Chagas Disease Diagnostic Testing in Two Academic Hospitals in New Orleans, Louisiana: A Call to Action

Proaño, Alvaro; Dumonteil, Eric; Herrera, Claudia

doi:10.3390/tropicalmed8050277

Cited by 4 publications

(2 citation statements)

References 37 publications

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“…These screening test results must be confirmed with another FDA-approved test, due to variable test performance among populations [ 20 , 21 ]. Nonetheless, even using a low estimate for the true prevalence of infection of 1%, there may be over 3000 cases not yet diagnosed or referred to treatment in Louisiana [ 10 , 22 ]. Therefore, prioritizing testing within affected communities is crucial for quantifying Louisiana’s disease burden.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Community Awareness and Screening of Chagas Disease in the Latin American Community of Greater New Orleans

Herrera,

Bernabé,

Dumonteil

et al. 2023

TropicalMed

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Chagas disease is a public health problem in the Americas, from the southern United States (USA) to Argentina. In the USA, less than 1% of domestic cases have been identified and less than 0.3% of total cases have received treatment. Little is known about affected immigrant Latin American communities. A prospective study was conducted to assess knowledge about Chagas disease among the Latin American community living in the Greater New Orleans area. Participants answered a baseline questionnaire, viewed a short educational video presentation, completed a post-presentation questionnaire, and were screened with an FDA-approved blood rapid diagnostic test (RDT). A total of 154 participants from 18 Latin American countries (n = 138) and the USA (n = 16) were enrolled and screened for Trypanosoma cruzi infection. At baseline, 57% of the participants knew that Chagas disease is transmitted through an insect vector, and 26% recognized images of the vector. Following the administration of an educational intervention, the participants’ knowledge regarding vector transmission increased to 91% and 35% of participants were able to successfully identify images of the vector. Five participants screened positive for T. cruzi infection, indicating a 3.24% [95%CI: 1.1–7.5%] prevalence of Trypanosoma cruzi infection within the Latin American community of the New Orleans area. Results highlight the urgent need for improving access to education and diagnostics of Chagas disease.

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Section: Discussionmentioning

confidence: 99%

Assessment of Community Awareness and Screening of Chagas Disease in the Latin American Community of Greater New Orleans

Herrera,

Bernabé,

Dumonteil

et al. 2023

TropicalMed

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“…Only two drugs are available for treating patients, but their efficacy decreases dramatically as disease progresses, and their side effects lead to frequent treatment interruptions and non-compliance 4 – 6 . Structural barriers for accessing diagnostic testing and treatment also considerably restrict access to appropriate care for patients 7 – 9 .…”

Section: Introductionmentioning

confidence: 99%

Immunoglobin and T cell receptor repertoire changes induced by a prototype vaccine against Chagas disease in naïve rhesus macaques

Dumonteil,

Tu,

Desale

et al. 2023

Preprint

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A vaccine against Trypanosoma cruzi, the agent of Chagas disease, would be an excellent additional tool for disease control. A recombinant vaccine based on Tc24 and TSA1 parasite antigens was found to be safe and immunogenic in naïve macaques. Here we performed a transcriptomic analysis of PBMC responses to vaccination, to shed light on the immunogenicity of this vaccine and guide the optimization of doses and formulation. RNA-sequencing analysis indicated a clear transcriptomic response of PBMCs from macaques after three vaccine doses, with the up-regulation of several immune cell activation pathways and a broad non-polarized immune profile. Analysis of the IgG repertoire showed that it had a rapid turnover with novel IgGs produced following each vaccine dose, while the TCR repertoire presented several persisting clones that were expanded after each vaccine dose. These data suggest that three vaccine doses may be needed for optimum immunogenecity and support the further evaluation of the protective efficacy of this vaccine.

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Ecological interactions of Triatoma sanguisuga (Hemiptera: Reduviidae) and risk for human infection with Trypanosoma cruzi (Kinetoplastida: Trypanosomatidae) in Illinois and Louisiana

Dumonteil,

Tu,

Jiménez

et al. 2024

Journal of Medical Entomology

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Triatoma sanguisuga (Leconte) is one of the most widely distributed kissing bugs in the United States, associated with an extensive zoonotic circulation of Trypanosoma cruzi, the agent of Chagas disease, in a large part of the country. However, the actual risk for human infection in the United States is poorly understood. Here, we further assessed the ecology of T. sanguisuga bugs collected in residents’ houses in Illinois and Louisiana, using a metagenomic approach to identify their blood-feeding sources, T. cruzi parasites and gut microbiota. Blood meal analysis revealed feeding on domestic animals (dogs, cats, pigs, goats, and turkeys), synanthropic species (raccoons, opossums, and squirrels), as well as the more sylvatic white-tail deer. Human blood was identified in 11/14 (78%) of bugs, highlighting a frequent vector–human contact. The infection rate with T. cruzi was 53% (8/15), and most infected bugs (6/8) had fed on humans. A total of 41 bacterial families were identified, with significant differences in microbiota alpha and beta diversity between bugs from Louisiana and Illinois. However, predicted metabolic functions remained highly conserved, suggesting important constraints to fulfill their role in bug biology. These results confirmed a significant risk for vector-borne transmission of T. cruzi to humans in Louisiana and Illinois, which warrants more active screening for human infections. Also, while there is broad plasticity in the bacterial composition of T. sanguisuga microbiota, there are strong constraints to preserve metabolic profile and function, making it a good target for novel vector control strategies.

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Chagas Disease Diagnostic Testing in Two Academic Hospitals in New Orleans, Louisiana: A Call to Action

Cited by 4 publications

References 37 publications

Assessment of Community Awareness and Screening of Chagas Disease in the Latin American Community of Greater New Orleans

Assessment of Community Awareness and Screening of Chagas Disease in the Latin American Community of Greater New Orleans

Immunoglobin and T cell receptor repertoire changes induced by a prototype vaccine against Chagas disease in naïve rhesus macaques

Ecological interactions of Triatoma sanguisuga (Hemiptera: Reduviidae) and risk for human infection with Trypanosoma cruzi (Kinetoplastida: Trypanosomatidae) in Illinois and Louisiana

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