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Trypanosomiasis, american
Diagnostic Methods
Clinical methods Pros and cons
Parasitological diagnosis 
 The definitive diagnosis of American trypanosomiasis (Chagas disease) is done by detecting trypomastigotes in the blood after concentration.
Parasitaemia is highest during acute febrile episodes early in the course of the disease. Parasites are rarely detected in lymph nodes or skeletal muscle.
In chronic often asymptomatic infections, no trypanosomes can be found in the peripheral blood due to immune elimination.
  • Unsatisfactory sensitivity of parasitological methods
  • No morphological differentiation between T. cruzi and the non-pathogenic T. rangeli
 Molecular diagnosis 
 Detection of DNA in the blood or in tissue samples is a new alternative to confirm serological screening results. Nested and real-time PCR methods have been developed to detect Chagas infections in the blood or in biopsies.
  • Highly sensitive molecular methods can replace histology if they are available
 Antigen detection 
 No tests are available 
 Antibody detection 
 Serological methods are important for the screening of exposed populations. A series of serological tests have been commercialized using different test formats (mainly IFA and ELISA).
  • High sensitivity
  • Acceptable specificity but for many tests, false-positive results due to other co-endemic haemoflagellate infections (e.g. Leishmania spp.)