prevalence differed among host species, among study areas, and among trapping sites according to the number of host species present. We used generalized linear mixed models to identify predictors of T. cruzi infection for all rodents and each host species, respectively. RESULTS We detected T. cruzi in all host species in all study areas in New Orleans, but not in Baton Rouge. Though overall infection prevalence was 11%, it varied by study area and trapping site. There was no difference in prevalence by species, but roof rats exhibited the broadest geographical distribution of infection across the city. Infected rodents were trapped in densely populated neighborhoods like the French Quarter. Infection prevalence seasonally varied with abandonment, increasing with greater abandonment during the summer and declining with greater abandonment during the winter. CONCLUSIONS Our findings illustrate that T. cruzi can be widespread in urban landscapes, suggesting that transmission and disease risk is greater than is currently recognized. Our findings also suggest that there is disproportionate risk of transmission in historically underserved communities, which could reinforce long-standing socioecological disparities in New Orleans and elsewhere.
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Affiliation(s)
- Bruno M. Ghersi
- Department of Ecology & Evolutionary Biology, University of Tennessee, Knoxville, TN USA
| | - Anna C. Peterson
- Department of Ecology & Evolutionary Biology, University of Tennessee, Knoxville, TN USA
| | - Nathaniel L. Gibson
- Department of Ecology & Evolutionary Biology, University of Tennessee, Knoxville, TN USA
| | - Asha Dash
- Department of Tropical Medicine, Vector-Borne Infectious Disease Research Center, Tulane University, School of Public Health and Tropical Medicine, New Orleans, LA USA
| | - Ardem Elmayan
- Department of Tropical Medicine, Vector-Borne Infectious Disease Research Center, Tulane University, School of Public Health and Tropical Medicine, New Orleans, LA USA
| | - Hannah Schwartzenburg
- Department of Tropical Medicine, Vector-Borne Infectious Disease Research Center, Tulane University, School of Public Health and Tropical Medicine, New Orleans, LA USA
| | - Weihong Tu
- Department of Tropical Medicine, Vector-Borne Infectious Disease Research Center, Tulane University, School of Public Health and Tropical Medicine, New Orleans, LA USA
| | - Claudia Riegel
- City of New Orleans Mosquito, Termite, Rodent Control Board, New Orleans, LA USA
| | - Claudia Herrera
- Department of Tropical Medicine, Vector-Borne Infectious Disease Research Center, Tulane University, School of Public Health and Tropical Medicine, New Orleans, LA USA
| | - Michael J. Blum
- Department of Ecology & Evolutionary Biology, University of Tennessee, Knoxville, TN USA
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Affiliation(s)
- Fernando Abad-Franch
- Núcleo de Medicina Tropical, Faculdade de Medicina, Universidade de Brasília, Brasília, Brazil
- * E-mail:
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Buss LF, Campos de Oliveira- da Silva L, Moreira CHV, Manuli ER, Sales FC, Morales I, Di Germanio C, de Almeida-Neto C, Bakkour S, Constable P, Pinto-Filho MM, Ribeiro AL, Busch M, Sabino EC. Declining antibody levels to Trypanosoma cruzi correlate with polymerase chain reaction positivity and electrocardiographic changes in a retrospective cohort of untreated Brazilian blood donors. PLoS Negl Trop Dis 2020; 14:e0008787. [PMID: 33108390 PMCID: PMC7647114 DOI: 10.1371/journal.pntd.0008787] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 04/21/2020] [Revised: 11/06/2020] [Accepted: 09/09/2020] [Indexed: 02/06/2023] Open
Abstract
Background Although infection with Trypanosoma cruzi is thought to be lifelong, less than half of those infected develop cardiomyopathy, suggesting greater parasite control or even clearance. Antibody levels appear to correlate with T. cruzi (antigen) load. We test the association between a downwards antibody trajectory, PCR positivity and ECG alterations in untreated individuals with Chagas disease. Methodology/Principal findings This is a retrospective cohort of T. cruzi seropositive blood donors. Paired blood samples (index donation and follow-up) were tested using the VITROS Immunodiagnostic Products Anti-T.cruzi (Chagas) assay (Ortho Clinical Diagnostics, Raritan NJ) and PCR performed on the follow-up sample. A 12-lead resting ECG was performed. Significant antibody decline was defined as a reduction of > 1 signal-to-cutoff (S/CO) unit on the VITROS assay. Follow-up S/CO of < 4 was defined as borderline/low. 276 untreated seropositive blood donors were included. The median (IQR) follow-up was 12.7 years (8.5–16.9). 56 (22.1%) subjects had a significant antibody decline and 35 (12.7%) had a low/borderline follow-up result. PCR positivity was lower in the falling (26.8% vs 52.8%, p = 0.001) and low/borderline (17.1% vs 51.9%, p < 0.001) antibody groups, as was the rate of ECG abnormalities. Falling and low/borderline antibody groups were predominantly composed of individuals with negative PCR and normal ECG findings: 64% and 71%, respectively. Conclusions/Significance Low and falling antibody levels define a phenotype of possible spontaneous parasite clearance. Infection with the single-celled parasite Trypanosoma cruzi (Chagas disease) is thought to be lifelong. However, only a third of infected people develop Chagas cardiomyopathy–the main disease manifestation. This may reflect the different extent to which individuals control the parasite, with some potentially clearing it entirely. In chronically infected immunocompetent patients, a marker of parasite burden is the quantity of antibody against T. cruzi in the blood: more parasite, more immune stimulation, more antibody. In this study we show how antibody levels change over many years in a cohort of untreated patients with Chagas disease. We find that among individuals with falling or low/borderline antibody levels there was a lower rate of parasite detection in the blood and a lower rate of cardiomyopathy. 60% of subjects with falling antibody levels had no evidence of active disease, twice as many as among patients with other antibody trajectories (stable or rising). Our findings support an account of the natural history of Chagas disease in which a proportion of those infected achieve a greater control of the parasite, with some individuals potentially clearing it completely.
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Affiliation(s)
- Lewis F. Buss
- Instituto de Medicina Tropical da Faculdade de Medicina (FMUSP) da Universidade de São Paulo, São Paulo, Brazil
| | | | - Carlos H. V. Moreira
- Instituto de Medicina Tropical da Faculdade de Medicina (FMUSP) da Universidade de São Paulo, São Paulo, Brazil
| | - Erika R. Manuli
- Instituto de Medicina Tropical da Faculdade de Medicina (FMUSP) da Universidade de São Paulo, São Paulo, Brazil
| | - Flavia C. Sales
- Instituto de Medicina Tropical da Faculdade de Medicina (FMUSP) da Universidade de São Paulo, São Paulo, Brazil
| | - Ingra Morales
- Instituto de Medicina Tropical da Faculdade de Medicina (FMUSP) da Universidade de São Paulo, São Paulo, Brazil
| | - Clara Di Germanio
- Vitalant Research Institute, San Francisco, CA, United States of America
| | | | - Sonia Bakkour
- Vitalant Research Institute, San Francisco, CA, United States of America
| | - Paul Constable
- Ortho Clinical Diagnostics, Rochester, NY, United States of America
| | - Marcelo M. Pinto-Filho
- Telehealth Center, Hospital das Clínicas, and Internal Medicine Department, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Antonio L. Ribeiro
- Telehealth Center, Hospital das Clínicas, and Internal Medicine Department, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Michael Busch
- Vitalant Research Institute, San Francisco, CA, United States of America
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, United States of America
| | - Ester C. Sabino
- Instituto de Medicina Tropical da Faculdade de Medicina (FMUSP) da Universidade de São Paulo, São Paulo, Brazil
- * E-mail:
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Herreros-Cabello A, Callejas-Hernández F, Gironès N, Fresno M. Trypanosoma Cruzi Genome: Organization, Multi-Gene Families, Transcription, and Biological Implications. Genes (Basel) 2020; 11:E1196. [PMID: 33066599 PMCID: PMC7602482 DOI: 10.3390/genes11101196] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [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: 09/07/2020] [Revised: 10/08/2020] [Accepted: 10/12/2020] [Indexed: 01/20/2023] Open
Abstract
Chagas disease caused by the parasite Trypanosoma cruzi affects millions of people. Although its first genome dates from 2005, its complexity hindered a complete assembly and annotation. However, the new sequencing methods have improved genome annotation of some strains elucidating the broad genetic diversity and complexity of this parasite. Here, we reviewed the genomic structure and regulation, the genetic diversity, and the analysis of the principal multi-gene families of the recent genomes for several strains. The telomeric and sub-telomeric regions are sites with high recombination events, the genome displays two different compartments, the core and the disruptive, and the genome plasticity seems to play a key role in the survival and the infection process. Trypanosoma cruzi (T. cruzi) genome is composed mainly of multi-gene families as the trans-sialidases, mucins, and mucin-associated surface proteins. Trans-sialidases are the most abundant genes in the genome and show an important role in the effectiveness of the infection and the parasite survival. Mucins and MASPs are also important glycosylated proteins of the surface of the parasite that play a major biological role in both insect and mammal-dwelling stages. Altogether, these studies confirm the complexity of T. cruzi genome revealing relevant concepts to better understand Chagas disease.
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Affiliation(s)
- Alfonso Herreros-Cabello
- Centro de Biología Molecular Severo Ochoa, Consejo Superior de Investigaciones Científicas, Universidad Autónoma de Madrid, Cantoblanco, 28049 Madrid, Spain; (A.H.-C.); (F.C.-H.)
| | - Francisco Callejas-Hernández
- Centro de Biología Molecular Severo Ochoa, Consejo Superior de Investigaciones Científicas, Universidad Autónoma de Madrid, Cantoblanco, 28049 Madrid, Spain; (A.H.-C.); (F.C.-H.)
| | - Núria Gironès
- Centro de Biología Molecular Severo Ochoa, Consejo Superior de Investigaciones Científicas, Universidad Autónoma de Madrid, Cantoblanco, 28049 Madrid, Spain; (A.H.-C.); (F.C.-H.)
- Instituto Sanitario de Investigación Princesa, 28006 Madrid, Spain
| | - Manuel Fresno
- Centro de Biología Molecular Severo Ochoa, Consejo Superior de Investigaciones Científicas, Universidad Autónoma de Madrid, Cantoblanco, 28049 Madrid, Spain; (A.H.-C.); (F.C.-H.)
- Instituto Sanitario de Investigación Princesa, 28006 Madrid, Spain
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Morais RCSD, Melo MGND, Goes TCD, Pessoa E Silva R, Morais RFD, Guerra JADO, Brito MEFD, Brandão-Filho SP, Paiva Cavalcanti MD. Duplex qPCR for Leishmania species identification using lesion imprint on filter paper. Exp Parasitol 2020; 219:108019. [PMID: 33053400 DOI: 10.1016/j.exppara.2020.108019] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 10/05/2020] [Accepted: 10/09/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND American cutaneous leishmaniasis (ACL) is caused by different Leishmania parasites, which stimulate and direct the immune response against the infection. OBJECTIVE To evaluate the TaqMan probe technology applicability to diagnose and identifying of Leishmania spp. related to the ACL etiology. METHODOLOGY Through the MEGA 6.0 software, performed an in silico analysis using multiple alignments of Leishmania spp. which were available on GenBank for different genomic targets. The efficiency (e), specificity and detection limit (DL) were calculated for each system, these were associated to compose a duplex-qPCR (DqPCR). The samples of blood, lesion biopsy and lesion imprint on filter paper from patients residing in states of Amazonas (AM) and Pernambuco (PE)-Brazil, (cases and controls) were used to perform the DqPCR technique. The capacity to identify the Leishmania species was determined by comparison with isoenzymes method and sequencing analysis. RESULTS Internal Transcribed Spacer 1 (rDNA) was the target selected. Two sets of primers and probes were designed and combined: SVS for subgenus Viannia and LaS for L. (L.) amazonensis. The results were: SVSe = 93.24%, SVS DL = 50 fg/μL; LaSe = 89.3%, LaSLD = 5 fg/μL presented 100% of specificity. In total, 236 individuals participated of the present study, wherein were 101 blood samples, 33 biopsies and 147 lesion imprints. The imprint was the most sensitive sample, showing 83.06% of sensitivity, 86.96% of specificity and substantial agreement between the techniques analysis (k = 0.531; p < 0,001). Regarding the species identification, DqPCR and sequencing/isoenzymes have agreed at 100%, since the infection is caused by a single Leishmania species. CONCLUSION The DqPCR technique was applicable in diagnosis and identification of Leishmania spp. (subgenus Viannia and L. amazonensis). Furthermore, the lesion imprint is less invasive, allowing a fewer discomfort and greater acceptance by the patients, in addition of being low cost and easy handling.
