Department of Laboratory Medicine, University of California, SanFrancisco, San Francisco, California, USA.
School of Medicine, Baylor College of Medicine, Houston, Texas, USA.
J Infect Dis. 2024 Jan 12;229(1):198-202. doi: 10.1093/infdis/jiad404.
Chagas disease (CD) is a parasitic disease that affects ∼300 000 people living in the United States. CD leads to cardiac and/or gastrointestinal disease in up to 30% of untreated people. However, end-organ damage can be prevented with early diagnosis and antiparasitic therapy.
We reviewed electronic health records of patients who underwent testing for CD at four hospital systems in California and Texas between 2016 and 2020. Descriptive analyses were performed as a needs assessment for improving CD diagnosis.
In total, 470 patients were tested for CD. Cardiac indications made up more than half (60%) of all testing, and the most frequently cited cardiac condition was heart failure. Fewer than 1% of tests were ordered by obstetric and gynecologic services. Fewer than half (47%) of patients had confirmatory testing performed at the Centers for Disease Control and Prevention.
Four major hospitals systems in California and Texas demonstrated low overall rates of CD diagnostic testing, testing primarily among older patients with end-organ damage, and incomplete confirmatory testing. This suggests missed opportunities to diagnose CD in at-risk individuals early in the course of infection when antiparasitic treatment can reduce the risk of disease progression and prevent vertical transmission.
恰加斯病（Chagas disease，CD）是一种寄生虫病，影响着美国约 30 万人。未经治疗的人群中，高达 30%的人会出现心脏和/或胃肠道疾病。然而，早期诊断和驱虫治疗可预防终末器官损伤。
我们回顾了 2016 年至 2020 年期间，加利福尼亚州和德克萨斯州的四个医院系统中接受 CD 检测的患者的电子健康记录。进行描述性分析以评估改善 CD 诊断的需求。
共有 470 名患者接受了 CD 检测。心脏疾病的检测比例超过一半（60%），最常被引用的心脏疾病是心力衰竭。不到 1%的检测由妇产科服务机构开具。不到一半（47%）的患者在疾病控制与预防中心进行了确认性检测。
加利福尼亚州和德克萨斯州的四个主要医院系统的 CD 诊断检测总体率较低，主要针对有终末器官损伤的老年患者进行检测，且确认性检测不完全。这表明，在感染过程中，错过了在寄生虫感染早期诊断 CD 的机会，此时驱虫治疗可降低疾病进展的风险并预防垂直传播。
