Skip to main content Accessibility help

Comparison of four serological tests for the diagnosis of Chagas disease in a Colombian endemic area

  • R. GUTIERREZ (a1), V. M. ANGULO (a1), Z. TARAZONA (a1), C. BRITTO (a2) and O. FERNANDES (a2)...


The performance of 4 serological tests for the diagnosis of Chagas disease was evaluated in Santander, Colombia, a region still presenting active transmission. Serum samples from 638 individuals were submitted to an enzyme immunoassay test (EIA), using total lysate of a local Trypanosoma cruzi strain and 52·5% were positive (335/638). A subset of this group (94 positive individuals and 90 seronegatives) was randomly selected for further serological confirmation. Three additional tests were used – indirect immunofluorescence (IIF) and 2 distinct enzyme-linked immunosorbent assays using total lysate of the Y strain (EIA BM) and a mixture of 2 recombinant antigens (EIA RA). Seventy-nine patients were seropositive in all tests (84·0% – 79/94). The number of positive sera with the IIF, EIA RA and EIA BM was 84/94 (89·4%), 80/94 (85·1%) and 79/94 (84·0%), respectively. In 15 out of the 94 EIA seropositive patients (16·0%), 10 individuals were negative in all 3 tests (10·6% – 10/94). One was negative in the EIA BM and positive in the other two tests (1·1% – 1/94) and 4 patients were positive, solely, in the IIF assay (4·3% – 4/94). Relative to the 90 EIA negative individuals, 89 were confirmed in all other tests (98·9% – 89/90). One individual, although seronegative in the IIF, was positive in both confirmatory EIA tests (1·1% – 1/90). In addition, 120 blood specimens were submitted to PCR amplification. This group consisted of 79 confirmed seropositive cases, 16 individuals with discordant serological results and 25 validated seronegative individuals. The PCR was able to detect the presence of parasite DNA in 67 out of the 79 seropositive patients (84·8%), in 8 individuals with discordant serology (50·0%) and in only one seronegative individual (4·0%). The results pointed to the necessity for performing more than one serological test, preferentially with antigens from autochthonous strains, to achieve a reliable diagnosis of Chagas disease in Colombia.


Corresponding author

Tropical Medicine Department, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Av. Brasil 4365, 21045-900, Rio de Janeiro, Brasil. Tel/Fax: +55 21 22803740. E-mail:


