Chagas Disease pp 141-158 | Cite as

Diagnosis of Chagas Disease

  • Alejandro O. Luquetti
  • Alejandro G. SchijmanEmail author
Part of the Birkhäuser Advances in Infectious Diseases book series (BAID)


Diagnosis of Chagas disease is related to the phase of this protozoan infection. For acute phase, parasitological methods are preferred and for the chronic phase, serological ones. Parasitological methods comprise from the simplest wet smear, going through alternatives as concentration methods and tests that involve the multiplication of the parasite in media (hemoculture), triatomine insects (xenodiagnosis), or animals (inoculation of susceptible mammals), to more sophisticated molecular tests as polymerase chain reaction (PCR) and loop-mediated isothermal amplification (LAMP). All have indications, advantages, and disadvantages, as well as costs, all of which will be detailed in this chapter. Among serological tests, a vast repertoire has been also developed and standardized, from the simplest indirect hemagglutination to the sophisticated CMIA, including indirect immunofluorescence, ELISA, and rapid tests. As all are indirect tests, it is recommended to use at least two of them for a concluding laboratory result, in order to confirm or exclude the infection by Trypanosoma cruzi. Diagnosis may be used in different contexts as confirmation of the infection, exclusion of blood donors, epidemiological survey, congenital infection, or follow-up after specific treatment. In order to have a precise diagnosis, it is necessary to have commercial kits of proved performance and good laboratory practices, for which permanent training of laboratory personnel is mandatory. An external quality control will prove that these conditions have been fulfilled.


Chagas disease Trypanosoma cruzi Diagnosis Polymerase chain reaction Loop-mediated isothermal amplification Parasitological tests ELISA Congenital infection Trypanocidal treatment Reactivation 


  1. 1.
    Luquetti AO, Schmuñis GA. Diagnosis of Trypanosoma cruzi infection. Chapter 29. In: Telleria J, Tibayrenc M, editors. American Trypanosomiasis. Chagas Disease. One hundred years of research. 2nd ed. Amsterdam: Elsevier; 2017.Google Scholar
  2. 2.
    Luquetti AO, Rassi A. Diagnóstico Laboratorial da Infecção pelo Trypanosoma cruzi. In: Brener Z, Andrade AZ, Barral-Neto M, editors. Trypanosoma cruzi e Doença de Chagas. 2nd ed. Rio de Janeiro: Guanabara Koogan; 2000. p. 344–78.Google Scholar
  3. 3.
    Carlier Y, Torrico F, Sosa-Estani S, Russomando G, Luquetti AO, Freilij H, Vinas PA. Congenital Chagas disease: recommendations for diagnosis, treatment and control of newborns, siblings and pregnant women. PLoS Negl Trop Dis. 2011;5:e1250.PubMedPubMedCentralCrossRefGoogle Scholar
  4. 4.
    Luquetti AO, Ferreira MS. Diagnóstico da doença de Chagas na coinfecção T. cruzi/HIV. In: Almeida EA, editor. Epidemiologia e clínica da coinfecção Trypanosoma cruzi/HIV. Campinas: Editora Universidade Estadual de Campinas; 2015.Google Scholar
  5. 5.
    Schmunis GA, Yadon ZE. Chagas disease: a Latin American health problem becoming a world health problem. Acta Trop. 2010;115:14–21.Google Scholar
  6. 6.
    Zingales B, Miles MA, Campbell DA, Tibayrenc M, Macedo AM, Teixeira MM, Schijman AG, Llewellyn MS, Lages-Silva E, Machado CR, Andrade SG, Sturm NR. The revised Trypanosoma cruzi subspecific nomenclature: rationale, epidemiological relevance and research applications. Infect Genet Evol. 2012;12(2):240–53. Review.CrossRefGoogle Scholar
  7. 7.
