Use of rapid diagnostic tests (RDTs) for conclusive diagnosis of chronic Chagas disease – field implementation in the Bolivian Chaco region

Chagas disease, caused by the parasite Trypanosoma cruzi, is the neglected tropical disease with a highest burden in Latin America. Its acute stage is mostly asymptomatic and goes unnoticed. Symptoms appear at the chronic stage, which is when diagnosis is usually made. This is based on the agreement...

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Autores: Lozano Beltran, Daniel-Franz, Rojas, Lizeth, Méndez, Susana, Casellas, Aina, Sanz, Sergi, Ortiz, Lourdes, Pinazo, Maria-Jesus, Abril, Marcelo, Gascón i Brustenga, Joaquim, Torrico, Faustino, Alonso Padilla, Julio
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/147178
Acceso en línea:https://hdl.handle.net/2445/147178
Access Level:acceso abierto
Palabra clave:Malaltia de Chagas
Tripanosoma
Chagas' disease
Trypanosoma
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spelling Use of rapid diagnostic tests (RDTs) for conclusive diagnosis of chronic Chagas disease – field implementation in the Bolivian Chaco regionLozano Beltran, Daniel-FranzRojas, LizethMéndez, SusanaCasellas, AinaSanz, SergiOrtiz, LourdesPinazo, Maria-JesusAbril, MarceloGascón i Brustenga, JoaquimTorrico, FaustinoAlonso Padilla, JulioMalaltia de ChagasTripanosomaChagas' diseaseTrypanosomaChagas disease, caused by the parasite Trypanosoma cruzi, is the neglected tropical disease with a highest burden in Latin America. Its acute stage is mostly asymptomatic and goes unnoticed. Symptoms appear at the chronic stage, which is when diagnosis is usually made. This is based on the agreement of two conventional serological tests such as Enzyme-Linked Immunosorbent Assays (ELISAs). There are commercial kits with good sensitivity and specificity but their use is impractical in many highly endemic regions with poorly equipped laboratories. Luckily, several rapid diagnostic tests (RDTs) are available for the detection of anti-T. cruzi immunoglobulins. They are easy to operate, require no cold storage, provide fast turnaround of results, and some can work with a tiny volume of whole blood as sample. With the aim to field validate their use we compared an alternative algorithm based on a combination of RDTs with the standard based on ELISAs. In both cases a third test was available in case of discordance. RDTs were implemented by mobile teams in field campaigns to detect chronic T. cruzi-infections in the Chaco region of Bolivia. ELISAs were made in the reference laboratories located in the main hospitals of Yacuiba and Villa Montes, two major cities of the region. We enrolled 685 subjects who voluntarily participated in the study and had not been treated against the disease before. The agreement between the two main RDTs was 93.1% (638/685) (kappa index = 0.86; CI 95% 0.83-0.90). In comparison to the ELISAs algorithm, the combined use of the RDTs provided a sensitivity of 97.7% and a specificity of 96.1%. These results support the use of RDTs for the diagnosis of chronic Chagas disease in the studied region, and encourage their evaluation in other regions of Bolivia and other endemic countries.Public Library of Science (PLoS)2020202020192019info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion13 p.application/pdfapplication/pdfhttps://hdl.handle.net/2445/147178Articles publicats en revistes (ISGlobal)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: http://dx.doi.org/10.1371/journal.pntd.0007877PLoS Neglected Tropical Diseases, 2019, vol. 13, num. 12, p. e0007877http://dx.doi.org/10.1371/journal.pntd.0007877cc by (c) Lozano et al., 2019http://creativecommons.org/licenses/by/3.0/es/info:eu-repo/semantics/openAccessoai:recercat.cat:2445/1471782026-05-29T05:05:01Z
dc.title.none.fl_str_mv Use of rapid diagnostic tests (RDTs) for conclusive diagnosis of chronic Chagas disease – field implementation in the Bolivian Chaco region
title Use of rapid diagnostic tests (RDTs) for conclusive diagnosis of chronic Chagas disease – field implementation in the Bolivian Chaco region
spellingShingle Use of rapid diagnostic tests (RDTs) for conclusive diagnosis of chronic Chagas disease – field implementation in the Bolivian Chaco region
Lozano Beltran, Daniel-Franz
Malaltia de Chagas
Tripanosoma
Chagas' disease
Trypanosoma