Hide All


ALMEIDA, E., KRIEGER, M. A., CARVALHO, M. R., OELEMANN, W. & GOLDENBERG, S. (1990). Use of recombinant antigens for the diagnosis of Chagas disease and blood bank screening. Memórias do Instituto Oswaldo Cruz 85, 513517.
ANDRADE, S. G., ANDRADE, V., ROCHA FILHO, F. D. & BARRAL NETTO, M. B. (1981). Antigenic analysis of various strains of Trypanosoma cruzi. Revista do Instituto de Medicina Tropical de São Paulo 23, 245250.
ANGULO, V. M., MUÑOZ, G. & TARAZONA, Z. (1993 a). Factores de riesgo de la vivienda para infestación domiciliaria por triatominos. Biomedica 12 (Suppl.), S124S125.
ANGULO, V. M., MUÑOZ, G., GÓMEZ, G., OCASIONES, R. E., GONZÁLES, C. I., PABA, J. & CHÁVEZ, A. M. (1993 b). Estudio epidemiologico y clinico de um foco de transmision de Trypanosoma cruzi em Santander. Biomedica 12 (Suppl.), S132.
ANGULO, V. M., ARISMENDI, M. J., JOYA, M. I., SANDOVAL, C. M. & GUTIÉRREZ, R. (1997). Infección natural por tripanosomatidos en triatomíneos (Hemiptera reduviidae) domiciliados en cinco municipios de Santander. Biomedica 17 (Suppl.), S161S162.
AVILA, H. A., SIGMAN, D. S., COHEN, L. M., MILLIKAN, R. C. & SIMPSON, L. (1991). Polymerase chain reaction amplification of Trypanosoma cruzi kinetoplast minicircle DNA isolated from whole blood lysates: diagnosis of chronic Chagas' disease. Molecular and Biochemical Parasitology 48, 211221.
BRENER, Z. & KRETTLI, A. U. (1990). Immunology of Chagas' disease. In Modern Parasite Biology: Cellular, Immunologic and Molecular Aspects (ed. Wyler, D. J.), pp. 247261. W.H. Freeman and Company, New York.
BRITTO, C., CARDOSO, M. A., WINCKER, P. & MOREL, C. M. (1993). A simple protocol for the physical cleavage of Trypanosoma cruzi kinetoplast DNA present in blood samples and its use in polymerase chain reaction (PCR)-based diagnosis of chronic Chagas disease. Memórias do Instituto Oswaldo Cruz 88, 171172.
BUSCAGLIA, C. A. & DI NOIA, J. M. (2003). Trypanosoma cruzi clonal diversity and the epidemiology of Chagas' disease. Microbes and Infection 5, 419427.
CAMARGO, M. E. (1992). An appraisal of Chagas' disease serodiagnosis. In Chagas' disease (American Trypanosomiasis): its Impact on Transfusion and Clinical Medicine (ed. ISBT Brazil 1992), pp. 165178. ISBT, São Paulo.
CARVALHO, M. R., KRIEGER, M. A., ALMEIDA, E., OELEMANN, W., SHIKANAI-YASSUDA, M. A., FERREIRA, A. W., BORGES-PEREIRA, J., SÁEZ-ALQUÉZAR, A., DORLHIAC-LLACER, P. E., CHAMONE, D. F. & GOLDENBERG, S. (1993). Chagas' disease diagnosis: evaluation of several tests in blood bank screening. Transfusion 33, 830834.
COURA, J. R., JUNQUEIRA, A. C., BOIA, M. N., FERNANDES, O., BONFANTE, C., CAMPOS, J. E., SANTOS, L. & DEVERA, R. (2002). Chagas disease in the Brazilian Amazon: a new cross-sectional study. Revista do Instituto de Medicina Tropical de São Paulo 44, 159165.
CUERVO, P., CUPOLILLO, E., SEGURA, I., SARAVIA, N. & FERNANDES, O. (2002). Genetic diversity of colombian sylvatic Trypanosoma cruzi isolates revealed by the ribosomal DNA. Memórias do Instituto Oswaldo Cruz 97, 877880.
DI NOIA, J. M., BUSCAGLIA, C. A., DE MARCHI, C. R., ALMEIDA, I. C. & FRASCH, A. C. C. (2002). A Trypanosoma cruzi small surface molecule provides the first immunological evidence that Chagas' disease is due to a single parasite lineage. Journal of Experimental Medicine 195, 401413.
GOMES, Y. M., PEREIRA, R. A. V., NAKAZAWA, M., ROSA, S. D., BARROS, D. S. M. N., FERREIRA, G. P. A., SILVA, D. E., OGATTA, Y. F. S., KRIEGER, M. A. & GOLDENBERG, S. (2001). Serodiagnosis of chronic Chagas infection by using EIE-recombinant-Chagas-Biomanguinhos kit. Memórias do Instituto Oswaldo Cruz 96, 497501.
GUHL, F. (1999). Estado actual del control de la enfermedad de Chagas en Colombia. Medicina Buenos Aires 59 (Suppl.), S103S116.
GUHL, F., HUDSON, L., MARINKELLE, C. J., MORGAN, S. J. & JARAMILLO, C. A. (1985). Antibody response to experimental Trypanosoma rangeli infection and its implication for the immunodiagnosis of South American trypanosomiasis. Acta Tropica 42, 311318.
GUHL, F., HUDSON, L., MARINKELLE, C. J., JARAMILLO, C. A. & BRIDGE, D. (1987). Clinical Trypanosoma rangeli infection as a complication of Chagas' disease. Parasitology 94, 475484.
KRIEGER, M. A., ALMEIDA, E., OELEMANN, W., LAFAILLE, J. J., PEREIRA, J. B., CARVALHO, M. R. & GOLDENBERG, S. (1992). Use of recombinant antigens for the accurate immunodiagnosis of Chagas' disease. American Journal of Tropical Medicine and Hygiene 46, 427434.
LAFAILLE, J. J., LINSS, J., KRIEGER, M. A., SOUTO-PADRON, T., DE SOUZA, W. & GOLDENBERG, S. (1989). Structure and expression of two Trypanosoma cruzi genes encoding antigenic proteins bearing repetitive epitopes. Molecular and Biochemical Parasitology 35, 127136.
MONCAYO, A. (1997). Progress towards the elimination of transmission of Chagas disease in Latin America. World Health Statistical Quarter 50, 195198.
MONCAYO, A. & LUQUETTI, A. O. (1990). Multicentre double blind study for evaluation of Trypanosoma cruzi defined antigens as diagnostic reagents. Memórias do Instituto Oswaldo Cruz 85, 489495.
SAIKI, R. K., SCHARF, S., FALOONA, F., MULLIS, K. B., HORN, G. T., ERLICH, H. A. & ARNHEIM, N. (1985). Enzymatic amplification of β-globin genomic sequences and restriction site analysis for diagnosis of sickle cell anemia. Science 230, 13501354.
SALDAÑA, A. & SOUSA, O. E. (1996). Trypanosoma rangeli and Trypanosoma cruzi: cross-reaction among their immunogenic components. Memórias do Instituto Oswaldo Cruz 91, 8182.
SCHMUÑIS, G. A. (1991). Trypanosoma cruzi, the etiologic agent of Chagas' disease: status in the blood supply in endemic and non-endemic countries. Transfusion 31, 547557.
STURM, N. R., DEGRAVE, W., MOREL, C. M. & SIMPSON, L. (1989). Sensitive detection and schizodeme classification of Trypanosoma cruzi cells by amplification of kinetoplast minicircle DNA sequences: use in diagnosis of Chagas' disease. Molecular and Biochemical Parasitology 33, 205214.
VOLLER, A., DRAPER, C., BIDWELL, D. E. & BARTLETT, A. (1975). Microplate enzyme-linked immunosorbent assay for Chagas' disease. Lancet 1, 426428.
WINCKER, P., BRITTO, C., BORGES-PEREIRA, J., CARDOSO, M. A., OELEMANN, W. & MOREL, C. M. (1994). Use of a simplified polymerase chain reaction procedure to detect Trypanosoma cruzi in blood samples from chronic chagasic patients in a rural endemic area. American Journal of Tropical Medicine and Hygiene 51, 771777.
WINCKER, P., TELLERIA, J., BOSSENO, M. F., CARDOSO, M. A., MARQUES, P., YAKSIC, N., AZNAR, C., LIEGEARD, P., HONTEBEYRIE, M., NOIREAU, F., MOREL, C. M. & BRENIERE, S. F. (1997). PCR-based diagnosis for Chagas' disease in Bolivian children living in an active transmission area: comparison with conventional serological and parasitological diagnosis. Parasitology 114, 367373.
WORLD HEALTH ORGANIZATION (1996). Control of Tropical Disease. Chagas' Disease. A Disease Whose Days are Numbered. World Health Organization, Geneva.


Comparison of four serological tests for the diagnosis of Chagas disease in a Colombian endemic area

  • R. GUTIERREZ (a1), V. M. ANGULO (a1), Z. TARAZONA (a1), C. BRITTO (a2) and O. FERNANDES (a2)...


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed