{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T19:32:33Z","timestamp":1771615953581,"version":"3.50.1"},"update-to":[{"DOI":"10.1371\/journal.pntd.0013996","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000}}],"reference-count":74,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:00:00Z","timestamp":1770940800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["CAPES - Finance Code 001"],"award-info":[{"award-number":["CAPES - Finance Code 001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["304474\/2015-0, 306037\/2019-0, 307935\/2023-0"],"award-info":[{"award-number":["304474\/2015-0, 306037\/2019-0, 307935\/2023-0"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004586","name":"Funda\u00e7\u00e3o Carlos Chagas Filho de Amparo \u00e0 Pesquisa do Estado do Rio de Janeiro","doi-asserted-by":"publisher","award":["CNE E-26\/ 210.190\/2018 and E26\/202.572\/2019"],"award-info":[{"award-number":["CNE E-26\/ 210.190\/2018 and E26\/202.572\/2019"]}],"id":[{"id":"10.13039\/501100004586","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004586","name":"Funda\u00e7\u00e3o Carlos Chagas Filho de Amparo \u00e0 Pesquisa do Estado do Rio de Janeiro","doi-asserted-by":"publisher","award":["JCNE E-26\/201.314\/2021"],"award-info":[{"award-number":["JCNE E-26\/201.314\/2021"]}],"id":[{"id":"10.13039\/501100004586","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004586","name":"Funda\u00e7\u00e3o Carlos Chagas Filho de Amparo \u00e0 Pesquisa do Estado do Rio de Janeiro","doi-asserted-by":"publisher","award":["Programa De Apoio \u00e0 Jovem Cientista Mulher Com V\u00ednculo em ICTS Do Estado Do Rio de Janeiro (E-26\/210.063\/2024)"],"award-info":[{"award-number":["Programa De Apoio \u00e0 Jovem Cientista Mulher Com V\u00ednculo em ICTS Do Estado Do Rio de Janeiro (E-26\/210.063\/2024)"]}],"id":[{"id":"10.13039\/501100004586","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006507","name":"Funda\u00e7\u00e3o Oswaldo Cruz","doi-asserted-by":"publisher","award":["441671\/2024-1"],"award-info":[{"award-number":["441671\/2024-1"]}],"id":[{"id":"10.13039\/501100006507","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006507","name":"Funda\u00e7\u00e3o Oswaldo Cruz","doi-asserted-by":"publisher","award":["INOVA\/VPPCB-Fiocruz-Fellowship (Project 8690)"],"award-info":[{"award-number":["INOVA\/VPPCB-Fiocruz-Fellowship (Project 8690)"]}],"id":[{"id":"10.13039\/501100006507","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Chagas disease (CD), caused by infection with the protozoan parasite\n                      <jats:italic>Trypanosoma cruzi<\/jats:italic>\n                      , is a neglected tropical illness that affects 6\u20137 million individuals worldwide. CD may progress to chronic cardiac (CARD), digestive (DIG), or cardio-digestive (CARD\/DIG) forms. Parasite genetic diversity, defined in discrete typing units (DTUs) TcI-TcVI and TcBat, may contribute to clinical forms. Here, we challenged this idea by studying a population born in the State of Pernambuco, Northeast of Brazil.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methodology\/Principal Findings<\/jats:title>\n                    <jats:p>\n                      Patients born in eco-geographically distinct mesoregions (Sert\u00e3o, Agreste, Zona da Mata, and Metropolitan Region) attending the referral PROCAPE hospital were serologically diagnosed for CD and characterized as non-CARD (16.5%), CARD (67%), DIG (12.1%), and CARD\/DIG (4.3%). Out of 346 CD patients not subjected to etiological treatment, 128 (37%) were positive for conventional PCR targeting\n                      <jats:italic>T. cruzi<\/jats:italic>\n                      kDNA. DTU genotyping using pre-established primers and algorithms revealed 85\/128 (66%) samples amplified for at least one target, and of these, 49 (58%) were classified into DTUs, showing a higher distribution of DTUs TcV (16) and TcIII (13) but also TcIV (7), TcI (3), TcVI (3), and TcII (1). Mixed infections by TcI\u2009+\u2009TcV (2), TcIII\u2009+\u2009TcIV (3), and TcIII\u2009+\u2009TcV (1) were also found. Out of the 49 classified samples, 36 were CARD patients (73.5%), infected mainly by TcV (13) and TcIII (10). Considering patients\u2019 birthplace, in the Agreste, all DTUs were detected, with prevailing TcV and TcIII; in Zona da Mata, DTU characterization reflected the input of samples (21\/49, 43%), again mainly TcV and TcIII.