Mixed infections by different Trypanosoma cruzi discrete typing units among Chagas disease patients in an endemic community in Panama
Metadata
Show full item recordAuthor
Prescilla Ledezma, Alexa; Blandon, Roberto; Schijman, Alejandro G.; Benatar, Alejandro; Saldaña, Azael; Osuna Carrillo De Albornoz, AntonioEditorial
Public Library Science
Date
2020-11-12Referencia bibliográfica
Ledezma AP, Blandon R, Schijman AG, Benatar A, Saldaña A, Osuna A (2020) Mixed infections by different Trypanosoma cruzi discrete typing units among Chagas disease patients in an endemic community in Panama. PLoS ONE 15 (11): e0241921. [https://doi.org/10.1371/journal. pone.0241921]
Sponsorship
Instituto Carlos III, Ministerio de Sanidad, Gobierno de Espana through the ERANet program; Fundación Ramon Areces; Spanish Government PGC2018-099424-B-I00; Secretaria Nacional de Ciencia Tecnología e Innovación (SENACYT); National Research System (SNISENACYT-PANAMA); Instituto para la Formación y Aprovechamiento de Recursos Humanos (IFARHU), Government of Panama; Project Research in Prevention of Congenital CHAGAS DISEASE: Parasitological, placental and immunological markers" ELAC2014/HID-0328; Project "Research in prevention of Congenital Chagas Disease: Parasitological, placental and immunological markers" ERANet17/HLH-0142; Interactoma de las Exovesiculas de T. cruzi y de los inmunocomplejos que forman con las células del hospedador; Implicaciones en la patología de la Enfermedad de ChagasAbstract
Background
Trypanosoma cruzi, the hemoparasite that causes Chagas disease, is divided into six Discrete
Typing Units or DTUs: TcI-TcVI plus Tcbat. This genetic diversity is based on ecobiological
and clinical characteristics associated with particular populations of the parasite. The
main objective of this study was the identification of DTUs in patients with chronic chagasic
infections from a mountainous rural community in the eastern region of Panama.
Methods
A total of 106 patients were tested for Chagas disease with three serological tests (ELISA,
rapid test, and Western blot). Molecular diagnosis and DTU typing were carried out by conventional
PCRs and qPCR targeting different genomic markers, respectively. As a control
sample for the typing, 28 patients suspected to be chagasic from the metropolitan area of
Panama City were included.
Results
Results showed a positivity in the evaluated patients of 42.3% (33/78); high compared to
other endemic regions in the country. In the control group, 20/28 (71.43%) patients presented
positive serology. The typing of samples from rural patients showed that 78.78%
(26/33) corresponded to TcI, while 9.09% (3/33) were mixed infections (TcI plus TcII/V/VI).
Seventy-five percent (15/20) of the patients in the control group presented TcI, and in five
samples it was not possible to typify the T. cruzi genotype involved.Conclusions
These results confirm that TcI is the main DTU of T. cruzi present in chronic chagasic
patients from Panama. However, the circulation of other genotypes (TcII/V/VI) in this country
is described for the first time. The eco-epidemiological characteristics that condition the
circulation of TcII/V/VI, as well as the immune and clinical impact of mixed infections in this
remote mountainous region should be investigated, which will help local action programs in
the surveillance, prevention, and management of Chagas disease.