    Yun O, Lima MA, Ellman T, Chambi W, Castilho S, Flevaud L, Roddy P, Parreño F, Viñas PA, Palma PP. Feasibility, drug safety, and effectiveness of etiological treatment programs for Chagas disease in Honduras, Guatemala, and Bolívia: 10-year experience of Mèdecins Sans Frontières. PLoS Negl Trop Dis. 2009;3(e):488. Scholar
  8. 8.
    Rassi A, Rezende JM, Luquetti AO, Rassi A Jr. Clinical phases and forms of chagas disease. Chapter 28. In: Telleria J, Tibayrenc M, editors. American Trypanosomiasis. Chagas Disease. One hundred years of research. 2nd ed. Amsterdam: Elsevier; 2017.Google Scholar
  9. 9.
    Luquetti AO, Tavares SB, Siriano L da R, de Oliveira RA, Campos DE, de Morais CA, de Oliveira EC. Congenital transmission of Trypanosoma cruzi in central Brazil. A study of 1,211 individuals born to infected mothers. Mem Inst Oswaldo Cruz. 2015;110:369–76.PubMedPubMedCentralCrossRefGoogle Scholar
  10. 10.
    Strout RG. A method for concentrating hemoflagellates. J. Parasit. 1962;48:100.PubMedCrossRefGoogle Scholar
  11. 11.
    Freilij H, Altcheh J. Chagas congénito. In: Storino R, Milei J, editors. Enfermedad de Chagas. Buenos Aires: Edit. Doyma; 1994.Google Scholar
  12. 12.
    Castro AM, Luquetti AO, Rassi A, Chiari E, Galvão LMC. Detection of parasitemia profiles by blood culture after treatment of human chronic Trypanosoma cruzi infection. Parasitology Research. 2006;99:379–83.PubMedCrossRefGoogle Scholar
  13. 13.
    Santos AH, Silva IG, Rassi A. Estudo comparativo entre o xenodiagnóstico natural e o artificial em chagásicos crônicos. Rev Soc Bras Med Trop. 1995;28:367–73.PubMedCrossRefGoogle Scholar
  14. 14.
    Oliveira EC, Stefani MMA, Luquetti AO, Vencio EF, Moreira MAR, Souza C, Rezende JM. Trypanosoma cruzi and experimental Chagas disease: characterization of a stock isolated from a patient with associated digestive and cardiac form. Rev Soc Bras Med Trop. 1993;26:25–33.PubMedCrossRefGoogle Scholar
  15. 15.
    Avila HA, Pereira JB, Thiemann O, et al. Detection of Trypanosoma cruzi in blood specimens of chronic chagasic patients by polymerase chain reaction amplification of kinetoplast minicircle DNA: comparison with serology and xenodiagnosis. J Clin Microbiol. 1993;31:2421–6.PubMedPubMedCentralGoogle Scholar
  16. 16.
    Britto C, Cardoso MA, Vanni CM, et al. Polymerase chain reaction detection of Trypanosoma cruzi in human blood samples as a tool for diagnosis and treatment evaluation. Parasitology. 1995;110(Pt 3):241–7.PubMedCrossRefGoogle Scholar
  17. 17.
    Moser DR, Kirchhoff LV, Donelson JE. Detection of Trypanosoma cruzi by DNA amplification using the polymerase chain reaction. J Clin Microbiol. 1989;27(7):1477–82.PubMedPubMedCentralGoogle Scholar
  18. 18.
    Piron M, Fisa R, Casamitjana N, et al. Development of a real-time PCR assay for Trypanosoma cruzi detection in blood samples. Acta Tropica. 2007;103:195–200.PubMedCrossRefGoogle Scholar
  19. 19.
    Duffy T, Cura CI, Ramirez JC, et al. Analytical performance of a multiplex real-time PCR assay using TaqMan probes for quantification of Trypanosoma cruzi satellite DNA in blood samples. PLoS Negl Trop Dis. 2013;7(1):e2000.PubMedPubMedCentralCrossRefGoogle Scholar
  20. 20.
