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慢性恰加斯病快速诊断检测的应用:一份专家会议报告。

The use of rapid diagnostic tests for chronic Chagas disease: An expert meeting report.

作者信息

Perez Freddy, Vermeij Debbie, Salvatella Roberto, Castellanos Luis Gerardo, de Sousa Andrea Silvestre

机构信息

Communicable Diseases Prevention, Control, and Elimination Department, Pan American Health Organization, Washington, DC, United States of America.

Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil.

出版信息

PLoS Negl Trop Dis. 2024 Aug 8;18(8):e0012340. doi: 10.1371/journal.pntd.0012340. eCollection 2024 Aug.

Abstract

Chagas disease, caused by Trypanosoma cruzi, affects millions of people globally and is associated with significant underdiagnosis and undertreatment. Current diagnostic algorithms face challenges in remote regions. We aimed to review the potential of rapid diagnostic tests (RDTs) for screening or diagnosing chronic Chagas disease in endemic areas. An expert panel representing scientific and academic institutions from the Americas convened with the aim of discussing the use of RDTs. The study employed the nominal group technique, gathering insights from diverse experts during a 3-day meeting. Panel discussions covered RDT application, research protocols, and regulatory mechanisms. The results indicate that RDTs play a crucial role in surveillance and screening, although limitations in sensitivity and specificity exist. The expert group recommends standardized protocols, emphasizes the importance of cost-effectiveness assessments, and highlights the need to consider geographic validation. Despite these challenges, RDTs present a promising avenue for improving Chagas disease diagnosis in resource-limited settings. Future research and a collaborative approach are deemed essential for effective implementation.

摘要

恰加斯病由克氏锥虫引起,全球数百万人受其影响,且存在严重的诊断不足和治疗不足问题。当前的诊断算法在偏远地区面临挑战。我们旨在评估快速诊断检测(RDT)在流行地区筛查或诊断慢性恰加斯病的潜力。一个代表美洲科研和学术机构的专家小组召开会议,讨论RDT的使用。该研究采用名义群体技术,在为期3天的会议期间收集不同专家的见解。小组讨论涵盖了RDT的应用、研究方案和监管机制。结果表明,尽管RDT在敏感性和特异性方面存在局限性,但在监测和筛查中发挥着关键作用。专家组建议采用标准化方案,强调成本效益评估的重要性,并突出考虑地理验证的必要性。尽管存在这些挑战,但RDT为改善资源有限环境下的恰加斯病诊断提供了一条有前景的途径。未来的研究和合作方法被认为对有效实施至关重要。

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本文引用的文献

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Practical diagnostic algorithms for Chagas disease: a focus on low resource settings.恰加斯病的实用诊断算法:聚焦资源匮乏地区
Expert Rev Anti Infect Ther. 2023 Jul-Dec;21(12):1287-1299. doi: 10.1080/14787210.2023.2279110. Epub 2023 Nov 24.
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Chagas disease in non-endemic settings.非流行地区的恰加斯病。
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