Influence of sexual hormones on Chagas disease / Influencia de las hormonas sexuales en la enfermedad de Chagas

Abstract Objective: Analyze sex hormone's influence during Chagas disease. Methods: Male and female BALB/c mice were divided into six groups, four experimental (sham, orchiectomized, orchiectomized and supplemented with estradiol, orchiectomized supplemented with testosterone, oophorectomized, oophorectomized and supplemented with estradiol, and oophorectomized and supplemented with testosterone), and two control (healthy and intraperitoneally with T. cruzi strain NINOA infected). Clinical data were recorded daily, parasitemia was evaluated using a Neubauer chamber during the infection, and heart histopathological analysis was performed using the paraffin embedding technique. To analyze parasitemia curves and the area under the parametric curves, two-way ANOVA test was performed to correlate groups' data. P-values < 0.05 were considered statistically significant. Results: Higher mortality rates, cardiomegaly, hepatomegaly, ascites, edema, higher parasitemia levels, more amastigote nests, and more severe inflammatory infiltrate were found in higher testosterone concentration mice, whereas in higher estradiol concentration groups, paresia, prostration, edema, and necrosis were found. Conclusions: Our results showed that testosterone increased infection severity, whereas estradiol had the opposite effect. This research improves the understanding of sex hormones´ infuence upon this infection to contribute with the handling of Chagas´ disease.

Resumen Objetivo: Analizar la influencia de las hormonas durante la enfermedad de Chagas. Métodos: Se separaron grupos de ratones macho y hembras BALB/c, todos infectados con T. cruzi (cepa NINOA), 4 grupos experimentales de machos (Sham, orquidectamizados, orquidectimezados y suplementados con estradiol, orquidectamizaos y suplementados con testosterona). 4 grupos experimentales de hembras (oforectomizadas, oforectomizadas y suplementadas con estradiol, oforectomizadas y suplementadas con testosterona y sham), and y dos grupos control para cada sexo (sin infección e infectados intraperitonealmente con T. cruzi (cepa NINOA). Los datos clínicos fueron registrados diariamente, la parasitemia fue evaluada durante toda la infección utilizando una cámara de Neubauer y el análisis histopatológico del corazón fue realizada con la técnica de inclusión en parafina. Para el análisis de las curvas de parasitemia y el área bajo la curva, se realizó una prueba de ANOVA de dos vías, p < 0.05 fueron considerados estadísticamente diferentes. Resultados: Las mayores tasas de mortalidad, cardiomegalia, hepatomegalia y mayor infiltrado inflamatorio, se encontró en los ratones con una mayor concentración de testosterona. En contraste los ratones con mayor concentración de estradiol presentaron paresia, postración edema y necrosis. Conclusiones: Nuestros resultados ponen en manifiesto que la testosterona incrementa la severidad del curso de la enfermedad de Chagas, mientras que el estradiol tuvo el efecto opuesto. Este trabajo mejora el entendimiento del rol que juegan las hormonas sexuales en esta infección para contribuir en un mejor manejo de la enfermedad de Chagas.

GSK-3 kinase a putative therapeutic target in trypanosomatid parasites

ABSTRACT Trypanosomatids are an important group of parasites that predominate in tropical and subtropical areas of the planet, which cause diseases that are classified as forgotten and neglected by the world health organization. In this group of parasites, we find Trypanosoma cruzi, Trypanosoma brucei, Trypanosoma brucei rhodesiense and Leishmania spp, for which there is no vaccine available, and its control has focused mainly on pharmacological treatment. Due to the poverty situation where these diseases are found and the biological complexity of these parasites, there are multiple variables to control, including the diversity of species, the complexity of their life cycles, drug resistance, cytotoxicity, the limited use in pregnant women, the high costs of treatment and the little-known pharmacological mechanisms of action, among others. It is therefore necessary to find new strategies and approaches for the treatment of these parasitic diseases. Among these new approaches is the rational search for new targets based on the allosteric inhibition of protein kinases, which have been little studied in trypanosomatids. Among these kinases, we find Glycogen Synthase Kinase-3 (GSK-3), a kinase of great pharmacological interest, which is under intense basic and clinical research by pharmaceutical companies for the treatment of cancer. This kinase, highly studied in the PI3K/AKT/mTOR pathway signaling in humans, has an orthologous gene in these parasites (GSK-3 s), which has proven to be essential for them in response to different challenges; Therefore, it is notable to increase research in this kinase in order to achieve a broad structural and functional characterization in the different species of trypanosomatids.

