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Annals of Internal Medicine Feb 2023Chagas disease, which is caused by infection with the parasite , is a leading neglected tropical disease in the United States. An estimated 240 000 to 350 000 persons... (Review)
Review
Chagas disease, which is caused by infection with the parasite , is a leading neglected tropical disease in the United States. An estimated 240 000 to 350 000 persons in the United States are infected, primarily immigrants from Mexico, Central America, and South America, where the disease is endemic. The parasite is transmitted by the triatomine bug but can also be passed through blood transfusion, via organ transplant, or congenitally. Approximately 30% of infected persons later develop cardiac and/or gastrointestinal complications. Health care providers should consider screening at-risk patients with serologic testing. Early diagnosis and treatment with benznidazole or nifurtimox can help prevent complications.
Topics: Humans; United States; Chagas Disease; Trypanosoma cruzi; Nifurtimox; Emigrants and Immigrants; Organ Transplantation
PubMed: 36780647
DOI: 10.7326/AITC202302210 -
Journal of the American College of... Aug 2013Chagas disease, caused by the parasite Trypanosoma cruzi, is a serious health problem in Latin America and is an emerging disease in non-endemic countries. In recent... (Review)
Review
Chagas disease, caused by the parasite Trypanosoma cruzi, is a serious health problem in Latin America and is an emerging disease in non-endemic countries. In recent decades, the epidemiological profile of the disease has changed due to new patterns of immigration and successful control in its transmission, leading to the urbanization and globalization of the disease. Dilated cardiomyopathy is the most important and severe manifestation of human chronic Chagas disease and is characterized by heart failure, ventricular arrhythmias, heart blocks, thromboembolic phenomena, and sudden death. This article will present an overview of the clinical and epidemiological aspects of Chagas disease. It will focus on several clinical aspects of the disease, such as chronic Chagas disease without detectable cardiac pathology, as well as dysautonomia, some specific features, and the principles of treatment of chronic cardiomyopathy.
Topics: Chagas Disease; Death, Sudden, Cardiac; Humans; Prognosis
PubMed: 23770163
DOI: 10.1016/j.jacc.2013.05.046 -
Clinical Microbiology Reviews Dec 2019is the etiological agent of Chagas disease, usually transmitted by triatomine vectors. An estimated 20 to 30% of infected individuals develop potentially lethal cardiac... (Review)
Review
is the etiological agent of Chagas disease, usually transmitted by triatomine vectors. An estimated 20 to 30% of infected individuals develop potentially lethal cardiac or gastrointestinal disease. Sylvatic transmission cycles exist in the southern United States, involving 11 triatomine vector species and infected mammals such as rodents, opossums, and dogs. Nevertheless, imported chronic infections in migrants from Latin America vastly outnumber locally acquired human cases. Benznidazole is now FDA approved, and clinical and public health efforts are under way by researchers and health departments in a number of states. Making progress will require efforts to improve awareness among providers and patients, data on diagnostic test performance and expanded availability of confirmatory testing, and evidence-based strategies to improve access to appropriate management of Chagas disease in the United States.
Topics: Chagas Disease; Disease Management; Disease Susceptibility; Humans; Molecular Diagnostic Techniques; Molecular Epidemiology; Phenotype; Public Health Surveillance; Trypanosoma cruzi; United States
PubMed: 31776135
DOI: 10.1128/CMR.00023-19 -
Arquivos Brasileiros de Cardiologia Jul 2022
Topics: Chagas Cardiomyopathy; Chagas Disease; Heart; Heart Diseases; Humans
PubMed: 35830097
DOI: 10.36660/abc.20220418 -
Biochimica Et Biophysica Acta.... Dec 2020
Topics: Chagas Disease; Humans; Parasitic Sensitivity Tests; Trypanocidal Agents; Trypanosoma cruzi
PubMed: 32927344
DOI: 10.1016/j.bbadis.2020.165953 -
Pediatrics in Review Apr 2016
Topics: Chagas Disease; Humans; Infant, Newborn; Infectious Disease Transmission, Vertical
PubMed: 27037106
DOI: 10.1542/pir.2015-0116 -
Infectious Diseases of Poverty Apr 2020Chagas disease remains a serious problem for public health due to the high disease burden together with its global spreading patterns. However, current treatment and...
