Urban Trypanosoma cruzi Oral Transmission: from a Zoonotic Founder Focus to the Largest Microepidemic of Chagas Disease

Noya, Belkisyolé Alarcón de

doi:10.15226/sojmid/4/1/00147

Cited by 8 publications

(7 citation statements)

References 27 publications

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“…Isothermality (Bio3; 24.8%) was the most weighted variable for the model, with the remaining weight equally distributed among the other variables (4.7% on average). This would explain the eclecticism of this species towards different ecoregions, which facilitates the anthropogenic influence on its distribution and reinforces its role as a vector of the trypanosomas [ 8 , 10 , 45 , 46 ].…”

Section: Resultsmentioning

confidence: 99%

“…Species of Pantrongylus are considered potential vectors of Trypanosoma cruzi (Eukarya, Kinetoplastea, Trypanosomatidae), which is the etiological agent of CD. They are found in rural, urban, and suburban dwellings with wildlife corridors and vector domiciliation [ 7 , 8 , 9 , 10 , 11 ]. As a result, when other vectors have been chemically controlled, many of the Panstrongylus species have emerged as successors.…”

Section: Introductionmentioning

confidence: 99%

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Geographic Distribution of the Genus Panstrongylus Berg, 1879 in the Neotropic with Emphasis on Trypanosoma cruzi Vectors

Tineo-González,

Fermín,

Bonilla-Rivero

et al. 2023

TropicalMed

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Panstrongylus is a Neotropical taxa of 16 species, some more widespread than others, that act as vectors of Trypanosoma cruzi, the etiologic agent of Chagas disease (CD). This group is associated with mammalian reservoir niches. There are few studies of the biogeography and niche suitability of these triatomines. Using zoo-epidemiological occurrence databases, the distribution of Panstrongylus was determined based on bioclimatic modelling (DIVA GIS), parsimonious niche distribution (MAXENT), and parsimony analysis of endemic species (PAE). Through 517 records, a wide presence of P. geniculatus, P. rufotuberculatus, P. lignarius, and P. megistus was determined and recorded as frequent vectors of T. cruzi in rainforest habitats of 24–30 °C. These distributions were modeled with AUC >0.80 and <0.90, as well as with the seasonality of temperature, isothermality, and precipitation as relevant bioclimatic variables. Individual traces for each taxon in Panstrongylus—1036 records—showed widely dispersed lines for frequent vectors P. geniculatus, P. lignarius, P. rufotuberculatus, and P. megistus. Other occasional vectors showed more restricted dispersal, such as P. howardi, P. humeralis, P. lenti, P. lutzi, P. tupynambai, P. noireaiui, and P. chinai. Areas of defined environmental variation, geological change, and trans domain fluid fauna, such as the American Transition Zone and the Pacific Domain of Morrone, had the highest Panstrongylus diversity. Pan-biogeographic nodes appear to be areas of the greatest species diversity that act as corridors connecting biotopes and allowing fauna migration. Vicariance events in the geologic history of the continent need to be investigated. The geographical distribution of Panstrongylus overlapped with CD cases and Didelphis marsupialis/Dasypus novemcinctus presence, two important reservoirs in Central and South America. The information derived from the distribution of Panstrongylus provides knowledge for surveillance and vector control programs. It would increase information on the most and less relevant vector species of this zoonotic agent, for monitoring their population behavior.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Geographic Distribution of the Genus Panstrongylus Berg, 1879 in the Neotropic with Emphasis on Trypanosoma cruzi Vectors

Tineo-González,

Fermín,

Bonilla-Rivero

et al. 2023

TropicalMed

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“…ChD mainly affects poor people living in rural communities, who often get infected through triatomines [ 1 ]. However, the migration of people from rural to urban areas and the adaptation of wild vectors to the peripheries of large cities as Caracas, have allowed the establishment of enzootic cycles between reduvids such as Panstrongylus geniculatus and synanthropic mammals and humans, facilitating the contamination of food by infected triatomines or their feces [ 4 , 5 , 6 ]. Additionally, human-to-human transmissions (vertical mother–child infection, transfusions, organ transplants, reactivation), have changed the epidemiology and the clinical evolution of ChD in the urban environment [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…Generally, the oral outbreak communities occur in endemic areas where previous contact with the parasite cannot be ruled out. The Chacao outbreak occurred at a distance from the contamination site [ 4 , 8 ], so it can be stated that this middle-class school population, was not previously exposed to the parasite.…”

Section: Introductionmentioning

confidence: 99%

Ten years follow-up of the largest oral Chagas disease outbreak: Cardiological prospective cohort study

