Towards new care strategies in a suburban healthcare center in La Matanza, Argentina: performance evaluation of rapid diagnostic tests for Chagas disease in a non-endemic area

Abstract

Introduction: Chagas disease, caused by the protozoan parasite Trypanosoma cruzi, remains a major public health problem, affecting approximately seven million people worldwide. Although historically restricted to endemic regions, migration has led to its global distribution, increasing the relevance of congenital transmission in non-endemic areas. If not timely diagnosed and treated, infection can progress to chronic Chagas cardiomyopathy in nearly 30 % of patients, generating substantial social and healthcare burdens. Diagnosis requires concordant results from two or three serological assays based on different antigenic principles, limiting timely access to care in peripheral settings.Methods: We aimed to characterize the clinical, parasitological, and sociodemographic profile of individuals with T. cruzi infection in La Matanza (Buenos Aires Province, Argentina), and to assess the diagnostic performance of two rapid diagnostic tests (RDTs) from serum samples in this at-risk population.Results: In this cross-sectional prospective study including 103 subjects, epidemiological analysis revealed that most infected individuals originated from endemic areas, with a substantial proportion of infections consistent with congenital transmission. Clinical evaluation identified electrocardiographic abnormalities in 30.9 % of infected patients, predominantly right bundle branch block. Molecular characterization showed parasites belonging to DTU V (Discrete Typing Unit V) in 7 infections (one coinfected with DTU VI). RDT1 showed a sensitivity of 82.5 % and specificity of 100 %, whereas RDT2 exhibited a sensitivity of 87.5 % and specificity of 85.7 %.Discussion: Overall, our findings provide a comprehensive characterization of T. cruzi infected individuals in a non-endemic region with ongoing transmission dynamics shaped by migration and congenital infection, pointing out advantages and limitations of RDT use in peripheral healthcare settings.