    Ramírez JC, Cura CI, da Cruz Moreira O, et al. Analytical validation of quantitative real-time PCR methods for quantification of Trypanosoma cruzi DNA in blood samples from Chagas disease patients. J Mol Diagn. 2015;17(5):605–15.PubMedPubMedCentralCrossRefGoogle Scholar
  21. 21.
    Schijman AG, Bisio M, Orellana L, et al. International study to evaluate PCR methods for detection of Trypanosoma cruzi DNA in blood samples from Chagas disease patients. PLoS Negl Trop Dis. 2011;5(1):e93.CrossRefGoogle Scholar
  22. 22.
    Ramírez JC, Torres C, Curto MLA, Schijman AG. New insights into Trypanosoma cruzi evolution, genotyping and molecular diagnostics from satellite DNA sequence analysis. PLoS Negl Trop Dis. 2017;11(12):e0006139.PubMedPubMedCentralCrossRefGoogle Scholar
  23. 23.
    Guhl F, Vallejo GA. Trypanosoma (Herpetosoma) rangeli Tejera, 1920: an updated review. Mem Inst Oswaldo Cruz. 2003;98:435–42.PubMedCrossRefGoogle Scholar
  24. 24.
    Saldana A, Samudio F, Miranda A, et al. Predominance of Trypanosoma rangeli infection in children from a Chagas disease endemic area in the west-shore of the Panama canal. Mem Inst Oswaldo Cruz. 2005;100:729–31.PubMedCrossRefGoogle Scholar
  25. 25.
    Ramírez JC, Parrado R, Sulleiro E, de la Barra A, Rodriguez M, Villarroel S, Irazu L, Alonso-Vega C, Alves F, Curto M, Garcia L, Ortiz L, Torrico F, Gascon J, Flevaud L, Molina I, Ribeiro I, Schijman AG. First External quality assurance program for real-time PCR monitoring of treatment response in clinical trials of Chagas disease. PLoS One. 2017;12(11):e0188550. Scholar
  26. 26.
    Mori Y, Nagamine K, Tomita N, et al. Detection of loop-mediated isothermal amplification reaction by turbidity derived from magnesium pyrophosphate formation. Biochem Biophys Res Commun. 2001;289:150–4.PubMedCrossRefGoogle Scholar
  27. 27.
    Notomi T, Okayama H, Masubuchi H, et al. Loop-mediated isothermal amplification of DNA. Nucleic Acids Res 28: p. 2000;E63:266.Google Scholar
  28. 28.
    Thekisoe OM, Rodriguez CV, Rivas F, Coronel-Servian AM, Fukumoto S, Sugimoto C, et al. Detection of Trypanosoma cruzi and T. rangeli infections from Rhodnius pallescens bugs by loop-mediated isothermal amplification (LAMP). Am J Trop Med Hyg. 2010;82:855–60. Scholar
  29. 29.
    Rivero R, Bisio M, Velázquez EB, Esteva MI, Scollo K, González NL, Altcheh J, Ruiz AM. Rapid detection of Trypanosoma cruzi by colorimetric loop-mediated isothermal amplification (LAMP): a potential novel tool for the detection of congenital Chagas infection. Diagn Microbiol Infect Dis. 2017;89:26. pii: S0732-8893(17)30189-X.PubMedPubMedCentralCrossRefGoogle Scholar
  30. 30.
    Besuschio SA, Llano Murcia M, Benatar AF, Monnerat S, Cruz I, Picado A, Curto MLÁ, Kubota Y, Wehrendt DP, Pavia P, Mori Y, Puerta C, Ndung’u JM, Schijman AG. Analytical sensitivity and specificity of a loop-mediated isothermal amplification (LAMP) kit prototype for detection of Trypanosoma cruzi DNA in human blood samples. PLoS Negl Trop Dis. 2017;11:e0005779.PubMedPubMedCentralCrossRefGoogle Scholar
  31. 31.
    WHO. WHO technical report series no. 905. Control of Chagas Disease. Second report of the WHO Expert Committee. Geneva: World Health Organization; 2002.Google Scholar
  32. 32.