Improving in vitro screening compounds anti-Trypanosoma cruzi by GFP-expressing parasites

BACKGROUND Conventional microscopic counting is a widely utilised method for evaluating the trypanocidal effects of drugs on intracellular amastigotes. This is a low-cost approach, but it is time-consuming and reliant on the expertise of the microscopist. So, there is a pressing need for developing technologies to enhance the efficiency of low-cost anti-Trypanosoma cruzi drug screening. OBJECTIVES In our laboratory, we aimed to expedite the screening of anti-T. cruzi drugs by implementing a fluorescent method that correlates emitted fluorescence from green fluorescent protein (GFP)-expressing T. cruzi (Tc-GFP) with cellular viability. METHODS Epimastigotes (Y strain) were transfected with the pROCKGFPNeo plasmid, resulting in robust and sustained GFP expression across epimastigotes, trypomastigotes, and intracellular amastigotes. Tc-GFP epimastigotes and intracellular amastigotes were exposed to a serial dilution of benznidazole (Bz). Cell viability was assessed through a combination of microscopic counting, MTT, and fluorimetry. FINDINGS The fluorescence data indicated an underestimation of the activity of Bz against epimastigotes (IC50 75 µM x 14 µM). Conversely, for intracellular GFP-amastigotes, both fluorimetry and microscopy yielded identical IC50 values. Factors influencing the fluorimetry approach are discussed. MAIN CONCLUSIONS Our proposed fluorometric assessment is effective and can serve as a viable substitute for the time-consuming microscopic counting of intracellular amastigotes.

Conocimientos, actitudes y prácticas sobre la enfermedad de Chagas en una zona endémica de Boyacá, Colombia

Introducción: Los instrumentos para la obtención de información sobre los conocimientos, actitudes y prácticas de diversas enfermedades son ampliamente utilizados, ya que permiten obtener información clara y detallada de cada uno de los aspectos a indagar. Objetivo: Determinar conocimientos, actitudes y prácticas de la enfermedad de Chagas en una zona endémica de Boyacá, Colombia. Metodología: Estudio transversal que consistió en aplicar un instrumento validado que abordaba datos sociodemográficos, factores epidemiológicos, conocimientos, actitudes y prácticas de la enfermedad de Chagas en un integrante mayor de edad de 341 familias de Miraflores, Boyacá. Se emplearon escalas, óptimo, bueno, regular y malo; para el análisis bivariado se determinó el nivel de conocimientos, actitudes y prácticas con escala favorable y desfavorable. Se determinaron diferencias significativas de factores de riesgo, conocimientos, actitudes y prácticas de la enfermedad entre el grupo de hombres y mujeres encuestados. Resultados: El 68,6 % de la población nació en Miraflores, con un 48 % de escolaridad primaria y pertenecientes a la zona rural en su mayoría (57,2 %); en las mujeres predomina la ocupación de ama de casa, mientras que en los hombres es más frecuente la agricultura. Se identificaron conocimientos (48,1 %) y actitudes (82,1 %) óptimas sobre la enfermedad de Chagas que minimizan el riesgo de contraer la infección por T. cruzi; paradójicamente, se encontraron malas prácticas (61,9 %) en el hogar que no previenen la enfermedad. Se observó relación entre el nivel de escolaridad bajo, sexo femenino, ser menor de 49 años, vivir en zona urbana y actividades del hogar y un conocimiento favorable acerca de la enfermedad de Chagas, aunque sin evidencia estadística. Conclusiones: Se hace necesario incorporar programas que garanticen el aprendizaje y la implementación de actitudes y prácticas favorables contra la enfermedad en habitantes de zonas endémicas.

Introduction: The use of measurement tools to obtain information about knowledge, attitudes and practices of various diseases are widely used, since they allow to collect clear and detailed information of every aspect needing examination. Objective: Determine knowledge, attitudes and practices regarding Chagas disease in an endemic zone in Boyaca, Colombia. Methods: Cross-sectional study that consisted of applying a validated instrument that addressed sociodemographic data, epidemiological factors, knowledge, attitudes and practices of the Chagas disease in an adult member of 341 families from Miraflores, Boyaca. The scale categories used were optimal, good, regular and bad; for the bivariate analysis, the level of knowledge, attitudes and practices was determined with a favorable and unfavorable scale. Significant differences in risk factors, knowledge, attitudes and practices of the disease were determined between the group of men and women surveyed. Results: Sixty-eight percent of the population were born in Miraflores, 48% had primary education and most belonged to the rural area (57.2%); in women the occupation of housewife predominated, in men agriculture was more frequent. Optimal knowledge (48.1%) and attitudes (82.1%) about the Chagas disease that minimize the risk of contracting T. cruzi infection were identified. Paradoxically, bad practices that did not prevent the disease were found at home (61,9%). significant regarding the low level of schooling, female gender, being under 49 years of age, living in an urban area and household activities, all of the above allows a favorable knowledge about Chagas disease, although without statistical evidence. Conclusion: It is necessary to incorporate programs that guarantee learning and implementation of favorable attitudes and practices against the disease in inhabitants of endemic areas.

