Rapid Diagnostic Tests for Trypanosoma cruzi Infection: Field Evaluation of Two Registered Kits in a Region of Endemicity and a Region of Nonendemicity in Argentina

• Autores: Lopez-Albízu, Constanza; Danesi, Emmaria; Piorno, Pablo; Fernandez, Mariana; García Campos, Francisco; Scollo, Karenina; Crudo, Favio
• Año de publicación: 2020
• Idioma: inglés
• Tipo de recurso: artículo
• Fuente: Journal of clinical microbiology 2020; 58(12):1-10
• Materia: Serología; Enfermedad de Chagas; Trypanosoma cruzi; Enfermedades Transmisibles; Parasitología
• Institución: Administración Nacional de Laboratorios e Institutos de Salud "Dr. Carlos G. Malbrán"

Fil: Lopez-Albizu, Constanza. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Parasitología; Argentina.
Fil: Danesi, Emmaría. ANLIS Dr.C.G.Malbrán. Centro Nacional de Diagnóstico e Investigación de Endemo-Epidemias; Argentina
Fil: Piorno, Pablo. Asociación para Desarrollo Sanitario Regional (ADESAR); Argentina.
Fil: Fernandez, Mariana. Asociación para Desarrollo Sanitario Regional (ADESAR); Argentina.
Fil: García Campos, Francisco. Ministerio de Salud Pública de Salta; Argentina.
Fil: Scollo, Karenina. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Parasitología; Argentina.
Fil: Crudo, Favio. Asociación para Desarrollo Sanitario Regional (ADESAR); Argentina.
Infection by Trypanosoma cruzi (Chagas disease [ChD]) affects around 7 million people in the Americas, most of whom are unaware of their status due to lack of clinical manifestations and poor access to diagnosis. Rapid diagnostic tests (RDTs) are widely used for screening for different infections (HIV, hepatitis B, and syphilis), and their application for ChD would facilitate access to diagnosis, especially in remote areas where health services have scarce resources. We conducted a prospective intervention study in 2018 to evaluate in the field two in vitro RDTs for ChD, authorized by the National Administration of Medicaments, Aliments, and Medical Technologies of Argentina (ANMAT), in areas of endemicity and nonendemicity in Argentina. We recruited 607 volunteers older than 18 years in Salta province and the city of Buenos Aires. The RDTs Ab Standard Diagnostics SD Bioline (SD) and Check Chagas Wiener Lab (WL) were performed in situ with whole-blood samples, and confirmatory serology was done at a reference center. The rate of infection with T. cruzi was 17.8% (108/607). The SD test showed 97.2% sensitivity (95% confidence interval [CI], 93.5 to 100) and 91.7% specificity (95% CI, 96.2 to 99.2%), and the WL test showed 93.4% sensitivity (95% CI, 88.2 to 98.6%) and 99.1% specificity (95% CI, 91.9 to 100%). The sensitivity and specificity for the two RDTs tested were higher than previously reported. These results encourage the use of the tested RDTs in Salta province and for further field studies for the implementation of these RDTs in other epidemiological scenarios. This will be very important to improve access to diagnosis of Chagas and its clinical management as a neglected disease, especially in remote areas with health access barriers.