Chagas disease remains a serious problem for public health due to the high disease burden together with its global spreading patterns. However, current treatment and vector control are highly challenged by drug and insecticide resistance. Chemotherapy and vector control have been proved to be effective attempts to minimize the disease burden. Continued efforts are necessary to keep adapting the surveillance-response systems to the dynamic health systems. More attention and investments are needed to improve appropriate strategy and technology in different settings. This may be accomplished by creating effective risk early warning, addressing vulnerability and building resilience systems, implementing a vector surveillance system, as well as innovating research and technology.
Topics: Animals; Chagas Disease; Disease Vectors; Global Health; Humans
PubMed: 32336294
DOI: 10.1186/s40249-020-00658-7 -
Revista Da Sociedade Brasileira de... 2017
Topics: Animals; Chagas Disease; Disease Vectors; Humans; Neglected Diseases
PubMed: 28700043
DOI: 10.1590/0037-8682-0254-2017 -
Infectious Diseases of Poverty Oct 2023The complexity of the Chagas disease and its phases is impossible to have a unique test for both phases and a lot of different epidemiological scenarios. Currently,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The complexity of the Chagas disease and its phases is impossible to have a unique test for both phases and a lot of different epidemiological scenarios. Currently, serology is the reference standard technique; occasionally, results are inconclusive, and a different diagnostic technique is needed. Some guidelines recommend molecular testing. A systematic review and meta-analysis of available molecular tools/techniques for the diagnosis of Chagas disease was performed to measure their heterogeneity and efficacy in detecting Trypanosoma cruzi infection in blood samples.
METHODS
A systematic review was conducted up to July 27, 2022, including studies published in international databases. Inclusion and exclusion criteria were defined to select eligible studies. Data were extracted and presented according to PRISMA 2020 guidelines. Study quality was assessed using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). A random-effects model was used to calculate pooled sensitivity, specificity, and diagnostic odds ratio (DOR). Forest plots and a summary of the receiving operating characteristics (SROC) curves displayed the outcomes. Heterogeneity was determined by I and Tau statistics and P values. Funnel plots and Deek's test were used to assess publication bias. A quantitative meta-analysis of the different outcomes in the two different clinical phases was performed.
RESULTS
We identified 858 records and selected 32 papers. Studies pertained to endemic countries and nonendemic areas with adult and paediatric populations. The sample sizes ranged from 17 to 708 patients. There were no concerns regarding the risk of bias and applicability of all included studies. A positive and nonsignificant correlation coefficient (S = 0.020; P = 0.992) was obtained in the set of studies that evaluated diagnostic tests in the acute phase population (ACD). A positive and significant correlation coefficient (S = 0.597; P < 0.000) was obtained in the case of studies performed in the chronic phase population (CCD). This resulted in high heterogeneity between studies, with the master mix origin and guanidine addition representing significant sources.
INTERPRETATION/CONCLUSIONS AND RELEVANCE
The results described in this meta-analysis (qualitative and quantitative analyses) do not allow the selection of the optimal protocol of molecular method for the study of Trypanosoma cruzi infection in any of its phases, among other reasons due to the complexity of this infection. Continuous analysis and optimization of the different molecular techniques is crucial to implement this efficient diagnosis in endemic areas.
Topics: Adult; Child; Humans; Sensitivity and Specificity; Chagas Disease
PubMed: 37845734
DOI: 10.1186/s40249-023-01143-7 -
Pediatrics in Review Apr 2023
Topics: Humans; Chagas Disease; Infectious Disease Transmission, Vertical
PubMed: 37002357
DOI: 10.1542/pir.2022-005857