Analytical Evaluation of Dried Blood Spot and Rapid Diagnostic Test as a New Strategy for Serological Community Screening for Chronic Chagas Disease
Silgado, Aroa (Hospital Universitari Vall d'Hebron)
Gual-Gonzalez, Lídia (University of South Carolina)
Sánchez-Montalvá, Adrián (Hospital Universitari Vall d'Hebron)
Oliveira Souto, Inés (Hospital Universitari Vall d'Hebron)
Goterris, Lidia (Hospital Universitari Vall d'Hebron)
Serre-Delcor, Núria (Hospital Universitari Vall d'Hebron)
Esperalba, Juliana (Hospital Universitari Vall d'Hebron)
Gomez-i-Prat, Jordi (Hospital Universitari Vall d'Hebron)
Fernández-Naval, Candela (Hospital Universitari Vall d'Hebron)
Molina Romero, Israel (Hospital Universitari Vall d'Hebron)
Pumarola, Tomàs (Hospital Universitari Vall d'Hebron)
Sulleiro Igual, Elena (Hospital Universitari Vall d'Hebron)
Universitat Autònoma de Barcelona

Date:	2021
Abstract:	Background: Chagas disease is a public health problem not only in Latin America, but also in other regions, including Spain, due to migration movements. Conventional serological diagnosis requires an invasive sample (plasma or serum) and a well-equipped laboratory. To circumvent those limitations, blood samples dried on filter paper (DBS) or Rapid Diagnostic Test (RDT) could be a practical alternative to reference protocol for serological screening in epidemiological studies. We evaluated the usefulness of dried blood sampling and a rapid diagnostic test (Trypanosoma Detect™) for the detection of antibodies against T. cruzi for their use in community-based screening. Methodology/Principal Findings: A total of 162 stored paired whole-blood and serum samples from Latin American migrants and 25 negative-control blood samples were included. Diagnosis of chronic Chagas disease was performed in serum according to WHO algorithms. Blood samples were retrospectively collected as dried spots and then analyzed using two different serological techniques, enzyme-linked immunosorbent assay (ELISA) and electrochemiluminescence immunoassay (E-CLIA). Whole-blood samples were also used to evaluate a rapid diagnostic test based on immunochromatography. A better correlation with conventional serum was observed in dried blood elutes using E-CLIA than ELISA (97% vs. 77% sensitivity, respectively). Both assays reported 100% specificity. The median cut-off index values of E-CLIA for dried blood were significantly lower than those for serum (138. 1 vs. 243. 3, P<0. 05). The Trypanosoma Detect™ test presented a sensitivity and specificity of 89. 6% and 100%, respectively. Conclusions: The detection of antibodies against T. cruzi in dried blood samples shows a higher sensitivity when using E-CLIA compared with ELISA. Trypanosoma Detect™ is easier to use but has a lower sensitivity. Hence, we propose a sequential strategy based on performing the rapid test first, and a negative result will be confirmed by DBS-ECLIA for use in community Chagas disease screening programs.
Grants:	Fundació la Marató de TV3 20182610
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	Frontiers in cellular and infection microbiology, Vol. 11 (15 2021) , p. 736630, ISSN 2235-2988

DOI: 10.3389/fcimb.2021.736630
PMID: 34604116

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