# Point-of-care diagnostic test for T. cruzi (Chagas) infection

> **NIH NIH R44** · KEPHERA DIAGNOSTICS, LLC · 2024 · $1,015,000

## Abstract

Project Summary
Chagas disease, caused by infection with the parasite Trypanosoma cruzi, is the most prevalent parasitic
disease in the western hemisphere, infecting 8-11 million individuals and with over 70 million at risk. The infection
is transmitted by an insect vector that is native to Latin America, but can also be acquired through blood
transfusion, organ transplant, or congenitally. Following a brief acute phase, the parasite persists for years in
infected carriers, often asymptomatically, but can cause cardiomyopathy and other pathological conditions
leading to severe morbidity and mortality. In the U.S., T. cruzi is prevalent in Latin American immigrant
populations, where it poses an underrecognized health risk. The gradual encroachment of the insect vector into
the southernmost regions of the U.S. has also raised the threat of autochthonous transmission. Chagas disease
is challenging to diagnose due to the combination of genotypic and hence antigenic variation across its
geographical range, complex immunological interactions with the human host, and cross-reactivities with other
parasites. Serology has become the mainstay for diagnosis, especially for chronic infection, but the above
challenges have hampered the accuracy of serologic tests such that multiple assays are commonly used in a
triangulation algorithm to establish final results.
The majority of those at risk for T. cruzi infection live in low-resource, underdeveloped areas where contact with
the vector insects is hard to avoid, but medical care is relatively primitive and laboratory infrastructure is absent.
For these reasons, rapid, point-of-care tests have become increasingly desirable as tools for diagnosis and
epidemiological surveillance of Chagas disease. However, the current generation of Chagas rapid tests is limited
by suboptimal performance, both in sensitivity and specificity, largely due to the reliance on recombinant antigens
which are specific to certain T. cruzi lineages and often fail to detect Mexican and Central American Chagas
cases. To date, only one Chagas rapid test has been cleared by FDA. We propose to complete development of
a rapid test for Chagas disease, based on a native protein antigen from cultured T. cruzi termed TESA
(Trypanosomal Excreted/Secreted Antigens). We have developed procedures to produce with high yield, enrich
and concentrate the antigenic component of TESA, making it suitable for use in a lateral flow assay. In Phase I
studies, the prototype TESA rapid test has shown clinical sensitivity and specificity approaching 100% across a
range of samples from diverse regions spanning the endemic geography of Latin America, including Mexico and
Central America. In Phase II, we will complete development of the TESA lateral flow rapid test in a cost-effective
format suitable for point-of-care use in low-resource settings. The clinical and analytical performance of the test
will be evaluated in a clinical study involving over 1,000 Chagas pati...

## Key facts

- **NIH application ID:** 10817826
- **Project number:** 5R44AI136172-04
- **Recipient organization:** KEPHERA DIAGNOSTICS, LLC
- **Principal Investigator:** Andrew E. Levin
- **Activity code:** R44 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $1,015,000
- **Award type:** 5
- **Project period:** 2018-08-07 → 2026-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10817826

## Citation

> US National Institutes of Health, RePORTER application 10817826, