Comparison of seven diagnostic tests to detect Trypanosoma cruzi infection in patients in chronic phase of Chagas disease

Colombia Médica

Luisa Fernanda Duarte²  Giovanna Rincón²  Oscar Roberto Flórez²  Clara Isabel González¹ 

[1] Grupo de Inmunología y Epidemiología Molecular, GIEM, Facultad de Salud, Universidad Industrial de Santander, Bucaramanga;Grupo de Inmunología y Epidemiología Molecular, GIEM, Facultad de Salud, Universidad Industrial de Santander, Bucaramanga

关键词: Chagas disease;    Trypanosoma cruzi;    Enzyme linked immunosorbent assay;    Diagnosis;    Recombinant Proteins;    Polymerase Chain Reaction;    Colombia;   

DOI  :  

学科分类：医学（综合）

来源: Universidad del Valle * Facultad de Salud / Universidad del Valle, Faculty of Health

【 摘 要 】

Objective:To compare the diagnostic performance of seven methods to determineTrypanosoma cruziinfection in patients with chronic Chagas disease. Methods:Analytical study, using the case-control design, which included 205 people (patients with Chagasic cardiomyopathy, n= 100; control group, n= 105). Three enzyme linked immunosorbent assays, one indirect hemagglutination assay and one immunochromatographic test were assessed. Additionally, DNA amplification was performed via the PCR method using kinetoplast and nuclear DNA as target sequences. For the comparative analysis of diagnostic tests, the parameters used were sensitivity, specificity, positive and negative predictive values, Receiver Operator Characteristic (ROC), positive and negative likelihood ratio, as well as κ quality analysis. Results:The commercial Bioelisa Chagas test showed the highest sensitivity (98%), specificity (100%), and positive and negative predictive values; additionally it had the highest discriminatory power. Otherwise, the amplification ofT. cruziDNA in blood samples showed low values of sensitivity (kinetoplast DNA= 51%, nuclear DNA= 22%), but high values of specificity (100%), and moderate to low discriminatory ability. Conclusion:The comparative analysis among the different methods suggests that the diagnostic strategy ofT. cruziinfection in patients with chronic Chagas disease can be performed using ELISA assays based on recombinant proteins and/or synthetic peptides, which show higher diagnosis performance and can confirm and exclude the diagnosis ofT. cruziinfection. The molecular methods show poor performance when used in the diagnosis of patients with chronic Chagas disease.

【 授权许可】

Unknown