by Truyens C, Dumonteil E, Alger J, Cafferata ML, Ciganda A, Gibbons L, Herrera C, Sosa-Estani S, Buekens P. Journal of Clinical Microbiology 2021; 59(12). doi: 10.1128/JCM.01062-21
Summary: Chagas disease is mostly diagnosed using serological tests, but there is no gold standard to measure test performance. The authors used samples from a cohort of T. cruzi-infected women from Argentina, Honduras, and Mexico to evaluate the reactivity of two rapid diagnostic tests and one enzyme-linked immunosorbent assay (ELISA). When using at least two serological tests to confirm seropositivity, over 12% of T. cruzi infection cases from Argentina were missed by serological tests, over 21% in Honduras, and 72% in Mexico. This varying test performance was not due to differences in parasitemia, but may be impacted by geographic differences in parasite strains and genetic differences between human populations. Improved serological diagnostics are urgently needed to ensure optimum identification of cases.