The fitted curve was obtained empirically without requiring any specification of the relationship between the variables. = polymerase chain reaction.(TIF) pone.0139363.s003.tif (408K) GUID:?9AA0F591-111D-4E8D-B74D-875461F35B02 S3 Fig: Scatter plot of percentages of positive xenodiagnosis and PCR assessments in treated subjects with chronic infection based on risk of bias. Red: low risk of bias, blue: high risk of bias. PCR = polymerase chain reaction.(TIF) pone.0139363.s004.tif (415K) GUID:?E1ED52B9-A4F0-4645-AF29-CEE9A1A8546C S4 Fig: Scatter plot of percentages of unfavorable conventional serological test in treated subjects with chronic infection based on the country of origin. Red: Argentina, Bolivia, Chile and Paraguay, blue: Brazil, green: other countries. ELISA = enzyme-linked immunosorbent assay, IIF = indirect immunofluorescence, IHA = indirect hemagglutination assay.(TIF) pone.0139363.s005.tif (396K) GUID:?EE554422-FB67-4065-A3CF-C710A684B31A S5 Fig: Scatter plot of percentages of unfavorable conventional serological test in treated subjects with chronic infection based on the risk of bias. Red: low risk of bias, blue: high risk of bias. ELISA = enzyme-linked immunosorbent assay, IIF = indirect immunofluorescence, IHA = indirect hemagglutination assay.(TIF) pone.0139363.s006.tif (387K) GUID:?AB994C17-166C-437B-AFF5-624E162BDE66 S6 Fig: Scatter plot of percentages of unfavorable conventional serological test in treated subjects with chronic infection based on age at treatment. Red: children, blue: adults. ELISA = enzyme-linked immunosorbent assay, IIF = indirect immunofluorescence, IHA = indirect hemagglutination assay.(TIF) pone.0139363.s007.tif (377K) GUID:?B61E2460-69D0-4F27-AAF4-BDAFA69F686A S1 Protocol: Pre-registered review protocol. (PDF) pone.0139363.s008.pdf (135K) GUID:?5EBDD0AF-4726-42E1-923E-37652ACB4985 S1 Table: Characteristic of included studies (n = 54). Ag = antigen, AT-ELISA = chemiluminescent enzyme-linked immunosorbent assay with a trypomastigote mucin antigen, BZN = benznidazole, CF = complement fixation, CoML = complement mediated lysis, d = day, DA-2ME = direct agglutination with 2-mercaptoethanol, ELISA = enzyme-linked immunosorbent assay, ELISA-F29 = ELISA test using the F29 protein of proteins in a Luminex-based format, NFTX = nifurtimox, PCR = polymerase chain reaction, rCRP = recombinant complement regulatory protein, RCT = randomised controlled trial, rt-PCR = real time PCR, RAM-ELISA = ELISA with a recombinant antigen mixture, SAPA = shed acute-phase antigen, TESA-blot = Vwf immunoblot assay, XD = xenodiagnosis, y = years. 1conventional in house serological assessments (unless indicated otherwise). 2commercial conventional test. 3 nonconventional test.(PDF) pone.0139363.s009.pdf (50K) GUID:?5A28226C-2B7B-4F3E-B837-B5DC82EEC439 S2 Table: Table of excluded studies (n = 8). BNZ = benznidazole, d = day, Tiliroside kg = kilogram, mg = milligram, NFTX = nifurtimox.(PDF) pone.0139363.s010.pdf (22K) GUID:?A5FF39C5-9018-40D8-AB4E-149F38FF9869 Data Availability StatementAll relevant data are within the paper and its Supporting Information files. Abstract Background Chagas disease is usually caused by the flagellate protozoan Trypanosoma cruzi (contamination is variable. Treatment failure is usually indicated by a Tiliroside positive parasitological and/or molecular test (persistence of parasitemia). Objectives To summarize the pattern of response to treatment of parasitological, molecular and serological assessments performed during the follow-up of subjects with Tiliroside chronic contamination. Methods Electronic searches in relevant databases and screening of citations of potentially eligible articles were accomplished. Organizations focusing on neglected infectious diseases were asked for help in identifying relevant studies. Included studies were randomized controlled trials (RCTs), quasi-RCTs, and cohort studies involving adults and children with chronic contamination who received trypanocidal treatment (benznidazole or nifurtimox) and were followed over time. The assessment of risk of bias was performed separately for each study design. The Cochrane Collaborations tool and the guidelines developed by Hayden et al. were used. Tiliroside Two reviewers extracted all data independently. A third review author was consulted in case of discordant opinion. Additional analyses were defined in ad-hoc basis. Scatter plots for percentage of positive parasitological and molecular assessments and for unfavorable serological tests were developed by using the lowess curve technique. Heterogeneity was measured by I2. The Tiliroside protocol was registered in PROSPERO, an international prospective register of systematic review protocols (Registration Number CRD42012002162). Results Out of 2,136 citations screened, 54 studies (six RCTs and 48 cohort studies) were included. The smoothed curves for positive xenodiagnosis and positive polymerase chain reaction (PCR) were characterized by a sharp decrease at twelve month posttreatment. Afterwards, they reached 10C20% and 40% for xenodiagnosis and PCR, respectively. The smoothed curves for unfavorable conventional serological assessments increased up to 10% after 48 months of treatment. In the long-term, the rate of negativization was between 20% and 45%. The main sources of bias identified across cohort studies were the lack of control for confounding and attrition bias. In general, RCTs were judged as low risk of bias in all domains. The level of heterogeneity across included studies was moderate to high. Additional analysis were incomplete because of the limited.