Chagas Disease in Southern Coastal Ecuador: Coinfections with Arboviruses and a Comparison of Serological Assays for Chagas Disease Diagnosis

Am J Trop Med Hyg. 2018 Dec;99(6):1530-1533. doi: 10.4269/ajtmh.18-0441. Epub 2018 Oct 18.

Abstract

Occurrence of Chagas disease and arbovirus coinfections is unknown, despite the vast co-endemic areas throughout the Americas. This study examined the proportion of individuals positive for Trypanosoma cruzi and coinfections with dengue, chikungunya, and Zika viruses in Machala, Ecuador (January 2014-December 2015). Chagas seropositivity was evaluated with five commercially available assays. Dengue infections were identified by nonstructural protein 1 rapid test and enzyme linked immunosorbent assay (ELISA), immunoglobulin M ELISA, and reverse transcription PCR (RT-PCR); chikungunya and Zika infections were identified by RT-PCR. Of 658 individuals, six were positive for T. cruzi (0.91%), including one T. cruzi/dengue coinfection and one T. cruzi/chikungunya/dengue coinfection. The clinical manifestations of coinfected individuals corresponded to severe dengue and dengue with warning signs, respectively. We observed discrepant results by using the Hemagen Chagas kit and the rapid test Chagas Detect Plus (false positives: 3.9% and 15.4%), highlighting the need to assess diagnostic assays in geographic regions with distinct taxonomic units of T. cruzi.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aged
  • Antigens, Viral / blood*
  • Chagas Disease / diagnosis
  • Chagas Disease / epidemiology*
  • Chagas Disease / parasitology
  • Chikungunya Fever / diagnosis
  • Chikungunya Fever / epidemiology*
  • Chikungunya Fever / parasitology
  • Chikungunya virus / genetics
  • Chikungunya virus / immunology
  • Chikungunya virus / isolation & purification
  • Coinfection
  • Dengue / diagnosis
  • Dengue / epidemiology*
  • Dengue / parasitology
  • Dengue Virus / genetics
  • Dengue Virus / immunology
  • Dengue Virus / isolation & purification
  • Ecuador / epidemiology
  • Enzyme-Linked Immunosorbent Assay / standards
  • Female
  • Humans
  • Male
  • Middle Aged
  • RNA, Viral / blood*
  • Reverse Transcriptase Polymerase Chain Reaction / standards
  • Trypanosoma cruzi / immunology
  • Trypanosoma cruzi / isolation & purification
  • Zika Virus / genetics
  • Zika Virus / immunology
  • Zika Virus / isolation & purification
  • Zika Virus Infection / diagnosis
  • Zika Virus Infection / epidemiology*
  • Zika Virus Infection / parasitology

Substances

  • Antigens, Viral
  • RNA, Viral