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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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Autores principales: Hyson, Peter, Barahona, Lilian Vargas, Pedraza-Arévalo, Laura C., Schultz, Jonathan, Mestroni, Luisa, da Consolação Moreira, Maria, Taylor, Matthew, Franco-Paredes, Carlos, Benamu, Esther, Ramanan, Poornima, Rassi, Anis, Hawkins, Kellie, Henao-Martínez, Andrés F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8261631/
https://www.ncbi.nlm.nih.gov/pubmed/34072787
http://dx.doi.org/10.3390/tropicalmed6020093
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author Hyson, Peter
Barahona, Lilian Vargas
Pedraza-Arévalo, Laura C.
Schultz, Jonathan
Mestroni, Luisa
da Consolação Moreira, Maria
Taylor, Matthew
Franco-Paredes, Carlos
Benamu, Esther
Ramanan, Poornima
Rassi, Anis
Hawkins, Kellie
Henao-Martínez, Andrés F.
author_facet Hyson, Peter
Barahona, Lilian Vargas
Pedraza-Arévalo, Laura C.
Schultz, Jonathan
Mestroni, Luisa
da Consolação Moreira, Maria
Taylor, Matthew
Franco-Paredes, Carlos
Benamu, Esther
Ramanan, Poornima
Rassi, Anis
Hawkins, Kellie
Henao-Martínez, Andrés F.
author_sort Hyson, Peter
collection PubMed
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 Trypanosoma cruzi (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.
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spelling pubmed-82616312021-07-08 Experiences with Diagnosis and Treatment of Chagas Disease at a United States Teaching Hospital—Clinical Features of Patients with Positive Screening Serologic Testing Hyson, Peter Barahona, Lilian Vargas Pedraza-Arévalo, Laura C. Schultz, Jonathan Mestroni, Luisa da Consolação Moreira, Maria Taylor, Matthew Franco-Paredes, Carlos Benamu, Esther Ramanan, Poornima Rassi, Anis Hawkins, Kellie Henao-Martínez, Andrés F. Trop Med Infect Dis Article 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 Trypanosoma cruzi (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. MDPI 2021-05-31 /pmc/articles/PMC8261631/ /pubmed/34072787 http://dx.doi.org/10.3390/tropicalmed6020093 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Hyson, Peter
Barahona, Lilian Vargas
Pedraza-Arévalo, Laura C.
Schultz, Jonathan
Mestroni, Luisa
da Consolação Moreira, Maria
Taylor, Matthew
Franco-Paredes, Carlos
Benamu, Esther
Ramanan, Poornima
Rassi, Anis
Hawkins, Kellie
Henao-Martínez, Andrés F.
Experiences with Diagnosis and Treatment of Chagas Disease at a United States Teaching Hospital—Clinical Features of Patients with Positive Screening Serologic Testing
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_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_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_sort experiences with diagnosis and treatment of chagas disease at a united states teaching hospital—clinical features of patients with positive screening serologic testing
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8261631/
https://www.ncbi.nlm.nih.gov/pubmed/34072787
http://dx.doi.org/10.3390/tropicalmed6020093
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