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1.
Mem. Inst. Oswaldo Cruz ; 115: e200214, 2020. tab, graf
Article in English | SES-SP, LILACS, SES-SP | ID: biblio-1135280

ABSTRACT

BACKGROUND Chagas disease, resulting from Trypanosoma cruzi infections, continues to be a health concern mainly in Latin American countries where the parasite is endemic. The laboratory diagnosis of a chronic infection is determined through serological assays for antibodies against T. cruzi and several tests are available that differ in key components, formats and methodologies. To date, no single test meets the criteria of a gold standard. The situation is further complicated by the difficulties associated with performance comparisons between different immunoassays or methodologies executed at different times and geographical areas. OBJECTIVE To improve the diagnosis of Chagas disease, the WHO coordinated the development of two International Biological Reference Standards for antibodies against anti-T. cruzi: NIBSC 09/186 and NIBSC 09/188 that respectively represent geographical regions with the highest prevalence of TcII and TcI lineages of the parasite. METHODS The principle goal of this study was to verify the behavior of these standards when assayed by several commercially available serological tests that employ different methods to capture and detect human anti-T. cruzi antibodies. FINDINGS AND MAIN CONCLUSIONS The results reinforce the recommendation that these standards be considered for performance evaluations of commercialised immunoassays and should be an integral step in the development of new test components or assay paradigms.


Subject(s)
Humans , Trypanosoma cruzi/isolation & purification , Serologic Tests/standards , Chagas Disease/diagnosis , Reference Standards , Trypanosoma cruzi/immunology , World Health Organization , Immunoassay/methods , Serologic Tests/methods , Antibodies, Protozoan/blood , Chagas Disease/parasitology
2.
RELAMPA, Rev. Lat.-Am. Marcapasso Arritm ; 31(4): 133-137, out.-dez. 2018.
Article in Spanish | LILACS | ID: biblio-999084

ABSTRACT

A Doença de Chagas atinge milhões de pessoas na América Latina e a evolução para cardiopatia crônica tem como seu principal desfecho a morte súbita cardíaca (MSC). Neste artigo, revisamos, sob a luz da medicina baseada em evidências, os principais aspectos sobre marcadores prognósticos clínicos e de imagem (especificamente a análise da fibrose em ressonância magnética) e terapêutica existente no tratamento e prevenção da MSC, como terapia farmacológica, evidências sobre dispositivos implantáveis e tratamento invasivo de arritmias ventriculares


Chagas disease affects millions of people in Latin America and its evolution to heart disease has the sudden cardiac death (SCD) as one main outcome. In this article, we sought to review the essential evidence-based aspects about prognostic markers and treatments for SCD, including farmacological treatment, use of implantable devices and invasive treatment of ventricular arrhthymias


Subject(s)
Humans , Male , Female , Chagas Cardiomyopathy/therapy , Death, Sudden, Cardiac/prevention & control , Chagas Disease , Prognosis , Stroke Volume , Trypanosoma cruzi/immunology , Magnetic Resonance Spectroscopy/methods , Chronic Disease , Tachycardia, Ventricular , Defibrillators, Implantable , Drug Therapy/methods
3.
Rev. Soc. Bras. Med. Trop ; 51(5): 616-621, Sept.-Oct. 2018. tab
Article in English | LILACS | ID: biblio-957454

ABSTRACT

Abstract INTRODUCTION: The transmission of Chagas disease (CD) through blood transfusion, organ transplantation, and oral transmission has gained greater visibility as a result of intensified vector control activities in endemic regions and to control CD in non-endemic regions. In Brazil, Ceará is one of the states that perform the most organ transplants. Therefore, the objective of this study was to assess the prevalence of Trypanosoma cruzi infection in organ donor candidates. METHODS: A retrospective analysis was performed on data from potential organ donors at the Center of Transplantation of the State of Ceará from 2010 - 2015. RESULTS: Data from a total of 2,822 potential donors were obtained, of which 1,038 were effective donors and 1,784 were excluded, likely due to lack of family authorization or medical contraindication. The prevalence of T. cruzi infection among these potential donors was 1.3% (n = 29). The majority of infected donors were males aged 41 - 60 years, residing in the interior of the state. Interestingly, 72.4% (n = 21) had positive or inconclusive serology for additional infections, such as cytomegalovirus, hepatitis B and C, and toxoplasmosis. Probability analysis revealed that stroke was the most common cause of death among potential donors with CD. CONCLUSIONS: There was a high prevalence of CD and other coinfections among potential solid organ donors in Ceará, and statistical tests have shown that these individuals are at increased risk of stroke when compared to potential non-reactive donors. This work highlights the importance of screening DC infection in potential donors.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Young Adult , Tissue Donors/statistics & numerical data , Trypanosoma cruzi/immunology , Antibodies, Protozoan/blood , Chagas Disease/epidemiology , Brazil/epidemiology , Seroepidemiologic Studies , Retrospective Studies , Middle Aged
4.
Rev. Soc. Bras. Med. Trop ; 51(5): 660-664, Sept.-Oct. 2018. tab, graf
Article in English | LILACS | ID: biblio-1041481

