TY - JOUR
T1 - Geographie variation in the sensitivity of recombinant antigen-based rapid tests for chronic trypanosoma cruzi infection
AU - Verani, Jennifer R.
AU - Seitz, Amy
AU - Gilman, Robert H.
AU - Lafuente, Carlos
AU - Galdos-Cardenas, Gerson
AU - Kawai, Vivian
AU - De Lafuente, Elizabeth
AU - Ferrufino, Lisbeth
AU - Bowman, Natalie M.
AU - Pinedo-Cancino, Viviana
AU - Levy, Michael Z.
AU - Steurer, Francis
AU - Todd, Charles W.
AU - Kirchhoff, Louis V.
AU - Cabrera, Lilia
AU - Verastegui, Manuela
AU - Bern, Caryn
PY - 2009/3
Y1 - 2009/3
N2 - Chagas disease affects 8-11 million people throughout the Americas. Early detection is crucial for timely treatment and to prevent non-vectorial transmission. Recombinant antigen-based rapid tests had high sensitivity and specificity in laboratory evaluations, but no Peruvian specimens were included in previous studies. We evaluated Stat-Pak and Trypanosoma Detect rapid tests in specimens from Bolivia and Peru. Specimens positive by three conventional assays were confirmed positives; specimens negative by two or more assays were confirmed negatives. In Bolivian specimens, Stat-Pak and Trypanosoma Detect tests were 87.5% and 90.7% sensitive, respectively; both showed 100% specificity. Sensitivity in Peruvian specimens was much lower: 26.6-33.0% (Stat-Pak) and 54.3-55.2% (Trypanosoma Detect); both had specificities > 98%. Even in Bolivian specimens, these sensitivities are inadequate for stand-alone screening. The low sensitivity in Peru may be related to parasite strain differences. Chagas disease rapid tests should be field tested in each geographic site before widespread implementation for screening.
AB - Chagas disease affects 8-11 million people throughout the Americas. Early detection is crucial for timely treatment and to prevent non-vectorial transmission. Recombinant antigen-based rapid tests had high sensitivity and specificity in laboratory evaluations, but no Peruvian specimens were included in previous studies. We evaluated Stat-Pak and Trypanosoma Detect rapid tests in specimens from Bolivia and Peru. Specimens positive by three conventional assays were confirmed positives; specimens negative by two or more assays were confirmed negatives. In Bolivian specimens, Stat-Pak and Trypanosoma Detect tests were 87.5% and 90.7% sensitive, respectively; both showed 100% specificity. Sensitivity in Peruvian specimens was much lower: 26.6-33.0% (Stat-Pak) and 54.3-55.2% (Trypanosoma Detect); both had specificities > 98%. Even in Bolivian specimens, these sensitivities are inadequate for stand-alone screening. The low sensitivity in Peru may be related to parasite strain differences. Chagas disease rapid tests should be field tested in each geographic site before widespread implementation for screening.
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U2 - 10.4269/ajtmh.2009.80.410
DO - 10.4269/ajtmh.2009.80.410
M3 - Article
C2 - 19270291
AN - SCOPUS:62949222879
SN - 0002-9637
VL - 80
SP - 410
EP - 415
JO - American Journal of Tropical Medicine and Hygiene
JF - American Journal of Tropical Medicine and Hygiene
IS - 3
ER -