RESUMO
We developed a protein to rapidly and accurately diagnose Chagas disease, a life-threatening illness identified by the WHO as a critical worldwide public health risk. Limitations in present day serological tests are complicating the current health situation and contributing to most infected persons being unaware of their condition and therefore untreated. To improve diagnostic testing, we developed an immunological mimic of the etiological agent, Trypanosoma cruzi, by combining ten pathogen-specific epitopes within the beta-barrel protein structure of Thermal Green Protein. The resulting multi-epitope protein, DxCruziV3, displayed high specificity and sensitivity as the antibody capture reagent in an ELISA platform with an analytical sensitivity that exceeds WHO recommendations. Within an immunochromatographic platform, DxCruziV3 showed excellent performance for the point of application diagnosis in a region endemic for multiple diseases, the municipality of Barcelos in the state of Amazonas, Brazil. In total, 167 individuals were rapidly tested using whole blood from a finger stick. As recommended by the Brazilian Ministry of Health, venous blood samples were laboratory tested by conventional assays for comparison. Test results suggest utilizing DxCruziV3 in different assay platforms can confidently diagnose chronic infections by T. cruzi. Rapid and more accurate results will benefit everyone but will have the most noticeable impact in resource-limited rural areas where the disease is endemic.
Assuntos
Doença de Chagas , Ensaio de Imunoadsorção Enzimática , Epitopos , Testes Sorológicos , Trypanosoma cruzi , Doença de Chagas/diagnóstico , Doença de Chagas/sangue , Doença de Chagas/imunologia , Humanos , Ensaio de Imunoadsorção Enzimática/métodos , Trypanosoma cruzi/imunologia , Testes Sorológicos/métodos , Epitopos/imunologia , Doença Crônica , Masculino , Sensibilidade e Especificidade , Feminino , Adulto , Anticorpos Antiprotozoários/sangue , Anticorpos Antiprotozoários/imunologia , Pessoa de Meia-Idade , Antígenos de Protozoários/imunologia , Antígenos de Protozoários/sangue , Brasil/epidemiologiaRESUMO
About two thousand cases of pertussis are reported in Brazil each year, with the highest incidence and mortality rates occurring in children under one year old. The disease is becoming common in Brazil; however the state of Rio de Janeiro has been showing low reporting figures in relation to other states in the Southeast region. This research work aimed to evaluate the difficulties faced by medical teams when confirming suspect cases of pertussis in healthcare units throughout the state of Rio de Janeiro and to use available data to confirm pertussis diagnosis within the last two years. Epidemiological surveys were conducted among medical personnel from healthcare units who presented the main obstacles to confirming suspect cases. Results show that a lack of laboratory diagnosis, poor differential diagnosis, low knowledge of the disease and a lack of clinical experience are, among other factors, relevant to the low reporting rates in the region...
Cerca de dois mil casos de coqueluche são relatados no Brasil a cada ano. Crianças com menos de 1 ano de idade pertencem ao grupo com maiores taxas de incidência e letalidade. Apesar de a doença estar se tornando cada vez mais frequente no Brasil, o estado do Rio de Janeiro vem apresentando baixos índices de informação comparativamente a outros estados da Região Sudeste. Portanto, este trabalho teve como objetivo avaliar tanto as dificuldades enfrentadas pelas equipes médicas ao confirmar casos suspeitos de coqueluche em unidades de saúde em todo o estado do Rio de Janeiro quanto a disponibilidade de dados para confirmar o diagnóstico da coqueluche nos últimos dois anos. O levantamento epidemiológico foi realizado entre o pessoal médico de unidades de saúde que apresentaram dificuldades para a confirmação de casos suspeitos. Os resultados indicaram alguns fatores relevantes para as baixas taxas de notificação na região: falta de diagnóstico laboratorial, inconsistência do diagnóstico diferencial, escassez de conhecimento sobre a doença e falta de experiência clínica...