Prevalence of Trypanosoma cruzi's Discrete Typing Units in a cohort of Latin American migrants in Spain

Angela Martinez-Perez, Cristina Poveda, Juan David Ramírez, Francesca Norman, Núria Gironés, Felipe Guhl, Begoña Monge-Maillo, Manuel Fresno, Rogelio López-Vélez

Resultado de la investigación: Contribución a RevistaArtículo

17 Citas (Scopus)

Resumen

© 2016 Elsevier B.V.Chagas disease is caused by the protozoan Trypanosoma cruzi. This is an endemic disease in the Americas, but increased migration to Europe has made it emerge in countries where it was previously unknown, being Spain the second non endemic country in number of patients. T. cruzi is a parasite with a wide genetic diversity, which has been grouped by consensus into 6 Discrete Typing Units (DTUs) affecting humans. Some authors have linked these DTUs either to a specific epidemiological context or to the different clinical presentations. Our main objective was to describe the T. cruzi DTUs identified from a population of chronically infected Latin American migrants attending a reference clinic in Madrid. 149 patients meeting this condition were selected for the study. Molecular characterization was performed by an algorithm that combines PCR of the intergenic region of the mini exon-gene, the 24Sα and 18S regions of rDNA and the variable region of the satellite DNA. A descriptive analysis was performed and associations between geographical/clinical data and the different DTUs were tested. DTUs could be determined in 105 out of 149 patients, 93.3% were from Bolivia, 67.7% were women and median age was 35 years (IQR 29-44). The most common DTU found was TcV (58; 55.2%), followed by TcIV (17; 16.2%), TcII (10; 9.5%) and TcI (4; 3.8%). TcIII and TcVI were not identified from any patient, and 15.2% patients presented mixed infections. In addition, we determined DTUs after treatment in a subset of patients. In 57% patients had different DTUs before and after treatment. DTUs distribution from this study indicates active transmission of T. cruzi is occurring in Bolivia, in both domestic and sylvatic cycles. TcIV was confirmed as a cause of chronic human disease. The current results indicate no correlation between DTU and any specific clinical presentation associated with Chagas disease, nor with geographical origin. Treatment with benznidazole does not always clear T. cruzi's genetic material from blood, and DTUs detected in the same patient may vary over time indicating that polyparasitism is frequent.
Idioma originalEnglish (US)
Páginas (desde-hasta)145-150
Número de páginas6
PublicaciónActa Tropica
DOI
EstadoPublished - may 1 2016

Huella dactilar

Trypanosoma cruzi
Spain
Bolivia
Chagas Disease
Blood Grouping and Crossmatching
Satellite DNA
Endemic Diseases
Intergenic DNA
Ribosomal DNA
Coinfection
Genes
Exons
Parasites
Chronic Disease
Therapeutics
Polymerase Chain Reaction
Population

Citar esto

Martinez-Perez, Angela ; Poveda, Cristina ; Ramírez, Juan David ; Norman, Francesca ; Gironés, Núria ; Guhl, Felipe ; Monge-Maillo, Begoña ; Fresno, Manuel ; López-Vélez, Rogelio. / Prevalence of Trypanosoma cruzi's Discrete Typing Units in a cohort of Latin American migrants in Spain. En: Acta Tropica. 2016 ; pp. 145-150.
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title = "Prevalence of Trypanosoma cruzi's Discrete Typing Units in a cohort of Latin American migrants in Spain",
abstract = "{\circledC} 2016 Elsevier B.V.Chagas disease is caused by the protozoan Trypanosoma cruzi. This is an endemic disease in the Americas, but increased migration to Europe has made it emerge in countries where it was previously unknown, being Spain the second non endemic country in number of patients. T. cruzi is a parasite with a wide genetic diversity, which has been grouped by consensus into 6 Discrete Typing Units (DTUs) affecting humans. Some authors have linked these DTUs either to a specific epidemiological context or to the different clinical presentations. Our main objective was to describe the T. cruzi DTUs identified from a population of chronically infected Latin American migrants attending a reference clinic in Madrid. 149 patients meeting this condition were selected for the study. Molecular characterization was performed by an algorithm that combines PCR of the intergenic region of the mini exon-gene, the 24Sα and 18S regions of rDNA and the variable region of the satellite DNA. A descriptive analysis was performed and associations between geographical/clinical data and the different DTUs were tested. DTUs could be determined in 105 out of 149 patients, 93.3{\%} were from Bolivia, 67.7{\%} were women and median age was 35 years (IQR 29-44). The most common DTU found was TcV (58; 55.2{\%}), followed by TcIV (17; 16.2{\%}), TcII (10; 9.5{\%}) and TcI (4; 3.8{\%}). TcIII and TcVI were not identified from any patient, and 15.2{\%} patients presented mixed infections. In addition, we determined DTUs after treatment in a subset of patients. In 57{\%} patients had different DTUs before and after treatment. DTUs distribution from this study indicates active transmission of T. cruzi is occurring in Bolivia, in both domestic and sylvatic cycles. TcIV was confirmed as a cause of chronic human disease. The current results indicate no correlation between DTU and any specific clinical presentation associated with Chagas disease, nor with geographical origin. Treatment with benznidazole does not always clear T. cruzi's genetic material from blood, and DTUs detected in the same patient may vary over time indicating that polyparasitism is frequent.",
author = "Angela Martinez-Perez and Cristina Poveda and Ram{\'i}rez, {Juan David} and Francesca Norman and N{\'u}ria Giron{\'e}s and Felipe Guhl and Bego{\~n}a Monge-Maillo and Manuel Fresno and Rogelio L{\'o}pez-V{\'e}lez",
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Martinez-Perez, A, Poveda, C, Ramírez, JD, Norman, F, Gironés, N, Guhl, F, Monge-Maillo, B, Fresno, M & López-Vélez, R 2016, 'Prevalence of Trypanosoma cruzi's Discrete Typing Units in a cohort of Latin American migrants in Spain', Acta Tropica, pp. 145-150. https://doi.org/10.1016/j.actatropica.2016.01.032

