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6 results on '"Mónica, del Barco"'

1. Diagnostic reliability of an immunochromatographic test for Chagas disease screening at a primary health care centre in a rural endemic area

Author

Diego Mendicino, Mariana Stafuza, Carlina Colussi, Mónica del Barco, Mirtha Streiger, and Edgardo Moretti

Subjects
Chagas disease, serological test, immunochromatographic assay, Microbiology, QR1-502, Infectious and parasitic diseases, RC109-216
Abstract

Many patients with Chagas disease live in remote communities that lack both equipment and trained personnel to perform a diagnosis by conventional serology (CS). Thus, reliable tests suitable for use under difficult conditions are required. In this study, we evaluated the ability of personnel with and without laboratory skills to perform immunochromatographic (IC) tests to detect Chagas disease at a primary health care centre (PHCC). We examined whole blood samples from 241 patients and serum samples from 238 patients. Then, we calculated the percentage of overall agreement (POA) between the two groups of operators for the sensitivity (S), specificity (Sp) and positive (PPV) and negative (NPV) predictive values of IC tests compared to CS tests. We also evaluated the level of agreement between ELISAs and indirect haemagglutination (IHA) tests. The readings of the IC test results showed 100% agreement (POA = 1). The IC test on whole blood showed the following values: S = 87.3%; Sp = 98.8%; PPV = 96.9% and NPV = 95.9%. Additionally, the IC test on serum displayed the following results: S = 95.7%; Sp = 100%; PPV = 100% and NPV = 98.2%. Using whole blood, the agreement with ELISA was 96.3% and the agreement with IHA was 94.1%. Using serum, the agreement with ELISA was 97.8% and the agreement with IHA was 96.6%. The IC test performance with serum samples was excellent and demonstrated its usefulness in a PHCC with minimal equipment. If the IC test S value and NPV with whole blood are improved, then this test could also be used in areas lacking laboratories or specialised personnel.

Published
2014
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2. Trypanocide treatment among adults with chronic Chagas disease living in Santa Fe city (Argentina), over a mean follow-up of 21 years: parasitological, serological and clinical evolution Tratamento tripanocida em adultos chagásicos crônicos, residentes na cidade de Santa Fé (Argentina), com seguimento de 21 anos em média: evolução parasitológica, sorológica e clínica

Author

Diana L. Fabbro, Mirtha L. Streiger, Enrique D. Arias, María L. Bizai, Mónica del Barco, and Norberto A. Amicone

Subjects
Doença de Chagas, Tratamento, Pacientes chagásicos, Seguimento, Chagas disease, Treatment, Chagasic patients, Follow-up, Arctic medicine. Tropical medicine, RC955-962
Abstract

The efficacy of treatment with nifurtimox and/or benznidazole among adults with chronic Chagas disease with no previous electrocardiographic disturbances was evaluated over a mean follow-up of 21 years, by means of conventional serology, xenodiagnosis, clinical examination, electrocardiograms and chest X-ray. One hundred and eleven patients, between 17 and 46 years old, were studied: 54 underwent treatment (nifurtimox 27, benznidazole 27) and 57 remained untreated (control group). Xenodiagnosis was performed on 65% of them: 36/38 of the treated and 9/34 of the untreated patients had previous positive xenodiagnosis. Post-treatment, 133 xenodiagnoses were performed on 41 patients, all resulting negative. In the control group, 29 xenodiagnoses were performed on 14 patients; 2 resulted positive. Sera stored during the follow-up were simultaneously analyzed through conventional serology tests (IHA; DA-2ME; IIF). The serological evolution in the treated group was: a) 37% underwent negative seroconversion (nifurtimox 11, benznidazole 9); b) 27.8% decreased titers (nifurtimox 9, benznidazole 6), 9 showed inconclusive final serology (nifurtimox 7, benznidazole 2); c) 35.2% remained positive with constant titers (nifurtimox 7; benznidazole 12). The control group conserved the initial antibody levels during the follow-up. In the clinical evolution, 2/54 (3.7%) of the treated and 9/57 (15.8%) of the untreated patients showed electrocardiographic disturbances attributable to Chagas myocardiopathy, with a statistically relevant difference (pAvaliamos a eficácia do nifurtimox e/ou benznidazol, durante 21 anos em média, em adultos chagásicos crônicos sem alterações eletrocardiográficas iniciais, mediante sorologia convencional, xenodiagnóstico, exames clínicos, eletrocardiográficos e radiografia do tórax. Estudamos 111 pacientes (17 a 46 anos): 54 foram tratados (27 com nifurtimox e 27 com benznidazol) e 57 formaram o grupo controle. Foram submetidos ao xenodiagnóstico 65% dos pacientes estudados: 36/38 tratados e 9/34 do grupo controle com xenodiagnóstico positivo prévio. Após tratamento, foram realizados 133 xenodiagnósticos em 41 pacientes, sendo todos negativos. Foram realizados 29 xenodiagnósticos em 14 pacientes do grupo controle, 2 foram positivos. A sorologia convencional foi realizada em soros estocados durante o seguimento. Evolução sorológica. Grupo tratado: a) 37% negativaram (nifurtimox 11, benznidazol 9); b) 27,8% diminuíram a titulação (nifurtimox 9, benznidazol 6), 9 deles apresentaram sorologia final discordante (nifurtimox 7, benznidazol 2; c) 35,2% permaneceram positivos com titulação constante (nifurtimox 7, benznidazol 12). Grupo controle: conservou os níveis iniciais de anticorpos durante o seguimento. Evolução clínica: 2/54 (3,7%) pacientes tratados e 9/57 não tratados apresentaram alterações eletrocardiográficas atribuíveis a miocardiopatia chagásica. Diferenças estatisticamente significantes (p

