Irene Losada

Universitat de Barcelona

Author Statistics

Papers

Citation

H-Index

i-10 index

Research Trends

Author Order

Document Type

Co-Authors

María‐Jesús Pinazo

Barcelona Institute for Global Health

Joaquím Gascón

Hospital Clínic de Barcelona

Julio Alonso-Padilla

Instituto de Salud Carlos III

Natalia Rodríguez-Valero

Universitat de Barcelona

Nieves Martínez-Peinado

Barcelona Institute for Global Health

Daniel Camprubí

Universitat de Barcelona

José Muñóz

Hospital Clínic de Barcelona

Juan Carlos Gabaldón-Figueira

Barcelona Institute for Global Health

Carme Subirá

Hospital Clínic de Barcelona

Sofía Ardiles-Ruesjas

Barcelona Institute for Global Health

Cooperative Institutions

Universitat de Barcelona

Barcelona Institute for Global Health

Hospital Clínic de Barcelona

Instituto de Salud Carlos III

Hospital Universitario 12 De Octubre

Centro de Investigación Biomédica en Red

Research Institute Hospital 12 de Octubre

Consorci Institut D'Investigacions Biomediques August Pi I Sunyer

Universidad Complutense de Madrid

Manhiça Health Research Centre

Author Statistics

Papers

Citation

H-Index

i-10 index

Research Field

Clinical use of molecular methods for Trypanosoma cruzi infection in endemic and non-endemic countries: Benefits, limitations and challenges

Frontiers in Parasitology (2023)

María‐Jesús Pinazo Colin Forsyth Constanza Lopez-Albízu Margarita Bisio Adriana González Martínez

Trypanosoma cruzi infection is diagnosed by parasitological, molecular, and serological tests. Molecular methods based on DNA amplification provide a more sensitive alternative to classical parasitological techniques for detecting evidence of T. cruzi parasitemia, and are the preferred tests for congenital and oral transmission cases and parasite reactivation in chronically infected immunosuppressed individuals. In newborns at risk of vertical transmission, simplified diagnostic algorithms that provide timely results can reduce the high follow-up losses observed with current algorithms. Molecular methods have also proved useful for monitoring T. cruzi infection in solid organ transplantation recipients, regardless of host immune status, allowing parasite detection even before symptom manifestation. Furthermore, in the absence of other biomarkers and a practical test of cure, and given the limitations of serological methods, recent clinical guidelines have included polymerase chain reaction (PCR) to detect therapeutic failure after antiparasitic treatment in chronically infected adults. Increasing evidence supports the use of molecular tests in a clinical context, given the improved sensitivity and specificity of current assays – characteristics which largely depend on epidemiological factors and genetic and antigenic variability among T. cruzi strains. Further development and registration of commercial PCR kits will improve the use of molecular tests. We discuss the attributes of PCR and other molecular tests for clinical management in people with T. cruzi infection.

Chagas Disease

Molecular diagnostics

Protozoan infection

10.3389/fpara.2023.1241154

Cite

Citations (3)

Prevalence and diagnostic accuracy of different diagnostic tests for Chagas disease in an indigenous community of the Paraguayan Chaco

PLoS neglected tropical diseases (2025)

Sofía Ardiles-Ruesjas Vidalia Lesmo Valeria González-Romero Zully Cubilla Lilian Chena