ABSTRACT

Abstract INTRODUCTION: We evaluated clinical and epidemiological characteristics of Trypanosoma cruzi infection in Sergipe. METHODS: In this cross-sectional study, we collected serum samples to identify serological markers of Chagas disease. A questionnaire was used, and electrocardiogram, echocardiogram, chest radiography, and contrast radiography of esophagus and colon were performed. RESULTS: T. cruzi infection seroprevalence was 12.1%, mean age of subjects was 55 years, 90% had an elementary school education, 78.6% were agriculture workers, and 60.5% had electrocardiographic abnormalities. CONCLUSIONS: A high prevalence of T. cruzi infection was observed in mostly elderly individuals.


Subject(s)
Humans , Male , Female , Adult , Trypanosoma cruzi/immunology , Antibodies, Protozoan/blood , Chagas Disease/epidemiology , Endemic Diseases , Socioeconomic Factors , Brazil/epidemiology , Enzyme-Linked Immunosorbent Assay , Seroepidemiologic Studies , Prevalence , Cross-Sectional Studies , Chagas Disease/diagnosis , Chagas Disease/immunology , Fluorescent Antibody Technique, Indirect , Middle Aged
5.
Rev. Soc. Bras. Med. Trop ; 51(4): 467-474, July-Aug. 2018. graf
Article in English | LILACS | ID: biblio-957441

ABSTRACT

Abstract INTRODUCTION: The detection of Trypanosoma cruzi in tissue samples is important in many situations, such as testing of the reactivation of the infection. The detection of T. cruzi nests in endomyocardial biopsies (EMB) may be useful to evaluate graft rejection. Given their scarcity, such nests are not routinely identified. To increase the diagnosis sensitivity, immunohistochemistry (IHC) may serve as a promising strategy. Here, we validate an antiserum for the detection of T. cruzi infection by IHC. METHODS: We used 1) positive controls (PCs) - 13 EMB, 12 skin biopsies, and 1 heart with T. cruzi nests as sections stained with hematoxylin and eosin (HE); 2) negative controls - a) 10 explant hearts and 10 EMB with no amastigote nests or clinical/laboratory signs of chagasic infection; and b) eight samples with leishmaniasis, toxoplasmosis, or histoplasmosis; and 3) Cases - 31 EMB of chagasic patients with no parasite nests in HE sections but detected positive for T. cruzi DNA by polymerase chain reaction. As a primary antibody, a hyperimmune serum from T. cruzi-infected rabbits was used. RESULTS: IHC results were positive for 21 of 26 PCs (80.8%) and one case of cutaneous leishmaniasis. In 4 of 31 cases, IHC revealed nests (12.9%), which were undetected by conventional histological examination. CONCLUSIONS: This study shows that IHC with the tested antiserum increases the sensitivity of the diagnosis and may be recommended for routine use in EMB analyses of cardiac transplant patients with Chagas disease.


Subject(s)
Humans , Trypanosoma cruzi/immunology , Antibodies, Protozoan/blood , DNA, Protozoan/analysis , Chagas Disease/diagnosis , Endocardium/parasitology , Antibodies, Monoclonal/blood , Biopsy , Immunohistochemistry , Case-Control Studies , Polymerase Chain Reaction , Sensitivity and Specificity , Antibody Formation
6.
Rev. Soc. Bras. Med. Trop ; 51(3): 310-317, Apr.-June 2018. tab, graf
Article in English | LILACS | ID: biblio-957421

ABSTRACT

Abstract INTRODUCTION: Chagas disease is caused by the flagellate protozoan Trypanosoma cruzi, being one of the leading causes of morbidity and mortality in the Americas with an estimated six to seven million infected people worldwide. In Brazil, the improvement in vector control and blood donor screening has evidenced the important epidemiological role of congenital transmission of Chagas disease. METHODS: A serological survey for Chagas disease was performed in 3,952 newborns in the southern region of Sergipe using paper filter disks of dried blood samples. The newborns were screened using the Sergipe State Neonatal Screening Program between July 2015 and July 2016, and 3,749 and 750 blood samples were obtained for the IgG enzyme-linked immunosorbent assay and indirect immunofluorescence assay, respectively. In addition, mothers of the children who presented initial reagent serology were examined. RESULTS: Among 3,749 blood samples, samples of two children were positive for the enzyme-linked immunosorbent assay; however, their confirmation test results were negative, suggesting passive transfer of the mother's antibody. One puerpera was identified with Chagas disease, with a prevalence of 0.02%. CONCLUSIONS: Congenital Chagas disease was not observed in newborns in the Southern region of Sergipe. However, Chagas disease was observed in women of reproductive age. Therefore, effective measurements for monitoring and systematic evaluation should be conducted. The Neonatal Screening Program proved to be an effective public health strategy for the prevention and control of Chagas disease.