title_short Use of rapid diagnostic tests (RDTs) for conclusive diagnosis of chronic Chagas disease – field implementation in the Bolivian Chaco region
title_full Use of rapid diagnostic tests (RDTs) for conclusive diagnosis of chronic Chagas disease – field implementation in the Bolivian Chaco region
title_fullStr Use of rapid diagnostic tests (RDTs) for conclusive diagnosis of chronic Chagas disease – field implementation in the Bolivian Chaco region
title_full_unstemmed Use of rapid diagnostic tests (RDTs) for conclusive diagnosis of chronic Chagas disease – field implementation in the Bolivian Chaco region
title_sort Use of rapid diagnostic tests (RDTs) for conclusive diagnosis of chronic Chagas disease – field implementation in the Bolivian Chaco region
dc.creator.none.fl_str_mv Lozano Beltran, Daniel-Franz
Rojas, Lizeth
Méndez, Susana
Casellas, Aina
Sanz, Sergi
Ortiz, Lourdes
Pinazo, Maria-Jesus
Abril, Marcelo
Gascón i Brustenga, Joaquim
Torrico, Faustino
Alonso Padilla, Julio
author Lozano Beltran, Daniel-Franz
author_facet Lozano Beltran, Daniel-Franz
Rojas, Lizeth
Méndez, Susana
Casellas, Aina
Sanz, Sergi
Ortiz, Lourdes
Pinazo, Maria-Jesus
Abril, Marcelo
Gascón i Brustenga, Joaquim
Torrico, Faustino
Alonso Padilla, Julio
author_role author
author2 Rojas, Lizeth
Méndez, Susana
Casellas, Aina
Sanz, Sergi
Ortiz, Lourdes
Pinazo, Maria-Jesus
Abril, Marcelo
Gascón i Brustenga, Joaquim
Torrico, Faustino
Alonso Padilla, Julio
author2_role author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Malaltia de Chagas
Tripanosoma
Chagas' disease
Trypanosoma
topic Malaltia de Chagas
Tripanosoma
Chagas' disease
Trypanosoma
description Chagas disease, caused by the parasite Trypanosoma cruzi, is the neglected tropical disease with a highest burden in Latin America. Its acute stage is mostly asymptomatic and goes unnoticed. Symptoms appear at the chronic stage, which is when diagnosis is usually made. This is based on the agreement of two conventional serological tests such as Enzyme-Linked Immunosorbent Assays (ELISAs). There are commercial kits with good sensitivity and specificity but their use is impractical in many highly endemic regions with poorly equipped laboratories. Luckily, several rapid diagnostic tests (RDTs) are available for the detection of anti-T. cruzi immunoglobulins. They are easy to operate, require no cold storage, provide fast turnaround of results, and some can work with a tiny volume of whole blood as sample. With the aim to field validate their use we compared an alternative algorithm based on a combination of RDTs with the standard based on ELISAs. In both cases a third test was available in case of discordance. RDTs were implemented by mobile teams in field campaigns to detect chronic T. cruzi-infections in the Chaco region of Bolivia. ELISAs were made in the reference laboratories located in the main hospitals of Yacuiba and Villa Montes, two major cities of the region. We enrolled 685 subjects who voluntarily participated in the study and had not been treated against the disease before. The agreement between the two main RDTs was 93.1% (638/685) (kappa index = 0.86; CI 95% 0.83-0.90). In comparison to the ELISAs algorithm, the combined use of the RDTs provided a sensitivity of 97.7% and a specificity of 96.1%. These results support the use of RDTs for the diagnosis of chronic Chagas disease in the studied region, and encourage their evaluation in other regions of Bolivia and other endemic countries.
publishDate 2019
dc.date.none.fl_str_mv 2019
2019
2020
2020
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/147178
url https://hdl.handle.net/2445/147178
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: http://dx.doi.org/10.1371/journal.pntd.0007877
PLoS Neglected Tropical Diseases, 2019, vol. 13, num. 12, p. e0007877
http://dx.doi.org/10.1371/journal.pntd.0007877
dc.rights.none.fl_str_mv cc by (c) Lozano et al., 2019
http://creativecommons.org/licenses/by/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc by (c) Lozano et al., 2019
http://creativecommons.org/licenses/by/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 13 p.
application/pdf
application/pdf
dc.publisher.none.fl_str_mv Public Library of Science (PLoS)
publisher.none.fl_str_mv Public Library of Science (PLoS)
dc.source.none.fl_str_mv Articles publicats en revistes (ISGlobal)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812455

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