Lucia Brum-Soares1, Juan-Carlos Cubides1, Iris Burgos1, Carlota Monroy2, Leticia Castillo3, Selene González3, Pedro Albajar Viñas4, Pedro Pablo Palma Urrutia5. 1. Unidade Médica Brasileira, Médicos Sem Fronteiras, Rio de Janeiro, Rio de Janeiro, Brazil. 2. Laboratory of Medical and Parasitical Entomology, San Carlos University, Guatemala City, Guatemala. 3. Parasitology Department, National Laboratory of Public Health, Guatemala City, Guatemala. 4. Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland. 5. Medical Department, Doctors Without Borders, Barcelona, Spain.
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.
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.
Authors: Maan Zrein; Elodie Granjon; Lucie Gueyffier; Julie Caillaudeau; Peter Liehl; Hans Pottel; Clareci Silva Cardoso; Claudia Di Lorenzo Oliveira; Lea Campos de Oliveira; Tzong-Hae Lee; Ariela Mota Ferreira; Antonio Luiz P Ribeiro; Michael P Busch; Ester Cerdeira Sabino Journal: PLoS Negl Trop Dis Date: 2018-02-09
Authors: Maiara M Romanelli; Maiara Amaral; Fernanda Thevenard; Lucas M Santa Cruz; Luis O Regasini; Alvaro E Migotto; João Henrique G Lago; Andre G Tempone Journal: ACS Omega Date: 2022-08-04