    Abras A, Gállego M, Llovet T, Tebar S, Herrero M, et al. Serological diagnosis of chronic Chagas disease: is it time for a change? J Clin Microbiol. 2016;54:1566–72.PubMedPubMedCentralCrossRefGoogle Scholar
  33. 33.
    Luquetti AO, Ponce C, Ponce E, Esfandiari J, Schijman A, Revollo S, Añez N, Zingales B, Aldao RR, Gonzalez A, Levin M, Umezawa E, Franco da Silveira J. Chagas disease diagnosis: a multicentric evaluation of Chagas Stat-Pak, a rapid immunochromatographic assay with recombinant proteins of Trypanosoma cruzi. Journal of Diagnostic Microbiology and Infectious disease. 2003;46:265–71.PubMedCrossRefGoogle Scholar
  34. 34.
    Sanchez-Camargo CL, Albajar-Vinas P, Wilkins PP, Nieto J, Leiby DA, Paris L, et al. Comparative evaluation of 11 commercialized rapid diagnostic tests for detecting Trypanosoma cruzi antibodies in serum banks in areas of endemicity and nonendemicity. J Clin Microbiol. 2014;52(7):2506–12.PubMedPubMedCentralCrossRefGoogle Scholar
  35. 35.
    Castro-Sesquen YE, Gilman RH, Galdos-Cardenas G, et al. Use of a novel Chagas urine nanoparticle test (chunap) for diagnosis of congenital Chagas disease. PLoS Negl Trop Dis. 2014;8(10):e3211.PubMedPubMedCentralCrossRefGoogle Scholar
  36. 36.
    Cura CI, Lattes R, Nagel C, et al. Early molecular diagnosis of acute Chagas disease after transplantation with organs from Trypanosoma cruzi-infected donors. Am J Transplant. 2013;13:3253–61.CrossRefGoogle Scholar
  37. 37.
    Affranchino JL, Ibanez CF, Luquetti AO, Rassi A, Reyes MB, Macina RA, Aslund L, Pettersson U, ACC F. Identification of a Trypanosoma cruzi antigen that is shed during the acute phase of Chagas’ disease. Mol. Bioch. Parasitol. 1989;34:221–8.CrossRefGoogle Scholar
  38. 38.
    Alarcon de Noya B, Diaz-Bello Z, Colmenares C, Ruiz-Guevara R, Mauriello L, Zavala-Jaspe R, et al. Large urban outbreak of orally acquired acute Chagas disease at a school in Caracas, Venezuela. J Infect Dis. 2010;201:1308 1315.CrossRefGoogle Scholar
  39. 39.
    Shikanai-Yasuda MA, Carvalho NB. Oral transmission of Chagas disease. Clin Infect Dis. 2012;54:845–52. Scholar
  40. 40.
    Silva-Dos-Santos D, Barreto-de-Albuquerque J, Guerra B, Moreira OC, Berbert LR, Ramos MT, Mascarenhas BAS, Britto C, Morrot A, Serra Villa-Verde DM, Garzoni LR, Savino W, Cotta-de-Almeida V, Meis J. Unraveling Chagas disease transmission through the oral route: gateways to T. cruzi infection and target tissues. PLoS Negl Trop Dis. 2017;11(4):e0005507. Scholar
  41. 41.
    Noya BA, Díaz-Bello Z, Colmenares C, Ruiz-Guevara R, Mauriello L, Muñoz-Calderón A, Noya O. Update on oral Chagas disease outbreaks in Venezuela: epidemiological, clinical and diagnostic approaches. Mem Inst Oswaldo Cruz. 2015;110:3786. Review.CrossRefGoogle Scholar
  42. 42.
    Ramírez JD, Montilla M, Cucunubá ZM, Floréz AC, Zambrano P, Guhl F. Molecular epidemiology of human oral Chagas disease outbreaks in Colombia. PLoS Negl Trop Dis. 2013;7:e2041. Scholar
  43. 43.