Blood parasites (Kinetoplastida: Trypanosomatidae) infecting birds in the Brazilian Amazon / Parásitos sanguíneos (Kinetoplastida: Trypanosomatidae) que infectan aves en la Amazonía brasileña

Abstract Introduction: Trypanosomes are hemoparasites that can be observed circulating in the peripheral blood of birds. Parasitological studies in birds in their natural environment are neglected, but are important for research relating to transmission, maintenance of the biological cycle, and abundance, among other parasitological aspects. Objective: To describe infections by Trypanosoma sp. in birds in the Brazilian Amazon, as well as the prevalence, morphological and morphometric characteristics of this hemoparasite. Methods: In the Tapajós National Forest, we captured a total of 125 birds, mostly from the order Passeriformes. We obtained blood samples from the ulnar vein using sterile insulin needles, and aliquots of blood using a microhematocrit capillary tube. We made blood smears in triplicate and stained with the Giemsa method. We viewd the morphotypes of the Trypanosoma sp. under the light microscope with objective lenses of 40 X and 100 X. To determine the morphometric characteristics of Trypanosomatidae, we used the Zen Blue Edition 2 software package. Results: We observed the presence of hemoparasites in the trypomastigote form in specimens of Thamnophilidae, Dendrocolaptidae and Conopophagidae, with low prevalence. Only one morphotype of Trypanosoma sp. was detected and measurement. Conclusions: We report the infection by Trypanosoma sp. in species of ecological importance, such as Phlegopsis nigromaculata, endangered in Brazil. The morphology and morphometry of the morphotype found could contribute to more detailed descriptions of these hemoparasites.

Resumen Introducción: Los tripanosomas son hemoparásitos que pueden observarse circulando en la sangre periférica de las aves. Los estudios parasitológicos en aves en el medio natural son escasos, pero son importantes para la investigación relacionada con la transmisión, el mantenimiento del ciclo biológico y la abundancia, entre otros aspectos parasitológicos. Objetivo: Describir infecciones por Trypanosoma sp. en aves de la Amazonia brasileña, así como la prevalencia, características morfológicas y morfométricas de este hemoparásito. Métodos: En la Floresta Nacional de Tapajós, capturamos un total de 125 aves, la mayoría del orden Passeriformes. Obtuvimos muestras de sangre por punción de la vena cubital del ala con agujas estériles de insulina. Con un tubo capilar microhematocrito, obtuvimos alícuotas de sangre. Realizamos frotis de sangre por triplicado y teñimos con el método de Giemsa. Visualizamos los morfotipos de Trypanosoma sp. al microscopio óptico con lentes objetivos de 40 X y 100 X. Para determinar las características morfométricas de Trypanosomatidae, usamos el paquete informático Zen Blue Edition 2. Resultados: Observamos la presencia de hemoparásitos en la forma tripomastigote en ejemplares de la familia de aves Thamnophilidae, Dendrocolaptidae y Conopophagidae, con baja prevalencia. Solo detectamos un morfotipo de Trypanosoma sp. Conclusión: Reportamos la infección por Trypanosoma sp. en especies de importancia ecológica, como Phlegopsis nigromaculata en peligro de extinción en Brasil. La morfología y morfometría del morfotipo encontrado puede contribuir con descripciones más detalladas de estos hemoparásitos.

Contribuições para a mobilização social, comunicação e educação em saúde sobre a doença de Chagas no YouTube ­ percurso e notas sobre o canal Falamos de Chagas / Contributions to social mobilization, communication and health education on Chagas disease on YouTube ­ route and notes on the channel Falamos de Chagas / Aportes a la movilización social, comunicación y educación en salud sobre la enfermedad de Chagas en YouTube ­ trayectoria y notas en el canal Falamos de Chagas

A doença de Chagas crônica afeta seis milhões de pessoas em regiões endêmicas, com 30 mil novos casos anuais ­ logo, espaços de divulgação científica são muito importantes para ofertar informações de qualidade à população. As iniciativas envolvendo o controle da doença de Chagas não podem se limitar às pesquisas com enfoque biológico. Este estudo objetiva apresentar um panorama sobre o processo de construção do canal Falamos de Chagas, no YouTube, sua importância para a comunicação, a informação, a educação em saúde e a mobilização social, bem como refletir sobre a qualidade de uma subamostra de vídeos do canal. Trata-se de um estudo qualitativo, dividido em duas fases: criação do canal e análise qualitativa dos vídeos sobre a doença disponíveis no YouTube. Observamos que existe potencial nas redes sociais, enquanto recurso de comunicação, contudo é preciso cautela, uma vez que se faz necessária a certificação da qualidade do material

Chronic Chagas disease affects six million people in endemic regions, with 30,000 new infected cases an-nually ­ thus, initiatives involving science diffusion are relevant to offer qualified information to the people. Chagas disease control initiatives cannot be limited to the level of biological focused research. This study aims to present an overview of the construction process of the YouTube channel Falando de Chagas, its importance for communication, information, health education and social mobilization, as well as to reflect on the quality of a subsample of videos present in the channel. Qualitative in nature, the study was divided into two stages: construction of the channel and qualitative analysis of videos about the disease available on YouTube. We observed that there is potential for social networks as communication resources, but caution is needed in their use, since the quality of the material needs certification

