RESUMO
The diagnosis of Chagas disease mostly relies on the use of multiple serologic tests that are often unavailable in many of the remote settings where the disease is highly prevalent. In the Teniente Irala Fernández Municipality, in central Paraguay, efforts have been made to increase the diagnostic capabilities of specific rural health centres, but no quality assurance of the results produced has been performed. We comparatively analysed the results obtained with 300 samples tested using a commercial rapid diagnostic test (RDT) and enzyme linked immunosorbent assays (ELISA) at the laboratory of the Teniente Irala Fernández Health Center (CSTIF) with those generated upon repeating the tests at an independent well-equipped research laboratory (CEDIC). A subgroup of 52 samples were further tested at Paraguay's Central Public Health Laboratory (LCSP) by means of a different technique to evaluate the diagnostic performance of the tests carried out at CSTIF. We observed an excellent agreement between the ELISA results obtained at CSTIF and CEDIC (kappa coefficients between 0.85 and 0.93 for every kit evaluated), and an overall good performance of the tests carried out at CSTIF. However, the sensitivity of one kit was lower at CSTIF (81.3 %) than at CEDIC (100 %). The individual use of an RDT to detect the infection at CSTIF showed a similar sensitivity to that obtained combining it to an ELISA test (92.3% vs 88.5, p = 1). Nonetheless, the generalizability of this result is yet limited and will require of further studies.
Assuntos
Doença de Chagas , Atenção Primária à Saúde , População Rural , Sensibilidade e Especificidade , Testes Sorológicos , Paraguai , Humanos , Doença de Chagas/diagnóstico , Testes Sorológicos/métodos , Testes Sorológicos/normas , Adulto , Masculino , Feminino , Garantia da Qualidade dos Cuidados de Saúde , Adolescente , Ensaio de Imunoadsorção Enzimática/métodos , Ensaio de Imunoadsorção Enzimática/normas , Pessoa de Meia-Idade , Criança , Adulto Jovem , Pré-Escolar , Idoso , Anticorpos Antiprotozoários/sangueRESUMO
BACKGROUND: Mother-to-child transmission of Chagas disease (CD) has become a relevant problem in both endemic and non-endemic areas. METHODS: Description of the CUIDA Chagas Project - Communities United for Innovation, Development and Attention for Chagas disease'. RESULTS: Through innovative and strategic research, this project will provide improved diagnostic and treatment options as well as replicable implementation models that are adaptable to different contexts. CONCLUSIONS: By integrating test, treat and care actions for CD into primary health care practices, the burden of CD on people and health systems may be significantly reduced.
Assuntos
Doença de Chagas , Transmissão Vertical de Doenças Infecciosas , Bolívia/epidemiologia , Brasil/epidemiologia , Doença de Chagas/diagnóstico , Doença de Chagas/epidemiologia , Doença de Chagas/prevenção & controle , Colômbia , Feminino , Humanos , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Paraguai/epidemiologiaRESUMO
ABSTRACT Background: Mother-to-child transmission of Chagas disease (CD) has become a relevant problem in both endemic and non-endemic areas. Methods: Description of the CUIDA Chagas Project - Communities United for Innovation, Development and Attention for Chagas disease'. Results: Through innovative and strategic research, this project will provide improved diagnostic and treatment options as well as replicable implementation models that are adaptable to different contexts. Conclusions: By integrating test, treat and care actions for CD into primary health care practices, the burden of CD on people and health systems may be significantly reduced.