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Affiliation(s)
| | | | - Tayná Correia de Goes
- Aggeu Magalhães Institute, FIOCRUZ-PE. Rego Avenue, University City, Recife, Pernambuco, ZIP 50670-420, Brazil.
| | - Rômulo Pessoa E Silva
- Aggeu Magalhães Institute, FIOCRUZ-PE. Rego Avenue, University City, Recife, Pernambuco, ZIP 50670-420, Brazil.
| | - Rômulo Freire de Morais
- Medicine Tropical Foundation, Dr. Heitor Vieira Dourado, Pedro Teixeira Avenue, Dom Pedro, Manaus, Amazonas, ZIP 69040-000, Brazil.
| | - Jorge Augusto de Oliveira Guerra
- Medicine Tropical Foundation, Dr. Heitor Vieira Dourado, Pedro Teixeira Avenue, Dom Pedro, Manaus, Amazonas, ZIP 69040-000, Brazil.
| | | | - Sinval Pinto Brandão-Filho
- Aggeu Magalhães Institute, FIOCRUZ-PE. Rego Avenue, University City, Recife, Pernambuco, ZIP 50670-420, Brazil.
| | - Milena de Paiva Cavalcanti
- Aggeu Magalhães Institute, FIOCRUZ-PE. Rego Avenue, University City, Recife, Pernambuco, ZIP 50670-420, Brazil.
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Calvet CM, Silva TA, Thomas D, Suzuki B, Hirata K, Siqueira-Neto JL, McKerrow JH. Long term follow-up of Trypanosoma cruzi infection and Chagas disease manifestations in mice treated with benznidazole or posaconazole. PLoS Negl Trop Dis 2020; 14:e0008726. [PMID: 32970692 PMCID: PMC7561097 DOI: 10.1371/journal.pntd.0008726] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 10/15/2020] [Accepted: 08/17/2020] [Indexed: 12/27/2022] Open
Abstract
Chagas' Disease, caused by the protozoan parasite Trypanosoma cruzi, is responsible for up to 41% of the heart failures in endemic areas in South America and is an emerging infection in regions of North America, Europe, and Asia. Treatment is suboptimal due to two factors. First, the lack of an adequate biomarker to predict disease severity and response to therapy; and second, up to 120-days treatment course coupled with a significant incidence of adverse effects from the drug currently used. Because the disease can manifest itself clinically a few years to decades after infection, controversy remains concerning the suitability of current drug treatment (benznidazole), and the efficacy of alternative drugs (e.g. posaconazole). We therefore followed the clinical course, and PCR detection of parasite burden, in a mouse model of infection for a full year following treatment with benznidazole or posaconazole. Efficacy of the two drugs depended on whether the treatment was performed during the acute model or the chronic model of infection. Posaconazole was clearly superior in treatment of acute disease whereas only benznidazole had efficacy in the chronic model. These results have important implications for the design and analysis of human clinical trials, and the use of specific drugs in specific clinical settings. Chagas disease is a parasitic infection that can be incapacitating, leading to heart failure with risk of sudden death. Currently, only one drug treatment is available, Benznidazole, but it demands a long period of treatment, has variable efficacy and leads to serious side effects that can lead to discontinuation of the treatment. An alternative therapy, the anti-fungal drug, Posaconazole, was repurposed for treatment of Chagas disease, but its use has been controversial with conflicting results in studies from different groups. In our approach, we followed the parasitic infection, disease symptoms and persistence of the pathogen in mice for a full year after treatment with Benznidazole or Posaconazole. Posaconazole treatment was more effective in the early infection (acute disease) whereas only Benznidazole had efficacy in the chronic model. This information can have important implications for the design and analysis of human clinical trials, and the use of specific drugs in specific clinical settings.
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Affiliation(s)
- Claudia Magalhães Calvet
- Center for Discovery and Innovation in Parasitic Diseases, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, California, United States of America
- Cellular Ultrastructure Laboratory, Oswaldo Cruz Institute (IOC), FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Tatiana Araújo Silva
- Center for Discovery and Innovation in Parasitic Diseases, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, California, United States of America
- Cellular Ultrastructure Laboratory, Oswaldo Cruz Institute (IOC), FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Diane Thomas
- Center for Discovery and Innovation in Parasitic Diseases, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, California, United States of America
| | - Brian Suzuki
- Center for Discovery and Innovation in Parasitic Diseases, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, California, United States of America
| | - Ken Hirata
- Center for Discovery and Innovation in Parasitic Diseases, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, California, United States of America
| | - Jair Lage Siqueira-Neto
- Center for Discovery and Innovation in Parasitic Diseases, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, California, United States of America
| | - James H. McKerrow
- Center for Discovery and Innovation in Parasitic Diseases, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, California, United States of America
- * E-mail:
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Lilioso M, Reigada C, Pires-Silva D, Fontes FVHM, Limeira C, Monsalve-Lara J, Folly-Ramos E, Harry M, Costa J, Almeida CE. Dynamics of food sources, ecotypic distribution and Trypanosoma cruzi infection in Triatoma brasiliensis from the northeast of Brazil. PLoS Negl Trop Dis 2020; 14:e0008735. [PMID: 32986738 PMCID: PMC7575107 DOI: 10.1371/journal.pntd.0008735] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 05/06/2020] [Revised: 10/20/2020] [Accepted: 08/19/2020] [Indexed: 12/15/2022] Open
Abstract
Innovative approaches used to combat Chagas disease transmission tend to combine a set of comprehensive efforts to understand the ecology of local vectors. In this work we identified molecularly the blood meal of 181 Triatoma brasiliensis, distributed in 18 populations (8 sylvatic and 10 peridomestic), which were collected across a range of 240 km (East-West) and 95 km (North-South) in the semi-arid region of northeastern, Brazil. We used the vertebrate mitochondrial gene (cytochrome B) sequencing applied to DNA isolated from bug midgut to identify the insect blood meal sources via the BLAST procedure. The peridomestic populations were classified according to two main hypotheses of site-occupancy for T. brasiliensis: the first says that the infestation is mainly driven by structures that resemble its natural habitat (stony-like ecotopes) and the second assumes that it is associated with key-hosts (rodents and goats). Rodents of the Caviidae family (Galea spixii and Kerodon rupestris) were identified as the key-host of T. brasiliensis, but also the potential Trypanosoma cruzi reservoir-able to connect the sylvatic and domestic T. cruzi cycle. Cats also deserve to be studied better, as potential T. cruzi reservoirs. By modeling the food sources + site-occupancy + T. cruzi natural infection, we identified man-made ecotopes suitable for forming dense triatomine infestations with high rates of T. cruzi natural infection, which may be taken into account for vector control measures.
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Affiliation(s)
- Maurício Lilioso
- Instituto de Biologia, Universidade Estadual de Campinas – UNICAMP, Brazil
| | - Carolina Reigada
- Centro de Ciências Biológicas e da Saúde, Departamento de Ecologia e Biologia Evolutiva, Universidade Federal de São Carlos – UFSCAR, Brazil
| | - Dayane Pires-Silva
- Instituto de Biologia, Universidade Estadual de Campinas – UNICAMP, Brazil
| | | | - Cleanne Limeira
- Instituto de Biologia, Universidade Estadual de Campinas – UNICAMP, Brazil
| | | | | | - Myriam Harry
- Université Paris-Saclay, CNRS, IRD, UMR Évolution, Génomes, Comportement et Écologie, Gif-sur-Yvette, France
| | - Jane Costa
- Laboratório de Biodiversidade Entomológica, Instituto Oswaldo Cruz, Fiocruz, Av. Brasil, Manguinhos, Rio de Janeiro, Brazil
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Besuschio SA, Picado A, Muñoz-Calderón A, Wehrendt DP, Fernández M, Benatar A, Diaz-Bello Z, Irurtia C, Cruz I, Ndung’u JM, Cafferata ML, Montenegro G, Sosa Estani S, Lucero RH, Alarcón de Noya B, Longhi SA, Schijman AG. Trypanosoma cruzi loop-mediated isothermal amplification (Trypanosoma cruzi Loopamp) kit for detection of congenital, acute and Chagas disease reactivation. PLoS Negl Trop Dis 2020; 14:e0008402. [PMID: 32797041 PMCID: PMC7458301 DOI: 10.1371/journal.pntd.0008402] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 01/22/2020] [Revised: 08/31/2020] [Accepted: 05/20/2020] [Indexed: 12/15/2022] Open
Abstract
A Trypanosoma cruzi Loopamp kit was recently developed as a ready-to-use diagnostic method requiring minimal laboratory facilities. We evaluated its diagnostic accuracy for detection of acute Chagas disease (CD) in different epidemiological and clinical scenarios. In this retrospective study, a convenience series of clinical samples (venous blood treated with EDTA or different stabilizer agents, heel-prick blood in filter paper or cerebrospinal fluid samples (CSF)) from 30 infants born to seropositive mothers (13 with congenital CD and 17 noninfected), four recipients of organs from CD donors, six orally-infected cases after consumption of contaminated guava juice and six CD patients coinfected with HIV at risk of CD reactivation (N = 46 patients, 46 blood samples and 1 CSF sample) were tested by T. cruzi Loopamp kit (Tc LAMP) and standardized quantitative real-time PCR (qPCR). T. cruzi Loopamp accuracy was estimated using the case definition in the different groups as a reference. Cohen's kappa coefficient (κ) was applied to measure the agreement between Tc LAMP (index test) and qPCR (reference test). Sensitivity and specificity of T. cruzi Loopamp kit in blood samples from the pooled clinical groups was 93% (95% CI: 77-99) and 100% (95% CI: 80-100) respectively. The agreement between Tc LAMP and qPCR was almost perfect (κ = 0.92, 95% CI: 0.62-1.00). The T. cruzi Loopamp kit was sensitive and specific for detection of T. cruzi infection. It was carried out from DNA extracted from peripheral blood samples (via frozen EDTA blood, guanidine hydrochloride-EDTA blood, DNAgard blood and dried blood spots), as well as in CSF specimens infected with TcI or TcII/V/VI parasite populations. The T. cruzi Loopamp kit appears potentially useful for rapid detection of T. cruzi infection in congenital, acute and CD reactivation due to HIV infection.