Published
2007
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3. Trypanocide treatment among adults with chronic Chagas disease living in Santa Fe city (Argentina), over a mean follow-up of 21 years: parasitological, serological and clinical evolution

Author

Mirtha Streiger, Mónica del Barco, Diana L. Fabbro, Norberto A. Amicone, Enrique Arias, and María Laura Bizai

Subjects
Adult, Male, Microbiology (medical), Chagas disease, medicine.medical_specialty, Tratamento, Time Factors, Adolescent, Seguimento, Physical examination, Chagasic patients, Gastroenterology, Doença de Chagas, Serology, Electrocardiography, Pharmacotherapy, Internal medicine, medicine, Humans, Chagas Disease, Serologic Tests, Seroconversion, Nifurtimox, medicine.diagnostic_test, business.industry, Follow-up, Middle Aged, medicine.disease, Trypanocidal Agents, Xenodiagnosis, Surgery, Treatment, Treatment Outcome, Infectious Diseases, Nitroimidazoles, Benznidazole, Chronic Disease, Drug Therapy, Combination, Female, Parasitology, Epidemiologic Methods, business, Pacientes chagásicos, medicine.drug
Abstract

The efficacy of treatment with nifurtimox and/or benznidazole among adults with chronic Chagas disease with no previous electrocardiographic disturbances was evaluated over a mean follow-up of 21 years, by means of conventional serology, xenodiagnosis, clinical examination, electrocardiograms and chest X-ray. One hundred and eleven patients, between 17 and 46 years old, were studied: 54 underwent treatment (nifurtimox 27, benznidazole 27) and 57 remained untreated (control group). Xenodiagnosis was performed on 65% of them: 36/38 of the treated and 9/34 of the untreated patients had previous positive xenodiagnosis. Post-treatment, 133 xenodiagnoses were performed on 41 patients, all resulting negative. In the control group, 29 xenodiagnoses were performed on 14 patients; 2 resulted positive. Sera stored during the follow-up were simultaneously analyzed through conventional serology tests (IHA; DA-2ME; IIF). The serological evolution in the treated group was: a) 37% underwent negative seroconversion (nifurtimox 11, benznidazole 9); b) 27.8% decreased titers (nifurtimox 9, benznidazole 6), 9 showed inconclusive final serology (nifurtimox 7, benznidazole 2); c) 35.2% remained positive with constant titers (nifurtimox 7; benznidazole 12). The control group conserved the initial antibody levels during the follow-up. In the clinical evolution, 2/54 (3.7%) of the treated and 9/57 (15.8%) of the untreated patients showed electrocardiographic disturbances attributable to Chagas myocardiopathy, with a statistically relevant difference (p

Published
2007

4. Evolutive behavior towards cardiomyopathy of treated (nifurtimox or benznidazole) and untreated chronic chagasic patients

Author

María Piacenza, Mónica del Barco, Enrique Arias, Mirtha Streiger, Diana Fabbro de Suasnábar, Mónica Ingaramo, and Norberto A. Amicone

Subjects
Adult, Chagas Cardiomyopathy, Male, Chagas disease, medicine.medical_specialty, Follow, Adolescent, Cardiomyopathy, Gastroenterology, Asymptomatic, Cardiomyopa, Age Distribution, Pharmacotherapy, Internal medicine, medicine, Treatm, Humans, Longitudinal Studies, Sex Distribution, Adverse effect, Nifurtimox, business.industry, General Medicine, Middle Aged, medicine.disease, Trypanocidal Agents, Infectious Diseases, Nitroimidazoles, Benznidazole, Case-Control Studies, Chronic Disease, Female, Chronic Chagas'dise, medicine.symptom, business, Xenodiagnosis, Follow-Up Studies, medicine.drug
Abstract

