Geographie variation in the sensitivity of recombinant antigen-based rapid tests for chronic trypanosoma cruzi infection

Jennifer R. Verani, Amy Seitz, Robert H. Gilman, Carlos Lafuente, Gerson Galdos-Cardenas, Vivian Kawai, Elizabeth De Lafuente, Lisbeth Ferrufino, Natalie M. Bowman, Viviana Pinedo-Cancino, Michael Z. Levy, Francis Steurer, Charles W. Todd, Louis V. Kirchhoff, Lilia Cabrera, Manuela Verastegui, Caryn Bern

Research output: Contribution to journalArticlepeer-review

95 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)410-415
Number of pages6
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume80
Issue number3
DOIs
StatePublished - Mar 2009
Externally publishedYes

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