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Affiliation(s)
- Susana A. Besuschio
- Laboratorio de Biología Molecular de la Enfermedad de Chagas, Instituto de Investigaciones en Ingeniería Genética y Biología Molecular “Dr Héctor Torres”, (INGEBI-CONICET), Buenos Aires, Argentina
| | - Albert Picado
- Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland
| | - Arturo Muñoz-Calderón
- Laboratorio de Biología Molecular de la Enfermedad de Chagas, Instituto de Investigaciones en Ingeniería Genética y Biología Molecular “Dr Héctor Torres”, (INGEBI-CONICET), Buenos Aires, Argentina
| | - Diana P Wehrendt
- Laboratorio de Biología Molecular de la Enfermedad de Chagas, Instituto de Investigaciones en Ingeniería Genética y Biología Molecular “Dr Héctor Torres”, (INGEBI-CONICET), Buenos Aires, Argentina
| | - Marisa Fernández
- Hospital de Enfermedades Infecciosas “Dr. Francisco J. Muñiz” Buenos Aires, Argentina
- Instituto Nacional de Parasitología, “Dr Mario Fatala Chabén”, ANLIS CG Malbrán, Buenos Aires, Argentina
| | - Alejandro Benatar
- Laboratorio de Biología Molecular de la Enfermedad de Chagas, Instituto de Investigaciones en Ingeniería Genética y Biología Molecular “Dr Héctor Torres”, (INGEBI-CONICET), Buenos Aires, Argentina
| | - Zoraida Diaz-Bello
- Instituto de Medicina Tropical, Universidad Central de Venezuela, Caracas, Venezuela 5
| | - Cecilia Irurtia
- Hospital Nacional “Profesor Alejandro Posadas”, Villa Sarmiento, Buenos Aires, Argentina
| | - Israel Cruz
- Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Joseph M Ndung’u
- Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland
| | - María L Cafferata
- Departamento en Salud de la Madre y el Niño, Instituto de Efectividad Clínica y Sanitaria – Centro de Investigación en Epidemiología y Salud Pública (IECS-CIESP), Buenos Aires, Argentina
| | - Graciela Montenegro
- Hospital Nacional “Profesor Alejandro Posadas”, Villa Sarmiento, Buenos Aires, Argentina
| | - Sergio Sosa Estani
- Instituto Nacional de Parasitología, “Dr Mario Fatala Chabén”, ANLIS CG Malbrán, Buenos Aires, Argentina
| | - Raúl H. Lucero
- Área de Biología Molecular, Instituto de Medicina Regional, Universidad Nacional del Nordeste, Resistencia, Argentina
| | | | - Silvia A Longhi
- Laboratorio de Biología Molecular de la Enfermedad de Chagas, Instituto de Investigaciones en Ingeniería Genética y Biología Molecular “Dr Héctor Torres”, (INGEBI-CONICET), Buenos Aires, Argentina
| | - Alejandro G Schijman
- Laboratorio de Biología Molecular de la Enfermedad de Chagas, Instituto de Investigaciones en Ingeniería Genética y Biología Molecular “Dr Héctor Torres”, (INGEBI-CONICET), Buenos Aires, Argentina
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Sáez-Alquezar A, Junqueira ACV, Durans ADM, Guimarães AV, Corrêa JA, Provance DW, Cabello PH, Coura JR, Viñas PA. Application of WHO International Biological Reference Standards to evaluate commercial serological tests for chronic Chagas disease. Mem Inst Oswaldo Cruz 2020; 115:e200214. [PMID: 32725060 PMCID: PMC7379854 DOI: 10.1590/0074-02760200214] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 07/09/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Chagas disease, resulting from Trypanosoma cruzi infections, continues to be a health concern mainly in Latin American countries where the parasite is endemic. The laboratory diagnosis of a chronic infection is determined through serological assays for antibodies against T. cruzi and several tests are available that differ in key components, formats and methodologies. To date, no single test meets the criteria of a gold standard. The situation is further complicated by the difficulties associated with performance comparisons between different immunoassays or methodologies executed at different times and geographical areas. OBJECTIVE To improve the diagnosis of Chagas disease, the WHO coordinated the development of two International Biological Reference Standards for antibodies against anti-T. cruzi: NIBSC 09/186 and NIBSC 09/188 that respectively represent geographical regions with the highest prevalence of TcII and TcI lineages of the parasite. METHODS The principle goal of this study was to verify the behavior of these standards when assayed by several commercially available serological tests that employ different methods to capture and detect human anti-T. cruzi antibodies. FINDINGS AND MAIN CONCLUSIONS The results reinforce the recommendation that these standards be considered for performance evaluations of commercialised immunoassays and should be an integral step in the development of new test components or assay paradigms.
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Affiliation(s)
- Amadeo Sáez-Alquezar
- Sociedade Brasileira de Análises Clínicas, Programa Nacional de Controle de Qualidade, Rio de Janeiro, RJ, Brasil
| | | | - Andressa da Matta Durans
- Fundação Oswaldo Cruz-Fiocruz, Centro de Desenvolvimento Tecnológico em Saúde, Rio de Janeiro, RJ, Brasil
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório Interdisciplinar de Pesquisas Médicas, Rio de Janeiro, RJ, Brasil
| | - André Valpassos Guimarães
- Sociedade Brasileira de Análises Clínicas, Programa Nacional de Controle de Qualidade, Rio de Janeiro, RJ, Brasil
| | - José Abol Corrêa
- Sociedade Brasileira de Análises Clínicas, Programa Nacional de Controle de Qualidade, Rio de Janeiro, RJ, Brasil
| | - D William Provance
- Fundação Oswaldo Cruz-Fiocruz, Centro de Desenvolvimento Tecnológico em Saúde, Rio de Janeiro, RJ, Brasil
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório Interdisciplinar de Pesquisas Médicas, Rio de Janeiro, RJ, Brasil
| | - Pedro Hernan Cabello
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Genética Humana, Rio de Janeiro, RJ, Brasil
- Universidade do Grande Rio, Laboratório de Genética, Rio de Janeiro, RJ, Brasil
| | - José Rodrigues Coura
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Doenças Parasitárias, Rio de Janeiro, RJ, Brasil
| | - Pedro Albajar Viñas
- World Health Organization, Department of Control of Neglected Tropical Diseases, Geneva, Switzerland
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Tavares de Oliveira M, Sulleiro E, Silgado Gimenez A, de Lana M, Zingales B, Santana da Silva J, Marin-Neto JA, Molina I. Quantification of parasite burden of Trypanosoma cruzi and identification of Discrete Typing Units (DTUs) in blood samples of Latin American immigrants residing in Barcelona, Spain. PLoS Negl Trop Dis 2020; 14:e0008311. [PMID: 32497037 PMCID: PMC7271996 DOI: 10.1371/journal.pntd.0008311] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 02/07/2020] [Accepted: 04/20/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Trypanosoma cruzi has a high genetic and biological diversity and has been subdivided into seven genetic lineages, named TcI-TcVI and TcBat. DTUs TcI-TcII-TcV and TcVI are agents of ChD in different regions of Latin America. Due to population movements, the disease is an emergent global public health problem. Thus, the aim of this study was to quantify the parasitic load and identify the presence of T. cruzi DTUs in 101 Latin American immigrants with chronic ChD, residing in Barcelona, Spain. METHODOLOGY / PRINCIPAL FINDINGS 5ml of peripheral blood were collected in guanidine/EDTA from each patient for DNA extraction, quantification of the parasitic load and genotyping. A great variation of the parasitic load of the patients was verified: from 0.001 to 22.2 T. cruzi DNA (fg) / Blood DNA (ng). In patients from Bolivia the parasitic load was 3.76±4.43 T. cruzi DNA (fg) / Blood DNA (ng) (mean ± SD), in patients of other countries was 0.95±1.38 T. cruzi DNA (fg) / Blood DNA (ng). No statistically significant difference was observed in the parasitic load between patients with the indeterminate and cardiac forms of ChD (p = 0,57). Parasite genotyping was performed by multilocus conventional PCR. In patients from Bolivia there was a nearly equal prevalence of DTUs TcV (27/77), TcII/TcV/TcVI (26/77), and TcII/TcVI (22/77). TcVI was detected in only 2 samples (2/77). A higher prevalence of TcII/TcVI (19/24) was verified in patients of other countries, with low prevalence of TcII/TcV/TcVI (4/24) and TcV (1/24). CONCLUSIONS/SIGNIFICANCE In this study, low/medium parasitic load was found in all patients evaluated. Our data corroborate previous conclusions indicating that patients from the Bolivia, living in Spain, are predominantly infected by TcV, and TcVI DTUs. On the other hand, in Non-Bolivians patients TcII/TcVI predominated. Surprisingly, in our cohort of 101 patients no infection by TcI DTU was observed.
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Affiliation(s)
- Maykon Tavares de Oliveira
- Department of Infectious Diseases, Universitat Autònoma de Barcelona, Vall d’Hebron University Hospital. PROSICS, Barcelona. Spain
- Department of Internal Medicine, Cardiology Division, Medical School of Ribeirão Preto, University of São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | - Elena Sulleiro
- Department of Microbiology, Vall d’Hebron University Hospital. Universitat Autònoma de Barcelona. PROSICS Barcelona. Spain
| | - Aroa Silgado Gimenez
- Department of Microbiology, Vall d’Hebron University Hospital. Universitat Autònoma de Barcelona. PROSICS Barcelona. Spain
| | - Marta de Lana
- School of Pharmacy and Center for Research in Biological Sciences (NUPEB), Federal University of Ouro Preto (UFOP), Ouro Preto, MG, Brazil
| | - Bianca Zingales
- Department of Biochemistry, Institute of Chemistry, University of São Paulo (USP), São Paulo, SP, Brazil
| | - João Santana da Silva
- Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil.
| | - J. Antônio Marin-Neto
- Department of Internal Medicine, Cardiology Division, Medical School of Ribeirão Preto, University of São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | - Israel Molina
- Department of Infectious Diseases, Universitat Autònoma de Barcelona, Vall d’Hebron University Hospital. PROSICS, Barcelona. Spain
- * E-mail:
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28
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Molina-Morant D, Fernández ML, Bosch-Nicolau P, Sulleiro E, Bangher M, Salvador F, Sanchez-Montalva A, Ribeiro ALP, de Paula AMB, Eloi S, Correa-Oliveira R, Villar JC, Sosa-Estani S, Molina I. Efficacy and safety assessment of different dosage of benznidazol for the treatment of Chagas disease in chronic phase in adults (MULTIBENZ study): study protocol for a multicenter randomized Phase II non-inferiority clinical trial. Trials 2020; 21:328. [PMID: 32293523 PMCID: PMC7158046 DOI: 10.1186/s13063-020-4226-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [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: 10/02/2019] [Accepted: 03/03/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Chagas disease (CD) continues to be a neglected infectious disease with one of the largest burdens globally. Despite the modest cure rates in adult chronic patients and its safety profile, benznidazole (BNZ) is still the drug of choice. Its current recommended dose is based on nonrandomized studies, and efficacy and safety of the optimal dose of BNZ have been scarcely analyzed in clinical trials. METHODS/DESIGN MULTIBENZ is a phase II, randomized, noninferiority, double-blind, multicenter international clinical trial. A total of 240 patients with Trypanosoma CD in the chronic phase will be recruited in four different countries (Argentina, Brazil, Colombia, and Spain). Patients will be randomized to receive BNZ 150 mg/day for 60 days, 400 mg/day for 15 days, or 300 mg/day for 60 days (comparator arm). The primary outcome is the efficacy of three different BNZ therapeutic schemes in terms of dose and duration. Efficacy will be assessed according to the proportion of patients with sustained parasitic load suppression in peripheral blood measured by polymerase chain reaction. The secondary outcomes are related to pharmacokinetics and drug tolerability. The follow-up will be 12 months from randomization to end of study participation. Recruitment was started in April 2018. CONCLUSION This is a clinical trial conducted for the assessment of different dose schemes of BNZ compared with the standard treatment regimen for the treatment of CD in the chronic phase. MULTIBENZ may help to clarify which is the most adequate BNZ regimen in terms of efficacy and safety, predicated on sustained parasitic load suppression in peripheral blood. TRIAL REGISTRATION ClinicalTrials.gov, NCT03191162. Registered on 19 June 2017.
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Affiliation(s)
- D Molina-Morant
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, P° Vall d'Hebron 119, Edifici Mediterrània, VHIR, 08035, Barcelona, Spain
| | - M L Fernández
- Departamento de Clínica, Patología y Tratamiento, Instituto Nacional de Parasitología Dr. Mario Fatala Chaben, Ministerio de Salud y Desarrollo Social, Buenos Aires, Argentina
| | - P Bosch-Nicolau
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, P° Vall d'Hebron 119, Edifici Mediterrània, VHIR, 08035, Barcelona, Spain
| | - E Sulleiro
- Microbiology Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Bangher
- Instituto de Cardiología de Corrientes Juana Francisca Cabral (Argentina), Corrientes, Argentina
| | - F Salvador
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, P° Vall d'Hebron 119, Edifici Mediterrània, VHIR, 08035, Barcelona, Spain
| | - A Sanchez-Montalva
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, P° Vall d'Hebron 119, Edifici Mediterrània, VHIR, 08035, Barcelona, Spain
| | - A L P Ribeiro
- Programa de Pós-graduação Infectologia e Medicina Tropical, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - A M B de Paula
- Laboratory of Health Science, Postgraduate Program in Health Sciences, Universidade Estadual de Montes Claros (Unimontes), Montes Claros, MG, Brazil
| | - S Eloi
- Programa de Pós-graduação em Patologia, Departamento de Propedêutica Complementar, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Faculdade de Medicina da Universidade José do Rosário Vellano, Belo Horizonte, Brazil
| | - R Correa-Oliveira
- René Rachou Institute, Oswaldo Cruz Foundation, Belo Horizonte, Brazil
| | - J C Villar
- Faculty of Health Sciences, Universidad Autónoma de Bucaramanga and Research Department, Bucaramanga, Colombia
- Fundación Cardioinfantil - Instituto de Cardiología, Bogotá, Colombia
| | - S Sosa-Estani
- Chagas Clinical Program, Drugs for Neglected Disease initiative (DNDi), Geneva, Switzerland
- Epidemiology and Public Health Research Center, CONICET, Buenos Aires, Argentina
| | - I Molina
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, P° Vall d'Hebron 119, Edifici Mediterrània, VHIR, 08035, Barcelona, Spain.