The aim of this work was to compare the evolution of chronic chagasic untreated patients (UTPs) with that of benznidazole or nifurtimox-treated patients (TPs). A longitudinal study from a low endemic area (Santa Fe city, Argentina) was performed during an average period of 14 years. Serological and parasitological analyses with clinical exams, ECG and X-chest ray were carried out. At the onset, 19/198 infected patients showed chagasic cardiomyopathy (CrChM) while 179 were asymptomatic. In this latter group the frequency of CrChM during the follow-up was lower in TPs compared with UTPs (3.2% vs 7%). Within the CrChM group, 2/5 TPs showed aggravated myopathy whereas this happened in 9/14 UTPs. Comparing the clinical evolution of all patients, 5.9% of TPs and 13% of UTPs had unfavourable evolution, but the difference is not statistically relevant. Serological titers were assessed by IIF. Titers equal to or lower than 1/64 were obtained in 86% of the TPs, but only in 38% of UTPs. The differences were statistically significant (geometric mean: 49.36 vs. 98.2). Antiparasitic assessment of the drugs (xenodiagnosis) proved to be effective. The low sensitivity in chronic chagasic patients must be born in mind. Despite treated patients showed a better clinical evolution and lower antibody levels than untreated ones, it is necessary to carry on doing research in order to improve therapeutic guidelines, according to the risk/benefit equation and based on scientific and ethical principles. Para comparar a evolução dos infectados chagásicos crônicos não tratados (UTPs) e tratados (TPs) com nifurtimox ou benznidazol, fez-se um estudo longitudinal numa área de baixa endemicidade (cidade de Santa Fe, Argentina), com média de seguimento de 14 anos. Em cada controle foram feitas análises sorológicas e parasitológicas, exames clínicos, eletrocardiográficos e radiológicos. No inicio, 19/198 infectados apresentaram miocardiopatia chagásica crônica (MChCr), enquanto 179 eram assintomáticos. A frequência de MChCr no seguimento destes últimos foi 3,2% para os tratados e 7% para os não tratados. Dos pacientes com MChCr no início, 2/5 dos tratados e 9/14 dos não tratados agravaram sua miocardiopatia. Comparando a evolução clínica dos infectados, 5,9% dos tratados e 13% dos não tratados tiveram evolução desfavorável, mas esta diferença não é estatisticamente significativa. Na avaliação sorológica por IFI, 86% dos TPs e só 38% dos UTPs apresentaram títulos menores ou iguais a 1/64. As diferenças são estatisticamente significativas (média geométrica: 49,36 vs 98,2). Os xenodiagnósticos seriados realizados, demonstraram efetividade das drogas (considerar a baixa sensibilidade deste método na etapa crônica). Os pacientes tratados mostraram melhor evolução clínica e mais baixos níveis de anticorpos do que os não tratados. É preciso continuar as investigações para estabelecer pautas terapêuticas mais claras sobre a relação risco-benefício, sustentadas nos princípios científicos e éticos.

Published
2000

5. Humoral immune response against P2β from Trypanosoma cruzi in persons with chronic chagas disease: Its relationship with treatment against parasites and myocardial damage

Author

Diana L, Fabbro, Verónica, Olivera, Maria Laura, Bizai, Susana, Denner, Cristina, Diez, Iván, Marcipar, Iván, Mancipar, Mirtha, Streiger, Enrique, Arias, Mónica, del Barco, Diego, Mendicino, and Oscar, Bottasso

Subjects
Chagas disease, Male, Ribosomal Proteins, CIENCIAS MÉDICAS Y DE LA SALUD, Humoral Immune Response, Trypanosoma cruzi, Protozoan Proteins, Antibodies, Protozoan, Ciencias de la Salud, Biology, Asymptomatic, Group A, Group B, Virology, medicine, Animals, Humans, Chagas Disease, Nifurtimox, Articles, biology.organism_classification, medicine.disease, Trypanocidal Agents, Immunity, Humoral, Treatment, Enfermedades Infecciosas, Chronic infection, Infectious Diseases, Nitroimidazoles, Immunology, Chronic Disease, biology.protein, Parasitology, Female, Myocardial Damage, medicine.symptom, Antibody, Cardiomyopathies, medicine.drug
Abstract