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Conclusion\/Significance<\/jats:title>\n                    <jats:p>\n                      DTUs TcI-TcVI were only detected in the blood of patients born in the Agreste, area of ecological transition. Although not frequently found in human infections in Brazil, the prevailing TcV, TcIII, and TcIV were detected in patients born in Pernambuco. These data could not disclose an identifiable association of\n                      <jats:italic>T. cruzi<\/jats:italic>\n                      DTU circulating in the blood of patients with clinical forms of CD.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0013996","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T18:42:31Z","timestamp":1771008151000},"page":"e0013996","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Trypanosoma cruzi DTU parasite diversity and clinical outcomes in mesoregions of the Northeast Brazilian State of Pernambuco"],"prefix":"10.1371","volume":"20","author":[{"given":"Thayse","family":"do Esp\u00edrito Santo Prot\u00e1sio da Silva","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucia Elena","family":"Alvarado-Arnez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelica Martins","family":"Batista","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Marinho Martins Alves","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gloria","family":"Melo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina Veloso","family":"Carrazzone","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wilson","family":"Oliveira Jr","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Constan\u00e7a","family":"Britto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samanta Cristina das Chagas","family":"Xavier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Otacilio C.","family":"Moreira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5503-6754","authenticated-orcid":true,"given":"Joseli","family":"Lannes-Vieira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,2,13]]},"reference":[{"key":"pntd.0013996.ref001","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1590\/0037-8682-0505-2016","article-title":"2 nd Brazilian Consensus on Chagas Disease, 2015","volume":"49","author":"JC Dias","year":"2016","journal-title":"Rev Soc Bras Med Trop"},{"key":"pntd.0013996.ref002","author":"WHO","year":"2023"},{"issue":"6","key":"pntd.0013996.ref003","article-title":"SBC Guideline on the Diagnosis and Treatment of Patients with Cardiomyopathy of Chagas Disease - 2023","volume":"120","author":"JA Marin-Neto","year":"2023","journal-title":"Arq Bras Cardiol"},{"key":"pntd.0013996.ref004","doi-asserted-by":"crossref","first-page":"210","DOI":"10.3389\/fcimb.2020.00210","article-title":"Precision Health for Chagas Disease: Integrating Parasite and Host Factors to Predict Outcome of Infection and Response to Therapy","volume":"10","author":"SJ Martinez","year":"2020","journal-title":"Front Cell Infect Microbiol"},{"key":"pntd.0013996.ref005","doi-asserted-by":"crossref","DOI":"10.1590\/0074-02760220019","article-title":"Multi-therapeutic strategy targeting parasite and inflammation-related alterations to improve prognosis of chronic Chagas cardiomyopathy: a hypothesis-based approach","volume":"117","author":"J Lannes-Vieira","year":"2022","journal-title":"Mem Inst Oswaldo Cruz"},{"issue":"8","key":"pntd.0013996.ref006","doi-asserted-by":"crossref","first-page":"995","DOI":"10.1586\/14787210.2015.1056158","article-title":"Between a bug and a hard place: Trypanosoma cruzi genetic diversity and the clinical outcomes of Chagas disease","volume":"13","author":"LA Messenger","year":"2015","journal-title":"Expert Rev Anti Infect Ther"},{"issue":"7","key":"pntd.0013996.ref007","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1590\/S0074-02762009000700021","article-title":"A new consensus for Trypanosoma cruzi intraspecific nomenclature: second revision meeting recommends TcI to TcVI","volume":"104","author":"B Zingales","year":"2009","journal-title":"Mem Inst