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Meyers AC, Ellis MM, Purnell JC, Auckland LD, Meinders M, Saunders AB, Hamer SA. Selected cardiac abnormalities in Trypanosoma cruzi serologically positive, discordant, and negative working dogs along the Texas-Mexico border. BMC Vet Res 2020; 16:101. [PMID: 32228593 PMCID: PMC7106864 DOI: 10.1186/s12917-020-02322-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 07/17/2019] [Accepted: 03/19/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Chagas disease is increasingly recognized in the southern U.S., where triatomine vectors transmit Trypanosoma cruzi among wildlife and domestic dogs with occasional vector spillover to humans. As in humans, clinical outcome in dogs is variable, ranging from acute death to asymptomatic infections or chronic heart disease. In order to characterize cardiac manifestations of T. cruzi infections, we tracked a cohort of naturally-infected dogs and a matched cohort of uninfected dogs. We hypothesized that selected measures of cardiac disease (abnormal rate, abnormal rhythm, and elevated cardiac troponin I (cTnI; a biomarker of cardiac injury)) would occur more commonly in infected than uninfected dogs matched by age, breed, sex and location. In addition to the clearly positive and negative dogs, we specifically tracked dogs with discordant test results across three independent serological assays to gather clinical data that might elucidate the infection status of these animals and inform the utility of the different testing approaches. RESULTS We placed an ambulatory ECG monitor (Holter) on 48 government working dogs and analyzed 39 successful recordings that met length and quality criteria from 17 T. cruzi-infected, 18 uninfected dogs and 4 dogs with discordant results. Overall, 76.5% of positive, 100.0% of discordant, and 11.1% of negative dogs showed > 1 ECG abnormality (p < 0.0001), and positive and discordant dogs had a higher mean number of different types of ECG abnormalities than negative dogs (p < 0.001-0.014). The most common cardiac abnormalities included supraventricular and ventricular arrhythmias and atrioventricular block. Positive dogs had higher serum concentrations of cTnI than both negative dogs (p = 0.044) and discordant dogs (p = 0.06). Based on dog handler reports, nearly all (4/5; 80%) dogs with reported performance decline or fatigue were T. cruzi-infected dogs. CONCLUSIONS Further understanding cardiac manifestations in dogs naturally infected with T. cruzi is critical for prognostication, establishing a baseline for drug and vaccine studies, and better understanding of zoonotic risk.
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Affiliation(s)
- Alyssa C Meyers
- Veterinary Integrative Biosciences Department, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, MS4458, College Station, TX, 77843-4458, USA
| | - Megan M Ellis
- College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 1601 Campus Delivery, Fort Collins, CO, 80523-1601, USA
| | - Julia C Purnell
- Veterinary Integrative Biosciences Department, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, MS4458, College Station, TX, 77843-4458, USA
| | - Lisa D Auckland
- Veterinary Integrative Biosciences Department, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, MS4458, College Station, TX, 77843-4458, USA
| | - Marvin Meinders
- National Association of Federal Veterinarians, 1910 Sunderland Pl NW, Washington, D.C, 20036, USA
| | - Ashley B Saunders
- Veterinary Integrative Biosciences Department, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, MS4458, College Station, TX, 77843-4458, USA
| | - Sarah A Hamer
- Veterinary Integrative Biosciences Department, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, MS4458, College Station, TX, 77843-4458, USA.
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Berry ASF, Salazar-Sánchez R, Castillo-Neyra R, Borrini-Mayorí K, Arevalo-Nieto C, Chipana-Ramos C, Vargas-Maquera M, Ancca-Juarez J, Náquira-Velarde C, Levy MZ, Brisson D. Dispersal patterns of Trypanosoma cruzi in Arequipa, Peru. PLoS Negl Trop Dis 2020; 14:e0007910. [PMID: 32150562 PMCID: PMC7082062 DOI: 10.1371/journal.pntd.0007910] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 11/06/2019] [Revised: 03/19/2020] [Accepted: 02/18/2020] [Indexed: 12/30/2022] Open
Abstract
Anthropogenic environmental alterations such as urbanization can threaten native populations as well as create novel environments that allow human pests and pathogens to thrive. As the number and size of urban environments increase globally, it is more important than ever to understand the dispersal dynamics of hosts, vectors and pathogens of zoonotic disease systems. For example, a protozoan parasite and the causative agent of Chagas disease in humans, Trypanosoma cruzi, recently colonized and spread through the city of Arequipa, Peru. We used population genomic and phylogenomic tools to analyze whole genomes of 123 T. cruzi isolates derived from vectors and non-human mammals throughout Arequipa to determine patterns of T. cruzi dispersal. The data show significant population genetic structure within city blocks-parasites in the same block tend to be very closely related-but no population structure among blocks within districts-parasites in neighboring blocks are no more closely related to one another than to parasites in distant districts. These data suggest that T. cruzi dispersal within a block occurs regularly and that occasional long-range dispersal events allow the establishment of new T. cruzi populations in distant blocks. Movement of domestic animals may be the primary mechanism of inter-block and inter-district T. cruzi dispersal.
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Affiliation(s)
- Alexander S. F. Berry
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
- Department of Biology, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Renzo Salazar-Sánchez
- Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Arequipa, Peru
| | - Ricardo Castillo-Neyra
- Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Arequipa, Peru
- Department of Biostatistics, Epidemiology and Informatics, The Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Katty Borrini-Mayorí
- Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Arequipa, Peru
| | - Claudia Arevalo-Nieto
- Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Arequipa, Peru
| | - Claudia Chipana-Ramos
- Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Arequipa, Peru
| | - Melina Vargas-Maquera
- Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Arequipa, Peru
| | - Jenny Ancca-Juarez
- Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Arequipa, Peru
| | - César Náquira-Velarde
- Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Arequipa, Peru
| | - Michael Z. Levy
- Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Arequipa, Peru
- Department of Biostatistics, Epidemiology and Informatics, The Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Dustin Brisson
- Department of Biology, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- * E-mail:
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Affiliation(s)
- Alan Koff
- From the Sections of Infectious Disease (A.K., M.M., M.G.) and Cardiovascular Medicine (T.A.), the Division of Internal Medicine (A.K., M.M., M.G., T.A.), and the Department of Pathology (S.D.), Yale University School of Medicine, New Haven, CT
| | - Maricar Malinis
- From the Sections of Infectious Disease (A.K., M.M., M.G.) and Cardiovascular Medicine (T.A.), the Division of Internal Medicine (A.K., M.M., M.G., T.A.), and the Department of Pathology (S.D.), Yale University School of Medicine, New Haven, CT
| | - Santiago Delgado
- From the Sections of Infectious Disease (A.K., M.M., M.G.) and Cardiovascular Medicine (T.A.), the Division of Internal Medicine (A.K., M.M., M.G., T.A.), and the Department of Pathology (S.D.), Yale University School of Medicine, New Haven, CT
| | - Matthew Grant
- From the Sections of Infectious Disease (A.K., M.M., M.G.) and Cardiovascular Medicine (T.A.), the Division of Internal Medicine (A.K., M.M., M.G., T.A.), and the Department of Pathology (S.D.), Yale University School of Medicine, New Haven, CT
| | - Tariq Ahmad
- From the Sections of Infectious Disease (A.K., M.M., M.G.) and Cardiovascular Medicine (T.A.), the Division of Internal Medicine (A.K., M.M., M.G., T.A.), and the Department of Pathology (S.D.), Yale University School of Medicine, New Haven, CT
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Tasdemir D, MacIntosh AJJ, Stergiou P, Kaiser M, Mansour NR, Bickle Q, Huffman MA. Antiprotozoal and antihelminthic properties of plants ingested by wild Japanese macaques (Macaca fuscata yakui) in Yakushima Island. J Ethnopharmacol 2020; 247:112270. [PMID: 31589965 DOI: 10.1016/j.jep.2019.112270] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 09/30/2019] [Accepted: 10/01/2019] [Indexed: 06/10/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Primates forage on a variety of plant parts to balance their dietary intake to meet requirements of energy, nutrition and maintenance, however the reason(s) leading them to ingest some plants which have no nutritional value and/or contain bioactive or even toxic secondary metabolites is recently gaining closer attention. The growing literature suggests that primates consume plants for medicinal purposes (self-medication) as well, particularly when infected with parasites and pathogens (bacteria, viruses, microbes). Interestingly, some of the plants they consume are also used by humans for similar purposes or may have potential uses for humans. MATERIALS AND METHODS As part of a 16-month study of the parasite ecology of a sub-species of Japanese macaques (Macaca fuscata yakui) on the island of Yakushima, we surveyed their feeding habits and collected a subset of plants and plant parts observed being ingested by macaques. The ethnomedicinal value of these plants was surveyed and methanolic extracts of 45 plant parts were tested in vitro against important parasites of humans, including four protozoan parasites Plasmodium falciparum, Trypanosoma brucei rhodesiense, T. cruzi and Leishmania donovani, and the trematode flatworm Schistosoma mansoni. Potential toxicity of the extracts was also assessed on mammalian cells. RESULTS A wide range of ethnomedicinal uses in Asia for these plants is noted, with 37% associated with the treatment of parasites, pathogens and related symptoms. Additionally, the 45 extracts tested showed broad and significant activity against our test organisms. All extracts were active against T. b. rhodesiense. The majority (over 80%) inhibited the growth of P. falciparum and L. donovani. Half of the extracts also displayed antiprotozoal potential against T. cruzi while only several extracts were active against both larval and adult stages of S. mansoni. Cytotoxicity was generally low, although several extracts lacked specific toxicity to test parasites. CONCLUSIONS Our results indicated a number of plants and their parts to have antiparasitic activity not previously reported in the ethnopharmacological literature. Enhanced understanding of the primate diets, particularly during periods of intensified parasite infection risk may help to further narrow down plants of interest for lead compound development. The study of animal self-medication is a complementary approach, with precedence, to drug discovery of new lead drug compounds against human parasitic diseases.
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Affiliation(s)
- Deniz Tasdemir
- Department of Pharmaceutical and Biological Chemistry, Centre for Pharmacognosy and Phytotherapy, School of Pharmacy, University of London, London, WC1N 1AX, UK; GEOMAR Centre for Marine Biotechnology, Research Unit Marine Natural Products Chemistry, GEOMAR Helmholtz Centre for Ocean Research Kiel, 24106, Kiel, Germany; Kiel University, Christian-Albrechts-Platz 4, 24118, Kiel, Germany.
| | - Andrew J J MacIntosh
- Primate Research Institute, Kyoto University, Kanrin 41-2, 484-8506, Inuyama, Japan
| | - Polyxeni Stergiou
- Department of Pharmaceutical and Biological Chemistry, Centre for Pharmacognosy and Phytotherapy, School of Pharmacy, University of London, London, WC1N 1AX, UK
| | - Marcel Kaiser
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, CH-4051, Basel, Switzerland; University of Basel, 4003, Basel, Switzerland
| | - Nuha R Mansour
- Department of Infection Biology, Faculty of Infectious and Tropical Disease, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, United Kingdom
| | - Quentin Bickle
- Department of Infection Biology, Faculty of Infectious and Tropical Disease, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, United Kingdom
| | - Michael A Huffman
- Primate Research Institute, Kyoto University, Kanrin 41-2, 484-8506, Inuyama, Japan.