Subject(s)
Humans , Male , Female , Infant, Newborn , Trypanosoma cruzi/immunology , Antibodies, Protozoan/blood , Chagas Disease/congenital , Chagas Disease/diagnosis , Brazil/epidemiology , Enzyme-Linked Immunosorbent Assay , Seroepidemiologic Studies , Prevalence , Cross-Sectional Studies , Neonatal Screening , Chagas Disease/epidemiology , Fluorescent Antibody Technique, Indirect
7.
Rev. bras. parasitol. vet ; 27(2): 232-236, Apr.-June 2018. tab, graf
Article in English | LILACS | ID: biblio-1042468

ABSTRACT

Abstract The aim of this study were to detect antibodies anti-Leishmania spp. and anti-Trypanosoma cruzi in two different populations of domestic cats (Felis catus domesticus) from North Paraná referred for surgical castration and to determine which characteristics of the animals studied may be associated with seropositivity. Serum samples from 679 cats were analyzed using enzyme-linked immunosorbent assay (ELISA) and indirect immunofluorescence antibody test (IFAT) in series. Associations between age, sex, race, year of care and animal group were verified using the simple logistic regression. Percentage of 8.5% (58/679) of cats were positive for Leishmania spp. and 7.6% (51/673) for T. cruzi by the tests ELISA and IFAT. Animals collected by non-governmental animal protection organizations presented more seropositivity for Leishmania spp. (p<0.0001). Results shown that Leishmania spp. and T. cruzi are present in domestic cats in the northern part of the state of Paraná, as well as, owners of non-governmental animal protection organizations may be more exposed to leishmaniasis when compared to other animal owners evaluated in the present study.


Resumo O objetivo desse estudo foi detectar a presença de anticorpos IgG anti-Leishmania spp. e anti-Trypanosoma cruzi em duas populações de gatos domésticos (Felis catus domesticus) do Norte do Paraná encaminhados para castração cirúrgica e determinar quais as características dos animais estudados que podem estar associadas à soropositividade. Amostras de soro de 679 gatos foram analisadas utilizando-se os testes imunoenzimático (ELISA) e a reação de imunofluorescência indireta (RIFI), em série. Associações entre idade, sexo, raça, ano de atendimento e grupo animal ​​foram verificadas usando regressão logística simples. Um percentual de 8,5% (58/679) dos gatos apresentou positividade para Leishmania spp. e 7,6% (51/673) para T. cruzi pelos testes ELISA e RIFI. Gatos mantidos em organizações não governamentais de proteção animal apresentaram maior sororeatividade para Leishmania spp. (p<0.0001). As sorologias reativas para Leishmania spp. e Trypanosoma cruzi mostram que esses agentes estão presentes em gatos domésticos na parte norte do estado do Paraná, bem como, os proprietários de organizações não governamentais de proteção animal podem estar mais expostos à leishmaniose quando comparados com outros proprietários de animais avaliados no presente estudo.


Subject(s)
Animals , Male , Female , Trypanosoma cruzi/immunology , Antibodies, Protozoan/blood , Cat Diseases/parasitology , Cat Diseases/blood , Leishmaniasis/veterinary , Cats/parasitology , Chagas Disease/veterinary , Leishmania/immunology , Brazil/epidemiology , Cat Diseases/epidemiology , Leishmaniasis/blood , Leishmaniasis/epidemiology , Seroepidemiologic Studies , Chagas Disease/blood , Chagas Disease/epidemiology , Risk Assessment
8.
Rev. Soc. Bras. Med. Trop ; 51(2): 190-197, Mar.-Apr. 2018. tab, graf
Article in English | LILACS | ID: biblio-897070

ABSTRACT

Abstract INTRODUCTION: Chagas disease is caused by the protozoa Trypanosoma cruzi. Its main reservoir is the domestic dog, especially in rural areas with favorable characteristics for vector establishment and proliferation. The aims of this study were to collect data, survey and map the fauna, and identify T. cruzi infection in triatomines, as well as to assess the presence of anti-T. cruzi antibodies in dogs in rural areas of the municipality of Mossoró, Brazil. METHODS: An active entomologic research was conducted to identify adult specimens through an external morphology dichotomous key. The analysis of natural infection by T. cruzi in the insects was performed by isolation in culture and polymerase chain reaction. The antibody testing for T. cruzi in dogs was performed by enzyme-linked immunosorbent assay and indirect immunofluorescence assay. RESULTS: A total of 68 triatomines were captured, predominantly the Triatoma brasiliensis brasiliensis (Neiva 1911) species. The vector mapping displayed areas with greater risk for parasite transmission. Of the examined triatomines (51 specimens), 41.2% (21/51) were positive on polymerase chain reaction, and all were negative on culture. In the serum testing, 11% (25/218) of dogs were seropositive, but no association was found between the serologic results and the presence and infection by T. cruzi in triatomines. CONCLUSIONS: This study demonstrated the movement of T. cruzi in the studied area, by the presence of vectors and naturally infected domestic reservoirs. The mapping of the studied rural area demonstrates the risk of disease transmission.


