Surveillance of vector-borne pathogens under imperfect detection: lessons from Chagas disease risk (mis)measurement

Scientific Reports
Thaís Tâmara Castro Minuzzi-SouzaRodrigo Gurgel-Gonçalves

Abstract

Vector-borne pathogens threaten human health worldwide. Despite their critical role in disease prevention, routine surveillance systems often rely on low-complexity pathogen detection tests of uncertain accuracy. In Chagas disease surveillance, optical microscopy (OM) is routinely used for detecting Trypanosoma cruzi in its vectors. Here, we use replicate T. cruzi detection data and hierarchical site-occupancy models to assess the reliability of OM-based T. cruzi surveillance while explicitly accounting for false-negative and false-positive results. We investigated 841 triatomines with OM slides (1194 fresh, 1192 Giemsa-stained) plus conventional (cPCR, 841 assays) and quantitative PCR (qPCR, 1682 assays). Detections were considered unambiguous only when parasitologists unmistakably identified T. cruzi in Giemsa-stained slides. qPCR was >99% sensitive and specific, whereas cPCR was ~100% specific but only ~55% sensitive. In routine surveillance, examination of a single OM slide per vector missed ~50-75% of infections and wrongly scored as infected ~7% of the bugs. qPCR-based and model-based infection frequency estimates were nearly three times higher, on average, than OM-based indices. We conclude that the risk of vector-borne ...Continue Reading

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Citations

Jan 18, 2019·Revista Da Sociedade Brasileira De Medicina Tropical·Liliana CroccoClaudia S Rodriguez
Feb 15, 2019·Emerging Infectious Diseases·Megan C NiederwerderTrevor J Hefley
Nov 20, 2019·Veterinary Medicine and Science·Filipe C ReisRodrigo Gurgel-Gonçalves
Dec 28, 2019·Parasites & Vectors·Gilmar RibeiroMitermayer G Dos Reis
Nov 30, 2019·Gates Open Research·UNKNOWN Collaborating Group on Chagas Disease Modelling

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Methods Mentioned

BETA
optical microscopy
PCR
PCRs

Software Mentioned

Presence
EPRS

Related Concepts