La enfermedad de Chagas crónica afecta seis millones de personas en regiones endémicas, con 30.000 nuevos casos anuales ­ los espacios de divulgación científica son muy importantes para ofrecer información a la población. Las iniciativas de control de la enfermedad de Chagas no pueden limitarse al nivel de investigación con enfoque biológico. El estudio tiene como objetivo presentar un panorama del proceso de construcción del canal Falando de Chagas, en YouTube, su importancia para la comunicación, información, educación en salud y movilización social, así como reflexionar sobre la calidad de una submuestra de videos presentes en la canal. De naturaleza cualitativa, el estudio se dividió en dos fases: construcción del canal y análisis cualitativo de videos sobre la enfermedad disponibles en YouTube. Observamos que existe potencial para las redes sociales como recurso de comunicación, sin embargo, se requiere cautela en su uso, ya que se requiere certificar la calidad del material

Diagnóstico de la Enfermedad de Chagas congénito: Aspectos relevantes

Introducción: El presente artículo describe aspectos relevantes entorno de la Enfermedad de Chagas congénita, tales como epidemiología, sintomatología, revisión de casos clínicos y las técnicas diagnósticas. Métodos: Se realizó una revisión de la literatura por medio de bases de datos bibliográficas como PubMed, Science direct, Scopus, Plos One, SciELO, teniendo como criterio de inclusión las publicaciones artículos o comprendidos entre enero de 2013 y enero del año 2022 en idioma español e inglés. Resultados: Se determinó que la prevalencia de la Enfermedad de Chagas congénita aún es un problema de salud pública en áreas endémicas y no endémicas, siendo la serología materna indispensable para dar seguimiento oportuno a los casos. Conclusiones: Los seguimientos diagnósticos actuales difieren en los países endémicos y se están aplicando tamizajes en zonas no endémicas donde migran mujeres procedentes de áreas de trasmisión activa de la Enfermedad Chagásica.

Introduction: This article describes relevant aspects of congenital Chagas disease, such as epidemiology, symptoms, review of clinical cases, and diagnostic techniques. Methods: A review of the literature was carried out through bibliographic databases such as PubMed, Science direct, Scopus, Plos One, SciELO, having as inclusion criteria articles or publications between January 2013 and January 2022 in Spanish and English. Results: It was determined that the prevalence of congenital Chagas disease is still a public health problem in endemic and non-endemic areas, and maternal serology is essential for timely monitoring of cases. Conclusions: Current diagnostic follow-ups differ in endemic countries and screening is being applied in non-endemic areas where women from areas of active transmission of Chagasic disease migrate.

An atypical Trypanosoma lewisi infection in a 22-day-old neonate from India: An emergent zoonosis

Reports on atypical human trypanosomiasis, caused by Trypanosoma lewisi, are rare and so far a total of 19 reports on human infection with animal trypanosomes, which includes nine cases from Trypanosoma lewisi exist. Trypanosoma lewisi, a Stercorarian trypanosoma of rats, is transmitted by the fecal contamination of the wound or the bite caused by rat flea Ceratophyllus fasciatus. We report here an atypical neonatal infection of T. lewisi in a 22-day-old infant from Agra. The infant presented with a history of high fever, poor appetite, and lethargy for 3 days. The hematological parameters were normal except for a low platelet count. A high C-reactive protein (CRP) concentration of 70.49 mg/L indicated marked inflammation. The Leishman-stained thin blood smears were microscopically positive for the hemoflagellate. Based on the morphological features and further confirmed by polymerase chain reaction (PCR) assay, the hemoflagellate was identified as T. lewisi. Symptomatic treatment and antibiotic therapy helped in an uneventful recovery of the patient.

Exploring the performance of Escherichia coli outer membrane vesicles as a tool for vaccine development against Chagas disease

BACKGROUND Vaccine development is a laborious craftwork in which at least two main components must be defined: a highly immunogenic antigen and a suitable delivery method. Hence, the interplay of these elements could elicit the required immune response to cope with the targeted pathogen with a long-lasting protective capacity. OBJECTIVES Here we evaluate the properties of Escherichia coli spherical proteoliposomes - known as outer membrane vesicles (OMVs) - as particles with natural adjuvant capacities and as antigen-carrier structures to assemble an innovative prophylactic vaccine for Chagas disease. METHODS To achieve this, genetic manipulation was carried out on E. coli using an engineered plasmid containing the Tc24 Trypanosoma cruzi antigen. The goal was to induce the release of OMVs displaying the parasite protein on their surface. FINDINGS As a proof of principle, we observed that native OMVs - as well as those carrying the T. cruzi antigen - were able to trigger a slight, but functional humoral response at low immunization doses. Of note, compared to the non-immunized group, native OMVs-vaccinated animals survived the lethal challenge and showed minor parasitemia values, suggesting a possible involvement of innate trained immunity mechanism. MAIN CONCLUSION These results open the range for further research on the design of new carrier strategies focused on innate immunity activation as an additional immunization target and venture to seek for alternative forms in which OMVs could be used for optimizing vaccine development.

