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恰加斯病诊断的回顾、进展与挑战:全面综述

Retrospect, advances and challenges in Chagas disease diagnosis: a comprehensive review.

作者信息

Schijman Alejandro Gabriel, Alonso-Padilla Julio, Britto Constança, Herrera Bernal Claudia Patricia

机构信息

Laboratorio de Biología Molecular de la Enfermedad de Chagas, Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr Héctor Torres", INGEBI- CONICET, Vuelta de Obligado 2490, Buenos Aires, 1428 ADN, Argentina.

Barcelona Institute for Global Health (ISGlobal), Hospital Clinic - University of Barcelona, Carrer Rosselló 149, 08036, Barcelona, Spain.

出版信息

Lancet Reg Health Am. 2024 Jun 20;36:100821. doi: 10.1016/j.lana.2024.100821. eCollection 2024 Aug.

Abstract

Chagas disease, caused by , affects millions worldwide. The 2030 WHO roadmap aims to eliminate it as a public health concern, emphasising the need for timely diagnosis to enhance treatment access. Current diagnostic algorithms, which rely on multiple tests, have prolonged turnaround times. This proves particularly problematic in resource-limited settings. Addressing this issue necessitates the validation and adoption of innovative tools. We explore recent developments in Chagas disease diagnosis, reviewing historical context and advancements. Despite progress, challenges persist. This article contributes to the understanding of current and future directions in this neglected healthcare area. Parasitological methods are simple but exhibit low sensitivity and require supplementary tests. Molecular methods, with automation potential, allow quantification and higher throughput. Serological tools show good performance but struggle with parasite antigenic diversity. Prioritising point-of-care tests is crucial for widespread accessibility and could offer a strategy to control disease impact. Ultimately, balancing achievements and ongoing obstacles is essential for comprehensive progress.

摘要

恰加斯病由[病原体名称未给出]引起,影响着全球数百万人。世界卫生组织2030年路线图旨在消除恰加斯病这一公共卫生问题,强调需要及时诊断以增加治疗机会。目前依赖多项检测的诊断算法周转时间较长。这在资源有限的环境中尤其成问题。解决这一问题需要验证和采用创新工具。我们探讨了恰加斯病诊断的最新进展,回顾了历史背景和进步。尽管取得了进展,但挑战依然存在。本文有助于理解这一被忽视的医疗领域的当前和未来方向。寄生虫学方法简单,但灵敏度低,需要补充检测。分子方法具有自动化潜力,能够进行定量和更高通量的检测。血清学工具表现良好,但在应对寄生虫抗原多样性方面存在困难。优先发展即时检测对于广泛普及至关重要,并且可以提供一种控制疾病影响的策略。最终,平衡已取得的成就和持续存在的障碍对于全面进展至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/72ab/11246061/817ec762156e/gr1.jpg

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