Oswaldo Cruz"},{"issue":"6","key":"pntd.0013996.ref008","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1017\/S0031182009005861","article-title":"A new genotype of Trypanosoma cruzi associated with bats evidenced by phylogenetic analyses using SSU rDNA, cytochrome b and Histone H2B genes and genotyping based on ITS1 rDNA","volume":"136","author":"A Marcili","year":"2009","journal-title":"Parasitology"},{"issue":"12","key":"pntd.0013996.ref009","article-title":"Association between Trypanosoma cruzi DTU TcII and chronic Chagas disease clinical presentation and outcome in an urban cohort in Brazil","volume":"15","author":"MAP Nielebock","year":"2020","journal-title":"PLoS One"},{"issue":"9","key":"pntd.0013996.ref010","article-title":"Pathogen diversity, immunity, and the fate of infections: lessons learned from Trypanosoma cruzi human-host interactions","volume":"3","author":"LMD Magalh\u00e3es","year":"2022","journal-title":"Lancet Microbe"},{"issue":"2","key":"pntd.0013996.ref011","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1016\/j.meegid.2011.12.009","article-title":"The revised Trypanosoma cruzi subspecific nomenclature: rationale, epidemiological relevance and research applications","volume":"12","author":"B Zingales","year":"2012","journal-title":"Infect Genet Evol"},{"issue":"11","key":"pntd.0013996.ref012","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0006939","article-title":"Exploring the parasite load and molecular diversity of Trypanosoma cruzi in patients with chronic Chagas disease from different regions of Brazil","volume":"12","author":"\u00cd Rodrigues-Dos-Santos","year":"2018","journal-title":"PLoS Negl Trop Dis"},{"issue":"12","key":"pntd.0013996.ref013","first-page":"2339","article-title":"Fifteen Years after the Definition of Trypanosoma cruzi DTUs: What Have We Learned?","volume":"13","author":"B Zingales","year":"2023","journal-title":"Life (Basel)"},{"issue":"4","key":"pntd.0013996.ref014","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1017\/S0031182011002186","article-title":"Trypanosoma cruzi discrete typing units in Chagas disease patients from endemic and non-endemic regions of Argentina","volume":"139","author":"CI Cura","year":"2012","journal-title":"Parasitology"},{"issue":"5","key":"pntd.0013996.ref015","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0000687","article-title":"Lineage analysis of circulating Trypanosoma cruzi parasites and their association with clinical forms of Chagas disease in Bolivia","volume":"4","author":"R del Puerto","year":"2010","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0013996.ref016","doi-asserted-by":"crossref","first-page":"104329","DOI":"10.1016\/j.meegid.2020.104329","article-title":"Potential association of Trypanosoma cruzi DTUs TcV and TcVI with the digestive form of Chagas disease","volume":"84","author":"MM Monje-Rumi","year":"2020","journal-title":"Infect Genet Evol"},{"issue":"7","key":"pntd.0013996.ref017","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0041284","article-title":"Trypanosoma cruzi IV causing outbreaks of acute Chagas disease and infections by different haplotypes in the Western Brazilian Amazonia","volume":"7","author":"WM Monteiro","year":"2012","journal-title":"PLoS One"},{"key":"pntd.0013996.ref018","article-title":"Detection of Trypanosoma cruzi DTUs TcI and TcIV in two outbreaks of orally-transmitted Chagas disease in the Northern region of Brazil","volume":"65","author":"de Freitas VLT","year":"2023","journal-title":"Rev Inst Med Trop Sao Paulo"},{"issue":"3","key":"pntd.0013996.ref019","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.actatropica.2010.03.003","article-title":"Genetic analyses of Trypanosoma cruzi isolates from naturally infected triatomines and humans in northeastern Brazil","volume":"115","author":"ACJ C\u00e2mara","year":"2010","journal-title":"Acta Trop"},{"issue":"3","key":"pntd.0013996.ref020","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.actatropica.2011.08.001","article-title":"Trypanosoma cruzi I-III in southern Brazil causing individual and mixed infections in humans, sylvatic reservoirs and triatomines","volume":"120","author":"NG Abolis","year":"2011","journal-title":"Acta