Occurrence and distribution of Panstrongylus megistus (Burmeister, 1835) (Hemiptera, Reduviidae) in a metropolitan area of Southern Brazil

ABSTRACT Two triatomine genera (Panstrongylus and Triatoma) have essentially been recorded in Rio Grande do Sul State, Brazil. Panstrongylus megistus should be highlighted since this species is one of the main vectors of Trypanosoma cruzi in Brazil, due to its wide geographical distribution and the high susceptibility to this protozoan. This study aimed to present not only the occurrence and distribution of P. megistus in the Porto Alegre city's metropolitan area (PAMA), Rio Grande do Sul State, Brazil, but also the rates of T. cruzi infection, from 2009 to 2020. The PAMA, which comprises 34 cities and 4.4 million habitants, extends across the transition area in two biomes - Pampa and Mata Atlantica - found in the state. Results showed that P. megistus was recorded in 76.5% of cities (i.e., 26 out of 34), mainly in Porto Alegre city, where the vector was found in 11 out of the 12 years that were monitored. Three hundred and nineteen specimens were captured. Two hundred and sixty-seven specimens (83.7%) were located intradomicile (p < 0.0001), while 52.3% positivity for T. cruzi was found. Thus, P. megistus is important in the PAMA, because it invades and colonizes the households. Moreover, the high rates of T. cruzi infection have drawn attention.

Triatoma rubrovaria (Hemiptera, Reduviidae, Triatominae) in the Pampa biome, Brazil: a retrospective study of its occurrence and abundance

ABSTRACT Triatoma rubrovaria has been captured in some areas of Rio Grande do Sul State (RS), Brazil, as this species can be found in the Pampa biome. Its distribution across this biome should be described in detail to verify the potential of this vector to transmit Trypanosoma cruzi. This study aimed to investigate the occurrence of T. rubrovaria in the Pampa biome and transitional areas of RS. The collected information resulted from the analysis of secondary data provided by the Centro Estadual de Vigilancia em Saude (CEVS - State's Center of Health Surveillance). The following aspects were taken into consideration: the year in which the insect was captured, the city, the number of specimens captured, invasion or domiciliation, the notification in the household, surroundings or both, and T. cruzi infection. The data comprised the period from 2009 to 2020, in 109 cities located in the Pampa biome and 98 located in transitional areas. The Pampa biome exhibited 85% of the occurrences of T. rubrovaria, while 1.2% of specimens were T. cruzi-like positive. Both the first and second biennia concentrated 64.6% of captures. Alegrete city, Cangucu city and Piratini city were the locations in the Pampa where the largest numbers of specimens were found. Regarding the transitional areas, Roque Gonzales city, Santiago city and Santana da Boa Vista city exhibited the largest numbers. Most insects were adults, which were found in households. Even though positivity for T. cruzi-like was low, the species still has epidemiological importance in the region.

Review on trypanosomiasis and their prevalence in some country on the Red Sea / Avaliação da tripanossomíase e sua prevalência em alguns países do mar Vermelho

Abstract Trypanosomiasis is a protozoan infection affecting both human and animals in almost all parts of the world. It can affect a very large range of domestic and wild hosts including camelids, equines, cattle, buffaloes, sheep, goats, pigs, dogs and other carnivores, deer, gazelles and elephants. This review paper was designed to address the effect of this economically important disease in countries on the Red Sea, especially in Egypt, Sudan, Somalia, and Saudi Arabia during the period 2010 to 2020. The prevalence of trypanosomiasis is different between these countries due to different types of diagnostic methods (Giemsa-stained blood smears, Hematocrit centrifugation, Serological test, and molecular analysis PCR) used and differential distribution of vector (Tse tse) flies. In current review, retrospective studies of published literature on distribution and prevalence of Trypanosoma evansi infection in the Red Sea Countries was conducted [Google Scholar and PubMed were used to retrieve the published literature from 2000-2020. A total of 77 published articles met the eligibility criteria and were reviewed. A total of 16 reports have been reported on the prevalence and distribution of Trypnosoma evansi infection in the Red Sea Countries have been from 2010-2020]. According to the published literature, we can say that trypanosomiasis in camels are more prevalent in Sudan than in other countries, followed by 17% and 51.78% in both clinical and non-clinical cases. Hence, the reliable diagnostic tests should be used for rapid treatment or control of the disease as if not treated appropriately in early-stage, can lead to death of the camels.

Resumo A tripanossomíase é uma infecção por protozoário que afeta humanos e animais em quase todas as partes do mundo. Pode afetar grande variedade de hospedeiros domésticos e selvagens, incluindo camelídeos, equinos, gado, búfalos, ovelhas, cabras, porcos, cães e outros carnívoros, veados, gazelas e elefantes. Este artigo de revisão foi elaborado para abordar o efeito dessa doença economicamente importante em países do mar Vermelho, especialmente Egito, Sudão, Somália e Arábia Saudita, durante o período de 2010 a 2020. A prevalência de tripanossomíase é diferente entre esses países devido a tipos distintos de métodos diagnósticos (esfregaços de sangue corados com Giemsa, centrifugação de hematócrito, teste sorológico e PCR de análise molecular) usados ​​e distribuição diferencial de moscas vetoras (tsé-tsé). Na revisão atual, foram realizados estudos retrospectivos da literatura publicada sobre distribuição e prevalência da infecção por Trypanosoma evansi nos países do mar Vermelho [Google Scholar e PubMed foram usados ​​para recuperar a literatura publicada de 2000 a 2020. Um total de 77 artigos publicados preencheu os critérios de elegibilidade e foi revisado. E há também 16 relatos sobre a prevalência e distribuição da infecção por Trypnosoma evansi nos países do mar Vermelho, de 2010 a 2020]. De acordo com a literatura publicada, podemos afirmar que a tripanossomíase em camelos é mais prevalente no Sudão do que em outros países, seguida por 17% e 51,78% em casos clínicos e não clínicos. Assim, os testes diagnósticos confiáveis ​​devem ser utilizados para o tratamento rápido ou controle da doença, pois, se eles não forem tratados de forma adequada na fase inicial, isso pode levar à morte dos camelos.

