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Retrospect, advances and challenges in Chagas disease diagnosis: a comprehensive review
Alejandro Gabriel Schijman1, Julio Alonso-Padilla2,3, Constança Britto4
1Laboratorio de Biología Molecular de la Enfermedad de Chagas, Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr Héctor Torres", INGEBI- CONICET, Vuelta de Obligado 2490, Buenos Aires, 1428 ADN, Argentina.
Insights
Timely diagnosis of Chagas disease is crucial for treatment access and elimination goals. Innovative point-of-care tests are needed to overcome limitations of current multi-test algorithms, especially in resource-limited settings.
Area of Science:
- Neglected tropical diseases
- Infectious disease diagnostics
- Public health
Background:
- Chagas disease, caused by Trypanosoma cruzi, impacts millions globally.
- The World Health Organization (WHO) aims for its elimination by 2030, highlighting diagnostic needs.
- Current diagnostic algorithms are time-consuming, posing challenges in resource-limited areas.
Purpose of the Study:
- To review historical context and recent advancements in Chagas disease diagnostics.
- To identify challenges and future directions for improving diagnostic accessibility.
- To emphasize the need for innovative tools to meet elimination goals.
Main Methods:
- Review of parasitological, molecular, and serological diagnostic methods.
- Analysis of diagnostic performance, sensitivity, and specificity.
- Exploration of point-of-care testing strategies.
Main Results:
- Parasitological methods lack sensitivity; molecular methods offer quantification and throughput.
- Serological tools face challenges with parasite antigenic diversity.
- Point-of-care tests are critical for accessibility and disease control.
Conclusions:
- Despite progress, challenges in Chagas disease diagnosis persist.
- Innovative diagnostic strategies, particularly point-of-care tests, are essential for widespread accessibility.
- Balancing achievements and obstacles is key to comprehensive progress in controlling Chagas disease.
Abstract:
Chagas disease, caused by Trypanosoma cruzi, affects millions worldwide. The 2030 WHO roadmap aims to eliminate it as a public health concern, emphasising the need for timely diagnosis to enhance treatment access. Current diagnostic algorithms, which rely on multiple tests, have prolonged turnaround times. This proves particularly problematic in resource-limited settings. Addressing this issue necessitates the validation and adoption of innovative tools. We explore recent developments in Chagas disease diagnosis, reviewing historical context and advancements. Despite progress, challenges persist. This article contributes to the understanding of current and future directions in this neglected healthcare area. Parasitological methods are simple but exhibit low sensitivity and require supplementary tests. Molecular methods, with automation potential, allow quantification and higher throughput. Serological tools show good performance but struggle with parasite antigenic diversity. Prioritising point-of-care tests is crucial for widespread accessibility and could offer a strategy to control disease impact. Ultimately, balancing achievements and ongoing obstacles is essential for comprehensive progress.
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