Quality assurance of serologic testing for Chagas disease in a primary care setting of rural Paraguay.
Acta Trop
; 259: 107382, 2024 Nov.
Article
em En
| MEDLINE
| ID: mdl-39244140
ABSTRACT
The diagnosis of Chagas disease mostly relies on the use of multiple serologic tests that are often unavailable in many of the remote settings where the disease is highly prevalent. In the Teniente Irala Fernández Municipality, in central Paraguay, efforts have been made to increase the diagnostic capabilities of specific rural health centres, but no quality assurance of the results produced has been performed. We comparatively analysed the results obtained with 300 samples tested using a commercial rapid diagnostic test (RDT) and enzyme linked immunosorbent assays (ELISA) at the laboratory of the Teniente Irala Fernández Health Center (CSTIF) with those generated upon repeating the tests at an independent well-equipped research laboratory (CEDIC). A subgroup of 52 samples were further tested at Paraguay's Central Public Health Laboratory (LCSP) by means of a different technique to evaluate the diagnostic performance of the tests carried out at CSTIF. We observed an excellent agreement between the ELISA results obtained at CSTIF and CEDIC (kappa coefficients between 0.85 and 0.93 for every kit evaluated), and an overall good performance of the tests carried out at CSTIF. However, the sensitivity of one kit was lower at CSTIF (81.3 %) than at CEDIC (100 %). The individual use of an RDT to detect the infection at CSTIF showed a similar sensitivity to that obtained combining it to an ELISA test (92.3% vs 88.5, p = 1). Nonetheless, the generalizability of this result is yet limited and will require of further studies.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Atenção Primária à Saúde
/
População Rural
/
Testes Sorológicos
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Sensibilidade e Especificidade
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Doença de Chagas
Limite:
Adolescent
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Adult
/
Aged
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Child
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Child, preschool
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
America do sul
/
Paraguay
Idioma:
En
Revista:
Acta Trop
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Espanha
País de publicação:
Holanda