{"doi":"10.1093/cid/ciaa1101","title":"Use of a Latent Class Analysis in the Diagnosis of Chronic Chagas Disease in the Washington Metropolitan Area","abstract":"BACKGROUND: The diversity of individuals at risk for Trypanosoma cruzi infection in the United States poses challenges for diagnosis. We evaluated the diagnostic accuracy of Food and Drug Administration (FDA)-cleared tests in the Washington Metropolitan area (WMA). METHODS: In total, 1514 individuals were evaluated (1078 from Mexico, Central and northern South America [TcI-predominant areas], and 436 from southern South America [TcII/V/VI-predominant areas]). Optical density (OD) values from the Hemagen EIA and Chagatest v.3 Wiener, and categorical results of the IgG-TESA-blot (Western blot with trypomastigote excretory-secretory antigen), and the Chagas detect plus (CDP), as well as information of area of origin were used to determine T. cruzi serostatus using latent class analysis. RESULTS: We detected 2 latent class (LC) of seropositives with low (LC1) and high (LC2) antibody levels. A significantly lower number of seropositives were detected by the Wiener, IgG-TESA-blot, and CDP in LC1 (60.6%, P < .001, 93.1%, P = .014, and 84.9%, P = .002, respectively) as compared to LC2 (100%, 100%, and 98.2%, respectively). LC1 was the main type of seropositives in TcI-predominant areas, representing 65.0% of all seropositives as opposed to 22.8% in TcII/V/VI-predominant areas. The highest sensitivity was observed for the Hemagen (100%, 95% confidence interval [CI]: 96.2-100.0), but this test has a low specificity (90.4%, 95% CI: 88.7-91.9). The best balance between positive (90.9%, 95% CI: 83.5-95.1), and negative (99.9%, 95% CI: 99.4-99.9) predictive values was obtained with the Wiener. CONCLUSIONS: Deficiencies in current FDA-cleared assays were observed. Low antibody levels are the main type of seropositives in individuals from TcI-predominant areas, the most frequent immigrant group in the United States.","journal":"Clinical Infectious Diseases","year":2020,"id":98628,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":31,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.7726,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":486446,"name":"Antonella Saldaña","orcid":"0009-0007-3905-5913","position":1,"is_corresponding":false},{"id":487540,"name":"Dhayanna Patino Nava","orcid":null,"position":2,"is_corresponding":false},{"id":448519,"name":"Tabitha Bayangos","orcid":null,"position":3,"is_corresponding":false},{"id":487541,"name":"Diana Paulette Evans","orcid":null,"position":4,"is_corresponding":false},{"id":487542,"name":"Kelly DeToy","orcid":null,"position":5,"is_corresponding":false},{"id":487543,"name":"Alexia Trevino","orcid":null,"position":6,"is_corresponding":false},{"id":486447,"name":"Rachel Marcus","orcid":"0000-0002-6229-8864","position":7,"is_corresponding":false},{"id":235422,"name":"Caryn Bern","orcid":"0000-0001-8195-7303","position":8,"is_corresponding":false},{"id":304253,"name":"Robert H. Gilman","orcid":"0000-0002-9037-0712","position":9,"is_corresponding":false},{"id":323515,"name":"Kawsar R. Talaat","orcid":"0000-0002-4899-6260","position":10,"is_corresponding":false},{"id":487544,"name":"Chagas Working Group in Peru and the United States","orcid":null,"position":11,"is_corresponding":false},{"id":487545,"name":"Carol Avila","orcid":null,"position":12,"is_corresponding":false},{"id":487546,"name":"Fabiola Camacho","orcid":null,"position":13,"is_corresponding":false},{"id":487547,"name":"Sdenka Herrera","orcid":null,"position":14,"is_corresponding":false},{"id":486448,"name":"Andrés Jiménez","orcid":"0009-0009-2785-2186","position":15,"is_corresponding":false},{"id":487548,"name":"Veronika Lozano","orcid":null,"position":16,"is_corresponding":false},{"id":379299,"name":"Edith Málaga","orcid":"0000-0002-0075-6655","position":17,"is_corresponding":false},{"id":487549,"name":"Mariel Merida","orcid":null,"position":18,"is_corresponding":false},{"id":487550,"name":"Carolina Morales","orcid":null,"position":19,"is_corresponding":false},{"id":487551,"name":"Rodrigo Quintero Solis","orcid":null,"position":20,"is_corresponding":false},{"id":487552,"name":"Fiorella Sotomayor","orcid":null,"position":21,"is_corresponding":false},{"id":487553,"name":"Alisha Tung","orcid":null,"position":22,"is_corresponding":false},{"id":487554,"name":"Anna Spector","orcid":null,"position":23,"is_corresponding":false},{"id":379300,"name":"Manuela Verástegui","orcid":"0000-0002-7500-1353","position":24,"is_corresponding":false},{"id":487555,"name":"Young-Hee Yang","orcid":null,"position":25,"is_corresponding":false},{"id":487556,"name":"F. Zapata","orcid":null,"position":26,"is_corresponding":false},{"id":447679,"name":"Yagahira E. Castro-Sesquen","orcid":"0000-0001-6824-9206","position":0,"is_corresponding":true}],"reference_count":32,"raw_metadata":null,"created_at":"2026-07-18T22:36:58.511143Z","pmid":"32766826","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}