    Blanchet D, Breniere SF, Schijman AG, et al. First report of a family outbreak of Chagas disease in French Guiana and posttreatment follow-up. Infect Genet Evol. 2014;28:245–50.PubMedCrossRefGoogle Scholar
  44. 44.
    Diez M, Favaloro L, Bertolotti A, Burgos JM, Vigliano C, Lastra MP, Levin MJ, Arnedo A, Nagel C, Schijman AG, Favaloro RR. Usefulness of PCR strategies for early diagnosis of Chagas’ disease reactivation and treatment follow-up in heart transplantation. Am J Transplant. 2007;7:1633–40.PubMedPubMedCentralCrossRefGoogle Scholar
  45. 45.
    Cura CI, Ramírez JC, Rodríguez M, Lopez-Albízu C, Irazu L, Scollo K, Sosa-Estani S. Comparative study and analytical verification of PCR methods for the diagnosis of congenital Chagas Disease. J Mol Diagn. 2017;19:673. pii: S1525-1578(17)30108-3.PubMedCrossRefGoogle Scholar
  46. 46.
    Bua J, Volta BJ, Perrone AE, et al. How to improve the early diagnosis of Trypanosoma cruzi infection: relationship between validated conventional diagnosis and quantitative DNA amplification in congenitally infected children. PLoS Negl Trop Dis. 2013;7(10):e2476.PubMedPubMedCentralCrossRefGoogle Scholar
  47. 47.
    Schijman AG, Altcheh J, Burgos JM, et al. Aetiological treatment of congenital Chagas’ disease diagnosed and monitored by the polymerase chain reaction. J Antimicrob Chemother. 2003;52(3):441–9.PubMedPubMedCentralCrossRefGoogle Scholar
  48. 48.
    Mora MC, Sanchez-Negrette O, Marco D, et al. Early diagnosis of congenital Trypanosoma cruzi infection using PCR, hemoculture, and capillary concentration, as compared with delayed serology. J Parasitol. 2005;91:1468–73.PubMedCrossRefGoogle Scholar
  49. 49.
    Messenger LA, Gilman RH, Verastegui M, Galdos-Cardenas G, Sanchez G, Valencia E, Sanchez L, Malaga E, Rendell VR, Jois M, Shah V, Santos N, Del Carmen Abastoflor M, LaFuente C, Colanzi R, Bozo R, Bern C, Working Group on Chagas disease in Bolivia and Peru. Towards improving early diagnosis of congenital Chagas disease in an endemic setting. Clin Infect Dis. 2017;65:268. Scholar
  50. 50.
    Benatar AF, Besuschio SA, Bortolotti S, Ramirez JC, Cafferata ML, Danesi E, Lopez Albizu C, Ciganda A, Lara L, Agolti G, Seu S, Uequìn V, Curet L, Adamo EL, Black F, Lucero H, Esteva M, Bua J, Longhi C, MdeA S, Poeylaut-Palena A, Scollo K, Althabe F, Capriotti G, Rojkin F, Sosa Estani S, Schijman AG. Validation of a real time PCR kit prototype for early diagnosis of congenital Chagas disease in a multicenter field study. Medicina. 2017;77(Suppl I):400.Google Scholar
  51. 51.
    Basombrío MA, Nasser J, Segura MA, Marco D, Sánchez Negrette O, Padilla M, Mora MC. The transmission of Chagas disease in Salta and the detection of congenital cases. Medicina (B Aires). 1999;59(Suppl 2):143–6. Spanish.Google Scholar
  52. 52.
    Bern C. Chagas disease in the immunosuppressed host. Curr Opin Infect Dis. 2012;25:450–7.PubMedCrossRefGoogle Scholar
  53. 53.