Chagas disease (CD), caused by the protozoan Trypanosoma cruzi (T. cruzi), poses a major health challenge in Paraguay, especially in the resource-limited Chaco region. Rapid diagnostic tests (RDTs) are valuable tools to enhance diagnostic access. This study evaluates CD prevalence and risk factors in an indigenous community in the Paraguayan Chaco and validates the national RDT-based diagnostic algorithm for resource-limited settings against the recommended standard algorithm, which relies solely on conventional serological tests. A descriptive cross-sectional study was conducted in Casanillo, Presidente Hayes, Paraguay. In July 2023, a two-week field campaign was executed using a non-probability convenience sampling method targeting individuals aged over 9 months. Screening involved a single RDT, with positives confirmed via enzyme-linked immunosorbent assay (ELISA). Algorithm accuracy was validated externally at the National Reference Laboratory of Paraguay against the standard algorithm, which, in this study, included an ELISA and Hemagglutination test. Discordant cases were resolved with a second ELISA or Immunofluorescence. The study involved 999 participants, with a median age of 26 years (IQR 12-45), and 51.1% were female. The RDT-based diagnostic algorithm showed 97.1% agreement (κ = 0.94, 95%CI: 0.90-0.98) with the standard algorithm. The RDT alone had 96.0% agreement (κ = 0.91, 95%CI: 0.87-0.96), while the confirmatory ELISA had 94.3% agreement (κ = 0.88, 95%CI: 0.83-0.93). The algorithm's sensitivity/specificity (95%CI) were 94.6% (89.2-97.8)/98.6% (96.1-99.7), with the RDT at 94.6% (89.2-97.8)/96.8% (93.6-98.7) and the ELISA at 96.9% (92.3-99.2)/92.7% (88.5-95.8). T.cruzi infection seroprevalence was 12.6% (95%CI: 9.56-16.52). Age, Sanapaná ethnicity, and awareness of CD vectors were significantly associated with infection odds. No significant associations were found with other typical CD risk factors, clinical history, or health habits. The study underscores the high burden of T. cruzi infection in indigenous communities in the Paraguayan Chaco, urging immediate interventions for improved diagnosis and treatment. The combination of RDTs with conventional serology for diagnostic screening in resource-constrained settings proved useful, and its further use is encouraged.

Chagas Disease

Rapid diagnostic test

Tropical Medicine

10.1371/journal.pntd.0012861

Cite

Citations (0)

Prevalence and clinical characteristics of pulmonary TB among pregnant and post-partum women

The International Journal of Tuberculosis and Lung Disease (2022)

Dinis Nguenha Sozinho Acácio Adrià Murias‐Closas N. Ramanlal Belén Saavedra

SETTING: Antenatal care (ANC) and postpartum care (PPC) clinic in Manhiça District, Mozambique.OBJECTIVE: To estimate the prevalence of TB among pregnant and post-partum women and describe the clinical characteristics of the disease in a rural area of Southern Mozambique.METHODS: We conducted a cross-sectional TB prevalence study among pregnant and post-partum women recruited from September 2016 to March 2018 at the Manhiça Health Care Center (MHC). We recruited two independent cohorts of women consecutively presenting for routine pregnancy or post-partum follow-up visits.RESULTS: A total of 1,980 women from the ANC clinic and 1,010 from the PPC clinic were enrolled. We found a TB prevalence of 505/100,000 (95% CI: 242-926) among pregnant women and 297/100,000 (95% CI: 61-865) among post-partum women. Among HIV-positive pregnant women, TB prevalence was 1,626/100,000 (95% CI: 782-2,970) and among postpartum HIV-positive women, TB prevalence was 984/100,000 (95% CI: 203-2,848).CONCLUSIONS: The burden of TB was not higher in postpartum women than in pregnant women. Most TB cases were detected in HIV-positive women. TB screening and diagnostic testing among pregnant and postpartum women attending ANC and PPC clinics in Manhiça District is acceptable and feasible.

Post partum

Cross-sectional study

10.5588/ijtld.21.0567

Cite

Citations (2)

How do we measure adherence to anti-tuberculosis treatment?

Expert Review of Anti-infective Therapy (2016)

Salomé Valencia Montserrat León‐García Irene Losada Guillermo Sequera Manuel Fernández Quevedo

Introduction: Completion of anti-tuberculosis (TB) treatment is of paramount importance for TB patients, as well as for the global efforts of TB control. However, there is neither a gold-standard measure to monitor adherence to TB treatment nor a widely used definition for different levels of adherence.Areas covered: in this review we aim to describe the different methods used to measure patients' adherence to anti-TB treatment, identifying their main strengths and limitations, with a focus on low resource settings.Expert commentary: there is a need for continuing the quest for a low cost, reliable and acceptable measure of adherence to TB treatment. We should harmonize treatment adherence measurement to allow adequate comparison of different interventions aimed at increasing adherence to TB treatment, although the way we ensure adherence can affect adherence endpoints themselves. The accuracy of adherence measurement is of importance in the context of drug clinical development.

