Detection of Trypanosoma cruzi and Treatment Monitoring by PCR from Dried Blood Spot Samples in Children.
BACKGROUND
Parasitic infections by Trypanosoma cruzi (T. cruzi) are frequent in children from endemic areas. Specific therapies have been successfully used in pediatric populations to treat this disease. T. cruzi diagnosis should be optimized and become available for any clinical environment.


OBJECTIVE
To study T. cruzi prevalence in children from an area of active transmission and carry out a posttreatment follow-up. To verify the feasibility of detecting DNA of T. cruzi from dried blood spot.


METHODS
We analyzed presence of T. cruzi in 78 Aboriginal children (Toba community) that attended to a rural school of Chaco province, Argentina. Serum and whole blood (dried blood spot) were assessed by means of serological techniques and PCR. Positive children received Benznidazole. Diagnosis and post treatment follow-up of T. cruzi infection were performed.


RESULTS
The serology assay showed infection in 34 of 78 (43.5%) children studied; PCR was positive in 5/34, displaying parasitemia. Serology remained positive in 28/28 children 120 days post-treatment, while PCR was positive in 18/28 (6/34 children were lost in follow-up). No adverse effects during the treatment were reported.


CONCLUSIONS
We were able to establish T. cruzi prevalence in the studied population and also to prove the usefulness of dried blood spot for T. cruzi detection using PCR in isolated areas. This method allowed us to verify early treatment failure. Possible causes of this failure are discussed below.
Laboratorio de Biología Molecular e Histocompatibilidad. Hospital Privado Universitario de Córdoba.
Ariel German
AG
Sánchez
Servicio de Pediatría. Hospital Privado Universitario de Córdoba.
Emilio
E
Alvarellos
Servicio de Nefrología Pediátrica. Hospital Privado Universitario de Córdoba.
Isolda
I
Kohout
Servicio de Pediatría Clínica Universitaria Reina Fabiola.
Diego G
DG
Rodriguez Schulz
Servicio de Pediatría del Sanatorio Allende.
Enrique
E
Cordeiro
Servicio de Infectología. Hospital Privado Universitario de Córdoba.
Juan Pablo
JP
Caeiro
Laboratorio de Biología Molecular e Histocompatibilidad. Hospital Privado Universitario de Córdoba.
Teresita
T
Alvarellos
D000293:Adolescent; D001118:Argentina / Q000453:epidemiology; D014355:Chagas Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D059788:Dried Blood Spot Testing; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D009593:Nitroimidazoles / Q000627:therapeutic use; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012424:Rural Population; D012680:Sensitivity and Specificity; D014344:Trypanocidal Agents / Q000627:therapeutic use; D014349:Trypanosoma cruzi / Q000235:genetics* / Q000302:isolation & purification
D009593:Nitroimidazoles; D014344:Trypanocidal Agents; C009999:benzonidazole