TY - JOUR
T1 - Experiences with diagnosis and treatment of chagas disease at a united states teaching hospital—clinical features of patients with positive screening serologic testing
AU - Hyson, Peter
AU - Barahona, Lilian Vargas
AU - Pedraza-Arévalo, Laura C.
AU - Schultz, Jonathan
AU - Mestroni, Luisa
AU - Moreira, Maria da Consolação
AU - Taylor, Matthew
AU - Franco-Paredes, Carlos
AU - Benamu, Esther
AU - Ramanan, Poornima
AU - Rassi, Anis
AU - Hawkins, Kellie
AU - Henao-Martínez, Andrés F.
N1 - Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2021/6
Y1 - 2021/6
N2 - 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.
AB - 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.
KW - Chagas disease
KW - Neglected tropical disease (NTD)
KW - Pretransplant screening
KW - Trypanosoma cruzi
KW - Trypanosomiasis
UR - http://www.scopus.com/inward/record.url?scp=85108257038&partnerID=8YFLogxK
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U2 - 10.3390/tropicalmed6020093
DO - 10.3390/tropicalmed6020093
M3 - Article
AN - SCOPUS:85108257038
SN - 2414-6366
VL - 6
JO - Tropical Medicine and Infectious Disease
JF - Tropical Medicine and Infectious Disease
IS - 2
M1 - 93
ER -