    Burgos JM, Diez M, Vigliano C, et al. Molecular identification of Trypanosoma cruzi discrete typing units in end-stage chronic Chagas heart disease and reactivation after heart transplantation. Clin Infect Dis. 2010;51:485–95.PubMedPubMedCentralCrossRefGoogle Scholar
  54. 54.
    da Costa PA, Segatto M, Durso DF, de Carvalho Moreira WJ, Junqueira LL, de Castilho FM, de Andrade SA, Gelape CL, Chiari E, Teixeira-Carvalho A, Junho Pena SD, Machado CR, Franco GR, Filho GB, Vieira Moreira MDC, Mara Macedo A. Early polymerase chain reaction detection of Chagas disease reactivation in heart transplant patients. J Heart Lung Transplant. 2017;36:797–805.PubMedCrossRefGoogle Scholar
  55. 55.
    Burgos JM, Begher SB, Freitas JM, Bisio M, Duffy T, Altcheh J, Teijeiro R, Lopez Alcoba H, Deccarlini F, Freilij H, Levin MJ, Levalle J, Macedo AM, Schijman AG. Molecular diagnosis and typing of Trypanosoma cruzi populations and lineages in cerebral Chagas disease in a patient with AIDS. Am J Trop Med Hyg. 2005;73:1016–8.PubMedCrossRefGoogle Scholar
  56. 56.
    Perez-Molina JA, Rodriguez-Guardado A, Soriano A, et al. Guidelines on the treatment of chronic coinfection by Trypanosoma cruzi and HIV outside endemic areas. HIV Clin Trials. 2011;12:287–98.PubMedCrossRefGoogle Scholar
  57. 57.
    Almeida EA, Ramos-Junior AN, Correia D, et al. Co-infection Trypanosoma cruzi/HIV: systematic review (1980-2010). Rev Soc Bras Med Trop. 2011;44:762–70.CrossRefGoogle Scholar
  58. 58.
    Torrico F, Gascon J, Lourdes O, Cristina A-V, María-Jesús P, Alejandro S, Almeida Igor C, Fabiana A, Nathalie S-W, Isabela R, on behalf of the E1224 Study Group. Treatment of adult chronic indeterminate Chagas disease with benznidazole and three E1224 dosing regimens: a proof-of-concept, randomised, placebo-controlled trial. The Lancet Infectious Diseases. 2018;18:419.PubMedCrossRefGoogle Scholar
  59. 59.
    Luquetti AO, Passos ADC, Silveira AC, Ferreira AW, Macedo V, Prata AR. O inquérito nacional de soroprevalência de avaliação do controle da doença de Chagas no Brasil (2001-2008). Rev. Soc Brasileira Medicina Tropical. 2011;44(Suppl 2):108–21.CrossRefGoogle Scholar
  60. 60.
    Rassi A, Luquetti AO. Capítulo 53: Critérios de Cura da Infecção pelo Trypanosoma cruzi na Espécie Humana. In: Coura JR, editor. Dinâmica das doenças infecciosas e parasitárias, vol. 1. 2nd ed. Rio de Janeiro: Guanabra Koogan; 2013. p. 729–35.Google Scholar
  61. 61.
    Pinazo MJ, Thomas MC, Bua J, et al. Biological markers for evaluating therapeutic efficacy in Chagas disease, a systematic review. Expert Rev Anti Infect Ther. 2014;12:479–96.PubMedCrossRefGoogle Scholar
  62. 62.
    Murcia L, Carrilero B, Muñoz MJ, et al. Usefulness of PCR for monitoring benznidazole response in patients with chronic Chagas’ disease: a prospective study in a non-disease-endemic country. J Antimicrob Chemother. 2010;65:1759–64.PubMedCrossRefGoogle Scholar
  63. 63.
    Viotti R, Alarcon de Noya B, Araujo-Jorge T, et al. Towards a paradigm shift in the treatment of chronic Chagas disease. Antimicrob Agents Chemother. 2014;58(2):635–9.PubMedPubMedCentralCrossRefGoogle Scholar
  64. 64.