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McClean MCW, Bhattacharyya T, Mertens P, Murphy N, Gilleman Q, Gustin Y, Zeippen N, Xavier SCC, Jansen AM, Miles MA. A lineage-specific rapid diagnostic test (Chagas Sero K-SeT) identifies Brazilian Trypanosoma cruzi II/V/VI reservoir hosts among diverse mammalian orders. PLoS One 2020; 15:e0227828. [PMID: 31951634 PMCID: PMC6968848 DOI: 10.1371/journal.pone.0227828] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 12/30/2019] [Indexed: 02/07/2023] Open
Abstract
Trypanosoma cruzi, the protozoan agent of Chagas disease in the Americas, is comprised of six genetic lineages (TcI-TcVI) and a possible seventh (TcBat, related to TcI). Identification of T. cruzi lineages infecting reservoir mammalian species is fundamental to resolving transmission cycles. However, this is hindered by the limited sensitivity and technical complexity of parasite isolation and genotyping. An alternative approach is serology using T. cruzi lineage-specific epitopes, such as those of the trypomastigote small surface antigen (TSSA). For surveillance of T. cruzi lineage infections in mammal species from diverse Brazilian regions, we apply a novel rapid diagnostic test (RDT, Chagas Sero K-SeT), which incorporates the TSSA peptide epitope specific to TcII/V/VI (TSSApep-II/V/VI) and Protein G detection of antibodies. Chagas Sero K-SeT RDT results with sera from experimentally infected mice, from tamarin primates (Leontopithecus spp.) and from canines (Canis familiaris) were concordant with corresponding TSSApep-II/V/VI ELISAs. The Chagas Sero K-Set detected TcII/V/VI infections in Leontopithecus spp. from the Atlantic forest (n = 46), in C. familiaris (n = 16) and Thrichomys laurentius (n = 2) from Caatinga biome and Chiroptera (n = 1) from Acre, Amazonia. The Chagas Sero K-SeT RDT is directly applicable to TcII/V/VI-specific serological surveillance of T. cruzi infection in several different mammalian Orders. It can replace ELISAs and provides efficient, point-of-sampling, low-cost detection of TcII/V/VI infections, with at least equivalent sensitivity, although some mammals may be difficult to trap, and, not unexpectedly, Chagas Sero K-SeT could not recognise feline IgG. Knowledge of sylvatic hosts of T. cruzi can be expanded, new reservoir species discovered, and the ecology of transmission cycles clarified, particularly with adaptation to further mammalian Orders.
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Affiliation(s)
- Mairi C. W. McClean
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Tapan Bhattacharyya
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- * E-mail:
| | | | - Niamh Murphy
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | | | | | - Samanta C. C. Xavier
- Laboratory of Trypanosomatid Biology, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil
| | - Ana M. Jansen
- Laboratory of Trypanosomatid Biology, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil
| | - Michael A. Miles
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Abstract
The infection of triatomines with trypanosomes can be performed with different forms of the parasite, and the procedure is important not only for vector-parasite interaction studies but also for maintaining the infectivity of parasite strains, which guarantees more realistic biological and molecular investigations. Here, I describe how to infect the vector Rhodnius prolixus, a model species, with two different species of Trypanosoma.
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Affiliation(s)
- Alessandra A Guarneri
- Vector Behaviour and Pathogen Interaction Group, Instituto René Rachou, Belo Horizonte, MG, Brazil.
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Ty MC, Loke P, Alberola J, Rodriguez A, Rodriguez-Cortes A. Immuno-metabolic profile of human macrophages after Leishmania and Trypanosoma cruzi infection. PLoS One 2019; 14:e0225588. [PMID: 31841511 PMCID: PMC6913957 DOI: 10.1371/journal.pone.0225588] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [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: 04/01/2019] [Accepted: 11/07/2019] [Indexed: 12/12/2022] Open
Abstract
Macrophages can reprogram their metabolism in response to the surrounding stimuli, which affects their capacity to kill intracellular pathogens. We have investigated the metabolic and immune status of human macrophages after infection with the intracellular trypanosomatid parasites Leishmania donovani, L. amazonensis and T. cruzi and their capacity to respond to a classical polarizing stimulus (LPS and IFN-γ). We found that macrophages infected with Leishmania preferentially upregulate oxidative phosphorylation, which could be contributed by both host cell and parasite, while T. cruzi infection did not significantly increase glycolysis or oxidative phosphorylation. Leishmania and T. cruzi infect macrophages without triggering a strong inflammatory cytokine response, but infection does not prevent a potent response to LPS and IFN-γ. Infection appears to prime macrophages, since the cytokine response to activation with LPS and IFN-γ is more intense in infected macrophages compared to uninfected ones. Metabolic polarization in macrophages can influence infection and immune evasion of these parasites since preventing macrophage cytokine responses would help parasites to establish a persistent infection. However, macrophages remain responsive to classical inflammatory stimuli and could still trigger inflammatory cytokine secretion by macrophages.
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Affiliation(s)
- Maureen C. Ty
- New York University School of Medicine, Department of Microbiology, New York, NY, United States of America
| | - P’ng Loke
- New York University School of Medicine, Department of Microbiology, New York, NY, United States of America
| | - Jordi Alberola
- Dept Farmacologia, Toxicologia i Terapeutica, Facultat de Veterinaria, Edifici V, Universitat Autonoma de Barcelona, Bellaterra, Spain
| | - Ana Rodriguez
- New York University School of Medicine, Department of Microbiology, New York, NY, United States of America
- * E-mail:
| | - Alheli Rodriguez-Cortes
- New York University School of Medicine, Department of Microbiology, New York, NY, United States of America
- Dept Farmacologia, Toxicologia i Terapeutica, Facultat de Veterinaria, Edifici V, Universitat Autonoma de Barcelona, Bellaterra, Spain
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Apt W, Carrasco D, Fuentealba C, Canals M, Muñoz G, Saavedra M, Castillo JP, Zulantay I. Chronic Chagas disease: Quantification of Trypanosoma cruzi in peripheral blood and dejections of Triatoma infestans fed by xenodiagnosis in patients with and without cardiopathy. Acta Trop 2019; 200:105167. [PMID: 31513762 DOI: 10.1016/j.actatropica.2019.105167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 06/04/2019] [Revised: 08/30/2019] [Accepted: 09/07/2019] [Indexed: 01/27/2023]
Abstract
It is not currently known which individuals with chronic Chagas disease (ChD) will develop cardiopathy in a determined period and which will be maintained asymptomatic with normal routine laboratory tests all their lives. The parasite burden is a factor that could explain this different evolution. The objective of this study was to quantify Trypanosoma cruzi burden by real-time PCR in blood (qPCR-B) and dejections of triatomines fed by xenodiagnosis (qPCR-XD) in 90 individuals with chronic ChD untreated, classified according to XD results and the presence or absence of cardiopathy. All individuals came from hyperendemic areas of Chile and participated in the study under Informed Consent. The standard qPCR curves for qPCR-B and qPCR-XD were elaborated with a mixture of known concentrations of T. cruzi strains, performing DNA serial dilutions (1/10) with a dynamic range between 105 and 10-1 parasite equivalents/mL. The TaqManⓇ detection system was applied in a Stratagene Mx3000P thermocycler (Agilent Technologies, USA) with cruzi 1 and cruzi 2 satellite primers. 22.2% and 15.6% of cases with cardiopathy or without cardiopathy were XD positive. There was no significant difference between the groups. The positivity of qPCR-B and qPCR-XD in the positive XD group was 82.35% and 100%, respectively, while in the negative XD group was 55.26% and 42.10%, respectively. A superior qPCR value in chronic ChD patients with and without cardiopathy was determined for qPCR in cases with positive XD and positive qPCR-XD. The receiver operating characteristic (ROC) curve analyses show better accuracy for detecting parasite burden (area under the curve, AUC) for qPCR-XD in comparison to qPCR-B. That is to say, major performance in DNA samples obtained of positive XD (gold standard for viable T. cruzi) detected and quantified by qPCR-XD. A high percentage of cases with XD and qPCR-XD positive (80-100%) have result concordant with qPCR-B. In absence of XD, future challenges are especially related to the low parasitic load of chronic ChD patients treated with trypanocidal drugs and post-therapy parasitological evaluations by qPCR-B. Finally, no statistically significant differences were found between presence or absence of cardiopathy and XD, qPCR-B or qPCR-XD.
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Affiliation(s)
- Werner Apt
- Laboratorio de Parasitología Básico-Clínico, Programa de Biología Celular y Molecular, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Daniela Carrasco
- Laboratorio de Parasitología Básico-Clínico, Programa de Biología Celular y Molecular, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile; Escuela de Tecnología Médica, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Cristian Fuentealba
- Laboratorio de Parasitología Básico-Clínico, Programa de Biología Celular y Molecular, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile; Escuela de Tecnología Médica, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Mauricio Canals
- Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Gabriela Muñoz
- Laboratorio de Parasitología Básico-Clínico, Programa de Biología Celular y Molecular, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Miguel Saavedra
- Laboratorio de Parasitología Básico-Clínico, Programa de Biología Celular y Molecular, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Juan-Paul Castillo
- Laboratorio de Parasitología Básico-Clínico, Programa de Biología Celular y Molecular, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Inés Zulantay
- Laboratorio de Parasitología Básico-Clínico, Programa de Biología Celular y Molecular, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
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Vásquez Velásquez C, Russomando G, Espínola EE, Sanchez Z, Mochizuki K, Roca Y, Revollo J, Guzman A, Quiroga B, Rios Morgan S, Vargas Ortiz R, Zambrana Ortega A, Espinoza E, Nishizawa JE, Kamel MG, Kikuchi M, Mizukami S, Na-Bangchang K, Tien Huy N, Hirayama K. IL-17A, a possible biomarker for the evaluation of treatment response in Trypanosoma cruzi infected children: A 12-months follow-up study in Bolivia. PLoS Negl Trop Dis 2019; 13:e0007715. [PMID: 31553732 PMCID: PMC6760767 DOI: 10.1371/journal.pntd.0007715] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Accepted: 08/16/2019] [Indexed: 12/14/2022] Open
Abstract
Background The National Program for Chagas disease was implemented in Bolivia in 2006, and it greatly decreased the number of infections through vector control. Subsequently, a treatment regimen of benznidazole (BNZ) was started in seropositive school-age children living in certified vector control areas. Methods and findings We conducted a 12-month follow-up study and seven blood samples were taken during and after the treatment. Serology, conventional diagnostic PCR (cPCR) and quantitative Real-time PCR (qPCR) were performed. Plasma Th1/Th2/Th17 cytokines levels were also determined. Approximately 73 of 103 seropositive children complied with BNZ, with three interruptions due to side effects. To evaluate each individual’s treatment efficacy, the cPCR and qPCR values during the final 6 months of the follow-up period were observed. Among 57 children who completed follow-up, 6 individuals (11%) showed both cPCR(+) and qPCR(+) (non reactive), 24 (42%) cPCR(-) but qPCR(+) (ambiguous) and 27 (47%) cPCR(-) and qPCR(-) (reactive). Within 14 Th1/Th2/Th17 cytokines, IL-17A showed significantly higher levels in seropositive children before the treatment compared to age-matched seronegative children and significantly decreased to the normal level one-year after. Moreover, throughout the follow-up study, IL-17A levels were positively co-related to parasite counts detected by qPCR. At the 12 months’ time point, IL-17A levels of non-reactive subjects were significantly higher than either those of reactive or ambiguous subjects suggesting that IL-17A might be useful to determine the reactivity to BNZ treatment. Conclusions Plasma levels of IL-17A might be a bio-marker for detecting persistent infection of T. cruzi and its chronic inflammation. Chagas is a zoonosis endemic in 21 Latin American countries caused by T. cruzi. Results of common Benznidazole (BNZ) treatment vary by infection phase, treatment period, and dosage. In Bolivia, the national Chagas program controls vector distribution in different regions of the country. The program began BNZ treatment in school-age children from infestation-free endemic areas. Lack of information regarding follow-up and efficacy in children with recent chronic Chagas makes treatment failure difficult to detect in endemic areas. The present study aimed to estimate parasite DNA in blood through quantitative real-time and conventional PCR (qPCR, cPCR), and observe Th1/Th2/Th17 cytokine profiling during a 12-month follow-up in Bolivia school children. Results showed persistence of low, substantial amounts of T. cruzi DNA, and significantly higher IL-17A levels in the seropositive group before treatment than the seronegative group, which decreased to seronegative levels one year later. Of 57 treated, 6 showed cPCR positive results 6 months after treatment and were diagnosed as definitely non-reactive (10.5%). The six non-reactive individuals showed significantly higher levels of IL-17A at 12 months than residual reactive (cPCR negative, qPCR negative) and ambiguously reactive (cPCR negative, qPCR positive) groups, indicating that IL-17A might be a biomarker for non-reactive to BNZ.
