Evaluation of 2 Lateral Flow Rapid Tests in the Diagnosis of Chagas Disease in the Washington Metropolitan Area

Castro-Sesquen, Yagahira E.; Saldaña, Antonella; Nava, Dhayanna Patino; Evans, Diana Paulette; Bayangos, Tabitha; DeToy, Kelly; A, Trevino; Marcus, Rachel; Bern, Caryn; Gilman, Robert H.; Talaat, Kawsar R.; Avila, Carol; Camacho, Fabiola; Herrera, Sdenka; Jimenez, Athena; Lozano, Veronika; Málaga, Edith; Merida, M.R.; Morales, Carolina; Solis, Rodrigo; Sotomayor, F.; Tung, Alisha; Spector, Anna; Verástegui, Manuela; Yang, Young-Hee; Zapata, Fátima

doi:10.1093/ofid/ofab096

Cited by 6 publications

(7 citation statements)

References 13 publications

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“…Most of these works used whole blood for the CSP testing and either serum or plasma for conventional serological assays taken as reference. As previously mentioned, detection performance varied among municipalities, with sensibility and specificity ranging from 93.4 to 100.0% and from 97.3 to 99.3%, respectively [28,[31][32][33]. Noteworthily, lower sensitivities were obtained by Roddy et al and Chippaux et al when working with age groups ranging from 9 months to 17.9 years old (93.4%) and from 11 to 20 years old (89.2%), respectively [32,33].…”

Section: Performance Of Immunochromatographic Rapid Tests Commerciall...mentioning

confidence: 87%

“…Nonetheless, in 2005, the Chagas National Program of Bolivia incorporated the use of a specific rapid test (Chagas Stat-Pak, Chembio Inc.) as the frontline method in both clinical practice and seroepidemiological surveys [31]. Notably, Chagas Stat-Pak (CSP) has shown sensitivity and specificity ranging from 93.4 to 100.0% and from 97.3 to 99.3%, respectively, among Bolivian municipalities [28,[31][32][33]. However, to follow the recommended diagnosis algorithm, positive cases still must be confirmed by a conventional immunoassay [31].…”

Section: Applicability Of Rapids Tests and Its Perspectives In CD Con...mentioning

confidence: 99%

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Rapid Test and Chagas Disease: An Overview

Caminha¹,

Cavalcante²,

Menna-Barreto³

2023

Rapid Antigen Testing

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Chagas disease (CD) is an infectious illness with great socioeconomic impact. Historically, it has mainly affected the poor population in Latin America. However, globalization sets a new scenario, featuring an increasing CD incidence worldwide especially due to parasite transmission by infected blood in non-endemic countries. Noteworthily, CD is predominantly marked by a subclinical progression, so that for most cases, the correct diagnosis may take years, even decades, post infection. Public actions such as active search of infected people and donors screening are imperative for both identification of individual health assistance and disease control. Nonetheless, the main affected areas lack in laboratory infrastructure, resource and specialized personnel, making the use of conventional immunoassays unfeasible. Moreover, parasite genetic variability and cross-reaction with close-related infectious diseases imposes a stringent diagnosis algorithm. Thus, although rapid tests are a great option, its applicability is still restricted in the context of this disease. In this regard, this chapter will discuss the use of immunochromatographic-based assays for CD, their limitations and perspectives. The performance of commercially available kits in comparison to the conventional serologic tests will be also debated, covering their antigen selection, origin of population studied and type of samples.

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Section: Performance Of Immunochromatographic Rapid Tests Commerciall...mentioning

confidence: 87%

Section: Applicability Of Rapids Tests and Its Perspectives In CD Con...mentioning

confidence: 99%

Rapid Test and Chagas Disease: An Overview

Caminha¹,

Cavalcante²,

Menna-Barreto³

2023

Rapid Antigen Testing

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show abstract

“…This study was performed under the ethics committee of the Johns Hopkins School of Public Health (protocol IRB 6713) and all patients provided written informed consent. From February 2016 to April 2018, patients originally from Chagas-endemic countries were recruited from health fairs and recruitment events held at various churches, community centers, and consulates, in Virginia, Maryland and Washington D.C[32, 33]. Patients provided a blood sample and underwent a cardiovascular evaluation consisting of a clinical examination, electrocardiogram (EKG) and echocardiogram.…”

