dc.contributor.author |
Lozano, Daniel |
dc.contributor.author |
Rojas, Lizeth |
dc.contributor.author |
Méndez, Susana |
dc.contributor.author |
Casellas, Aina |
dc.contributor.author |
Sanz, Sergi |
dc.contributor.author |
Ortiz, Lourdes |
dc.contributor.author |
Pinazo, María Jesús |
dc.contributor.author |
Abril, Marcelo |
dc.contributor.author |
Gascón i Brustenga, Joaquim |
dc.contributor.author |
Torrico, Faustino |
dc.contributor.author |
Alonso Padilla, Julio |
dc.date |
2020-01-08T08:33:28Z |
dc.date |
2020-01-08T08:33:28Z |
dc.date |
2019-12-19 |
dc.date |
2019-12-27T19:01:09Z |
dc.identifier.citation |
1935-2735 |
dc.identifier.uri |
http://hdl.handle.net/2445/147178 |
dc.format |
13 p. |
dc.format |
application/pdf |
dc.language.iso |
eng |
dc.publisher |
Public Library of Science (PLoS) |
dc.relation |
Reproducció del document publicat a: http://dx.doi.org/10.1371/journal.pntd.0007877 |
dc.relation |
PLoS Neglected Tropical Diseases, 2019, vol. 13, num. 12, p. e0007877 |
dc.relation |
http://dx.doi.org/10.1371/journal.pntd.0007877 |
dc.rights |
cc by (c) Lozano et al., 2019 |
dc.rights |
info:eu-repo/semantics/openAccess |
dc.rights |
http://creativecommons.org/licenses/by/3.0/es/ |
dc.subject |
Malaltia de Chagas |
dc.subject |
Tripanosoma |
dc.subject |
Chagas' disease |
dc.subject |
Trypanosoma |
dc.title |
Use of rapid diagnostic tests (RDTs) for conclusive diagnosis of chronic Chagas disease – field implementation in the Bolivian Chaco region |
dc.type |
info:eu-repo/semantics/article |
dc.type |
info:eu-repo/semantics/publishedVersion |
dc.description.abstract |
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. |