WMJ Vol 123 Issue 3: Diagnosis of Chagas Disease by Detecting Species-Specific Repetitive Genomic DNA From Filtered Human Urine Sample

ABSTRACT

Introduction: Chagas disease caused by Trypanosoma cruzi (T cruzi) found in the Americas is often missed during the early stage of infection due to lack of sensitive diagnostic tests. The classic immunological and parasitological tests often fail in the acute phase due to the nonspecific and low antibody level nature of the infection and in the chronic phase due to low levels of trypanosomes in the blood. For successful control strategies, there must be a sensitive and specific diagnostic test.

Objective/methods: We have demonstrated the possibility (proof of concept) of detecting T cruzi-specific repeat DNA via polymerase chain reaction (PCR) by (1) spiking 15 urine samples collected from volunteers free of prior infection with 3 different concentrations of T cruzi (3 strains), Trypanosoma brucei, and Trypanosoma rhodesiense (African strain) genomic DNA and (2) from filtered collected clinical samples from Argentina. Three sets of primers were used.

Results: Our approach detected repeat DNA specific for T cruzi strains from 1 clinical sample by 2 sets of primer and from spiked urine by all 3 sets of primer but not the African species. A serial dilution (spiking) also was performed on T cruzistrains to detect sensitivities of the assay. One set of primers constantly detected satellite DNA for all T cruzi strains from 70 pg/μl to 175 fg/μl.

Conclusions: We were able to demonstrate the feasibility of detecting T cruzi-specific DNA from filtered urine samples by sensitive and specific PCR assay. Besides the evident increased sensitivity and specificity of primers, our approach can be used to explore Chagas prevalence in endemic areas - especially in congenital Chagas newborn screening - and in the acute phase.
 

Intended Audience

The intended audience for this continuing education activity is healthcare professionals caring for the people of Wisconsin and beyond.

Learning Objectives

As a result of this journal-based activity, learners as members of the healthcare team will be able to:

  1. Explain the limitations of traditional diagnostic methods for Chagas disease and how PCR-based assays improve sensitivity and specificity in detecting Trypanosoma cruzi DNA from human urine samples.
  2. Discuss the potential role of PCR diagnostics in Chagas disease screening and early detection in endemic regions.
  3. Suggest how species-specific genomic DNA detection can be incorporated into team-based strategies to control Chagas disease.
Course summary
Available credit: 
  • 1.00 AAPA Category 1 CME
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 ANCC Contact Hours
  • 1.00 University of Wisconsin–Madison Continuing Education Hours
    • 1.00 Approved for AMA PRA Category 1 Credit™
Registration opens: 
12/03/2024
Course expires: 
12/02/2025
Cost:
$0.00
Part of: 
Wisconsin Medical Journal Volume 123
Rating: 
0

FACULTY DISCLOSURE

It is the policy of the University of Wisconsin–Madison Interprofessional Continuing Education Partnership (ICEP) to identify, mitigate and disclose all relevant financial relationships with ineligible companies* held by the  speakers/presenters, authors, planners, and other persons who may influence content of this accredited continuing education (CE).  In addition, speakers, presenters and authors must disclose any planned discussion of unlabeled/unapproved uses of drugs or devices during their presentation.

For this accredited continuing education activity all relevant financial relationships have been mitigated and detailed disclosures are listed below.

Name of IndividualIndividual's Role in Activity

Financial Relationship Disclosure

Discussion of
Unlabeled/Unapproved
Uses of Drugs/Devices
in Presentation?

Marianna Shershneva, MD, PhDAccreditation SpecialistNo relevant relationships with ineligible companies to discloseNo
James Eberhard, MFAAccreditation SpecialistNo relevant relationships with ineligible companies to discloseNo
Miriam Price, BSAuthorNo relevant relationships with ineligible companies to discloseNo
Nilanjan Lodh, PhDAuthorNo relevant relationships with ineligible companies to discloseNo
George Lee Morris III, M.D., MPH DICReviewerNo relevant relationships with ineligible companies to discloseNo
Njeri Wainaina, MD, FACPReviewerNo relevant relationships with ineligible companies to discloseNo
Nathan Gundacker, MDReviewerNo relevant relationships with ineligible companies to discloseNo
Fahad Aziz, MDEditorNo relevant relationships with ineligible companies to discloseNo
Jennifer Esch, PharmD, MBA, BCPSReviewerNo relevant relationships with ineligible companies to discloseNo
Jessica Leiberg, DNP, ACNPReviewerNo relevant relationships with ineligible companies to discloseNo

*Ineligible companies are those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on, patients.

The ACCME does not consider providers of clinical services directly to patients to be ineligible companies.

Discloser List CME Internal Report

Accreditation

Accreditation Statement

Jointly Accredited Provider LogoIn support of improving patient care, this activity has been planned and implemented by the University of Wisconsin–Madison ICEP and the Wisconsin Medical Journal.  The University of Wisconsin–Madison ICEP is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.


Credit Designation Statements

American Medical Association (AMA)

The University of Wisconsin–Madison ICEP designates this journal-based CE activity for a maximum of 1.0 AMA PRA Category 1 Credit™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

American Nurses Credentialing Center (ANCC)

The University of Wisconsin–Madison ICEP designates this journal-based CE activity for a maximum of 1.0 ANCC contact hour.  

AMERICAN ACADEMY OF PHYSICIAN ASSISTANTS (AAPA)

The University of Wisconsin–Madison ICEP has been authorized by the American Academy of PAs  (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 1.0 AAPA Category 1 CME credits. Approval is valid until 12/02/2025. PAs should only claim credit commensurate with the extent of their participation.

Continuing Education Units

The University of Wisconsin–Madison ICEP, as a member of the University Professional & Continuing Education Association (UPCEA), authorizes this program for 0.1 continuing education units (CEUs) or 1 hour.

Available Credit

  • 1.00 AAPA Category 1 CME
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 ANCC Contact Hours
  • 1.00 University of Wisconsin–Madison Continuing Education Hours
    • 1.00 Approved for AMA PRA Category 1 Credit™

Cost:
$0.00
Please login or register to take this course.

Required Hardware/software

Free, current version of Chrome, Firefox, Safari, or Edge. Some older browsers and Microsoft Internet Explorer could produce error messages or not display the content correctly. 

Free, current version of Adobe Acrobat Reader or other .pdf reader.