Review on trypanosomiasis and their prevalence in some country on the Red Sea / Avaliação da tripanossomíase e sua prevalência em alguns países do mar Vermelho

Trypanosomiasis is a protozoan infection affecting both human and animals in almost all parts of the world. It can affect a very large range of domestic and wild hosts including camelids, equines, cattle, buffaloes, sheep, goats, pigs, dogs and other carnivores, deer, gazelles and elephants. This review paper was designed to address the effect of this economically important disease in countries on the Red Sea, especially in Egypt, Sudan, Somalia, and Saudi Arabia during the period 2010 to 2020. The prevalence of trypanosomiasis is different between these countries due to different types of diagnostic methods (Giemsa-stained blood smears, Hematocrit centrifugation, Serological test, and molecular analysis PCR) used and differential distribution of vector (Tse tse) flies. In current review, retrospective studies of published literature on distribution and prevalence of Trypanosoma evansi infection in the Red Sea Countries was conducted [Google Scholar and PubMed were used to retrieve the published literature from 2000-2020. A total of 77 published articles met the eligibility criteria and were reviewed. A total of 16 reports have been reported on the prevalence and distribution of Trypnosoma evansi infection in the Red Sea Countries have been from 2010-2020]. According to the published literature, we can say that trypanosomiasis in camels are more prevalent in Sudan than in other countries, followed by 17% and 51.78% in both clinical and non-clinical cases. Hence, the reliable diagnostic tests should be used for rapid treatment or control of the disease as if not treated appropriately in early-stage, can lead to death of the camels.

A tripanossomíase é uma infecção por protozoário que afeta humanos e animais em quase todas as partes do mundo. Pode afetar grande variedade de hospedeiros domésticos e selvagens, incluindo camelídeos, equinos, gado, búfalos, ovelhas, cabras, porcos, cães e outros carnívoros, veados, gazelas e elefantes. Este artigo de revisão foi elaborado para abordar o efeito dessa doença economicamente importante em países do mar Vermelho, especialmente Egito, Sudão, Somália e Arábia Saudita, durante o período de 2010 a 2020. A prevalência de tripanossomíase é diferente entre esses países devido a tipos distintos de métodos diagnósticos (esfregaços de sangue corados com Giemsa, centrifugação de hematócrito, teste sorológico e PCR de análise molecular) usados e distribuição diferencial de moscas vetoras (tsé-tsé). Na revisão atual, foram realizados estudos retrospectivos da literatura publicada sobre distribuição e prevalência da infecção por Trypanosoma evansi nos países do mar Vermelho [Google Scholar e PubMed foram usados para recuperar a literatura publicada de 2000 a 2020. Um total de 77 artigos publicados preencheu os critérios de elegibilidade e foi revisado. E há também 16 relatos sobre a prevalência e distribuição da infecção por Trypnosoma evansi nos países do mar Vermelho, de 2010 a 2020]. De acordo com a literatura publicada, podemos afirmar que a tripanossomíase em camelos é mais prevalente no Sudão do que em outros países, seguida por 17% e 51,78% em casos clínicos e não clínicos. Assim, os testes diagnósticos confiáveis devem ser utilizados para o tratamento rápido ou controle da doença, pois, se eles não forem tratados de forma adequada na fase inicial, isso pode levar à morte dos camelos.

Review on trypanosomiasis and their prevalence in some country on the Red Sea

Abstract Trypanosomiasis is a protozoan infection affecting both human and animals in almost all parts of the world. It can affect a very large range of domestic and wild hosts including camelids, equines, cattle, buffaloes, sheep, goats, pigs, dogs and other carnivores, deer, gazelles and elephants. This review paper was designed to address the effect of this economically important disease in countries on the Red Sea, especially in Egypt, Sudan, Somalia, and Saudi Arabia during the period 2010 to 2020. The prevalence of trypanosomiasis is different between these countries due to different types of diagnostic methods (Giemsa-stained blood smears, Hematocrit centrifugation, Serological test, and molecular analysis PCR) used and differential distribution of vector (Tse tse) flies. In current review, retrospective studies of published literature on distribution and prevalence of Trypanosoma evansi infection in the Red Sea Countries was conducted [Google Scholar and PubMed were used to retrieve the published literature from 2000-2020. A total of 77 published articles met the eligibility criteria and were reviewed. A total of 16 reports have been reported on the prevalence and distribution of Trypnosoma evansi infection in the Red Sea Countries have been from 2010-2020]. According to the published literature, we can say that trypanosomiasis in camels are more prevalent in Sudan than in other countries, followed by 17% and 51.78% in both clinical and non-clinical cases. Hence, the reliable diagnostic tests should be used for rapid treatment or control of the disease as if not treated appropriately in early-stage, can lead to death of the camels.

