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Future perspectives

The serological diagnosis has had profound advances in the last decade. Most infected individuals are correctly diagnosed. The main problems are due to poor control in two main variables: quality kits and laboratory practices. In any case a few sera (up to 2%) have doubtful results. Diagnosis ought to be handled by a clinician who decides based on clinical findings and serology results.

Although recent research showed that with the tests we have, most treated children will have negative serology in less than 15 months in areas of TcI, proving that conventional tests are good enough, and that the long time required for negati- vation is more dependent on the type of T. cruzi than the tests, new tests capable of measuring antibodies that assess cure or other approaches nonantibody dependent (proteomics) are needed.

Progress also could be made in diagnosis in rural areas, and rapid tests should help with this goal. Some efforts were performed to have several recombinants at the same device, but this will increase costs. Another advance would be development of a PCR kit that could be commercially available and used at the field, with enhanced sensitivity and specificity.

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