Between a bug and a hard place:Trypanosoma cruzigenetic diversity and the clinical outcomes of Chagas disease
Louisa Alexandra Messengera, Michael A. Milesa b, Caryn Bernc d
- aDepartment of Pathogen Molecular Biology, Faculty of Infectious Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
- bDepartment of Pathogen Molecular Biology , Faculty of Infectious Tropical Diseases , London School of Hygiene and Tropical Medicine , London , UK
- cGlobal Health Sciences , Department of Epidemiology and Biostatistics , School of Medicine , University of California San Francisco , San Francisco , CA , USA
- dGlobal Health Sciences, Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, San Francisco, CA, USA
Papers open inside SciRah from the original publisher or repository; SciRah never hosts them.
Abstract
Over the last 30 years, concomitant with successful transnational disease control programs across Latin America, Chagas disease has expanded from a neglected, endemic parasitic infection of the rural poor to an urbanized chronic disease, and now a potentially emergent global health problem. Trypanosoma cruzi infection has a highly variable clinical course, ranging from complete absence of symptoms to severe and often fatal cardiovascular and/or gastrointestinal manifestations. To date, few correlates of clinical disease progression have been identified. Elucidating a putative role for T. cruzi strain diversity in Chagas disease pathogenesis is complicated by the scarcity of parasites in clinical specimens and the limitations of our contemporary genotyping techniques. This article systematically reviews the historical literature, given our current understanding of parasite genetic diversity, to evaluate the evidence for any association between T. cruzi genotype and chronic clinical outcome, risk of congenital transmission or reactivation and orally transmitted outbreaks.
TL;DRThis article systematically reviews the historical literature, given the current understanding of parasite genetic diversity, to evaluate the evidence for any association between T. cruzi genotype and chronic clinical outcome, risk of congenital transmission or reactivation and orally transmitted outbreaks. (Semantic Scholar)