Trop"},{"key":"pntd.0013996.ref021","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.actatropica.2017.05.003","article-title":"Identification of novel mammalian hosts and Brazilian biome geographic distribution of Trypanosoma cruzi TcIII and TcIV","volume":"172","author":"JHS Barros","year":"2017","journal-title":"Acta Trop"},{"issue":"9","key":"pntd.0013996.ref022","first-page":"1049","article-title":"Trypanosoma cruzi TcIII\/Z3 genotype as agent of an outbreak of Chagas disease in the Brazilian Western Amazonia","volume":"15","author":"WM Monteiro","year":"2010","journal-title":"Trop Med Int Health"},{"key":"pntd.0013996.ref023","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.ijid.2015.08.012","article-title":"Trypanosoma cruzi III causing the indeterminate form of Chagas disease in a semi-arid region of Brazil","volume":"39","author":"K Martins","year":"2015","journal-title":"Int J Infect Dis"},{"issue":"11","key":"pntd.0013996.ref024","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0000899","article-title":"Chagas cardiomyopathy manifestations and Trypanosoma cruzi genotypes circulating in chronic Chagasic patients","volume":"4","author":"JD Ram\u00edrez","year":"2010","journal-title":"PLoS Negl Trop Dis"},{"issue":"6","key":"pntd.0013996.ref025","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0001707","article-title":"Geographical distribution of Trypanosoma cruzi genotypes in Venezuela","volume":"6","author":"HJ Carrasco","year":"2012","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0013996.ref026","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1186\/1756-3305-7-267","article-title":"Trypanosoma cruzi strain TcI is associated with chronic Chagas disease in the Brazilian Amazon","volume":"7","author":"RAG Santana","year":"2014","journal-title":"Parasit Vectors"},{"key":"pntd.0013996.ref027","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1007\/978-3-030-44054-1_8","article-title":"Etiologic treatment of Chagas disease: old drugs, new insights, challenges, and perspectives.","volume-title":"Chagas disease \u2013 a neglected tropical disease","author":"JA. Urbina","year":"2020"},{"issue":"2","key":"pntd.0013996.ref028","doi-asserted-by":"crossref","DOI":"10.7326\/AITC202302210","article-title":"Chagas Disease","volume":"176","author":"NS Hochberg","year":"2023","journal-title":"Ann Intern Med"},{"key":"pntd.0013996.ref029","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1007\/978-1-4939-9148-8_17","article-title":"Genotyping of Trypanosoma cruzi from Clinical Samples by Multilocus Conventional PCR","volume":"1955","author":"O da Cruz Moreira","year":"2019","journal-title":"Methods Mol Biol"},{"issue":"1","key":"pntd.0013996.ref030","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1186\/s13071-018-3067-2","article-title":"Trypanosoma cruzi transmission in the wild and its most important reservoir hosts in Brazil","volume":"11","author":"AM Jansen","year":"2018","journal-title":"Parasit Vectors"},{"key":"pntd.0013996.ref031","author":"Instituto Brasileiro de Geografia e Estat\u00edstica"},{"key":"pntd.0013996.ref032","author":"Brazilian Institute of Geography and Statistics (IBGE)","year":"2025"},{"issue":"4","key":"pntd.0013996.ref033","first-page":"192","article-title":"Serological survey of the prevalence of Chagas\u2019 infection in Brazil, 1975\/1980","volume":"26","author":"ME Camargo","year":"1984","journal-title":"Rev Inst Med Trop Sao Paulo"},{"key":"pntd.0013996.ref034","volume-title":"Boletim t\u00e9cnico doen\u00e7a de Chagas","year":"2025"},{"key":"pntd.0013996.ref035","first-page":"97","volume-title":"Portaria No 264, de 17 de fevereiro de 2020. Altera a Portaria de Consolida\u00e7\u00e3o no 4\/GM\/MS, de 28 de setembro de 2017, para incluir a doen\u00e7a de Chagas cr\u00f4nica, na Lista Nacional de Notifica\u00e7\u00e3o Compuls\u00f3ria de doen\u00e7as, agravos e eventos de sa\u00fade p\u00fablica nos servi\u00e7os de sa\u00fade p\u00fablicos e privados em todo o territ\u00f3rio nacional","author":"S Brasil M da","year":"2020"},{"key":"pntd.0013996.ref036","first-page":"1","article-title":"I Latin American guidelines for the diagnosis and treatment of Chagas cardiomyopathy","volume":"97","author":"de Andrade