Prevalence of Trypanosoma cruzi's Discrete Typing Units in a cohort of Latin American migrants in Spain. / Martinez-Perez, Angela; Poveda, Cristina; Ramírez, Juan David; Norman, Francesca; Gironés, Núria; Guhl, Felipe; Monge-Maillo, Begoña; Fresno, Manuel; López-Vélez, Rogelio.

En: Acta Tropica, 01.05.2016, p. 145-150.

Resultado de la investigación: Contribución a RevistaArtículo

TY - JOUR

T1 - Prevalence of Trypanosoma cruzi's Discrete Typing Units in a cohort of Latin American migrants in Spain

AU - Martinez-Perez, Angela

AU - Poveda, Cristina

AU - Ramírez, Juan David

AU - Norman, Francesca

AU - Gironés, Núria

AU - Guhl, Felipe

AU - Monge-Maillo, Begoña

AU - Fresno, Manuel

AU - López-Vélez, Rogelio

PY - 2016/5/1

Y1 - 2016/5/1

N2 - © 2016 Elsevier B.V.Chagas disease is caused by the protozoan Trypanosoma cruzi. This is an endemic disease in the Americas, but increased migration to Europe has made it emerge in countries where it was previously unknown, being Spain the second non endemic country in number of patients. T. cruzi is a parasite with a wide genetic diversity, which has been grouped by consensus into 6 Discrete Typing Units (DTUs) affecting humans. Some authors have linked these DTUs either to a specific epidemiological context or to the different clinical presentations. Our main objective was to describe the T. cruzi DTUs identified from a population of chronically infected Latin American migrants attending a reference clinic in Madrid. 149 patients meeting this condition were selected for the study. Molecular characterization was performed by an algorithm that combines PCR of the intergenic region of the mini exon-gene, the 24Sα and 18S regions of rDNA and the variable region of the satellite DNA. A descriptive analysis was performed and associations between geographical/clinical data and the different DTUs were tested. DTUs could be determined in 105 out of 149 patients, 93.3% were from Bolivia, 67.7% were women and median age was 35 years (IQR 29-44). The most common DTU found was TcV (58; 55.2%), followed by TcIV (17; 16.2%), TcII (10; 9.5%) and TcI (4; 3.8%). TcIII and TcVI were not identified from any patient, and 15.2% patients presented mixed infections. In addition, we determined DTUs after treatment in a subset of patients. In 57% patients had different DTUs before and after treatment. DTUs distribution from this study indicates active transmission of T. cruzi is occurring in Bolivia, in both domestic and sylvatic cycles. TcIV was confirmed as a cause of chronic human disease. The current results indicate no correlation between DTU and any specific clinical presentation associated with Chagas disease, nor with geographical origin. Treatment with benznidazole does not always clear T. cruzi's genetic material from blood, and DTUs detected in the same patient may vary over time indicating that polyparasitism is frequent.

AB - © 2016 Elsevier B.V.Chagas disease is caused by the protozoan Trypanosoma cruzi. This is an endemic disease in the Americas, but increased migration to Europe has made it emerge in countries where it was previously unknown, being Spain the second non endemic country in number of patients. T. cruzi is a parasite with a wide genetic diversity, which has been grouped by consensus into 6 Discrete Typing Units (DTUs) affecting humans. Some authors have linked these DTUs either to a specific epidemiological context or to the different clinical presentations. Our main objective was to describe the T. cruzi DTUs identified from a population of chronically infected Latin American migrants attending a reference clinic in Madrid. 149 patients meeting this condition were selected for the study. Molecular characterization was performed by an algorithm that combines PCR of the intergenic region of the mini exon-gene, the 24Sα and 18S regions of rDNA and the variable region of the satellite DNA. A descriptive analysis was performed and associations between geographical/clinical data and the different DTUs were tested. DTUs could be determined in 105 out of 149 patients, 93.3% were from Bolivia, 67.7% were women and median age was 35 years (IQR 29-44). The most common DTU found was TcV (58; 55.2%), followed by TcIV (17; 16.2%), TcII (10; 9.5%) and TcI (4; 3.8%). TcIII and TcVI were not identified from any patient, and 15.2% patients presented mixed infections. In addition, we determined DTUs after treatment in a subset of patients. In 57% patients had different DTUs before and after treatment. DTUs distribution from this study indicates active transmission of T. cruzi is occurring in Bolivia, in both domestic and sylvatic cycles. TcIV was confirmed as a cause of chronic human disease. The current results indicate no correlation between DTU and any specific clinical presentation associated with Chagas disease, nor with geographical origin. Treatment with benznidazole does not always clear T. cruzi's genetic material from blood, and DTUs detected in the same patient may vary over time indicating that polyparasitism is frequent.

U2 - 10.1016/j.actatropica.2016.01.032

DO - 10.1016/j.actatropica.2016.01.032

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JO - Acta Tropica

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