Experiences with Diagnosis and Treatment of Chagas Disease at a United States Teaching Hospital—Clinical Features of Patients with Positive Screening Serologic Testing
Chagas disease (CD) is the third most common parasitic infection globally and can cause cardiac and gastrointestinal complications. Around 300,000 carriers of CD live in the U.S., with about 3000 of those in Colorado. We described our experience in diagnosing CD at a Colorado teaching hospital to re...
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doaj-ee294e081221406a902cf0fbb845f5802021-06-01T01:44:37ZengMDPI AGTropical Medicine and Infectious Disease2414-63662021-05-016939310.3390/tropicalmed6020093Experiences with Diagnosis and Treatment of Chagas Disease at a United States Teaching Hospital—Clinical Features of Patients with Positive Screening Serologic TestingPeter Hyson0Lilian Vargas Barahona1Laura C. Pedraza-Arévalo2Jonathan Schultz3Luisa Mestroni4Maria da Consolação Moreira5Matthew Taylor6Carlos Franco-Paredes7Esther Benamu8Poornima Ramanan9Anis Rassi10Kellie Hawkins11Andrés F. Henao-Martínez12Department of Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USADivision of Infectious Diseases, University of Colorado School of Medicine, Aurora, CO 80045, USAFundación Universitaria Juan N Corpas, 18301 Bogotá, ColombiaDivision of Infectious Diseases, University of Colorado School of Medicine, Aurora, CO 80045, USAAdult Medical Genetics Program, Cardiovascular Institute, Division of Cardiology, University of Colorado School of Medicine, Aurora, CO 80045, USAFaculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte-Minas Gerais 31270-901, BrazilAdult Medical Genetics Program, Cardiovascular Institute, Division of Cardiology, University of Colorado School of Medicine, Aurora, CO 80045, USADivision of Infectious Diseases, University of Colorado School of Medicine, Aurora, CO 80045, USADivision of Infectious Diseases, University of Colorado School of Medicine, Aurora, CO 80045, USADivision of Infectious Diseases, University of Colorado School of Medicine, Aurora, CO 80045, USADivision of Cardiology, Anis Rassi Hospital, Goiânia 74110-020, BrazilDivision of Infectious Diseases, University of Colorado School of Medicine, Aurora, CO 80045, USADivision of Infectious Diseases, University of Colorado School of Medicine, Aurora, CO 80045, USAChagas disease (CD) is the third most common parasitic infection globally and can cause cardiac and gastrointestinal complications. Around 300,000 carriers of CD live in the U.S., with about 3000 of those in Colorado. We described our experience in diagnosing CD at a Colorado teaching hospital to revise screening eligibility criteria. From 2006 to 2020, we reviewed <i>Trypanosoma cruzi</i> (TC) IgG serology results for 1156 patients in our institution. We identified 23 patients (1.99%) who had a positive test. A total of 14/23 (60%) of positive serologies never had confirmatory testing, and 7 of them were lost to follow up. Confirmatory testing, performed in 9 patients, resulted in being positive in 3. One additional case of CD was identified by positive tissue pathology. All four confirmed cases were among patients born in Latin America. While most of the testing for CD at our institution is part of the pretransplant screening, no confirmed cases of CD derived from this strategy. Exposure risk in this population is not always documented, and initial positive results from screening are not always confirmed. The lack of standardized screening protocols for CD in our institution contributes to underdiagnosis locally and in health systems nationwide. Given a large number of individuals in the U.S. with chronic CD, improved screening is warranted.https://www.mdpi.com/2414-6366/6/2/93Chagas diseasetrypanosomiasis<i>Trypanosoma cruzi</i>neglected tropical disease (NTD)pretransplant screening |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Peter Hyson Lilian Vargas Barahona Laura C. Pedraza-Arévalo Jonathan Schultz Luisa Mestroni Maria da Consolação Moreira Matthew Taylor Carlos Franco-Paredes Esther Benamu Poornima Ramanan Anis Rassi Kellie Hawkins Andrés F. Henao-Martínez |
spellingShingle |
Peter Hyson Lilian Vargas Barahona Laura C. Pedraza-Arévalo Jonathan Schultz Luisa Mestroni Maria da Consolação Moreira Matthew Taylor Carlos Franco-Paredes Esther Benamu Poornima Ramanan Anis Rassi Kellie Hawkins Andrés F. Henao-Martínez Experiences with Diagnosis and Treatment of Chagas Disease at a United States Teaching Hospital—Clinical Features of Patients with Positive Screening Serologic Testing Tropical Medicine and Infectious Disease Chagas disease trypanosomiasis <i>Trypanosoma cruzi</i> neglected tropical disease (NTD) pretransplant screening |
author_facet |
Peter Hyson Lilian Vargas Barahona Laura C. Pedraza-Arévalo Jonathan Schultz Luisa Mestroni Maria da Consolação Moreira Matthew Taylor Carlos Franco-Paredes Esther Benamu Poornima Ramanan Anis Rassi Kellie Hawkins Andrés F. Henao-Martínez |
author_sort |
Peter Hyson |
title |
Experiences with Diagnosis and Treatment of Chagas Disease at a United States Teaching Hospital—Clinical Features of Patients with Positive Screening Serologic Testing |
title_short |
Experiences with Diagnosis and Treatment of Chagas Disease at a United States Teaching Hospital—Clinical Features of Patients with Positive Screening Serologic Testing |
title_full |
Experiences with Diagnosis and Treatment of Chagas Disease at a United States Teaching Hospital—Clinical Features of Patients with Positive Screening Serologic Testing |
title_fullStr |
Experiences with Diagnosis and Treatment of Chagas Disease at a United States Teaching Hospital—Clinical Features of Patients with Positive Screening Serologic Testing |
title_full_unstemmed |
Experiences with Diagnosis and Treatment of Chagas Disease at a United States Teaching Hospital—Clinical Features of Patients with Positive Screening Serologic Testing |
title_sort |
experiences with diagnosis and treatment of chagas disease at a united states teaching hospital—clinical features of patients with positive screening serologic testing |
publisher |
MDPI AG |
series |
Tropical Medicine and Infectious Disease |
issn |
2414-6366 |
publishDate |
2021-05-01 |
description |
Chagas disease (CD) is the third most common parasitic infection globally and can cause cardiac and gastrointestinal complications. Around 300,000 carriers of CD live in the U.S., with about 3000 of those in Colorado. We described our experience in diagnosing CD at a Colorado teaching hospital to revise screening eligibility criteria. From 2006 to 2020, we reviewed <i>Trypanosoma cruzi</i> (TC) IgG serology results for 1156 patients in our institution. We identified 23 patients (1.99%) who had a positive test. A total of 14/23 (60%) of positive serologies never had confirmatory testing, and 7 of them were lost to follow up. Confirmatory testing, performed in 9 patients, resulted in being positive in 3. One additional case of CD was identified by positive tissue pathology. All four confirmed cases were among patients born in Latin America. While most of the testing for CD at our institution is part of the pretransplant screening, no confirmed cases of CD derived from this strategy. Exposure risk in this population is not always documented, and initial positive results from screening are not always confirmed. The lack of standardized screening protocols for CD in our institution contributes to underdiagnosis locally and in health systems nationwide. Given a large number of individuals in the U.S. with chronic CD, improved screening is warranted. |
topic |
Chagas disease trypanosomiasis <i>Trypanosoma cruzi</i> neglected tropical disease (NTD) pretransplant screening |
url |
https://www.mdpi.com/2414-6366/6/2/93 |
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