    Moreira OC, Ramírez JD, Velázquez E, Melo MF, Lima-Ferreira C, Guhl F, Sosa-Estani S, Marin-Neto JA, Morillo CA, Britto C. Towards the establishment of a consensus real-time qPCR to monitor Trypanosoma cruzi parasitemia in patients with chronic Chagas disease cardiomyopathy: a substudy from the BENEFIT trial. Acta Trop. 2013;125:23–31.PubMedCrossRefGoogle Scholar
  65. 65.
    Alonso-Padilla J, Gallego M, Schijman AG, Gascon J. Molecular diagnostics for Chagas disease: up to date and novel methodologies. Expert Rev Mol Diagn. 2017;17:699–710.PubMedCrossRefGoogle Scholar
  66. 66.
    Molina I, Gomez i Prat J, Salvador F, et al. Randomized trial of posaconazole and benznidazole for chronic Chagas’ disease. N Engl J Med. 2014;370(20):1899–908.PubMedPubMedCentralCrossRefGoogle Scholar
  67. 67.
    Morillo CA, Marin-Neto JA, Avezum A, et al. Randomized trial of benznidazole for chronic Chagas’ cardiomyopathy. N Engl J Med. 2015;373:1295–306.CrossRefGoogle Scholar
  68. 68.
    Álvarez MG, Vigliano C, Lococo B, Bertocchi G, Viotti R. Prevention of congenital Chagas disease by benznidazole pre-treatment in reproductive-age women. An observational study. Acta Trop. 2017;174:149. pii: S0001-706X(16)30750-1.PubMedCrossRefGoogle Scholar
  69. 69.
    Morillo CA, Waskin H, Sosa-Estani S, Del Carmen Bangher M, Cuneo C, Milesi R, Mallagray M, Apt W, Beloscar J, Gascon J, Molina I, Echeverria LE, Colombo H, Perez-Molina JA, Wyss F, Meeks B, Bonilla LR, Gao P, Wei B, McCarthy M, Yusuf S, STOP-CHAGAS Investigators. Benznidazole and posaconazole in eliminating parasites in asymptomatic T. cruzi carriers: the STOP-CHAGAS trial. J Am Coll Cardiol. 2017;69:939–47. Scholar
  70. 70.
    Valdez F, Padilla A, Tarleton R. Identification of a rare dormant sub-population of Trypanosoma cruzi amastigotes able to reassume proliferation, infection and generation of new quiescent forms. Medicina. 2017;77(Suppl I):26.1.Google Scholar
  71. 71.
    WHO. Research priorities for Chagas disease, human African trypanosomiasis and Leishmaniasis. World Health Organization technical report series. Geneva: World Health Organization/Special Programme for Research and Training in Tropical Diseases (TDR); 2012. (975):v-xii, 1-100.Google Scholar
  72. 72.
    Schijman AG, Burgos JM, Marcet P. Molecular tools and strategies for diagnosis of Chagas Disease and leishmaniasis, Chapter 9. In: da Silva S, Cano MI, editors. Molecular and cellular biology of pathogenic trypanosomatids; Frontiers in parasitology, vol. 1. Sharjah: Bentham Science Publishers; 2016. p. 394–452.Google Scholar
  73. 73.
    Porras AI, Yadon ZE, Altcheh J, et al. Target product profile (TPP) for Chagas disease point-of-care diagnosis and assessment of response to treatment. PLoS Negl Trop Dis. 2015;9:e0003697.PubMedPubMedCentralCrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Alejandro O. Luquetti
    • 1
  • Alejandro G. Schijman
    • 2
    Email author
  1. 1.Núcleo de Estudos da doença de Chagas (NEDoC), Hospital das ClínicasFederal University of GoiasGoianiaBrazil
  2. 2.Laboratorio de Biología Molecular de la Enfermedad de ChagasInstituto de Investigaciones en Ingeniería Genética y Biología Molecular “Dr. Hector Torres” (INGEBI-CONICET)Ciudad de Buenos AiresArgentina

Personalised recommendations