1. Course of serological tests in treated subjects with chronic Trypanosoma cruzi infection: A systematic review and meta-analysis of individual participant data
- Author
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Emmaría Danesi, Yanina Sguassero, Olga Sánchez Negrette, Camila Aguiar, Laura Murcia, Cleudson Nery de Castro, Girley F. Machado-de-Assis, María Flores-Chávez, Marisel Maldonado, Celeste Aida Silveira, A.L. Andrade, Manuel Segovia, Josep M. Escribà, Cloé Duarte Fernandes, Mário Steindel, Marta de Lana, Wendell S.F. Meira, Israel Molina, Mirtha Streiger, Diana L. Fabbro, Karen N. Roberts, Daniel Comandé, Sergio Sosa-Estani, Aldo Solari, María M. Monje-Rumi, Alejandro Marcel Hasslocher-Moreno, Carlos Diego Lacunza, Inés Zulantay, Guillermina B Harvey, Cristina Beatriz Cuesta, Catalina Muñoz-San Martín, Ana Maria de Castro, Yves Jackson, Ninfa Vera de Bilbao, Agustín Ciapponi, Unión Europea, and World Health Organization (WHO/OMS)
- Subjects
0301 basic medicine ,Microbiology (medical) ,Adult ,Male ,medicine.medical_specialty ,Adolescent ,analysis ,Trypanosoma cruzi ,030106 microbiology ,030231 tropical medicine ,Serologic tests ,Antibodies, Protozoan ,Enzyme-Linked Immunosorbent Assay ,Follow-up studies ,Article ,Chronic disease ,Serology ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Internal medicine ,parasitic diseases ,Medicine ,Humans ,Chagas Disease ,Child ,Fluorescent Antibody Technique, Indirect ,Survival analysis ,ddc:613 ,biology ,business.industry ,Meta ,Hazard ratio ,Individual participant data ,Infant ,General Medicine ,Hemagglutination Tests ,biology.organism_classification ,Random effects model ,Confidence interval ,Institutional repository ,Meta-analysis ,Infectious Diseases ,Child, Preschool ,Female ,business - Abstract
Highlights • This is the first meta-analysis of individual data in chronic Trypanosoma cruzi infection after treatment. • The probability of seroreversion is variable along the course of follow-up. • An interaction was found between age at treatment and country setting. • The course of parasitological/molecular tests after treatment needs to be assessed., Objective To determine the course of serological tests in subjects with chronic Trypanosoma cruzi infection treated with anti-trypanosomal drugs. Methods A systematic review and meta-analysis was conducted using individual participant data. Survival analysis and the Cox proportional hazards regression model with random effects to adjust for covariates were applied. The protocol was registered in the PROSPERO database (http://www.crd.york.ac.uk/PROSPERO; CRD42012002162). Results A total of 27 studies (1296 subjects) conducted in eight countries were included. The risk of bias was low for all domains in 17 studies (63.0%). Nine hundred and thirteen subjects were assessed (149 seroreversion events, 83.7% censored data) for enzyme-linked immunosorbent assay (ELISA), 670 subjects (134 events, 80.0% censored) for indirect immunofluorescence assay (IIF), and 548 subjects (99 events, 82.0% censored) for indirect hemagglutination assay (IHA). A higher probability of seroreversion was observed within a shorter time span in subjects aged 1–19 years compared to adults. The chance of seroreversion also varied according to the country where the infection might have been acquired. For instance, the pooled adjusted hazard ratio between children/adolescents and adults for the IIF test was 1.54 (95% confidence interval 0.64–3.71) for certain countries of South America (Argentina, Bolivia, Chile, and Paraguay) and 9.37 (95% confidence interval 3.44–25.50) for Brazil. Conclusions The disappearance of anti-T. cruzi antibodies was demonstrated along the course of follow-up. An interaction between age at treatment and country setting was found.
- Published
- 2018