Journal Article > LetterFull Text
Rev Soc Bras Med Trop. 2018 December 31; Volume 52; DOI:10.1590/0037-8682-0262-2018
Forsyth C, Marchiol A, Herazo R, Chatelain E, Batista C, et al.
Rev Soc Bras Med Trop. 2018 December 31; Volume 52; DOI:10.1590/0037-8682-0262-2018
Journal Article > ResearchFull Text
Rev Soc Bras Med Trop. 2016 December 1; Volume 49 (Issue 6); 721-727.; DOI:10.1590/0037-8682-0415-2016
Brum-Soares L, Cubides JC, Burgos I, Monroy C, Castillo L, et al.
Rev Soc Bras Med Trop. 2016 December 1; Volume 49 (Issue 6); 721-727.; DOI:10.1590/0037-8682-0415-2016
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.
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.
Journal Article > CommentaryFull Text
Rev Soc Bras Med Trop. 2007 June 1; Volume 41 (Issue 3); 315-319.; DOI:10.1590/s0037-86822008000300020
MSF Access Campaign
Rev Soc Bras Med Trop. 2007 June 1; Volume 41 (Issue 3); 315-319.; DOI:10.1590/s0037-86822008000300020
Trypanosoma cruzi infection is often not detected early on or actively diagnosed, partly because most infected individuals are either asymptomatic or oligosymptomatic. Moreover, in most places, neither blood banks nor healthcare units offer diagnostic confirmation or treatment access. By the time patients present clinical manifestations of advanced chronic Chagas disease, specific treatment with current drugs usually has limited effectiveness. Better-quality serological assays are urgently needed, especially rapid diagnostic tests for diagnosis patients in both acute and chronic phases, as well as for confirming that a parasitological cure has been achieved. Some new antigen combinations look promising and it is important to assess which ones are potentially the best, together with their requirements in terms of investigation and development. In August 2007, a group of specialized researchers and healthcare professionals met to discuss the state of Chagas infection diagnosis and to build a consensus for a plan of action to develop efficient, affordable, accessible and easy-to-use diagnostic tests for Chagas disease. This technical report presents the conclusions from that meeting.
Trypanosoma cruzi; Chagas infection; Rapid diagnostic tests; Serology; Chagas disease
Trypanosoma cruzi; Chagas infection; Rapid diagnostic tests; Serology; Chagas disease
Journal Article > ReviewFull Text
Rev Soc Bras Med Trop. 2017 June 1; Volume 50 (Issue 3); 296-300.; DOI:10.1590/0037-8682-0433-2016
Pinheiro E, Brum-Soares L, Reis R, Cubides JC
Rev Soc Bras Med Trop. 2017 June 1; Volume 50 (Issue 3); 296-300.; DOI:10.1590/0037-8682-0433-2016
After more than one century since its discovery, Chagas disease is still extremely prevalent in 21 Latin American countries. Chagas disease is one of the most concerning public health problems in Latin America; the overall cost of CD treatment is approximately 7 billion United States dollars per year and it has a strong social impact on populations. Little progress has been made regarding the access to diagnosis and treatment at the primary health care level, calling into question the current policies to ensure the right to health and access to essential medications. In this article, diverse dimensions of access to treatment for Chagas disease are reviewed, illustrating the present state of benznidazole medication in relation to global production capacity, costs, and needs. The findings are based on an investigation requested by Médecins Sans Frontières Brazil through a consultancy in 2015, aiming to estimate the current costs of benznidazole production.