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Trypanosomiasis, american
Diagnosis

Diagnostic methods

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.

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.

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).

 

Diagnostic strategies 

  1. To diagnose an individual case
    In acute infections, the parasite might be detected in the blood. If this is not achieved, serology or molecular diagnostic methods could be used.
    Due to these newer methods, xenodiagnosis, i.e. to see whether reduviid bugs become infected after taking a blood meal on the patient – has become obsolete.
     
  2. To assess endemicity in an endemic area
    The optimal method would be to use rt-PCR if available.
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