Resumo A tripanossomíase é uma infecção por protozoário que afeta humanos e animais em quase todas as partes do mundo. Pode afetar grande variedade de hospedeiros domésticos e selvagens, incluindo camelídeos, equinos, gado, búfalos, ovelhas, cabras, porcos, cães e outros carnívoros, veados, gazelas e elefantes. Este artigo de revisão foi elaborado para abordar o efeito dessa doença economicamente importante em países do mar Vermelho, especialmente Egito, Sudão, Somália e Arábia Saudita, durante o período de 2010 a 2020. A prevalência de tripanossomíase é diferente entre esses países devido a tipos distintos de métodos diagnósticos (esfregaços de sangue corados com Giemsa, centrifugação de hematócrito, teste sorológico e PCR de análise molecular) usados e distribuição diferencial de moscas vetoras (tsé-tsé). Na revisão atual, foram realizados estudos retrospectivos da literatura publicada sobre distribuição e prevalência da infecção por Trypanosoma evansi nos países do mar Vermelho [Google Scholar e PubMed foram usados para recuperar a literatura publicada de 2000 a 2020. Um total de 77 artigos publicados preencheu os critérios de elegibilidade e foi revisado. E há também 16 relatos sobre a prevalência e distribuição da infecção por Trypnosoma evansi nos países do mar Vermelho, de 2010 a 2020]. De acordo com a literatura publicada, podemos afirmar que a tripanossomíase em camelos é mais prevalente no Sudão do que em outros países, seguida por 17% e 51,78% em casos clínicos e não clínicos. Assim, os testes diagnósticos confiáveis devem ser utilizados para o tratamento rápido ou controle da doença, pois, se eles não forem tratados de forma adequada na fase inicial, isso pode levar à morte dos camelos.

Detection of Trypanosoma cruzi DTUs TcI and TcIV in two outbreaks of orally-transmitted Chagas disease in the Northern region of Brazil

ABSTRACT This study describes the laboratory investigation of two acute Chagas disease outbreaks that occurred in the riverside communities of Marimarituba and Cachoeira do Arua, in the Santarem municipality, Para State, located in the Northern region of Brazil, and occurred in March 2016 and August 2017, respectively. The generation of data regarding the diversity of Trypanosoma cruzi parasites circulating in the Amazon region is key for understanding the emergence and expansion of Chagas disease. This study aimed to identify T. cruzi Discrete Typing Units (DTUs) involved in two outbreaks of acute Chagas disease (ACD) directly from the patient's biological sample. Nested and multiplex PCR targeting the 24Sα (rRNA) and mini-exon genes, respectively, were used to identify T. cruzi DTU in blood samples from patients diagnosed with ACD. The samples with positive cPCR were submitted for analysis for T. cruzi DTUs, which included 13 samples from the patients with ACD by oral transmission and two samples collected from two newborns of two women with ACD, from Marimarituba and Cachoeira do Arua. The samples were classified as T. cruzi TcIV, from Marimarituba's outbreak, and T. cruzi TcI, from Cachoeira do Arua's outbreak. The molecular identification of T. cruzi may increase understanding of the role of this parasite in Chagas disease's emergence within the Amazon region, contributing to the improvement of the management of this important, but also neglected, disease.

Trypanosoma cruzi DTU II coinfection with bacteria producing prolonged cutaneous lesion in a healthy young male

ABSTRACT Chagas disease (CD) is a neglected tropical disease caused by Trypanosoma cruzi and is genetically classified in six discrete typing units (DTUs). The isolates reported in Mexico are generally associated with DTU I. We presented a case of a prolonged cutaneous lesion in a Mexican man, caused by DTU II in coinfection with Bacillus velezensis and Corynebacterium sp. The patient assessment included a complete clinical history, physical exam, laboratory tests, and a skin biopsy. In the facial tissues, intracellular parasites were revealed. The PCR tests were positive for T. cruzi in tissue and blood samples. DNA satellite sequencing was correlated with the DTU II. The initial serological tests reported negative results. However, four months later, two serological tests reported positive results. These exams were performed in different health centers. Mexico is considered an endemic area for CD; nevertheless, this is just the second cutaneous case associated with a DTU different from DTU-I noted in this country. From an ecological point of view, this fact suggests a geographical expansion of DTU II and an association with atypical skin manifestations. Further studies should be conducted to understand this exciting association between DTU-II and prolonged cutaneous expression in humans.