Subject(s)
Animals , Dogs , Trypanosoma cruzi/immunology , Antibodies, Protozoan/blood , Triatominae/parasitology , Chagas Disease/veterinary , Dog Diseases/diagnosis , Insect Vectors/parasitology , Rural Population , Brazil/epidemiology , Polymerase Chain Reaction , Prevalence , Chagas Disease/diagnosis , Chagas Disease/epidemiology , Fluorescent Antibody Technique, Indirect , Dog Diseases/epidemiology
9.
Arq. bras. cardiol ; 110(4): 348-353, Apr. 2018. tab, graf
Article in English | LILACS | ID: biblio-888059

ABSTRACT

Abstract Background: Vimentin is a main structural protein of the cell, a component of intermediate cell filaments and immersed in cytoplasm. Vimentin is mimicked by some bacterial proteins and anti-vimentin antibodies occur in autoimmune cardiac disease, as rheumatic fever. In this work we studied vimentin distribution on LLC-MK2 cells infected with T. cruzi and anti-vimentin antibodies in sera from several clinical pictures of Chagas' disease or American Trypanosomiasis, in order to elucidate any vimentin involvement in the humoral response of this pathology. Objective: We standardized an indirect immunofluorescence assay (IFI) to determine sub cellular expression in either parasites and host cells, and ELISA to evaluate anti-vimentin antibodies in sera fron chagasic patients. Methods: We analyzed the distribution of vimentin in culture cells using indirect fluorescent assays, using as external controls anti-T. cruzi sera, derived from chronic infected patients for identification of the parasites in the same model. After infection and growth of T.cruzi amastigotes, those cells express larger amounts of vimentin, with heavy staining of cytoplasm outside the parasitophorous vacuole and some particle shadowing patterns, suggesting that vimentin are associated with cell cytoplasm. Anti-vimentin antibodies were present in most American trypanosomiasis samples, but notably, they are much more present in acute (76, 9%) or clinical defined syndromes, especially cardiac disease (87, 9%). Paradoxically, they were relatively infrequent in asymptomatic (25%) infected patients, which had a clearly positive serological reaction to parasite antigens, but had low frequency of anti-vimentin antibodies, similar to controls (2,5%). Conclusion: Our current data revealed that anti-vimentin antibodies induced during T. cruzi infection could be a marker of active disease in the host and its levels could also justify drug therapy in American Trypanosomiasis chronic infection, as a large group of asymptomatic patients would be submitted to treatment with frequent adverse reactions of the available drugs. Anti-vimentin antibodies could be a marker of cardiac muscle cell damage, appearing in American Trypanosomiasis patients during active muscle cell damage.


Resumo Fundamento: A Vimentina é uma proteína estrutural importante da célula, um componente dos filamentos celulares intermediários e imersa no citoplasma. Algumas proteínas bacterianas imitam a Vimentina e anticorpos anti-vimentina ocorrem em doenças cardíacas auto-imunes, como a febre reumática. Neste trabalho, estudamos a distribuição de vimentina em células LLC-MK2 infectadas com T. Cruzi e anticorpos anti-vimentina em soros de várias imagens clínicas da doença de Chagas ou tripanossomíases americanas, a fim de elucidar qualquer implicação da vimentina na resposta humoral desta patologia. Objetivo: padronizamos um teste de imunofluorescência indireta (IFI) para determinar a expressão subcelular em parasitas e células hospedeiras, e ELISA para testar anticorpos anti-vimentina em soros de pacientes chagásicos. Métodos: analisamos a distribuição de vimentina em células de cultura usando ensaios fluorescentes indiretos, utilizando como controles externos soros anti-T. Cruzi, derivados de pacientes com infecção crônica para a identificação de parasitas no mesmo modelo. Após a infecção e o crescimento de amastigotas de T. Cruzi, essas células expressam grandes quantidades de vimentina, com forte coloração do citoplasma fora da vacuola parasitófora e alguns padrões de sombreamento das partículas, sugerindo que a vimentina está associada ao citoplasma da célula. Os anticorpos anti-vimentina estavam presentes na maioria das amostras americanas de tripanossomíases, mas estão notavelmente mais presentes em síndromes agudas ou clinicamente definidas (76,9%), especialmente em doenças cardíacas (87,9%). Paradoxalmente, eram relativamente infrequentes em pacientes infectados assintomáticos (25%), que apresentavam uma reação sorológica claramente positiva aos antígenos parasitas, mas apresentavam baixa frequência de anticorpos anti-vimentina, semelhante aos controles (2,5%). Conclusão: Nossos dados atuais revelaram que os anticorpos anti-vimentina induzidos durante a infecção por T. Cruzi poderiam ser um marcador de doença ativa no hospedeiro e seus níveis também poderiam justificar o tratamento farmacológico em infecção crônica com tripanossomíase americana, uma vez que um grande grupo de pacientes assintomáticos seria submetido a tratamento com reações adversas frequentes aos medicamentos disponíveis. Os anticorpos anti-vimentina poderiam ser um marcador de danos nas células do músculo cardíaco, que aparece em pacientes com tripanossomíase americana durante o dano das células musculares ativas.


