# name
Use of rapid diagnostic tests (RDTs) for conclusive diagnosis of chronic Chagas disease – field implementation in the Bolivian Chaco region

# metadata.dc.description.abstract[].value
Chagas disease, caused by the parasite Trypanosoma cruzi,
                is the neglected tropical disease with a highest burden in Latin
                America. Its acute stage is mostly asymptomatic and goes
                unnoticed. Symptoms appear at the chronic stage, which is when
                diagnosis is usually made. This is based on the agreement of two
                conventional serological tests such as Enzyme-Linked
                Immunosorbent Assays (ELISAs). There are commercial kits with
                good sensitivity and specificity but their use is impractical in
                many highly endemic regions with poorly equipped laboratories.
                Luckily, several rapid diagnostic tests (RDTs) are available for
                the detection of anti-T. cruzi immunoglobulins. They are easy to
                operate, require no cold storage, provide fast turnaround of
                results, and some can work with a tiny volume of whole blood as
                sample. With the aim to field validate their use we compared an
                alternative algorithm based on a combination of RDTs with the
                standard based on ELISAs. In both cases a third test was
                available in case of discordance. RDTs were implemented by
                mobile teams in field campaigns to detect chronic T.
                cruzi-infections in the Chaco region of Bolivia. ELISAs were
                made in the reference laboratories located in the main hospitals
                of Yacuiba and Villa Montes, two major cities of the region. We
                enrolled 685 subjects who voluntarily participated in the study
                and had not been treated against the disease before. The
                agreement between the two main RDTs was 93.1% (638/685) (kappa
                index = 0.86; CI 95% 0.83-0.90). In comparison to the ELISAs
                algorithm, the combined use of the RDTs provided a sensitivity
                of 97.7% and a specificity of 96.1%. These results support the
                use of RDTs for the diagnosis of chronic Chagas disease in the
                studied region, and encourage their evaluation in other regions
                of Bolivia and other endemic countries.

# metadata.dc.relation.ispartof[].value
PLoS Neglected Tropical Diseases, 2019, vol. 13, num. 12, p. e0007877

# metadata.dc.source[].value
Articles publicats en revistes (ISGlobal)

# metadata.dc.title[].value
Use of rapid diagnostic tests (RDTs) for conclusive diagnosis of chronic Chagas disease – field implementation in the Bolivian Chaco region