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PCR-based diagnosis for Chagas' disease in Bolivian children living in an active transmission area: comparison with conventional serological and parasitological diagnosis

Published online by Cambridge University Press:  01 April 1997

P. WINCKER
Affiliation:
Laboratorio de Biologia Molecular e Doenças Endêmicas, Departmento de Bioquimica e Biologia Molecular, Instituto Oswaldo Cruz, Fundaçao Oswaldo Cruz, Av. Brasil 4365, 21045-900 Rio de Janeiro, Brazil Laboratoire Génome des Parasites, Parasitologie, Faculté de Médecine, 163 rue Auguste Broussonet, 34000 Montpellier, France
J. TELLERIA
Affiliation:
UR41, UMR ORSTOM/CNRS 9926 “Génétique moléculaire des Parasites et des Vecteurs”, CP 9214, La Paz, Bolivia
M. F. BOSSENO
Affiliation:
UR41, UMR ORSTOM/CNRS 9926 “Génétique moléculaire des Parasites et des Vecteurs”, CP 9214, La Paz, Bolivia
M. A. CARDOSO
Affiliation:
Laboratorio de Biologia Molecular e Doenças Endêmicas, Departmento de Bioquimica e Biologia Molecular, Instituto Oswaldo Cruz, Fundaçao Oswaldo Cruz, Av. Brasil 4365, 21045-900 Rio de Janeiro, Brazil
P. MARQUES
Affiliation:
Laboratorio de Biologia Molecular e Doenças Endêmicas, Departmento de Bioquimica e Biologia Molecular, Instituto Oswaldo Cruz, Fundaçao Oswaldo Cruz, Av. Brasil 4365, 21045-900 Rio de Janeiro, Brazil
N. YAKSIC
Affiliation:
Universidad mayor de San Andres, IBBA, CP 641, La Paz, Bolivia
C. AZNAR
Affiliation:
Institut Pasteur, Département d'Immunologie et Centre de Biologie médicale, 28 rue du Dr Roux, 75724 Paris Cedex 15, France
P. LIEGEARD
Affiliation:
Institut Pasteur, Département d'Immunologie et Centre de Biologie médicale, 28 rue du Dr Roux, 75724 Paris Cedex 15, France
M. HONTEBEYRIE
Affiliation:
Institut Pasteur, Département d'Immunologie et Centre de Biologie médicale, 28 rue du Dr Roux, 75724 Paris Cedex 15, France
F. NOIREAU
Affiliation:
UR 41 ORSTOM, C.P. 9214, La Paz, Bolivia
C. M. MOREL
Affiliation:
Laboratorio de Biologia Molecular e Doenças Endêmicas, Departmento de Bioquimica e Biologia Molecular, Instituto Oswaldo Cruz, Fundaçao Oswaldo Cruz, Av. Brasil 4365, 21045-900 Rio de Janeiro, Brazil
S. F. BRENIERE
Affiliation:
UR41, UMR ORSTOM/CNRS 9926 “Génétique moléculaire des Parasites et des Vecteurs”, CP 9214, La Paz, Bolivia

Abstract

A large field study has been performed in the Cochabamba region of Bolivia with the aim of comparing the polymerase chain reaction (PCR) with other diagnostic methods for Chagas' disease. The amplification of Trypanosoma cruzi-specific kinetoplast DNA sequences in blood samples was compared with classical serological methods, specific IgM detection and direct parasite visualization for 268 school children in a single village where Chagas' disease transmission is active. Of 113 children positive by classical serology or buffy coat examination, 106 were detected by PCR (sensitivity: 93·8%). We did not observe any significant difference of PCR sensitivity between initial (IgM and/or buffy coat positive) and indeterminate stage (only IgG positive) patients. Among the remaining 155 children unconfirmed as chagasic (who were either only IgM positive, IgG-, IgM-, and buffy coat-negative) only 1 case was PCR positive. This case may be due to DNA contamination, or to a very recent infection not detected otherwise, or to specific immune depression. These results show that PCR is a very sensitive parasitological test for Chagas' disease in active transmission regions. The future follow-up of the possibly infected patients who were only IgM-positive should clarify the interest of PCR and IgM tests in the detection of starting infections.

Type
Research Article
Copyright
© 1997 Cambridge University Press

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