title: High seroconversion rates in Trypanosoma cruzi chronic infection treated with benznidazole in people under 16 years in Guatemala.
abstract: Geographical, epidemiological, and environmental differences associated with therapeutic response to Chagas etiological treatment have been previously discussed. This study describes high seroconversion rates 72 months after benznidazole treatment in patients under 16 years from a project implemented by Doctors without Borders in Guatemala.
  An enzyme-linked immunosorbent assay was used to detect Trypanosoma cruzi IgG antibodies in capillary blood samples from patients 72 months after treatment. Fisher's exact test was used to establish association between characteristics, such as sex, age, and origin of patients, and final seroconversion. Kappa index determined concordance between laboratory tests. The level of significance was set to 5%.
  Ninety-eight patients, aged 6 months to 16 years, were available for follow-up. Sex and origin were not associated with seroconversion. Individuals older than 13 were more prone to maintain a positive result 72 months after treatment, although results were not highly significant. Laboratory tests presented elevated Kappa concordance (95% CI) = 0.8290 (0.4955-1), as well as high (97%) seroconversion rates.
  The high seroconversion rate found in this study emphasizes the importance of access to diagnosis, treatment, and follow-up of individuals affected by Chagas disease. Moreover, it contradicts the idea that it is not possible to achieve a cure with the currently available drugs. This study strongly supports expanding programs for patients infected with T. cruzi in endemic and non-endemic countries.
authors.affiliation: Unidade Médica Brasileira, Médicos Sem Fronteiras, Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Lucia
authors.initials: L
authors.lastname: Brum-Soares
authors.affiliation: Unidade Médica Brasileira, Médicos Sem Fronteiras, Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Juan-Carlos
authors.initials: JC
authors.lastname: Cubides
authors.affiliation: Unidade Médica Brasileira, Médicos Sem Fronteiras, Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Iris
authors.initials: I
authors.lastname: Burgos
authors.affiliation: Laboratory of Medical and Parasitical Entomology, San Carlos University, Guatemala City, Guatemala.
authors.forename: Carlota
authors.initials: C
authors.lastname: Monroy
authors.affiliation: Parasitology Department, National Laboratory of Public Health, Guatemala City, Guatemala.
authors.forename: Leticia
authors.initials: L
authors.lastname: Castillo
authors.affiliation: Parasitology Department, National Laboratory of Public Health, Guatemala City, Guatemala.
authors.forename: Selene
authors.initials: S
authors.lastname: González
authors.affiliation: Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland.
authors.forename: Pedro Albajar
authors.initials: PA
authors.lastname: Viñas
authors.affiliation: Medical Department, Doctors Without Borders, Barcelona, Spain.
authors.forename: Pedro Pablo Palma
authors.initials: PP
authors.lastname: Urrutia
mesh_terms: D000293:Adolescent; D000913:Antibodies, Protozoan / Q000097:blood*; D014355:Chagas Disease / Q000188:drug therapy* / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006166:Guatemala; D006801:Humans; D007223:Infant; D008297:Male; D009593:Nitroimidazoles / Q000627:therapeutic use*; D000069078:Seroconversion; D016896:Treatment Outcome; D014344:Trypanocidal Agents / Q000627:therapeutic use*; D014349:Trypanosoma cruzi / Q000276:immunology*
chemical_list: D000913:Antibodies, Protozoan; D009593:Nitroimidazoles; D014344:Trypanocidal Agents; C009999:benzonidazole