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Affiliation(s)
- Clara Vásquez Velásquez
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), School of Tropical Medicine and Global Health, Nagasaki University, Sakamoto, Nagasaki, Japan
- Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto, Nagasaki, Japan
| | - Graciela Russomando
- Departamento de Biología Molecular y Biotecnología, Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, Asunción, Paraguay
| | - Emilio E. Espínola
- Departamento de Biología Molecular y Biotecnología, Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, Asunción, Paraguay
| | - Zunilda Sanchez
- Departamento de Biología Molecular y Biotecnología, Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, Asunción, Paraguay
| | - Kota Mochizuki
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), School of Tropical Medicine and Global Health, Nagasaki University, Sakamoto, Nagasaki, Japan
- Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto, Nagasaki, Japan
| | - Yelin Roca
- Centro Nacional de Enfermedades Tropicales (CENETROP), Santa Cruz, Bolivia
| | - Jimmy Revollo
- Centro Nacional de Enfermedades Tropicales (CENETROP), Santa Cruz, Bolivia
| | - Angelica Guzman
- Centro Nacional de Enfermedades Tropicales (CENETROP), Santa Cruz, Bolivia
| | - Benjamín Quiroga
- Programa Departamental de Control de Chagas del Ministerio de Salud, Santa Cruz, Bolivia
| | - Susana Rios Morgan
- Programa Departamental de Control de Chagas del Ministerio de Salud, Santa Cruz, Bolivia
| | - Roberto Vargas Ortiz
- Programa Departamental de Control de Chagas del Ministerio de Salud, Santa Cruz, Bolivia
| | | | - Eida Espinoza
- Hospital Municipal Warnes "Nuestra Señora del Rosario", Santa Cruz, Bolivia
| | | | | | - Mihoko Kikuchi
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), School of Tropical Medicine and Global Health, Nagasaki University, Sakamoto, Nagasaki, Japan
| | - Shusaku Mizukami
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), School of Tropical Medicine and Global Health, Nagasaki University, Sakamoto, Nagasaki, Japan
| | - Kesara Na-Bangchang
- Chulabhorn International College of Medicine, Thammasat University, Pathumthani, Thailand
| | - Nguyen Tien Huy
- Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto, Nagasaki, Japan
- Department of Clinical Product Development, Institute of Tropical Medicine (NEKKEN), School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Kenji Hirayama
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), School of Tropical Medicine and Global Health, Nagasaki University, Sakamoto, Nagasaki, Japan
- Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto, Nagasaki, Japan
- * E-mail:
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Murphy N, Macchiaverna NP, Victoria Cardinal M, Bhattacharyya T, Mertens P, Zeippen N, Gustin Y, Gilleman Q, Gürtler RE, Miles MA. Lineage-specific rapid diagnostic tests can resolve Trypanosoma cruzi TcII/V/VI ecological and epidemiological associations in the Argentine Chaco. Parasit Vectors 2019; 12:424. [PMID: 31522683 PMCID: PMC6746045 DOI: 10.1186/s13071-019-3681-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 04/25/2019] [Accepted: 08/22/2019] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Trypanosoma cruzi, the protozoan agent of Chagas disease, is comprised of at least 6 genetic lineages (TcI-TcVI). Their geographical distribution, clinical associations and reservoir hosts are not fully elucidated, as genotyping is hampered due to the difficulty in isolating representative populations of organisms. Lineage-specific serological techniques may address these issues. METHODS Trypanosoma cruzi lineage-specific serological assays were performed on human, canine, feline and armadillo sera from the Gran Chaco in northern Argentina, a region of ongoing transmission. Synthetic peptides representing lineage-specific epitopes of the trypomastigote small surface antigen (TSSA) were used in ELISA, and the TcII/V/VI shared epitope peptide (TSSApep-II/V/VI) was used in the Chagas Sero K-SeT rapid diagnostic test (RDT). RESULTS Chagas Sero K-SeT RDT, using Protein G to detect human and canine IgG, was at least as sensitive as TSSApep-II/V/VI ELISA using specific secondary antibodies. For sera from humans TSSApep-II/V/VI seroprevalence by Chagas Sero K-SeT was 273/393 (69.5%), for dogs 48/73 (65.8%) and for armadillos 1/7 (14.3%); by ELISA for cats 5/19 (26.3%). The seroprevalence for humans was similar to that for Bolivian patients, amongst whom we previously observed an association of TSSApep-II/V/VI seropositivity with severity of cardiomyopathy. In humans, prevalence of TSSApep-II/V/VI recognition was associated with locality, and with increasing and decreasing age within the Qom and Creole populations, respectively. For dogs TSSApep-II/V/VI recognition was associated with being born before community-wide insecticide spraying (P = 0.05) and with Qom household (P < 0.001). CONCLUSIONS We show here that Chagas Sero K-SeT RDT can replace ELISA for TSSApep-II/V/VI serology of humans and dogs; for humans there were statistically significant associations between a positive Chagas Sero K-SeT RDT and being resident in Area IV, and for dogs association with Qom household or with being born before the mass spraying campaign; we also show that with cats the TcII/V/VI epitope can be detected by ELISA. We assessed the lineage distribution in an unprecedented 83% of the human T. cruzi-seropositive population. These results form the basis for more detailed studies, enabling rapid in-the-field surveillance of the distribution and clustering of these lineages among humans and mammalian reservoirs of T. cruzi infection.
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Affiliation(s)
- Niamh Murphy
- Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Natalia P. Macchiaverna
- Laboratorio de Eco-Epidemiología, Facultad de Ciencias Exacta y Naturales, Universidad de Buenos Aires, Ciudad Universitaria, C1428EHA Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas-Universidad de Buenos Aires, Instituto de Ecología, Genética y Evolución de Buenos Aires (IEGEBA), Ciudad Universitaria, C1428EHA Buenos Aires, Argentina
| | - M. Victoria Cardinal
- Laboratorio de Eco-Epidemiología, Facultad de Ciencias Exacta y Naturales, Universidad de Buenos Aires, Ciudad Universitaria, C1428EHA Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas-Universidad de Buenos Aires, Instituto de Ecología, Genética y Evolución de Buenos Aires (IEGEBA), Ciudad Universitaria, C1428EHA Buenos Aires, Argentina
| | - Tapan Bhattacharyya
- Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | | | | | | | | | - Ricardo E. Gürtler
- Laboratorio de Eco-Epidemiología, Facultad de Ciencias Exacta y Naturales, Universidad de Buenos Aires, Ciudad Universitaria, C1428EHA Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas-Universidad de Buenos Aires, Instituto de Ecología, Genética y Evolución de Buenos Aires (IEGEBA), Ciudad Universitaria, C1428EHA Buenos Aires, Argentina
| | - Michael A. Miles
- Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
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Moscatelli G, Moroni S, García Bournissen F, González N, Ballering G, Schijman A, Corral R, Bisio M, Freilij H, Altcheh J. Longitudinal follow up of serological response in children treated for Chagas disease. PLoS Negl Trop Dis 2019; 13:e0007668. [PMID: 31465522 PMCID: PMC6715178 DOI: 10.1371/journal.pntd.0007668] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 07/28/2019] [Indexed: 01/05/2023] Open
Abstract
Background Evaluation of therapeutic response in chronic Chagas disease is a major challenge, due to prolonged persistence of Trypanosoma cruzi-specific antibodies, lack of sensitivity of parasitological tests, and need for long-term follow-up to observe negative seroconversion of conventional serological tests (CS). The objective of this study was to evaluate F2/3-ELISA serology, a promising early biomarker of therapeutic response, and T.cruzi Polymerase chain reaction (PCR) for T. cruzi Deoxyribonucleic acid (DNA), for neonatal diagnosis and evaluation of parasitemia after treatment. Methods Prospective cohort study, with three-year clinical, serological and parasitological follow-up of pediatric Chagas disease patients treated with benznidazole. Serology was evaluated by Enzyme-Linked ImmunoSorbent Assay (ELISA), Indirect hemagglutination (IHA) and F2/3-ELISA; Parasitemia by microhematocrit (MH) and PCR. Results A cohort of 107 pediatric patients treated with benznidazole was enrolled in the study. ELISA and IHA were initially reactive in 100% of patients, F2/3-ELISA serology was reactive in 80% (86/107) and 91% (97/107) had detectable parasitemia. Seventy-six (71%) patients completed at least 36 months of serological follow up after treatment. Although a similar decreasing linear trend was observed for all serological tests, F2/3-ELISA presented earlier, age dependent, negative seroconversion compared to CS. All patients reaching undetectable CS titers had previously seroreverted by F2/3-ELISA. All patients with persistently decreasing antibody titers had negative PCRs throughout the follow up period. No new cardiological lesions were observed during the 3 years follow-up period. Conclusions The data reported here, using CS, F2/3 ELISA and PCR provide support for the efficacy of benznidazole in congenital Chagas diseases. These results provide support for scaling up of screening, diagnosis and access to benznidazole treatment. Trial registration ClinicalTrials.gov 0028/04 in the Research Council, Secretary of Health Buenos Aires city Goberment. Evaluation of therapeutic response in chronic Chagas disease is a major challenge, particularly in the early post-treatment phase, due to prolonged persistence of Trypanosoma cruzi-specific antibodies and lack of sensitivity of available parasitological tests. The main limitation in evaluating Chagas disease treatment response stems from the need for long-term follow-up to observe negative seroconversion of conventional serological tests. New biomarkers of cure are needed. We evaluated F2/3-ELISA, a promising early serological marker of therapeutic response, and T.cruzi PCR for T.cruzi DNA, for neonatal diagnosis and evaluation of parasitemia after treatment. F2/3-ELISA and PCR proved to be excellent early markers of treatment response that correlate with ELISA and IHA but can identify treatment response or failure at much earlier timepoints. This information can help design future paediatric clinical trials in Chagas disease.