Medication Adherence

Gold standard (test)

10.1080/14787210.2017.1264270

Cite

Citations (40)

Diagnostic Value of Platelet and Leukocyte Counts in the Differential Diagnosis of Fever in the Returning Traveler

American Journal of Tropical Medicine and Hygiene (2018)

Elisa Rubio Izaskun Alejo-Cancho Cristian Aylagas Daniel Camprubí Roser Ferré

Malaria, arbovirus infection and travelers' diarrhea are among the most common etiologies of fever after a stay in the tropics. Because the initial symptoms of these diseases often overlap, the differential diagnostic remains a challenge. The aim of this study was to establish the effectiveness of platelet and leukocyte counts in the differential diagnosis of fever in the returning traveler. Between 2013 and 2016, patients with a clinical suspicion of malaria, who had thick blood smears performed were retrospectively included. The microbiological etiology of each episode was established based on molecular detection in the case of arbovirus infection, the detection of pathogens in stool samples for diarrhea and other gastrointestinal symptoms and the thick and thin blood smear results for malaria. A total of 1,218 episodes were included. Malaria, arbovirus infection, and diarrhea and other gastrointestinal symptoms caused 102 (8.4%), 68 (5.6%), and 72 (5.9%) episodes, respectively. The median platelet counts in malaria episodes were 89 × 109/L and thrombocytopenia (< 150,000 × 109 platelets/L) yielded a 98% negative predictive value to predict malaria. The median leukocyte counts in arbovirus infection episodes were 3.19 × 109/L and leucopenia (< 4 × 109 leukocytes/L) yielded a 97.9% negative predictive value to predict arbovirus infections. Platelet and leukocyte counts were not significantly altered in episodes caused by diarrhea and other gastrointestinal symptoms. Initial platelet and leukocyte counts might be useful for the clinical differential diagnosis of fever in the returning traveler. Although these results are insufficient to establish a diagnosis, they should be considered in the initial clinical assessment.

Leukocyte Counts

Value (mathematics)

10.4269/ajtmh.18-0736

Cite

Citations (12)

P0238 / #1098: OUTCOMES FOLLOWING EXTRACORPOREAL MEMBRANE OXYGENATION IN CHILDREN WITH CONGENITAL AND ACQUIRED CARDIOPATHIES.

Pediatric Critical Care Medicine (2021)

J. Hernandez-Tiscareno Leopoldo Carrillo Medina Constanza Riera Adriana Puente-Barragán Llanos García Arce

Aims & Objectives: The goal of this study was to describe the clinical status and evolution of pediatric patients with congenital or acquired heart disease placed on ECMO (extracorporeal membrane oxygenation) support at a tertiary care Hospital in Mexico. Methods: DESIGN: A retrospective and descriptive study was designed, from January 2012 to January 2020. CONTEXT AND PARTICIPANTS: We reviewed all children with congenital or acquired heart disease admitted to the Cardiovascular Intensive Care Unit underwent extracorporeal membrane oxygenation support at a tertiary care Hospital. Results: A total of 27 patients met the inclusion criteria. Age range was 7-17 years (median 12 years). There was a female predominance (n = 15, 56 %). Overall 22 patients (81 %) received VA ECMO of which 13 (59 %) had central ECMO and 9 (41 %) had peripheral ECMO. Median ECMO duration was 218 hours. In 15 patients, ECMO was introduced after operation for congenital heart disease. The most common procedure-related complication was major haemorrhage (n = 11) and renal failure requiring renal replacement therapy (n = 9). Overall survival to hospital discharge was 63 %. all survivors were discharged with favourable neurological outcome. Conclusions: In this retrospective study of pediatric patients with heart disease supported on ECMO, survival to hospital discharge was 63%, similar to that collected by Extracorporeal Life Support Organization in 2019. Finally, ECMO for heart and respiratory failure in infants and children is effective, and allows time for recovery of cardiac dysfunction and acute hypoxic insult.