Subject(s)
Humans , Animals , Trypanosoma cruzi/immunology , Vimentin/immunology , Antibodies, Protozoan/immunology , Chagas Disease/immunology , Antigens, Protozoan/immunology , Reference Values , Enzyme-Linked Immunosorbent Assay/methods , Antibodies, Protozoan/analysis , Cells, Cultured , Analysis of Variance , Statistics, Nonparametric , Fluorescent Antibody Technique, Indirect/methods , Macaca mulatta , Antigens, Protozoan/analysis
10.
Mem. Inst. Oswaldo Cruz ; 113(3): 153-160, Mar. 2018. graf
Article in English | LILACS | ID: biblio-894905

ABSTRACT

BACKGROUND The current chemotherapy for Chagas disease is based on monopharmacology with low efficacy and drug tolerance. Polypharmacology is one of the strategies to overcome these limitations. OBJECTIVES Study the anti-Trypanosoma cruzi activity of associations of benznidazole (Bnz) with three new synthetic T. cruzi-triosephosphate isomerase inhibitors, 2, 3, and 4, in order to potentiate their actions. METHODS The in vitro effect of the drug combinations were determined constructing the corresponding isobolograms. In vivo activities were assessed using an acute murine model of Chagas disease evaluating parasitaemias, mortalities and IgG anti-T. cruzi antibodies. FINDINGS The effect of Bnz combined with each of these compounds, on the growth of epimastigotes, indicated an additive action or a synergic action, when combining it with 2 or 3, respectively, and an antagonic action when combining it with 4. In vivo studies, for the two chosen combinations, 2 or 3 plus one fifth equivalent of Bnz, showed that Bnz can also potentiate the in vivo therapeutic effects. For both combinations a decrease in the number of trypomastigote and lower levels of anti-T. cruzi IgG-antibodies were detected, as well clear protection against death. MAIN CONCLUSIONS These results suggest the studied combinations could be used in the treatment of Chagas disease.


Subject(s)
Triose-Phosphate Isomerase/chemistry , Trypanosoma cruzi/drug effects , Trypanosoma cruzi/immunology , Nitroimidazoles/pharmacology , Antibodies, Protozoan , Drug Synergism , Drug Therapy, Combination
11.
Rev. Soc. Bras. Med. Trop ; 50(6): 839-842, Nov.-Dec. 2017. tab, graf
Article in English | LILACS | ID: biblio-1041431

ABSTRACT

Abstract INTRODUCTION: Chagas disease is a neglected public health problem in Mexico; however, detailed studies to determine the seroprevalence in some states have not been performed. METHODS: A total 1,504 human serum from thirteen communities in Estado de Mexico, were analyzed with three diagnostics techniques. RESULTS: The overall seroprevalence was 9.1%, with high prevalence among people aged 51-60 years, while people aged 0-29 years were seronegative against T. cruzi. CONCLUSIONS: Our data demonstrated the seroprevalence of T. cruzi in the North of the Estado de Mexico, an area considered as non-endemic; however, epidemiological conditions necessary for natural transmission were found.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Aged , Aged, 80 and over , Young Adult , Trypanosoma cruzi/immunology , Antibodies, Protozoan/blood , Chagas Disease/epidemiology , Enzyme-Linked Immunosorbent Assay , Seroepidemiologic Studies , Prevalence , Chagas Disease/diagnosis , Mexico/epidemiology , Middle Aged
12.
Mem. Inst. Oswaldo Cruz ; 112(6): 437-446, June 2017. tab, graf
Article in English | LILACS | ID: biblio-841807

