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...
Published in: | PLOS Neglected Tropical Diseases |
---|---|
Main Authors: | , , , , , , , , , , |
Format: | Article in Journal/Newspaper |
Language: | English |
Published: |
Public Library of Science (PLoS)
2019
|
Subjects: | |
Online Access: | https://doi.org/10.1371/journal.pntd.0007877 https://doaj.org/article/3464d7fd32354f0ca54edd8063662633 |
id |
ftdoajarticles:oai:doaj.org/article:3464d7fd32354f0ca54edd8063662633 |
---|---|
record_format |
openpolar |
spelling |
ftdoajarticles:oai:doaj.org/article:3464d7fd32354f0ca54edd8063662633 2023-05-15T15:15:19+02:00 Use of rapid diagnostic tests (RDTs) for conclusive diagnosis of chronic Chagas disease - field implementation in the Bolivian Chaco region. Daniel Lozano Lizeth Rojas Susana Méndez Aina Casellas Sergi Sanz Lourdes Ortiz María Jesús Pinazo Marcelo Abril Joaquim Gascón Faustino Torrico Julio Alonso-Padilla 2019-12-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0007877 https://doaj.org/article/3464d7fd32354f0ca54edd8063662633 EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pntd.0007877 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0007877 https://doaj.org/article/3464d7fd32354f0ca54edd8063662633 PLoS Neglected Tropical Diseases, Vol 13, Iss 12, p e0007877 (2019) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2019 ftdoajarticles https://doi.org/10.1371/journal.pntd.0007877 2022-12-31T05:56:59Z 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. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Chaco ENVELOPE(-60.583,-60.583,-63.033,-63.033) PLOS Neglected Tropical Diseases 13 12 e0007877 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Daniel Lozano Lizeth Rojas Susana Méndez Aina Casellas Sergi Sanz Lourdes Ortiz María Jesús Pinazo Marcelo Abril Joaquim Gascón Faustino Torrico Julio Alonso-Padilla Use of rapid diagnostic tests (RDTs) for conclusive diagnosis of chronic Chagas disease - field implementation in the Bolivian Chaco region. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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. |
format |
Article in Journal/Newspaper |
author |
Daniel Lozano Lizeth Rojas Susana Méndez Aina Casellas Sergi Sanz Lourdes Ortiz María Jesús Pinazo Marcelo Abril Joaquim Gascón Faustino Torrico Julio Alonso-Padilla |
author_facet |
Daniel Lozano Lizeth Rojas Susana Méndez Aina Casellas Sergi Sanz Lourdes Ortiz María Jesús Pinazo Marcelo Abril Joaquim Gascón Faustino Torrico Julio Alonso-Padilla |
author_sort |
Daniel Lozano |
title |
Use of rapid diagnostic tests (RDTs) for conclusive diagnosis of chronic Chagas disease - field implementation in the Bolivian Chaco region. |
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. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2019 |
url |
https://doi.org/10.1371/journal.pntd.0007877 https://doaj.org/article/3464d7fd32354f0ca54edd8063662633 |
long_lat |
ENVELOPE(-60.583,-60.583,-63.033,-63.033) |
geographic |
Arctic Chaco |
geographic_facet |
Arctic Chaco |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 13, Iss 12, p e0007877 (2019) |
op_relation |
https://doi.org/10.1371/journal.pntd.0007877 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0007877 https://doaj.org/article/3464d7fd32354f0ca54edd8063662633 |
op_doi |
https://doi.org/10.1371/journal.pntd.0007877 |
container_title |
PLOS Neglected Tropical Diseases |
container_volume |
13 |
container_issue |
12 |
container_start_page |
e0007877 |
_version_ |
1766345680294510592 |