Renal replacement therapy

Extracorporeal

Life support

10.1097/01.pcc.0000739296.18633.dc

Cite

Citations (0)

Epidemiological and sociodemographic description of snakebite envenoming cases in Paraguay reported between 2015 and 2021

BMJ Public Health (2024)

Sofía Ardiles-Ruesjas Edgar Sanabria Victor Hugo Segovia Portillo Lorena Jara Oroa Viviana de Egea

Introduction Snakebite envenoming (SBE) is a public health problem in Paraguay where the presence of 15 medically important snake species has been reported. Blessed with large forested areas, its economy largely relies on agricultural production which increases the exposure of outdoor workers to the morbidity and mortality of SBE. Lack of sufficient and accurate epidemiological data highlights the importance of drawing an updated picture of SBE burden in the country. Methods We performed a retrospective descriptive study on secondary SBE data reported to the national surveillance system between 2015 and 2021. We addressed the availability and quality of the data and assessed its epidemiological and sociodemographic burden in Paraguay over that time period. Results In total, 1651 cases of SBE were reported between 2015 and 2021 representing an average of 235 cases per year (3.33 cases per 100 000 population). Overall, young males (68%, n=1125) of productive age (25 years old, IQR 29) in agricultural and/or livestock settings (47%, n=653) were the most affected population. Departments with a higher number of notifications were San Pedro (12%, n=191), Caazapá and Alto Paraná (10%, n=163). Regarding data quality, variables about clinical outcomes, treatment administration and case management were the worst reported. Conclusion SBE is a public health issue that affects young workers in rural areas in Paraguay. It mostly remains unattended and improvements in its reporting need to be done in order to gain a better insight into both the health and social burden of this neglected disease.

10.1136/bmjph-2023-000359

Cite

Citations (0)

Relevance of screening for Chagas and viral hepatitis in Bolivian migrants

Medicina Clínica (2020)

Irene Losada Giuseppe Gariup Aina Casellas Carme Subirá Natalia Rodríguez-Valero

Hepatitis C

Viral Hepatitis

10.1016/j.medcli.2020.06.063

Cite

Citations (1)

Significance of the isolation of Staphylococcus aureus from a central venous catheter tip in the absence of concomitant bacteremia: a clinical approach

European Journal of Clinical Microbiology & Infectious Diseases (2016)

Francisco López‐Medrano Jaime Lora‐Tamayo Mario Fernández‐Ruiz Irene Losada Pedro Hernández

Bacteremia

Concomitant

Central venous catheter

Blood Culture

10.1007/s10096-016-2740-7

Cite

Citations (3)

How do we classify organ involvement in Chagas disease? A systematic review of organ involvement since 1909, Highlighting the urgent need for a universal classification system in Chronic Chagas disease

PLoS neglected tropical diseases (2024)

Irene Losada Magdalena García Alejandro Marcel Hasslocher‐Moreno Ariadna Ortiga Sergi Sanz

Chagas disease (CD) is recognized as one of the 20 neglected tropical diseases by the World Health Organization (WHO), posing a significant global health challenge. The objective of this work was to conduct a systematic methodology review to explore the different classifications used to describe the presence and degree of organ involvement in patients with CD since the disease's description in 1909. We searched relevant electronic medical databases from their inception dates to July 2023. We also delved into historical variations and revisions of each classification, the necessary diagnostic methods, their prognostic value, and their uptake. Our study underscores the conspicuous absence of a universally accepted CD classification system for cardiac and digestive involvement, both in the context of clinical trials and within current clinical guidelines. This endeavour will facilitate cross-population comparisons if clinical manifestations and complementary test results are available for each patient, constituting a pivotal stride toward identifying precise prognoses and establishing a minimum data set requisite for a fitting CD classification, tailored to the test availability in both endemic and non-endemic regions.

Chagas Disease

Organ system

10.1371/journal.pntd.0012367

Cite

Citations (0)