title: Comparative evaluation of 11 commercialized rapid diagnostic tests for detecting Trypanosoma cruzi antibodies in serum banks in areas of endemicity and nonendemicity.
abstract: Chagas disease is one of the main public health issues in Latin America. Increasingly during the past few decades, Trypanosoma cruzi infection has been detected in North America, Europe, and the Western Pacific, mainly as a result of population movement. The limited availability of rapid serological diagnostic tests hinders rapid diagnosis and early treatment in areas of endemicity and nonendemicity. In collaboration with 11 national reference laboratories (NRLs) from different geographical areas, we evaluated the performances of commercialized serological rapid diagnostic tests (RDT) for T. cruzi infection. Eleven commercialized T. cruzi infection RDTs were evaluated on a total of 474 samples extensively tested with at least three different techniques for Chagas disease, maintained at controlled low temperatures, and stored in the serum banks of the 11 NRLs. We measured the sensitivity, specificity, and concordance of each RDT and provided an additional questionnaire to evaluate its ease of use. The selected RDTs in this study were performed under controlled laboratory conditions. Out of the 11 RDTs, we found 8 of them to be useful, with the cassette format favored over the strip. We did not observe significant differences in RDT performances in the different regions. Overall, the performance results were lower than those disclosed by the manufacturers. The results of this evaluation validate the possibility of using RDTs to diagnose Chagas disease, thereby decreasing the time to treatment at a primary health care facility for patients who are willing to be treated. Further studies should be conducted in the laboratory and in the field to confirm these data, expressly to evaluate reproducibility in resource-limited settings, or using whole blood in clinical settings in areas of endemicity and nonendemicity.
authors.affiliation: Médecins Sans Frontières Operational Center Barcelona-Athens (OCBA), Barcelona, Spain Universitat Autónoma de Barcelona, Grups de Recerca d'Amèrica i Àfrica Llatines (GRAAL), Barcelona, Spain Universidad Antonio Nariño (UAN), Bogotá, Colombia rdtchagasmsf@gmail.com laurence.flevaud@barcelona.msf.org.
authors.forename: Claudia L
authors.initials: CL
authors.lastname: Sánchez-Camargo
authors.affiliation: WHO-Program on Control of Chagas Disease, Department of Control of Neglected Tropical Diseases, Geneva, Switzerland.
authors.forename: Pedro
authors.initials: P
authors.lastname: Albajar-Viñas
authors.affiliation: Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.
authors.forename: Patricia P
authors.initials: PP
authors.lastname: Wilkins
authors.affiliation: Instituto Salud Carlos III (ISCIII), Madrid, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Nieto
authors.affiliation: American Red Cross, Holland Laboratory, Rockville, Maryland, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Leiby
authors.affiliation: AP-HP Hopital Pitié-Salpêtrière, Paris, France.
authors.forename: Luc
authors.initials: L
authors.lastname: Paris
authors.affiliation: Departamento de Diagnóstico, Instituto Nacional de Parasitología Dr. Mario Fatala Chabén, Buenos Aires, Argentina.
authors.forename: Karenina
authors.initials: K
authors.lastname: Scollo
authors.affiliation: Instituto Nacional de Salud (INS), Bogotá, Colombia.
authors.forename: Carolina
authors.initials: C
authors.lastname: Flórez
authors.affiliation: Instituto de Diagnóstico y Referencia Epidemiológicos (InDRE), Mexico City, Mexico.
authors.forename: Carmen
authors.initials: C
authors.lastname: Guzmán-Bracho
authors.affiliation: Hospital das Clínicas, Universidade Federal de Goiás, Goiás, Brazil.
authors.forename: Alejandro O
authors.initials: AO
authors.lastname: Luquetti
authors.affiliation: Centro Nacional de Referencia en Parasitología (CNRP), INCIENSA, Tres Rios, Costa Rica.
authors.forename: Nidia
authors.initials: N
authors.lastname: Calvo
authors.affiliation: Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Tadokoro
authors.affiliation: Programa Nacional de Controle de Qualidade (PNCQ), Río de Janeiro, Brazil.
authors.forename: Amadeo
authors.initials: A
authors.lastname: Saez-Alquezar
authors.affiliation: Médecins Sans Frontières Operational Center Barcelona-Athens (OCBA), Barcelona, Spain.
authors.forename: Pedro Pablo
authors.initials: PP
authors.lastname: Palma
authors.affiliation: Universitat Autónoma de Barcelona, Grups de Recerca d'Amèrica i Àfrica Llatines (GRAAL), Barcelona, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Martin
authors.affiliation: Médecins Sans Frontières Operational Center Barcelona-Athens (OCBA), Barcelona, Spain rdtchagasmsf@gmail.com laurence.flevaud@barcelona.msf.org.
authors.forename: Laurence
authors.initials: L
authors.lastname: Flevaud
mesh_terms: D000913:Antibodies, Protozoan / Q000097:blood*; D014355:Chagas Disease / Q000175:diagnosis*; D003955:Diagnostic Tests, Routine / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D019095:Point-of-Care Systems; D012680:Sensitivity and Specificity; D044967:Serum / Q000276:immunology*; D011795:Surveys and Questionnaires; D014349:Trypanosoma cruzi / Q000276:immunology*
chemical_list: D000913:Antibodies, Protozoan