JP","year":"2011","journal-title":"Arq Bras Cardiol"},{"key":"pntd.0013996.ref037","first-page":"7","article-title":"Brazilian consensus on Chagas disease","volume":"38","year":"2005","journal-title":"Rev Soc Bras Med Trop"},{"key":"pntd.0013996.ref038","volume-title":"Estimativas da popula\u00e7\u00e3o residente nos munic\u00edpios brasileiros com data de refer\u00eancia em 1\u00ba de julho de 1998","author":"IBGE","year":"1998"},{"key":"pntd.0013996.ref039","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1017\/S0031182000080823","article-title":"Polymerase chain reaction detection of Trypanosoma cruzi in human blood samples as a tool for diagnosis and treatment evaluation","author":"C Britto","year":"1995","journal-title":"Parasitology"},{"issue":"5","key":"pntd.0013996.ref040","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1016\/j.jmoldx.2015.04.010","article-title":"Analytical Validation of Quantitative Real-Time PCR Methods for Quantification of Trypanosoma cruzi DNA in Blood Samples from Chagas Disease Patients","volume":"17","author":"JC Ram\u00edrez","year":"2015","journal-title":"J Mol Diagn"},{"issue":"6","key":"pntd.0013996.ref041","doi-asserted-by":"crossref","first-page":"683","DOI":"10.4269\/ajtmh.2003.68.683","article-title":"Chronic Chagas\u2019 disease in rhesus monkeys (Macaca mulatta): evaluation of parasitemia, serology, electrocardiography, echocardiography, and radiology","volume":"68","author":"CME Carvalho","year":"2003","journal-title":"Am J Trop Med Hyg"},{"key":"pntd.0013996.ref042","volume-title":"Malha municipal digital \u2013 MMD","author":"Brazilian Institute of Geography and Statistics (IBGE)","year":"2024"},{"key":"pntd.0013996.ref043","doi-asserted-by":"crossref","first-page":"104128","DOI":"10.1016\/j.meegid.2019.104128","article-title":"Geographic distribution of Trypanosoma cruzi genotypes detected in chronic infected people from Argentina. Association with climatic variables and clinical manifestations of Chagas disease","volume":"78","author":"ML Bizai","year":"2020","journal-title":"Infect Genet Evol"},{"issue":"10","key":"pntd.0013996.ref044","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0007694","article-title":"Congenital Chagas disease: Updated recommendations for prevention, diagnosis, treatment, and follow-up of newborns and siblings, girls, women of childbearing age, and pregnant women","volume":"13","author":"Y Carlier","year":"2019","journal-title":"PLoS Negl Trop Dis"},{"issue":"1","key":"pntd.0013996.ref045","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0011895","article-title":"Efficacy of short-course treatment for prevention of congenital transmission of Chagas disease: A retrospective cohort study","volume":"18","author":"G Moscatelli","year":"2024","journal-title":"PLoS Negl Trop Dis"},{"issue":"1","key":"pntd.0013996.ref046","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1093\/trstmh\/trab089","article-title":"Congenital Chagas disease in Santa Cruz Department, Bolivia, is dominated by Trypanosoma cruzi lineage V","volume":"116","author":"L Sanchez","year":"2022","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"pntd.0013996.ref047","article-title":"Mapping the morbidity and mortality of Chagas disease in an endemic area in Brazil","volume":"64","author":"A Medeiros C de","year":"2022","journal-title":"Rev Inst Med Trop Sao Paulo"},{"issue":"5","key":"pntd.0013996.ref048","doi-asserted-by":"crossref","first-page":"165691","DOI":"10.1016\/j.bbadis.2020.165691","article-title":"What are we talking about when we talk about education and Chagas? A systematic review of the issue","volume":"1866","author":"M Sanmartino","year":"2020","journal-title":"Biochim Biophys Acta Mol Basis Dis"},{"issue":"6","key":"pntd.0013996.ref049","article-title":"Single nucleotide polymorphisms of cytokine-related genes and association with clinical outcome in a Chagas disease case-control study from Brazil","volume":"113","author":"LE Alvarado-Arnez","year":"2018","journal-title":"Mem Inst Oswaldo Cruz"},{"key":"pntd.0013996.ref050","article-title":"Influence of Angiotensin-converting Enzyme Insertion\/Deletion Gene Polymorphism in Progression of Chagas Heart Disease","volume":"53","author":"SMM