Section 2 Zoonotic Diseases

*Current Topics in Neglected Tropical Diseases*

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**66**

**69**

**1. Introduction**

**Chapter 5**

**Abstract**

More than a Hundred Years in the

Search for an Accurate Diagnosis

Chagas disease, or American trypanosomiasis, is a parasitic disease of the Americas. In nature, *Trypanosoma cruzi* is transmitted through various species of triatomine bugs. However, non-vectorial transmission can also occur, such as transmission through blood products or by transplanting infected organs, by vertical transmission, and lately by oral route. Currently, Chagas disease affects approximately 6–7 million people worldwide, and the process of urbanization in Latin America and migratory movements from endemic countries have led to Chagas disease being diagnosed in areas where the infection is not endemic. There are several methods for diagnosing Chagas disease. Some of these are mostly used for research purposes, while others are used in routine diagnostic laboratories. According to the World Health Organization (WHO), chronic Chagas disease diagnosis is based on two serological techniques. To establish a definitive diagnosis, the results must be concordant. In the case of discordances, the WHO proposes repeating serology in a new sample, and if results remain inconclusive, a confirmatory test should be performed. This chapter shows aspects of the diagnosis of Chagas disease, which varies in its sensitivity and specificity, and its use depends on the geographical location,

for Chagas Disease: Current

Panorama and Expectations

*Aracely López-Monteon, Eric Dumonteil*

the available resources, and the purpose of the diagnosis.

**Keywords:** chagas disease, *T. cruzi*, diagnosis, serology, antigens

The infection caused by the protozoan parasite *Trypanosoma cruzi* leads to Chagas disease, with an estimated 6–7 million infected people and nearly 60 million at risk of infection [1, 2]. Chagas disease ranks among the world's most neglected diseases and is considered to be the parasitic infection with the greatest socioeconomic impact in Latin America, being responsible for an estimated US\$ 1.2 billion in lost productivity annually [3]. It is a disease that a century after its discovery still requires appropriate control measures, effective treatment, and especially an accurate diagnosis. This disease is endemic to most countries in Latin America [4], but it has now become more important in other regions. The increasing presence of Chagas in non-endemic areas, as well as the resurgence of the disease in

*and Angel Ramos-Ligonio*

## **Chapter 5**