Tolerance and Adherence of Patients with Chronic Chagas Disease Treated with Benznidazole

ABSTRACT Background: Chagas disease (CD) treatment is commonly associated with a high incidence of adverse effects. It is crucial to study and update these adverse effects to improve the existing knowledge of which drugs to use and to clarify the information presented to patients. Methods: We analyzed the adverse effects of benznidazole in two cohorts of patients: a large retrospective study and a small prospective study. Results: This large retrospective study described the most and least common adverse effects in our area and characterized our Chagas disease population. This prospective study, along with a close follow-up of the treatment, detected more adverse effects and enhanced the patients' perception of the disease and treatment. Conclusions: This information is important for preventing non-medical-related withdrawals and for removing baseless fears. Better knowledge of patients could help us provide better care.

Epidemiological indicators of Chagas disease in the metropolitan region of Salvador, Bahia, Brazil

ABSTRACT Background: Chagas disease (CD) is caused by Trypanosoma cruzi and transmitted by triatomines. Historical information from the 20th century demonstrates T. cruzi records in the metropolitan region of Salvador (MRS), the third largest urban agglomeration in the Brazilian Northeast and the eighth largest in Brazil, an area with intense migratory activity from CD-endemic regions. Therefore, this study aimed to evaluate CD indicators (prevalence and mortality) in the MRS. Methods: A mixed ecological and descriptive study was conducted using secondary data. We analyzed data from 2008 to 2015: deaths due to CD, self-reported cases of CD, and blood donors that were non-negative for T. cruzi infection. Results: São Francisco do Conde was one of the municipalities with the highest mortality rates due to CD. The seroprevalence rates varied by year and municipality; those with the highest values were 2008: Vera Cruz, 2009: Mata de São João, 2010: Dias D'Ávila, 2011 and 2015: São Francisco do Conde, 2012: São Sebastião do Passé, and 2013 and 2014: Pojuca. Spatial correlations between the municipalities were not detected. Conclusions: We conclude that CD is present in the MRS. The indicators analyzed in the MRS are below-state-level data. Given the importance of indicator analysis for the surveillance and control of CD at the state and national levels, it is important to strengthen the surveillance program at the municipal level, including the regions classified as low risk for T. cruzi vector transmission.

Benznidazole treatment decreases IL-6 levels in Trypanosoma cruzi-infected human adipocytes differentiated from adipose tissue-derived stem cells

BACKGROUND Trypanosoma cruzi, which causes Chagas disease (CD), is a versatile haemoparasite that uses several strategies to evade the host's immune response, including adipose tissue (AT), used as a reservoir of infection. As it is an effective barrier to parasite evasion, the effectiveness of the drug recommended for treating CD, Benznidazole (BZ), may be questionable. OBJECTIVE To this end, we evaluated the parasite load and immunomodulation caused by BZ treatment in the culture of adipocytes differentiated from human adipose tissue-derived stem cells (ADSC) infected with T. cruzi. METHODS The ADSC were subjected to adipogenic differentiation. We then carried out four cultures in which we infected the differentiated AT with trypomastigote forms of the Y strain of T. cruzi and treated them with BZ. After the incubation, the infected AT was subjected to quantitative polymerase chain reaction (qPCR) to quantify the parasite load and transmission electron microscopy (TEM) to verify the infection. The supernatant was collected to measure cytokines, chemokines, and adipokines. FINDINGS We found elevated secretion of IL-6, CXCL-10/IP-10, CCL2/MCP-1, CCL5/RANTES, and leptin in infected fat cells. However, treatment with BZ promoted a decrease in IL-6. MAIN CONCLUSION Therefore, we believe that BZ has a beneficial role as it reduces inflammation in infected fat cells.

Predictors of Trypanosoma cruzi PCR positivity in patients with chronic Chagas disease

BACKGROUND A positive Trypanosoma cruzi polymerase chain reaction (PCR) is associated with a worse prognosis in patients with chronic Chagas disease (CD). OBJECTIVES To study the association of clinical, electrocardiographic, and echocardiographic characteristics and biomarker blood levels with positive T. cruzi PCR in chronic CD. METHODS This is a single-centre observational cross-sectional study. Positive T. cruzi PCR association with clinical, electrocardiographic, and echocardiographic characteristics, and biomarker blood levels were studied by logistic regression analysis. p values < 0.05 were considered significant. FINDINGS Among 333 patients with chronic CD (56.4% men; 62 ± 10 years), T. cruzi PCR was positive in 41.1%. Stepwise multivariate logistic regression showed an independent association between positive T. cruzi PCR and diabetes mellitus {odds ratio (OR) 0.53 [95% confidence interval (CI) 0.30-0.93]; p = 0.03}, right bundle branch block [OR 1.78 (95% CI 1.09-2.89); p = 0.02], and history of trypanocidal treatment [OR 0.13 (95% CI 0.04-0.38); p = 0.0002]. Among patients with a history of trypanocidal treatment (n = 39), only four (10%) patients had a positive T. cruzi PCR. MAIN CONCLUSIONS Among several studied parameters, only diabetes mellitus, right bundle branch block, and history of trypanocidal treatment showed an independent association with positive T. cruzi PCR. History of trypanocidal treatment was a strong protective factor against a positive T. cruzi PCR.