Browsing by Autor "Shah, Vishal"

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Field Evaluation of the InBios Chagas Detect Plus Rapid Test in Serum and Whole-Blood Specimens in Bolivia
(2022) Ferruﬁno, Lisbeth; Shah, Vishal; Gilman, Robert H.; Ramirez, Margot; Saenza, Eliana; Malaga, Edith; Sanchez, Gerardo
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4248774/
Field evaluation of the InBios Chagas detect plus rapid test in serum and whole-blood specimens in Bolivia.
(2014) Shah, Vishal; Ferrufino, Lisbeth; Gilman, Robert H; Ramirez, Margot; Saenza, Eliana; Malaga, Edith; Sanchez, Gerardo; Okamoto, Emi E; Sherbuck, Jacqueline E; Clark, Eva H; Galdos-Cardenas, Gerson; Bozo, Ricardo; Flores-Franco, Jorge Luis; Colanzi, Rony; Verastegui, Manuela; Bern, Caryn
Trypanosoma cruzi causes Chagas disease, which affects an estimated 7 million to 8 million people. Chagas disease is endemic throughout Latin America, with the highest prevalence in Bolivia. Conventional diagnosis requires a well-equipped laboratory with experienced personnel. We evaluated the Chagas Detect Plus (CDP) (InBios, Seattle, WA), a rapid immunochromatographic assay for IgG antibodies to T. cruzi. CDP performance was compared to infection status based on results obtained by indirect hemagglutination assay, immunofluorescent-antibody test, and enzyme-linked immunosorbent assay. Confirmed infection required positive results by at least 2 conventional assays. We used specimens from adults of both sexes in a general hospital in the city of Santa Cruz and from pregnant women in a hospital and children in villages in the Bolivian Chaco, an area of hyperendemicity. CDP was performed in paired whole-blood and serum specimens from 385 individuals in the two hospital studies and in 200 serum specimens from the community study. CDP showed sensitivities/specificities of 96.2% (95% confidence interval, 92.7 to 98.4)/98.8% (95.9 to 99.9) in whole blood and 99.3% (97.5 to 99.9)/96.9% (94.2 to 98.6) in serum, with no differences by sex, age group, or study site. CDP showed excellent sensitivity and specificity in our study population, comparable to those of conventional serology. The test is reliable for field surveys, requires no laboratory equipment, and performed well in serum and whole blood. The CDP could also be used for accurate maternal screening to identify neonates at risk of congenital transmission. CDP performance data in diverse geographic areas are needed to strengthen the evidence base for its use.
Sustained Domestic Vector Exposure Is Associated With Increased Chagas Cardiomyopathy Risk but Decreased Parasitemia and Congenital Transmission Risk Among Young Women in Bolivia
(Oxford University Press on behalf of the Infectious Diseases Society of America, 2022) Kaplinski, Michelle; Jois, Malasa; Galdos-Cardenas, Gerson; Rendell, Victoria R.; Shah, Vishal; Do, Rose Q.
Sustained Domestic Vector Exposure Is Associated With Increased Chagas Cardiomyopathy Risk but Decreased Parasitemia and Congenital Transmission Risk Among Young Women in Bolivia
(Oxford University Press on behalf of the Infectious Diseases Society of America, 2018) Kaplinski, Michelle; Jois, Malasa; Galdos-Cardenas, Gerson; Rendell, Victoria R.; Shah, Vishal; Do, Rose Q.; Marcus, Rachel; Burroughs Pena, Melissa S.; Abastoﬂor, Maria del Carmen; LaFuente, Carlos; Bozo, Ricardo; Valencia, Edward; Verastegui, Manuela; Colanzi, Rony; Gilman, Robert H.; Bern, Caryn
Sustained Domestic Vector Exposure Is Associated With Increased Chagas Cardiomyopathy Risk but Decreased Parasitemia and Congenital Transmission Risk Among Young Women in Bolivia.
(2015) Kaplinski, Michelle; Jois, Malasa; Galdos-Cardenas, Gerson; Rendell, Victoria R; Shah, Vishal; Do, Rose Q; Marcus, Rachel; Pena, Melissa S Burroughs; Abastoflor, Maria del Carmen; LaFuente, Carlos; Bozo, Ricardo; Valencia, Edward; Verastegui, Manuela; Colanzi, Rony; Gilman, Robert H; Bern, Caryn
BACKGROUND: We studied women and their infants to evaluate risk factors for congenital transmission and cardiomyopathy in Trypanosoma cruzi-infected women. METHODS: Women provided data and blood for serology and quantitative polymerase chain reaction (PCR). Infants of infected women had blood tested at 0 and 1 month by microscopy, PCR and immunoblot, and serology at 6 and 9 months. Women underwent electrocardiography (ECG). RESULTS: Of 1696 women, 456 (26.9%) were infected; 31 (6.8%) transmitted T. cruzi to their infants. Women who transmitted had higher parasite loads than those who did not (median, 62.0 [interquartile range {IQR}, 25.8-204.8] vs 0.05 [IQR, 0-29.6]; P < .0001). Transmission was higher in twin than in singleton births (27.3% vs 6.4%; P = .04). Women who had not lived in infested houses transmitted more frequently (9.7% vs 4.6%; P = .04), were more likely to have positive results by PCR (65.5% vs 33.9%; P < .001), and had higher parasite loads than those who had lived in infested houses (median, 25.8 [IQR, 0-64.1] vs 0 [IQR, 0-12.3]; P < .001). Of 302 infected women, 28 (9.3%) had ECG abnormalities consistent with Chagas cardiomyopathy; risk was higher for older women (odds ratio [OR], 1.06 [95% confidence interval {CI}, 1.01-1.12] per year) and those with vector exposure (OR, 3.7 [95% CI, 1.4-10.2]). We observed a strong dose-response relationship between ECG abnormalities and reported years of living in an infested house. CONCLUSIONS: We hypothesize that repeated vector-borne infection sustains antigen exposure and the consequent inflammatory response at a higher chronic level, increasing cardiac morbidity, but possibly enabling exposed women to control parasitemia in the face of pregnancy-induced Th2 polarization.