Molecular diagnostics for Chagas disease: up to date and novel methodologies

ABSTRACT

Introduction: Chagas disease is caused by the parasite Trypanosoma cruzi. It affects 7 million people, mainly in Latin America. Diagnosis is usually made serologically, but at some clinical scenarios serology cannot be used. Then, molecular detection is required for early detection of congenital transmission, treatment response follow up, and diagnosis of immune-suppression reactivation. However, present tests are technically demanding and require well-equipped laboratories which make them unfeasible in low-resources endemic regions.

Areas covered: Available molecular tools for detection of T. cruzi DNA, paying particular attention to quantitative PCR protocols, and to the latest developments of user-friendly molecular diagnostic methodologies.

Expert commentary: In the absence of appropriate biomarkers, molecular diagnosis is the only option for the assessment of treatment response. Besides, it is very useful for the early detection of acute infections, like congenital cases. Since current Chagas disease molecular tests are restricted to referential labs, research efforts must focus in the implementation of easy-to-use diagnostic tools in order to overcome the access to diagnosis gap.

KEYWORDS:

• Chagas disease
• Trypanosoma cruzi
• molecular detection
• quantitative PCR
• point-of-care
• isothermal amplification

Declaration of interest

J. Gascon, M. Gallego and A.G. Schijman are members of NHEPACHA scientific network. J. Gascon is a member of the scientific communities of CEADES (Bolivia) and ISGLOBAL. J. Alonso-Padilla’s position at ISGLOBAL is funded by Instituto de Salud Carlos III RICET Network for Cooperative Research in Tropical Diseases (RD12/0018/0010 ISCIII; MICINN, Spain). M. Gallego is Professor at the Faculty of Pharmacy of the University of Barcelona and Associate Researcher at ISGLOBAL. Currently, M. Gallego is supervisor in the EU funded Euroleish training network. A.G. Schijman is director of LABMECH and member of the Directory of INGEBI. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

Research by J. Alonso-Padilla, J. Gascon and M. Gallego is funded by the Departament d’Universitats i Recerca de la Generalitat de Catalunya, Spain [AGAUR; grant 2014SGR26], and by Instituto de Salud Carlos III RICET Network for Cooperative Research in Tropical Diseases [RD12/0018/0010 ISCIII; MICINN, Spain] awarded to J. Gascon. The authors have also received support from the Generalitat de Catalunya CERCA Programme. A.G. Schijman research is funded by the Argentinian National Agency of Science and Technology [PICT 2014-1188 and PICT V 2015-0074] and by European Commission funded ERANET-LAC HD 328.