Alves","year":"2020","journal-title":"Rev Soc Bras Med Trop"},{"issue":"11","key":"pntd.0013996.ref051","article-title":"Influence of angiotensin II type 1 receptors and angiotensin-converting enzyme I\/D gene polymorphisms on the progression of Chagas\u2019 heart disease in a Brazilian cohort: Impact of therapy on clinical outcomes","volume":"18","author":"ES Prot\u00e1sio da Silva T do","year":"2024","journal-title":"PLoS Negl Trop Dis"},{"issue":"6","key":"pntd.0013996.ref052","first-page":"1082","article-title":"Prevalence of Trypanosoma Cruzi Infection in Blood Donors","volume":"115","author":"da Costa AC","year":"2020","journal-title":"Arq Bras Cardiol"},{"issue":"1","key":"pntd.0013996.ref053","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1186\/s13071-018-2929-y","article-title":"Ageing with Chagas disease: an overview of an urban Brazilian cohort in Rio de Janeiro","volume":"11","author":"AG Vizzoni","year":"2018","journal-title":"Parasit Vectors"},{"issue":"2","key":"pntd.0013996.ref054","doi-asserted-by":"crossref","DOI":"10.4081\/gh.2019.786","article-title":"Evaluation and planning of Chagas control activities using geospatial tools","volume":"14","author":"D Weinberg","year":"2019","journal-title":"Geospat Health"},{"key":"pntd.0013996.ref055","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1590\/S0074-02762009000900018","article-title":"Usefulness of PCR-based assays to assess drug efficacy in Chagas disease chemotherapy: value and limitations","author":"CC Britto","year":"2009","journal-title":"Mem Inst Oswaldo Cruz"},{"issue":"1","key":"pntd.0013996.ref056","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0002000","article-title":"Analytical performance of a multiplex Real-Time PCR assay using TaqMan probes for quantification of Trypanosoma cruzi satellite DNA in blood samples","volume":"7","author":"T Duffy","year":"2013","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0013996.ref057","first-page":"100821","article-title":"Retrospect, advances and challenges in Chagas disease diagnosis: a comprehensive review","volume":"36","author":"AG Schijman","year":"2024","journal-title":"Lancet Reg Health Am"},{"issue":"9","key":"pntd.0013996.ref058","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0004997","article-title":"Molecular Diagnosis of Chagas Disease in Colombia: Parasitic Loads and Discrete Typing Units in Patients from Acute and Chronic Phases","volume":"10","author":"C Hern\u00e1ndez","year":"2016","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0013996.ref059","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.actatropica.2018.02.019","article-title":"Molecular diagnosis of Trypanosoma cruzi","volume":"184","author":"AG Schijman","year":"2018","journal-title":"Acta Trop"},{"issue":"1","key":"pntd.0013996.ref060","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0007024","article-title":"Improved DNA extraction technique from clot for the diagnosis of Chagas disease","volume":"13","author":"H Mayta","year":"2019","journal-title":"PLoS Negl Trop Dis"},{"issue":"5","key":"pntd.0013996.ref061","doi-asserted-by":"crossref","first-page":"768","DOI":"10.4269\/ajtmh.2008.79.768","article-title":"Polymerase chain reaction for chronic Trypanosoma cruzi infection yields higher sensitivity in blood clot than buffy coat or whole blood specimens","volume":"79","author":"S Fitzwater","year":"2008","journal-title":"Am J Trop Med Hyg"},{"issue":"10","key":"pntd.0013996.ref062","doi-asserted-by":"crossref","first-page":"1274","DOI":"10.1016\/S0002-9149(00)00747-5","article-title":"Prevalence of circulating Trypanosoma cruzi detected by polymerase chain reaction in patients with Chagas\u2019 cardiomyopathy","volume":"85","author":"OA Salomone","year":"2000","journal-title":"Am J Cardiol"},{"issue":"4","key":"pntd.0013996.ref063","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1002\/ejhf.220","article-title":"Detection of Trypanosoma cruzi DNA in blood by PCR is associated with Chagas cardiomyopathy and disease severity","volume":"17","author":"EC Sabino","year":"2015","journal-title":"Eur J Heart Fail"},{"key":"pntd.0013996.ref064","article-title":"Predictors of Trypanosoma cruzi PCR positivity in patients with chronic Chagas