ABSTRACT

BACKGROUND The Trypanosoma cruzi infection endemic in Latin America has now spread to several countries across four continents; this endemic involves triatomine vector-free protists. We hypothesised that the sexual transmission of T. cruzi contributes to the ongoing spread of Chagas disease. OBJECTIVES A short-term longitudinal study was conducted to evaluate this hypothesis. METHODS The study population comprised 109 subjects from four families, among whom 21 had been diagnosed with acute Chagas disease by direct parasitological analysis. Blood mononuclear cells and serum samples were obtained from each study subject once per year for three consecutive years. Enzyme-linked immunosorbent assay (ELISA) and indirect immunofluorescence serological examinations were used to detect specific T. cruzi antibodies. Polymerase chain reaction of T. cruzi DNA revealed 188-nucleotide bands, which hybridised to a specific radiolabelled probe and were confirmed by cloning and sequencing. RESULTS Three independent assessments at different time points revealed T. cruzi nuclear DNA footprints in 76% (83/109) of the study population with active infection. In contrast, the ELISA and indirect immunofluorescence assays detected the T. cruzi antibody in 28.4% (31/109) of the study samples. Moreover, the semen from 82.6% (19/23) of subjects people revealed harboured the 188- bp base pair T. cruzi footprint. Interestingly, the ejaculates of nuclear DNA-positive Chagas patient transmitted the T. cruzi upon peritoneal injection or infusion in the vagina of mice, and amastigotes were detected in the skeletal muscle, myocardium, vas deferens, and uterine tube. MAIN CONCLUSIONS T. cruzi infections can be transmitted from females or males to naïve mates through intercourse, and progeny showed discrepancies between the ratios of nuclear DNA footprints and specific antibody that can be explained by the tolerance attained during early embryo growth. Additional studies are needed to develop drugs to eradicate the infections. Additionally, the importance of a vigorous education, information, and communication program to prevent sexually transmitted Chagas disease in humans cannot be underemphasised.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Trypanosoma cruzi/genetics , Trypanosoma cruzi/immunology , Sexually Transmitted Diseases/epidemiology , Chagas Disease/transmission , Chagas Disease/epidemiology , Enzyme-Linked Immunospot Assay , Brazil/epidemiology , Polymerase Chain Reaction , Longitudinal Studies , Fluorescent Antibody Technique
14.
Braz. j. infect. dis ; 21(2): 180-184, Mar.-Apr. 2017. tab
Article in English | LILACS | ID: biblio-1039187

ABSTRACT

Abstract Chagas disease reactivation has been a defining condition for acquired immune deficiency syndrome in Brazil for individuals coinfected with Trypanosoma cruzi and HIV since 2004. Although the first coinfection case was reported in the 1980s, its prevalence has not been firmly established. In order to know coinfection prevalence, a cross-sectional study of 200 HIV patients was performed between January and July 2013 in the city of Pelotas, in southern Rio Grande do Sul, an endemic area for Chagas disease. Ten subjects were found positive for T. cruzi infection by chemiluminescence microparticle immunoassay and indirect immunofluorescence. The survey showed 5% coinfection prevalence among HIV patients (95% CI: 2.0-8.0), which was 3.8 times as high as that estimated by the Ministry of Health of Brazil. Six individuals had a viral load higher than 100,000 copies per µL, a statistically significant difference for T. cruzi presence. These findings highlight the importance of screening HIV patients from Chagas disease endemic areas.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , HIV Infections/complications , Chagas Disease/complications , Endemic Diseases , Socioeconomic Factors , Trypanosoma cruzi/immunology , Brazil/epidemiology , CD4-Positive T-Lymphocytes , HIV Infections/epidemiology , Prevalence , Cross-Sectional Studies , Chagas Disease/epidemiology , Lymphocyte Count , Fluorescent Antibody Technique, Indirect , Viral Load , Coinfection
15.
Rev. Soc. Bras. Med. Trop ; 50(1): 44-51, Jan.-Feb. 2017. tab
Article in English | LILACS | ID: biblio-842825

ABSTRACT

ABSTRACT INTRODUCTION: Chagas disease (CD) is currently considered a neglected disease; hence, identifying the factors associated with its high prevalence is essential. This study aimed to identify the seroprevalence of and the possible factors associated with CD in inhabitants of the City of Limoeiro do Norte, Northeastern Brazil. METHODS: Between April and November 2013, blood collection was conducted and a semi-structured questionnaire was administered. Blood samples that showed positive or possible serology for anti-Trypanosoma cruzi antibodies based on indirect immunofluorescence, hemagglutination indirect, and an enzyme-linked immunosorbent assay were analyzed. Associations between CD positivity and the study variables were analyzed using prevalence ratios (PR) with 95% confidence intervals (CI). RESULTS: A total of 812 individuals were analyzed, of which T. cruzi seropositivity was determined in 4.2% (34 individuals). Sociodemographic variables showing a significant association with T. cruzi positivity included age >50 years (PR = 27.6; 95% CI = 6.66-114.4), elementary level education (PR = 5.15; 95% CI = 1.83-14.47), and retirement (PR = 7.25; 95% CI = 3.72-14.14). Positivity for T. cruzi was 6.17 times higher in those who had a history of living in rammed earth houses compared with those who did not (95% CI = 2.19-17.37). There was no evidence of vertical transmission in the individuals studied. Among the individuals infected with T. cruzi, the majority reported having a comorbidity (p < 0.01). CONCLUSIONS: This study demonstrated the seroprevalence of CD and identified factors associated with a high prevalence of CD.


