Therapy, diagnosis and prognosis of chronic Chagas disease: insight gained in Argentina.
The purpose of this review is to describe research findings regarding chronic Chagas disease in Argentina that have changed the standards of care for patients with Trypanosoma cruzi infection. Indirect techniques (serological tests) are still the main tools for the primary diagnosis of infection in the chronic phase, but polymerase chain reaction has been shown to be promising. The prognosis of patients with heart failure or advanced stages of chagasic cardiomyopathy is poor, but a timely diagnosis during the initial stages of the disease would allow for prescription of appropriate therapies to offer a better quality of life. Treatment of T. cruzi infection is beneficial as secondary prevention to successfully cure the infection or to delay, reduce or prevent the progression to disease and as primary disease prevention by breaking the chain of transmission. Current recommendations have placed the bulk of the diagnostic and treatment responsibility on the Primary Health Care System. Overall, the current research priorities with respect to Chagas disease should be targeted towards (i) the production of new drugs that would provide a shorter treatment course with fewer side effects; (ii) the development of new tools to confirm cure after a full course of treatment during the chronic phase and (iii) biomarkers to identify patients with a high risk of developing diseases.
Sosa-Estani
Sergio
S
Centro Nacional de Diagnóstico e Investigación de Endemo-epidemias, Buenos Aires, Argentina. ssosa@msal.gov.ar
Viotti
Rodolfo
R
Segura
Elsa Leonor
EL
D001118:Argentina; D015415:Biomarkers / Q000097:blood; D002598:Chagas Cardiomyopathy / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality; D014355:Chagas Disease / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality; D002908:Chronic Disease; D018450:Disease Progression; D004562:Electrocardiography; D006801:Humans; D016133:Polymerase Chain Reaction; D011379:Prognosis; D012698:Serologic Tests / Q000379:methods; D014344:Trypanocidal Agents / Q000627:therapeutic use*
D015415:Biomarkers; D014344:Trypanocidal Agents