disease","volume":"118","author":"ACB de Lima","year":"2023","journal-title":"Mem Inst Oswaldo Cruz"},{"issue":"14","key":"pntd.0013996.ref065","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1056\/NEJMoa1507574","article-title":"Randomized trial of benznidazole for chronic chagas\u2019 cardiomyopathy","volume":"373","author":"CA Morillo","year":"2015","journal-title":"N Engl J Med"},{"key":"pntd.0013996.ref066","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.actatropica.2016.01.032","article-title":"Prevalence of Trypanosoma cruzi\u2019s Discrete Typing Units in a cohort of Latin American migrants in Spain","volume":"157","author":"A Martinez-Perez","year":"2016","journal-title":"Acta Trop"},{"issue":"3","key":"pntd.0013996.ref067","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.actatropica.2007.02.004","article-title":"Growth behaviour of two Trypanosoma cruzi strains in single and mixed infections: In vitro and in the intestinal tract of the blood-sucking bug, Triatoma brasiliensis","volume":"101","author":"CAC Ara\u00fajo","year":"2007","journal-title":"Acta Trop"},{"issue":"5","key":"pntd.0013996.ref068","doi-asserted-by":"crossref","first-page":"1805","DOI":"10.1016\/S0002-9440(10)65052-3","article-title":"Genetic characterization of Trypanosoma cruzi directly from tissues of patients with chronic Chagas disease: differential distribution of genetic types into diverse organs","volume":"156","author":"AR Vago","year":"2000","journal-title":"Am J Pathol"},{"issue":"1","key":"pntd.0013996.ref069","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.actatropica.2012.08.020","article-title":"Towards the establishment of a consensus real-time qPCR to monitor Trypanosoma cruzi parasitemia in patients with chronic Chagas disease cardiomyopathy: a substudy from the BENEFIT trial","volume":"125","author":"OC Moreira","year":"2013","journal-title":"Acta Trop"},{"key":"pntd.0013996.ref070","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.meegid.2017.01.016","article-title":"Molecular identification and genotyping of Trypanosoma cruzi DNA in autochthonous Chagas disease patients from Texas, USA","volume":"49","author":"MN Garcia","year":"2017","journal-title":"Infect Genet Evol"},{"issue":"1","key":"pntd.0013996.ref071","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1007\/s12639-021-01418-6","article-title":"Molecular characterization of Trypanosoma cruzi DTUs of the triatomine species in a Chagas disease endemic area","volume":"46","author":"TRM Silva","year":"2022","journal-title":"J Parasit Dis"},{"issue":"1","key":"pntd.0013996.ref072","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1186\/s12879-024-10178-6","article-title":"Eco-epidemiological aspects and risk factors associated with human Chagas disease in rural areas of the state of Piau\u00ed, Brazil","volume":"24","author":"AR da Silva Leal","year":"2024","journal-title":"BMC Infect Dis"},{"issue":"6","key":"pntd.0013996.ref073","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0000645","article-title":"The centennial of the discovery of Chagas disease: facing the current challenges","volume":"4","author":"J Lannes-Vieira","year":"2010","journal-title":"PLoS Negl Trop Dis"},{"issue":"3","key":"pntd.0013996.ref074","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1590\/0074-02760140410","article-title":"Congenital transmission of Trypanosoma cruzi in central Brazil. A study of 1,211 individuals born to infected mothers","volume":"110","author":"AO Luquetti","year":"2015","journal-title":"Mem Inst Oswaldo Cruz"}],"updated-by":[{"DOI":"10.1371\/journal.pntd.0013996","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000}}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0013996","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T18:55:47Z","timestamp":1771613747000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0013996"}},"subtitle":[],"editor":[{"given":"Carlos A.","family":"Buscaglia","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,2,13]]},"references-count":74,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2,13]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0013996","relation":{},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,13]]}}}