Subject(s)
Humans , Animals , Male , Female , Child, Preschool , Child , Adolescent , Adult , Aged , Aged, 80 and over , Young Adult , Trypanosoma cruzi/immunology , Antibodies, Protozoan/blood , Chagas Disease/epidemiology , Endemic Diseases , Socioeconomic Factors , Brazil/epidemiology , Enzyme-Linked Immunosorbent Assay , Epidemiologic Methods , Chagas Disease/diagnosis , Fluorescent Antibody Technique, Indirect , Middle Aged
16.
Mem. Inst. Oswaldo Cruz ; 112(1): 70-74, Jan. 2017. tab
Article in English | SES-SP, LILACS, SES-SP | ID: biblio-841755

ABSTRACT

With the urbanisation of the population in developing countries and the process of globalisation, Chagas has become an emerging disease in the urban areas of endemic and non-endemic countries. In 2006, it was estimated that the prevalence of Chagas disease among the general Bolivian population was 6.8%. The aim of the present study was to determine the prevalence of Trypanosoma cruzi infection among Bolivian immigrants living in São Paulo, Brazil. This study had a sample of 633 volunteers who were randomly selected from the clientele of primary care units located in the central districts of São Paulo, Brazil. Infection was detected by two different ELISA assays with epimastigote antigens, followed by an immunoblot with trypomastigote antigens as a confirmatory test. The prevalence of the infection was 4.4%. Risk factors independently associated with the infection were: a history of rural jobs in Bolivia, knowledge of the vector involved in transmission, and having relatives with Chagas disease. Brazil has successfully eliminated household vector transmission of T. cruzi, as well as its transmission by blood transfusion. The arrival of infected immigrants represents an additional challenge to primary care clinics to manage chronic Chagas disease, its vertical transmission, and the blood derivatives and organ transplant programs.


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Trypanosoma cruzi/immunology , Enzyme-Linked Immunosorbent Assay , Antibodies, Helminth/blood , Seroepidemiologic Studies , Chagas Disease/diagnosis , Chagas Disease/epidemiology , Emigrants and Immigrants/statistics & numerical data , Bolivia/ethnology , Brazil/epidemiology , Prevalence , Risk Factors
17.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 26(4): 240-245, out.-dez.2016.
Article in Portuguese | LILACS | ID: biblio-831558

ABSTRACT

Apesar de a doença de Chagas ter sido intensamente estudada ao longo de mais de um século desde sua descoberta, existem lacunas de conhecimento com relação aos mecanismos fisiopatogênicos que levam ao desenvolvimento tardio da cardiomiopatia chagásica crônica. Um aspecto intrigante da doença é a complexa interação entre o hospedeiro e o parasita e suas repercussões. A ocorrência de documentada inflamação tecidual, presente mais intensamente na fase aguda, mas persistente em baixa intensidade também na fase crônica, pode ser consequência do tropismo cardíaco do parasita ou de alterações autoimunes. Nesta revisão, nós abordaremos as evidências do papel patológico da persistência do parasita e da autoimunidade na patogênese da doença de Chagas


Although Chagas disease has been studied intensely for more than a century since it was first discovered, there are gaps in the knowledge of the physiopathogenic mechanism that lead to the late development of chronic chagasic cardiomyopathy. An intriguing aspect of the disease is the complex interaction between the host and the parasite and its repercussions. The occurrence of documented tissue inflammation, which is more intensely present in the acute phase but also persists with lower intensity in the chronic phase, may be a consequence of cardiac tropism of the parasite or of autoimmune changes. In this review, we address the evidence of the pathological role of persistence of the parasite and autoimmunity in the pathogenesis of Chagas disease


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Trypanosoma cruzi/immunology , Chagas Cardiomyopathy/pathology , Chagas Disease/etiology , Chagas Disease/parasitology , Echocardiography , Radiography , Allopurinol/pharmacology , Itraconazole/pharmacology , Electrocardiography
18.
Rev. Soc. Bras. Med. Trop ; 49(6): 768-771, Dec. 2016. tab
Article in English | LILACS | ID: biblio-1041389

ABSTRACT

Abstract: INTRODUCTION: The aim of this study was to investigate the prevalence of Chagas disease in patients treated at a Public Oncology Service in the City of Pelotas, Southern Brazil. METHODS: This study included 200 individuals undergoing cancer treatment and involved the use of a questionnaire and venous blood collection for the detection of anti-Trypanosoma cruzi antibody. RESULTS: The study found a 5% prevalence of patient seropositivity. Significant variables are presented and discussed in the article. CONCLUSIONS: Serological T. cruzi checks are recommended in cancer patients, especially individuals from endemic areas in Brazil and other Latin American countries.


Subject(s)
Humans , Male , Female , Adult , Aged , Aged, 80 and over , Young Adult , Trypanosoma cruzi/immunology , Antibodies, Protozoan/blood , Chagas Disease/epidemiology , Neoplasms/complications , Socioeconomic Factors , Brazil/epidemiology , Enzyme-Linked Immunosorbent Assay , Seroepidemiologic Studies , Prevalence , Chagas Disease/complications , Chagas Disease/diagnosis , Endemic Diseases , Middle Aged , Neoplasms/therapy
19.
Rev. Soc. Bras. Med. Trop ; 49(6): 721-727, Dec. 2016. tab, graf
Article in English | LILACS | ID: biblio-829672

