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Title: Chronic Chagas Disease Diagnosis: A Comparative Performance of Commercial Enzyme Immunoassay Tests
Authors: Santos, Fred Luciano Neves
Souza, Wayner Vieira de
Barros, Michelle da Silva
Nakazawa, Mineo
Krieger, Marco Aurélio
Gomes, Yara de Miranda
Affilliation: Fundação Oswaldo Cruz. Instituto Aggeu Magalhães. Laboratório de Referência para Doença de Chagas. Recife, PE, Brasil.
Fundação Oswaldo Cruz. Instituto Aggeu Magalhães. Departamento de Saúde Pública. Recife, PE, Brasil.
Fundação Oswaldo Cruz. Instituto Carlos Chagas. Instituto de Biologia Molecular do Paraná. Curitiba, PR, Brasil.
Abstract: There is a significant heterogeneity in reported performance of serological assays for Chagas disease diagnosis. The conventional serology testing in laboratory diagnosis and in blood banks is unsatisfactory because of a high number of inconclusive and misclassified results. We aimed to assess the quality of four commercially available enzyme-linked immunosorbent assay tests for their ability to detect Trypanosoma cruzi antibodies in 685 sera samples. Cross-reactivity was assessed by using 748 sera from patients with unrelated diseases. Initially, we found that the reactivity index against T. cruzi antigen was statistically higher in sera from Chagas disease patients compared with those from non-chagasic patients, supporting the notion that all evaluated tests have a good discriminatory ability toward the diagnosis of T. cruzi infection in patients in the chronic phase of the disease. Although all tests were similarly sensitive for diagnosing T. cruzi infection, there were significant variations in terms of specificity and cross-reactivity among them. Indeed, we obtained divergent results when testing sera from patient with unrelated diseases, particularly leishmaniasis, with the levels of cross-reactivity being higher in tests using whole T. cruzi extracts compared with those using recombinant proteins. Our data suggest that all four tests may be used for the laboratory diagnosis and routine blood screening diagnose for Chagas disease. We also emphasize that, despite their general good performance, caution is needed when analyzing the results when these tests are performed in areas where other diseases, particularly leishmaniasis, are endemic.
Keywords: Chagas Cardiomyopathy
Chronic Disease
Immunoenzyme Techniques
keywords: Cardiomiopatia Chagásica
Técnicas Imunoenzimáticas
DeCS: Cardiomiopatia Chagásica
Doença crônica
Técnicas Imunoenzimáticas
Issue Date: 2016
Citation: SANTOS, F. L. N. et al. Chronic Chagas Disease Diagnosis: A Comparative Performance of Commercial Enzyme Immunoassay Tests. The American Journal of Tropical Medicine and Hygiene, v. 94, n. 5, p. 1034–1039, 4 maio 2016. DOI 10.4269/ajtmh.15-0820.
DOI: 10.4269/ajtmh.15-0820
ISSN: 1476-1645
Copyright: open access
Appears in Collections:PE - IAM - Artigos de Periódicos

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