We investigated the relationship between potentially pathogenic antibodies against a Trypanosoma cruzi ribosomal protein (P2β) and the evolution of Chagas disease and the effect of trypanocidal treatment on these variables. Seventy-eight patients with chronic Chagas disease who were followed-up for more than 20 years were divided into three groups: 30 asymptomatic persons undergoing specific treatment (group A), 37 asymptomatic persons not undergoing specific treatment (group B), and 11 patients with chronic chagasic cardiomyopathy (CCC) who were not treated. Five patients in group B showed evolution to myocardial abnormalities. Among persons with CCC, six showed no changes; the remaining persons showed progression of cardiac involvement. Levels of antibodies to P2β in persons in group A decreased from their initial values. This finding was not observed in persons in groups B and C. Comparisons at the end of the follow-up showed lower amounts of antibodies to P2β in groups A and C. These findings support the benefits of specific treatment during chronic infection. Fil: Fabbro, Diana Lucrecia. Universidad Nacional del Litoral. Facultad de Bioquímica y Ciencias Biológicas. Centro de Invest.sobre Endemias Nacionales; Argentina Fil: Olivera, Veronica Soledad. Universidad Nacional del Litoral. Facultad de Bioquímica y Ciencias Biológicas. Centro de Invest.sobre Endemias Nacionales; Argentina Fil: Bizai, María Laura. Universidad Nacional del Litoral. Facultad de Bioquímica y Ciencias Biológicas. Centro de Invest.sobre Endemias Nacionales; Argentina Fil: Denner, Susana. Universidad Nacional del Litoral. Facultad de Bioquímica y Ciencias Biológicas. Centro de Invest.sobre Endemias Nacionales; Argentina Fil: Diez, Cristina Noemí. Universidad Nacional del Litoral. Facultad de Bioquímica y Ciencias Biológicas. Centro de Invest.sobre Endemias Nacionales; Argentina Fil: Marcipar, Iván Sergio. Universidad Nacional del Litoral. Facultad de Bioquímica y Ciencias Biológicas. Centro de Invest.sobre Endemias Nacionales; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe; Argentina Fil: Streiger, Mirtha. Universidad Nacional del Litoral. Facultad de Bioquímica y Ciencias Biológicas. Centro de Invest.sobre Endemias Nacionales; Argentina Fil: Arias, Enrique. Universidad Nacional del Litoral. Facultad de Bioquímica y Ciencias Biológicas. Centro de Invest.sobre Endemias Nacionales; Argentina Fil: del Barco, Mónica. Universidad Nacional del Litoral. Facultad de Bioquímica y Ciencias Biológicas. Centro de Invest.sobre Endemias Nacionales; Argentina Fil: Mendicino, Diego. Universidad Nacional del Litoral. Facultad de Bioquímica y Ciencias Biológicas. Centro de Invest.sobre Endemias Nacionales; Argentina Fil: Bottasso, Oscar Adelmo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional del Litoral. Facultad de Bioquímica y Ciencias Biológicas. Centro de Invest.sobre Endemias Nacionales; Argentina

Published
2011

6. Evaluación de ELISA F29 como marcador de eficacia del tratamiento etiológico en la enfermedad de Chagas

Author

Norberto A. Amicone, Mónica del Barco, Nora Malagrino, Susana Denner, Carlos Pravia, Diana L. Fabbro, Andrés M. Ruiz, Norberto Mendoza, Elsa Beatriz Velázquez, Enrique Arias, and Mirtha Streiger

Subjects
Chagas disease, Infectious Diseases, Parasitology, serological marker of therapeutic efficacy
Abstract

La proteína flagelar F29 es una proteína ligadora de calcio del Trypanosoma cruzi. En el presente trabajo se realizó un estudio transversal en sueros de pacientes con infección crónica por T. cruzi tratados con nifurtimox (Nx) o benznidazol (Bz) y no tratados, para evaluar el antígeno F29 como marcador de eficacia terapéutica. Se utilizó un ensayo inmuno-enzimático con la proteína recombinante F29 (ELISA F29) y se analizó su relación con la serología convencional (SC) y la evolución parasitológica y clínica en esos pacientes. Se estudiaron 118 sueros de pacientes que formaban parte de una cohorte, de los cuales se disponía de información retrospectiva, serológica, parasitológica y clínica.Los pacientes se dividieron en 3 grupos: A) 30 tratados negativizaron SC post-tratamiento; B) 34 tratados permanecieron con SC reactiva; C) 54 no tratados. Las muestras de suero se procesaron a doble ciego en forma simultánea mediante serología convencional (hemoaglutinación indirecta, aglutinación directa e inmunofluorescencia indirecta) y ELISA F29. El test ELISA F29 resultó no reactivo en: 100% del grupo A, 82,4% del grupo B y 13% del grupo C. Los infectados con alteraciones electrocar-diográficas compatibles con miocardiopatía chagásica crónica (n = 11) fueron reactivos al ELISA F29. Los pacientes en quienes los estudios parasitológicos (xenodiagnóstico y/o strout) fueron (+) presentaron elevada reactividad al ELISA F29. La correlación entre ELISA F29 y SC en los pacientes tratados con SC no reactiva (grupo A) y no tratados (grupo C), fue significativa (p < 0,05). En cambio, en pacientes tratados que mantuvieron la SC reactiva (grupo B) el test de ELISA F29 fue reactivo sólo en 17,6%. Estos resultados sugieren que el test ELISA F29, rápido y sencillo, podría ser útil para monitorear cambios post-tratamiento tripanocida.

Published
2007

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