Section: Methodsmentioning

confidence: 99%

“…The IgG-TESA-blot was developed and performed using the trypomastigote excreted-secreted antigen from the T. cruzi Y strain [36, 37]. Individuals with positive results on two or more tests were considered seropositive for Chagas disease[32, 33]. 10 Chagas-positive patients were randomly selected, and 23 Chagas-negative patients were matched by age, sex, region of origin, and cardiac disease stage.…”

Section: Methodsmentioning

confidence: 99%

Immunologic changes are detectable in the peripheral blood transcriptome of clinically asymptomatic Chagas cardiomyopathy patients

Duque,

So,

Castro-Sesquen

et al. 2023

Preprint

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Chagas disease, caused by the protozoan parasiteTrypanosoma cruzi, is a neglected parasitic disease that affects approximately 6 million individuals worldwide. Of those infected, 20-30% will go on to develop chronic Chagas cardiomyopathy (CCC), and ultimately many of these individuals will progress to advanced heart failure. The mechanism by which this progression occurs is poorly understood, as few studies have focused on early CCC. In this study, we sought to understand the physiologic changes associated withT. cruziinfection and the development of CCC. We analyzed gene expression in the peripheral blood of asymptomatic Chagas patients with early structural heart disease, Chagas patients without any signs or symptoms of disease, and Chagas-negative patients with and without early structural heart disease. Our analysis shows that early CCC was associated with a downregulation of various peripheral immune response genes, with gene expression changes suggestive of reduced antigen presentation and T cell activation. Notably, these genes and processes were distinct from those of early cardiomyopathy in Chagas-negative patients, suggesting that the processes mediating CCC may be unique from those mediating progression to other cardiomyopathies. This work highlights the importance of the immune response in early CCC, providing insight into the early pathogenesis of this disease. The changes we have identified may serve as biomarkers of progression and could inform strategies for the treatment of CCC in its early stages, before significant cardiac damage has occurred.

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“…Similarly, a sensitivity of 30% has been reported for Chagas Stat Pak in samples from Peru [ 13 ]; but an overall sensitivity of 87% was found in Bolivian samples [ 13 , 14 ]. Chagas Detect Plus, the only rapid test currently approved by the FDA, was shown to have variable performance according to geographic region [ 15 , 16 ]. In a study performed on US blood donors, this rapid test showed the highest sensitivities for those donors born in South America, the lowest sensitivities for those born in Mexico, and intermediate sensitivities for those born in Central America [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Identification of highly conserved Trypanosoma cruzi antigens for the development of a universal serological diagnostic assay

Majeau,

Dumonteil,

Herrera

2024

Emerging Microbes & Infections

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Chagas Disease is an important neglected tropical disease caused by Trypanosoma cruzi . There is no gold standard for diagnosis and commercial serological tests perform poorly in certain locations. By aligning T. cruzi genomes covering parasite genetic and geographic diversity, we identified highly conserved proteins that could serve as universal antigens for improved diagnosis. Their antigenicity was tested in high-density peptide microarrays using well-characterized plasma samples, including samples presenting true infections but discordant serology. Individual and combination of epitopes were also evaluated in peptide-ELISAs. We identified >1400 highly conserved T. cruzi proteins evaluated in microarrays. Remarkably, T. cruzi positive controls had a different epitope recognition profile compared to serologically discordant samples. In particular, multiple T. cruzi antigens used in current tests and their strain-variants, and novel epitopes thought to be broadly antigenic failed to be recognized by discordant samples. Nonetheless, >2000 epitopes specifically recognized by IgGs from both positive controls and discordant samples were identified. Evaluation of selected peptides in ELISA further illustrated the extensive variation in antibody profiles among subjects and a peptide combination could outperform a commercial ELISA, increasing assay sensitivity from 52.3% to 72.7%. Individual variation in antibody profiles rather than T. cruzi diversity appears to be the main factor driving differences in serological diagnostic performance according to geography, which will be important to further elucidate. ELISA with a combination of peptides recognized by a greater number of individuals could better capture infections, and further development may lead to an optimal antigen mixture for a universal diagnostic assay.

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Evaluation of 2 Lateral Flow Rapid Tests in the Diagnosis of Chagas Disease in the Washington Metropolitan Area

Cited by 6 publications

References 13 publications

Rapid Test and Chagas Disease: An Overview

Rapid Test and Chagas Disease: An Overview

Immunologic changes are detectable in the peripheral blood transcriptome of clinically asymptomatic Chagas cardiomyopathy patients

Identification of highly conserved Trypanosoma cruzi antigens for the development of a universal serological diagnostic assay

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