ABSTRACT

Abstract INTRODUCTION: Geographical, epidemiological, and environmental differences associated with therapeutic response to Chagas etiological treatment have been previously discussed. This study describes high seroconversion rates 72 months after benznidazole treatment in patients under 16 years from a project implemented by Doctors without Borders in Guatemala. METHODS: An enzyme-linked immunosorbent assay was used to detect Trypanosoma cruzi IgG antibodies in capillary blood samples from patients 72 months after treatment. Fisher's exact test was used to establish association between characteristics, such as sex, age, and origin of patients, and final seroconversion. Kappa index determined concordance between laboratory tests. The level of significance was set to 5%. RESULTS: Ninety-eight patients, aged 6 months to 16 years, were available for follow-up. Sex and origin were not associated with seroconversion. Individuals older than 13 were more prone to maintain a positive result 72 months after treatment, although results were not highly significant. Laboratory tests presented elevated Kappa concordance (95% CI) = 0.8290 (0.4955-1), as well as high (97%) seroconversion rates. CONCLUSIONS: The high seroconversion rate found in this study emphasizes the importance of access to diagnosis, treatment, and follow-up of individuals affected by Chagas disease. Moreover, it contradicts the idea that it is not possible to achieve a cure with the currently available drugs. This study strongly supports expanding programs for patients infected with T. cruzi in endemic and non-endemic countries.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Trypanocidal Agents/therapeutic use , Trypanosoma cruzi/immunology , Antibodies, Protozoan/blood , Chagas Disease/drug therapy , Nitroimidazoles/therapeutic use , Enzyme-Linked Immunosorbent Assay , Chronic Disease , Treatment Outcome , Chagas Disease/immunology , Seroconversion , Guatemala
20.
Rev. bras. parasitol. vet ; 25(4): 504-510, Sept.-Dec. 2016. tab, graf
Article in English | LILACS | ID: biblio-830046

ABSTRACT

Abstract Neighborhood dogs may act as reservoirs for several zoonotic protozoan infections, particularly in urban areas, thus constituting a potential public health threat. Accordingly, the aim of the present study was to evaluate the exposure of neighborhood dogs to four protozoan pathogens in public areas with high levels of human movement in Curitiba, southern Brazil. Blood samples from 26 neighborhood dogs were screened by means of the indirect immunofluorescent antibody test (IFAT) for Leishmania spp., Toxoplasma gondii, Trypanosoma cruzi and Neospora caninum, and a questionnaire was answered by the respective keeper. A total of 8/26 dogs (30.7%) seroreactive to T. gondii, 3/26 (11.5%) to N. caninum and 2/26 (7.7%) to both were identified. All the samples were seronegative for T. cruzi and Leishmania spp. Pathogen seroreactivity was not associated with the daily human movements or other epidemiological variables investigated (p > 0.05). In conclusion, the low seroprevalence for T. gondii and N. caninum indicated low environmental and food risk for animal infection and the seronegativity for Leishmania spp. and T. cruzi may reflect the absence of these pathogens in urban areas of Curitiba. Moreover, neighborhood dogs may be used as environmental sentinels for the presence of protozoan pathogens and their vectors.


Resumo Cães comunitários podem atuar como reservatórios para algumas zoonoses causadas por protozoários, principalmente em áreas urbanas, constituindo potencial ameaça à saúde pública. Portanto, o objetivo do presente estudo foi avaliar a exposição de cães comunitários a quatro protozoários em áreas públicas com alta circulação de pessoas, em Curitiba, Sul do Brasil. Amostras de sangue de 26 cães comunitários foram testadas pela reação de imunofluorescência indireta (RIFI) para Leishmania spp., Toxoplasma gondii, Trypanosoma cruzi e Neospora caninum, e um questionário foi respondido pelo respectivo mantenedor. Um total de 8/26 (30,7%) foram sororreagentes para T. gondii, 3/26 (11,5%) para N. caninum e 2/26 (7,7%) para ambos. Todas as amostras foram soronegativas para T. cruzi e Leishmania spp. Não houve associação entre sororreatividade para os patógenos pesquisados e o tráfego diário de pessoas e outras variáveis epidemiológicas analisadas (p > 0.05). Conclui-se a baixa soroprevalência para T. gondii e T. cruzi indica baixo risco ambiental e alimentar para a infecção dos animais, e a soronegatividade para Leishmania spp. e T. cruzi pode refletir a ausência desses patógenos em áreas urbanas de Curitiba. Além disso, os cães comunitários podem atuar como sentinelas ambientais quanto à presença de protozoários e seus vetores.


Subject(s)
Animals , Toxoplasma/isolation & purification , Trypanosoma cruzi/isolation & purification , Disease Reservoirs/parasitology , Neospora/isolation & purification , Dogs/parasitology , Leishmania/isolation & purification , Toxoplasma/immunology , Trypanosoma cruzi/immunology , Brazil , Antibodies, Protozoan/blood , Seroepidemiologic Studies , Toxoplasmosis, Animal/immunology , Toxoplasmosis, Animal/parasitology , Neospora/immunology , Dogs/blood , Leishmania/immunology
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