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Affiliation(s)
- Guillermo Moscatelli
- Parasitology service Ricardo Gutiérrez Children´s Hospital, Buenos Aires, Argentina
- Multidisciplinary Institute for Research of Pediatric Diseases- CONICET-GCBA, Buenos Aires, Argentina
- * E-mail:
| | - Samanta Moroni
- Parasitology service Ricardo Gutiérrez Children´s Hospital, Buenos Aires, Argentina
- Multidisciplinary Institute for Research of Pediatric Diseases- CONICET-GCBA, Buenos Aires, Argentina
| | - Facundo García Bournissen
- Parasitology service Ricardo Gutiérrez Children´s Hospital, Buenos Aires, Argentina
- Multidisciplinary Institute for Research of Pediatric Diseases- CONICET-GCBA, Buenos Aires, Argentina
| | - Nicolás González
- Parasitology service Ricardo Gutiérrez Children´s Hospital, Buenos Aires, Argentina
| | - Griselda Ballering
- Parasitology service Ricardo Gutiérrez Children´s Hospital, Buenos Aires, Argentina
| | - Alejandro Schijman
- Molecular Biology Laboratory of Chagas disease, INGEBI-CONICET, Buenos Aires, Argentina
| | - Ricardo Corral
- Parasitology service Ricardo Gutiérrez Children´s Hospital, Buenos Aires, Argentina
| | - Margarita Bisio
- Parasitology service Ricardo Gutiérrez Children´s Hospital, Buenos Aires, Argentina
| | - Héctor Freilij
- Parasitology service Ricardo Gutiérrez Children´s Hospital, Buenos Aires, Argentina
| | - Jaime Altcheh
- Parasitology service Ricardo Gutiérrez Children´s Hospital, Buenos Aires, Argentina
- Multidisciplinary Institute for Research of Pediatric Diseases- CONICET-GCBA, Buenos Aires, Argentina
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Francisco-González L, Rubio-San-Simón A, González-Tomé MI, Manzanares Á, Epalza C, Santos MDM, Gastañaga T, Merino P, Ramos-Amador JT. Congenital transmission of Chagas disease in a non-endemic area, is an early diagnosis possible? PLoS One 2019; 14:e0218491. [PMID: 31291269 PMCID: PMC6619651 DOI: 10.1371/journal.pone.0218491] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 06/02/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Chagas disease (CD) is an emergent disease in Europe, due to immigration. The aims of this study are to describe the epidemiological characteristics of a cohort of Chagas infected pregnant women in Spain, to assess the vertical transmission (VT) rate and evaluate the usefulness of the PCR in the diagnosis of congenital infection in the first months of life. METHODS A descriptive, retrospective study including Chagas seropositive pregnant women who were attended at three tertiary hospitals in Madrid, from January 2012 to September 2016. Infants were examined by PCR at birth and 1 month later and serologically studied at 9 months or later. Children were considered infected when the parasite was detected by PCR at any age or when serology remained positive without decline over the age of 9 months. RESULTS We included 122 seropositive-infected pregnant women, 81% were from Bolivia and only 8.2% had been treated before. 125 newborns were studied and finally 109 were included (12.8% lost the follow-up before performing the last serology). The VT rate was 2.75% (95% CI: 0,57-8,8%). Infected infants had positive PCR at birth and 1 month later. All of them were treated successfully with benznidazole (PCR and serology became negative later on). All non-infected children presented negative PCR. The mean age at which uninfected patients had negative serology was 10.5 months. CONCLUSIONS The VT rate is in keeping with literature and confirms the need to carry out a screening in pregnant women coming from endemic areas. PCR seems to be a useful tool to provide early diagnosis of congenital CD.
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Affiliation(s)
- Laura Francisco-González
- Department of Pediatrics, Hospital Clínico San Carlos, Complutense University of Madrid, Madrid, Spain
| | | | | | | | - Cristina Epalza
- Department of Pediatrics, Hospital Doce de Octubre, Madrid, Spain
| | | | - Teresa Gastañaga
- Department of Obstetrics and Gynaecology, Hospital Clínico San Carlos, Madrid, Spain
| | - Paloma Merino
- Department of Microbiology, Hospital Clínico San Carlos, Madrid, Spain
| | - José Tomás Ramos-Amador
- Department of Pediatrics, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, Madrid, Spain
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Rangel DA, Lisboa CV, Novaes RLM, Silva BA, Souza RDF, Jansen AM, Moratelli R, Roque ALR. Isolation and characterization of trypanosomatids, including Crithidia mellificae, in bats from the Atlantic Forest of Rio de Janeiro, Brazil. PLoS Negl Trop Dis 2019; 13:e0007527. [PMID: 31291252 PMCID: PMC6619607 DOI: 10.1371/journal.pntd.0007527] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [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: 09/19/2018] [Accepted: 06/06/2019] [Indexed: 01/30/2023] Open
Abstract
We studied infection by Trypanosomatidae in bats captured in two areas with different degradation levels in the Atlantic Forest of Rio de Janeiro state: Reserva Ecológica de Guapiaçu (REGUA) and Estação Fiocruz Mata Atlântica (EFMA). Furthermore, we evaluated whether the diversity of trypanosomatids changes according to bat diversity and the different levels of preservation in the region. The results showed no influence of the level of preservation on bat species richness (15 and 14 species, respectively), with similar chiropterofauna and higher abundance of two common fruit-eating bat species in the tropics: Carollia perspicillata and Artibeus lituratus. Of the 181 bat specimens analyzed by LIT/Schneider hemoculture, we detected 24 infected individuals (13%), including one positive Sturnira lilium individual that was also positive by fresh blood examination. Molecular characterization using nested PCR targeting the 18 SSU rRNA-encoding gene fragment showed similar trypanosomatid infection rates in bats from the two areas: 15% in REGUA and 11% in EFMA (p = 0.46). Trypanosoma dionisii was the most frequently detected parasite (54%), followed by T. cruzi DTUs TcI and TcIV and Trypanosoma sp., in Neotropical phyllostomid bats (RNMO63 and RNMO56); mixed infections by T. dionisii/T. cruzi TcIII and T. dionisii/T. cruzi TcI were also observed. The T. cruzi DTUs TcI and TcIV are the genotypes currently involved in cases of acute Chagas disease in Brazil, and T. dionisii was recently found in the heart tissue of an infected child. Surprisingly, we also describe for the first time Crithidia mellificae, a putative monoxenous parasite from insects, infecting a vertebrate host in the Americas. Bats from the Atlantic Forest of Rio de Janeiro state harbor a great diversity of trypanosomatids, maintaining trypanosomatid diversity in this sylvatic environment.
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Affiliation(s)
- Diana Azeredo Rangel
- Laboratório de Biologia de Tripanosomatídeos, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro/RJ, Brazil
| | - Cristiane Varella Lisboa
- Laboratório de Biologia de Tripanosomatídeos, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro/RJ, Brazil
| | - Roberto Leonan Morim Novaes
- Programa de Pós-Graduação em Biodiversidade e Biologia Evolutiva, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro/RJ, Brazil
- Fiocruz Mata Atlântica, Fundação Oswaldo Cruz, Rio de Janeiro/RJ, Brazil
| | - Bruno Alves Silva
- Laboratório de Biologia de Tripanosomatídeos, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro/RJ, Brazil
| | - Renan de França Souza
- Fiocruz Mata Atlântica, Fundação Oswaldo Cruz, Rio de Janeiro/RJ, Brazil
- Programa de Pós-Graduação em Ecologia e Evolução, Departamento de Ecologia, Universidade do Estado do Rio de Janeiro, Rio de Janeiro/RJ, Brazil
| | - Ana Maria Jansen
- Laboratório de Biologia de Tripanosomatídeos, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro/RJ, Brazil
| | - Ricardo Moratelli
- Fiocruz Mata Atlântica, Fundação Oswaldo Cruz, Rio de Janeiro/RJ, Brazil
| | - André Luiz Rodrigues Roque
- Laboratório de Biologia de Tripanosomatídeos, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro/RJ, Brazil
- * E-mail:
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Burki T. Recognition for Chagas disease. Lancet Infect Dis 2019; 19:699. [PMID: 31250822 DOI: 10.1016/s1473-3099(19)30319-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Ison MG, Lebeis TA, Barros N, Lewis GD, Massoth LR. Case 20-2019: A 52-Year-Old Woman with Fever and Rash after Heart Transplantation. N Engl J Med 2019; 380:2564-2573. [PMID: 31242366 DOI: 10.1056/nejmcpc1904040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Michael G Ison
- From the Department of Medicine, Northwestern Memorial Hospital, and the Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago (M.G.I.); and the Departments of Medicine (T.A.L., N.B., G.D.L.) and Pathology (L.R.M.), Massachusetts General Hospital, and the Departments of Medicine (T.A.L., N.B., G.D.L.) and Pathology (L.R.M.), Harvard Medical School - both in Boston
| | - Taylor A Lebeis
- From the Department of Medicine, Northwestern Memorial Hospital, and the Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago (M.G.I.); and the Departments of Medicine (T.A.L., N.B., G.D.L.) and Pathology (L.R.M.), Massachusetts General Hospital, and the Departments of Medicine (T.A.L., N.B., G.D.L.) and Pathology (L.R.M.), Harvard Medical School - both in Boston
| | - Nicolas Barros
- From the Department of Medicine, Northwestern Memorial Hospital, and the Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago (M.G.I.); and the Departments of Medicine (T.A.L., N.B., G.D.L.) and Pathology (L.R.M.), Massachusetts General Hospital, and the Departments of Medicine (T.A.L., N.B., G.D.L.) and Pathology (L.R.M.), Harvard Medical School - both in Boston
| | - Gregory D Lewis
- From the Department of Medicine, Northwestern Memorial Hospital, and the Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago (M.G.I.); and the Departments of Medicine (T.A.L., N.B., G.D.L.) and Pathology (L.R.M.), Massachusetts General Hospital, and the Departments of Medicine (T.A.L., N.B., G.D.L.) and Pathology (L.R.M.), Harvard Medical School - both in Boston
| | - Lucas R Massoth
- From the Department of Medicine, Northwestern Memorial Hospital, and the Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago (M.G.I.); and the Departments of Medicine (T.A.L., N.B., G.D.L.) and Pathology (L.R.M.), Massachusetts General Hospital, and the Departments of Medicine (T.A.L., N.B., G.D.L.) and Pathology (L.R.M.), Harvard Medical School - both in Boston
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Erazo D, Gottdenker NL, González C, Guhl F, Cuellar M, Kieran TJ, Glenn TC, Umaña JD, Cordovez J. Generalist host species drive Trypanosoma cruzi vector infection in oil palm plantations in the Orinoco region, Colombia. Parasit Vectors 2019; 12:274. [PMID: 31138275 PMCID: PMC6540391 DOI: 10.1186/s13071-019-3519-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 12/22/2018] [Accepted: 05/20/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Oil palm plantation establishment in Colombia has the potential to impact Chagas disease transmission by increasing the distribution range of Rhodnius prolixus. In fact, previous studies have reported Trypanosoma cruzi natural infection in R. prolixus captured in oil palms (Elaeis guineensis) in the Orinoco region, Colombia. The aim of this study is to understand T. cruzi infection in vectors in oil palm plantations relative to community composition and host dietary specialization by analyzing vector blood meals and comparing these results to vectors captured in a native palm tree species, Attalea butyracea. METHODS Rhodnius prolixus nymphs (n = 316) were collected from A. butyracea and E. guineensis palms in Tauramena, Casanare, Colombia. Vector blood meals from these nymphs were determined by amplifying and sequencing a vertebrate-specific 12S rRNA gene fragment. RESULTS Eighteen vertebrate species were identified and pigs (Sus scrofa) made up the highest proportion of blood meals in both habitats, followed by house mouse (Mus musculus) and opossum (Didelphis marsupialis). Individual bugs feeding only from generalist mammal species had the highest predicted vector infection rate, suggesting that generalist mammalian species are more competent hosts for T. cruzi infection . CONCLUSIONS Oil palm plantations and A. butyracea palms found in altered areas provide a similar quality habitat for R. prolixus populations in terms of blood meal availability. Both habitats showed similarities in vector infection rate and potential host species, representing a single T. cruzi transmission scenario at the introduced oil palm plantation and native Attalea palm interface.