Ruiz-Guevara,

Alarcón de Noya,

Mendoza

et al. 2023

PLoS Negl Trop Dis

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Background Chagas disease (ChD) is the most important endemy in Latin America. Some patients, develop chronic Chagasic cardiopathy (CCC) years after the acute phase. It is unknown if patients infected by the oral route have higher risk of developing early CCC. Methods and findings A prospective cohort study was conducted to assess morbidity and mortality during 10 years observation in 106 people simultaneously infected and treated in the largest known orally transmitted ChD outbreak in 2007. A preschooler died during the acute phase, but thereafter was no mortality associated to ChD. All acute phase findings improved in the first-year post-treatment. Each person was evaluated 8.7 times clinically, 6.4 by electrocardiogram (ECG)/Holter, and 1.7 by echocardiogram. Based on prevalence, the number of people who had any abnormalities (excluding repolarization abnormalities and atrial tachycardia which decreased) was higher than 2007, since they were found at least once between 2008–2017. However, when we evaluated incidence, except for clinical bradycardia and dizziness, it was observed that the number of new cases of all clinical and ECG findings decreased at the end of the follow-up. Between 2008–2017 there was not incidence of low voltage complex, 2nd degree AV block, long QT interval, left bundle branch block or left ventricular dysfunction that allowed the diagnosis of CCC. Total improvement prevailed over the persistence of all clinical and ECG/Holter findings, except for sinus bradycardia. Incomplete right bundle branch block, sinus bradycardia and/or T-wave inversion were diagnosed persistently in 9 children. The second treatment did not have significant influence on the incidence of clinical or ECG/Holter findings. Conclusions At the end of the 10-year follow-up, there were not clinical or ECG/Holter criteria for classifying patients with CCC. The incidence of arrhythmias and repolarization abnormalities decreased. However, special attention should be paid on findings that not revert as sinus bradycardia, or those diagnosed persistently in all ECG as sinus bradycardia, incomplete right bundle branch block or T-wave inversion. Early diagnosis and treatment may have contributed to the rapid improvement of these patients. In ChD follow-up studies prevalence overestimates the real dimension of abnormalities, the incidence looks as a better indicator.

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“…Since 2007, Venezuela has been the third country to report outbreaks of Chagas disease that are orally transmitted (oCD) through contaminated food. − In addition, it is the country with the highest number of patients involved in oCD microepidemics, with 103 affected patients . Despite 100% effective adherence to treatment in these patients, high rates of therapeutic failure have been reported …”

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confidence: 99%

Genetic Characterization of Trypanosoma cruzi I Populations from an Oral Chagas Disease Outbreak in Venezuela: Natural Resistance to Nitroheterocyclic Drugs

et al. 2023

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The oral transmission of Chagas disease (oCD) in Venezuela announced its appearance in 2007. Different from other populations affected by oCD and despite close supervision during treatment with nitroheterocyclic drugs, the result was treatment failure. We studied genetic features of natural bloodstream parasite populations and populations after treatment of nine patients of this outbreak. In total, we studied six hemoculture isolates, eight Pre-Tx blood samples, and 17 samples collected at two or three Post-Tx time-points between 2007 and 2015. Parasitic loads were determined by quantitative polymerase chain reaction (qPCR), and discrete typing units (DTU), minicircle signatures, and Tcntr-1 gene sequences were searched from blood samples and hemocultures. Half-maximal inhibitory concentration (IC 50 ) values were measured from the hemocultures. All patients were infected by TcI. Significant decrease in parasitic loads was observed between Pre-Tx and Post-Tx samples, suggesting the evolution from acute to chronic phase of Chagas disease. 60% of intra-DTU-I variability was observed between Pre-Tx and Post-Tx minicircle signatures in the general population, and 43 single-nucleotide polymorphisms (SNPs) were detected in a total of 12 Tcntr-1 gene sequences, indicative of a polyclonal source of infection. SNPs in three post-Tx samples produced stop codons giving rise to putative truncated proteins or displaced open reading frames, which would render resistance genes. IC 50 values varied from 5.301 ± 1.973 to 104.731 ± 4.556 μM, demonstrating a wide range of susceptibility. The poor drug response in the Pre-Tx parasite populations may be associated with the presence of naturally resistant parasite clones. Therefore, any information that can be obtained on drug susceptibility from in vitro assays, in vivo assays, or molecular characterization of natural populations of Trypanosoma cruzi becomes essential when therapeutic guidelines are designed in a given geographical area.

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Urban Trypanosoma cruzi Oral Transmission: from a Zoonotic Founder Focus to the Largest Microepidemic of Chagas Disease

Cited by 8 publications

References 27 publications

Geographic Distribution of the Genus Panstrongylus Berg, 1879 in the Neotropic with Emphasis on Trypanosoma cruzi Vectors

Geographic Distribution of the Genus Panstrongylus Berg, 1879 in the Neotropic with Emphasis on Trypanosoma cruzi Vectors

Ten years follow-up of the largest oral Chagas disease outbreak: Cardiological prospective cohort study

Genetic Characterization of Trypanosoma cruzi I Populations from an Oral Chagas Disease Outbreak in Venezuela: Natural Resistance to Nitroheterocyclic Drugs

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