E 
{free|totally free|free of charge|cost-free|absolutely free|no
E cost-free of charge. This study was approved by the ethics committee of the Geneva University Hospitals in January (protocol -).Diagnosis of T. cruzi infectionPeripheral blood was drawn by a qualified nurse and serum was kept refrigerated at uC. Two commercialized ELISA-based serological tests (ELISA cruzi, Biomerieux, Brazil and Bioelisa Chagas, Biokit, Spain), which detect antibodies against crude and recombinant T. cruzi antigens respectively, were performed according to manufacturers’ guidelines with Dynatech-MRW Microplate Washer. Chagas disease was diagnosed when both tests had been constructive. The two tests have been repeated in case of discrepant outcomes (e.g. positive-negative; doubtful-negative). External quality control consisted of testing serum samples from all men and women with good or discordant ELISA tests and from of individuals with damaging tests (Laboratory of Chagas illness, Goias University, Brazil). A combination of 4 serological tests wasChagas Disease in Switzerlandperformed (Chagatek ELISA, Biomerieux, Argentina; EIE Chagas Bio-Manguinhos, Brasil; Chagatest HAI, Wiener, Argentina; inhouse immunofluorescent test utilizing Biomerieux conjugate, Biomerieux, Brazil). Results were sent back with an integrated conclusion (good, negative or non-conclusive).Staging and Tyr-D-Ala-Gly-Phe-Leu management of the diseaseAll men and women with confirmed T. cruzi infection have been contacted by phone and underwent a clinical evaluation that integrated complete healthcare history, physical examination, and also a -lead electrocardiogram (ECG) having a -second DII strip. In case of symptoms or indicators suggestive of cardiac failure, history of syncope, or ECG changes consistent with CCC, an echocardiogram along with a -hour Holter recording were performed. Results of cardiac investigations had been independently reviewed by two cardiologists. The classification of CCC was according to the Brazilian ConsensusPatients with dysphagia to strong or liquid food andor with serious constipation (significantly less than PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/25883088?dopt=Abstract stools per week andor use of laxatives additional than days per week for extra than months) underwent gastro-intestinal tract barium examination. Oesophageal abnormalities were staged based on the classification of de RezendeThe colon was regarded abnormal if its diameter exceeded cm. Inside the absence of abnormal findings by ECG, echocardiography, -hour Holter recording, and barium research, Chagas disease was classified inside the indeterminate type of the chronic phase. As outlined by recent suggestions, all eligible situations were treated with nifurtimox or benznidazole for days .reference laboratory and proved to become damaging. Socio-demographic traits and clinical data of T. cruzi infected people in comparison to non-infected ones and analysis of factors associated with infection are shown in Tables and , respectively. Multivariate evaluation showed that significant predictive factors for T. cruzi infection were Bolivian origin (adjusted odds ratio (OR CI ), maternal infection with T. cruzi (OR CI ), and age older than years (OR CI ).Clinical descriptionClinical evaluation was performed in individuals , whereas individuals were lost to follow-up resulting from unexpected departure from Switzerland. Out of patients with ECG abnormalities constant with CCC, had been classified as grade A, a single as grade B and 1 couldn’t be totally investigated (Table). Twelve other individuals with typical ECG had symptoms or indicators consistent with heart disease. Seven of them underwent further investigations. 4 had echocardiographic sign.