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Affiliation(s)
- Diana Erazo
- Grupo de Investigación en Biología Matemática y Computacional (BIOMAC), Universidad de los Andes, Bogota, Colombia
| | - Nicole L. Gottdenker
- Department of Pathology, School of Veterinary Medicine, The University of Georgia, Athens, GA USA
| | - Camila González
- Centro de Investigaciones en Microbiología y Parasitología Tropical (CIMPAT), Facultad de Ciencias, Universidad de los Andes, Bogotá, Colombia
| | - Felipe Guhl
- Centro de Investigaciones en Microbiología y Parasitología Tropical (CIMPAT), Facultad de Ciencias, Universidad de los Andes, Bogotá, Colombia
| | - Monica Cuellar
- Grupo de Investigación en Ingeniería Biomédica (GIB), Universidad de los Andes, Bogota, Colombia
| | - Troy J. Kieran
- Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, GA USA
| | - Travis C. Glenn
- Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, GA USA
| | - Juan D. Umaña
- Grupo de Investigación en Biología Matemática y Computacional (BIOMAC), Universidad de los Andes, Bogota, Colombia
| | - Juan Cordovez
- Grupo de Investigación en Biología Matemática y Computacional (BIOMAC), Universidad de los Andes, Bogota, Colombia
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Angheben A, Buonfrate D, Cruciani M, Jackson Y, Alonso-Padilla J, Gascon J, Gobbi F, Giorli G, Anselmi M, Bisoffi Z. Rapid immunochromatographic tests for the diagnosis of chronic Chagas disease in at-risk populations: A systematic review and meta-analysis. PLoS Negl Trop Dis 2019; 13:e0007271. [PMID: 31150377 PMCID: PMC6561601 DOI: 10.1371/journal.pntd.0007271] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 06/12/2019] [Accepted: 02/28/2019] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Despite of a high disease burden, mainly in Latin America, Chagas disease (CD) is underdiagnosed and undertreated. Rapid diagnostic tests (RDTs) might improve the access to diagnosis. The aim of this study is to review the accuracy of commercially available RDTs used in field conditions for the diagnosis of chronic CD in populations at risk, in endemic and non-endemic countries. METHODS/PRINCIPAL FINDINGS We undertook a comprehensive search of the following databases: PubMed, SCOPUS, LILACS (last up-date on the 01st July, 2017), without language or date limits. Non-electronic sources have been also searched. This review included clinical studies with cohort recruitment of individuals at risk of T. cruzi exposure, without age limits; adequate reference standards for the diagnosis of CD. We excluded case-control studies and those testing RDTs during acute CD. Data on test accuracies were pooled through a bivariate random-effects model. Only one index test was evaluated separately. Geographical area, commercial brand, disease prevalence, study size, and risk of bias were explored as possible source of heterogeneity. Values of sensitivity and specificity were computed to obtain summary positive/negative likelihood ratios, and summary diagnostic odds ratio. Ten studies were included on six different immunochromatographic RDTs. The pooled sensitivity and specificity of the RDTs resulted 96.6% (95% CI 91.3-98.7%) and 99.3% (95% CI 98.4-99.7%), respectively. Test accuracy was particularly good in endemic areas (98.07%/99.03% of sensitivity/specificity, respectively). One test (Stat-Pak) showed an overall sensitivity of 97% (95% CI 87.6-99.3) and specificity of 99.4% (95% CI 98.6-99.8). CONCLUSIONS/SIGNIFICANCE RDTs demonstrated to be sufficiently accurate to recommend their use for screening in endemic areas, even as stand-alone tests. This approach might increase the accessibility to the diagnosis. However, an additional confirmatory test in case of positive result remains a prudent approach.
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Affiliation(s)
- Andrea Angheben
- Department of Infectious – Tropical Diseases and Microbiology, IRCCS Sacro Cuore - Don Calabria Hospital, Negrar, Verona, Italy
| | - Dora Buonfrate
- Department of Infectious – Tropical Diseases and Microbiology, IRCCS Sacro Cuore - Don Calabria Hospital, Negrar, Verona, Italy
| | - Mario Cruciani
- Infectious Diseases Unit, Azienda ULSS 9 Scaligera, Verona, Italy
| | - Yves Jackson
- Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
- Institute of Global Health, Geneva University, Geneva, Switzerland
| | | | - Joaquim Gascon
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Federico Gobbi
- Department of Infectious – Tropical Diseases and Microbiology, IRCCS Sacro Cuore - Don Calabria Hospital, Negrar, Verona, Italy
| | - Giovanni Giorli
- Department of Infectious – Tropical Diseases and Microbiology, IRCCS Sacro Cuore - Don Calabria Hospital, Negrar, Verona, Italy
| | - Mariella Anselmi
- Centro de Epidemiologia Comunitaria y Medicina Tropical (CECOMET), Esmeraldas, Ecuador
| | - Zeno Bisoffi
- Department of Infectious – Tropical Diseases and Microbiology, IRCCS Sacro Cuore - Don Calabria Hospital, Negrar, Verona, Italy
- Diagnostic and Public Health Department, University of Verona, Verona, Italy
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Cabe AM, Yañez F, Pinto R, López A, Ortiz S, Martin CMS, Botto-Mahan C, Solari A. Survivorship of wild caught Mepraia spinolai nymphs: The effect of seasonality and Trypanosoma cruzi infection after feeding and fasting in the laboratory. Infect Genet Evol 2019; 71:197-204. [PMID: 30953715 DOI: 10.1016/j.meegid.2019.04.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 03/08/2019] [Accepted: 04/02/2019] [Indexed: 11/17/2022]
Abstract
Chagas disease is caused by Trypanosoma cruzi. Vector survival is an important variable affecting vectorial capacity to determine parasite transmission risk. The aims of this study are to evaluate vector survival under fasting/starvation conditions of wild-caught Mepraia spinolai after feeding and fasting, the pathogenicity of T. cruzi infection, the parasite burden and seasonal variation in parasite discrete typing units (DTU). The survivorship of M. spinolai nymphs after two continuous artificial feedings was evaluated, assessing their infection with microscopic observation of fecal samples and PCR. Later, insects were fasted/starved until death. We performed qPCR analyses of parasite load in the fecal samples and dead specimens. T. cruzi genotyping was performed using conventional PCR amplicons and hybridization tests. Infection rate was higher in M. spinolai nymphs in summer and spring than in fall. Parasite burden varied from 3 to 250,000 parasites/drop. Survival rate for starved nymph stage II was lower in insects collected in the spring compared to summer and fall. TcII was the most frequent DTU. Mainly metacyclic trypomastigotes were excreted. We conclude that M. spinolai infection rate in nymphs varies among seasons, suggesting higher transmission risk in warmer seasons. However, nymphs stage II collected in spring are more sensitive to starvation compared to other seasons. TcII in single or mixed infection does not seem relevant to determine vector pathogenicity. These results of vector survivorship after fasting/starvation are important to determine the competence of M. spinolai as a vector of T. cruzi, since they excrete metacyclic trypomastigotes and the parasitism with T. cruzi seems to be poorly pathogenic to the vector under a severe fasting/starvation condition.
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Affiliation(s)
- A Mc Cabe
- Program of Cellular and Molecular Biology, ICBM, Faculty of Medicine, University of Chile, Chile
| | - F Yañez
- Program of Cellular and Molecular Biology, ICBM, Faculty of Medicine, University of Chile, Chile
| | - R Pinto
- Program of Cellular and Molecular Biology, ICBM, Faculty of Medicine, University of Chile, Chile
| | - A López
- Program of Cellular and Molecular Biology, ICBM, Faculty of Medicine, University of Chile, Chile
| | - S Ortiz
- Program of Cellular and Molecular Biology, ICBM, Faculty of Medicine, University of Chile, Chile.
| | - C Muñoz-San Martin
- Ecology Laboratory, Faculty of Veterinary Sciences and Livestock, University of Chile, Chile.
| | - C Botto-Mahan
- Department of Ecological Sciences, Faculty of Science, University of Chile, Chile.
| | - A Solari
- Program of Cellular and Molecular Biology, ICBM, Faculty of Medicine, University of Chile, Chile.
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Abstract
Biomarkers of infection with consistent discriminating power for diagnosis and/or prognosis are keystones for efficient therapeutic management of diseases. The protozoan Trypanosoma cruzi, the etiologic agent of Chagas disease (CD), exhibits high clinical and genetic diversity, making it difficult to define biomarkers. In animal models of infection, as well as in patients, many different outcomes have been described. Thus, pathophysiogenesis parameters were highly variable in patients and even in inbred animals, which impeded reliable one-dimensional diagnosis/prognosis. To help solve those problems, an in-depth analysis of the similarities and differences in the CD caused by different parasite strains or different patient conditions is needed. Multidimensional statistics may overcome the high variability for each individual parameter in patients and even in inbred animals, revealing some pathophysiological patterns that accurately allow diagnosis of clinical and physiopathological characteristics. Here, we describe this type of method and its application to T. cruzi infection.
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Affiliation(s)
- Julien Santi-Rocca
- Centro de Biología Molecular Severo Ochoa, Consejo Superior de Investigaciones Científicas (CSIC), Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Núria Gironès
- Centro de Biología Molecular Severo Ochoa, Consejo Superior de Investigaciones Científicas (CSIC), Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Manuel Fresno
- Centro de Biología Molecular Severo Ochoa, Consejo Superior de Investigaciones Científicas (CSIC), Universidad Autónoma de Madrid (UAM), Madrid, Spain.
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Abstract
Cytometric bead array (CBA) is a flow cytometry application that allows users to quantify multiple proteins simultaneously. Compared to other quantifier assays, as enzyme-linked immunosorbent assay (ELISA) and Western blot, CBA significantly reduces sample requirements and time to results. This technology allows for the design and creation of assays to measure a variety of analytes including inflammatory mediators, chemokines, immunoglobulin isotypes, intracellular signaling molecules, apoptotic mediators, adhesion molecules, and antibodies. Here we describe CBA steps to measure soluble cytokine levels in body fluids of infected patients by the protozoan Trypanosoma cruzi, morbidity known as Chagas disease.
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Affiliation(s)
- Nayara I Medeiros
- Cellular and Molecular Immunology, René Rachou Institute, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil
- Laboratory of Cell-Cell Interactions, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Juliana A S Gomes
- Laboratory of Cell-Cell Interactions, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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49
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Abstract
The development of accurate diagnostic tools and surrogate markers of parasitological response to treatment are priorities in Chagas disease (CD) research. For years, the detection of Trypanosoma cruzi DNA by PCR has proved to be useful in some clinical scenarios like acute CD, including cases of congenital transmission, CD reactivation in immunosuppressed patients, and posttreatment follow-up. In that sense, the implementation of quantitative real-time PCR (qPCR) assays was an important step in the development of more reliable tools for CD molecular diagnostics and treatment follow-up. In the last decade, two multicenter PCR studies allowed the harmonization and validation of standard operating procedures for PCR-based detection and quantification of T. cruzi DNA in blood samples. Herein we describe the two most used protocols to quantify parasitic load in human blood samples by multiplex qPCR assays and discuss some aspects to consider during planning and executing these procedures.
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Affiliation(s)
- Juan Carlos Ramírez
- Laboratorio de Biología Molecular de la Enfermedad de Chagas, Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr. Héctor N. Torres" (INGEBI), CONICET, Buenos Aires, Argentina.
| | - Otacilio da Cruz Moreira
- Laboratório de Biología Molecular e Doenças Endêmicas, Instituto Oswaldo Cruz/Fiocruz, Rio de Janeiro, Brazil
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50
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Eduardo AA, Santos LABO, Rebouças MC, Martinez PA. Patterns of vector species richness and species composition as drivers of Chagas disease occurrence in Brazil. Int J Environ Health Res 2018; 28:590-598. [PMID: 30063379 DOI: 10.1080/09603123.2018.1497776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 07/02/2018] [Indexed: 06/08/2023]
Abstract
Chagas disease represents one of the major health issue in Latin America. Epidemiological control is focused on disease vectors, so studies on the ecology of triatomine vectors constitute a central strategy. Recently, research at large spatial scale has been produced, and authors commonly rely on the assumption that geographical regions presenting good environmental conditions for most vector species are also those with high risk of infection. In the present work, we provide an explicit evaluation for this assumption. Employing species distribution models and epidemiological data for Chagas disease in Brazilian territory, our results show that species richness is a poor predictor for the observed pattern of Chagas disease occurrence. Species composition proved to be a better predictor. We stress that research on macroecology of infectious diseases should go beyond the analysis of biodiversity patterns and consider human infections as a central part of the focal ecological systems.
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Affiliation(s)
- Anderson A Eduardo
- a Laboratory of Integrative Research on Biodiversity (PIBi-Lab), Centro de Ciências Biológicas e da Saúde, Departamento de Biologia , Universidade Federal de Sergipe (UFS) , Aracaju , SE , Brazil
| | - Lucas A B O Santos
- b Laboratory of Molecular Biology , Hospital Universitário da Universidade Federal de Sergipe (HU-UFS) , Aracaju , SE , Brazil
| | - Mônica C Rebouças
- a Laboratory of Integrative Research on Biodiversity (PIBi-Lab), Centro de Ciências Biológicas e da Saúde, Departamento de Biologia , Universidade Federal de Sergipe (UFS) , Aracaju , SE , Brazil
| | - Pablo A Martinez
- a Laboratory of Integrative Research on Biodiversity (PIBi-Lab), Centro de Ciências Biológicas e da Saúde, Departamento de Biologia , Universidade Federal de Sergipe (UFS) , Aracaju , SE , Brazil
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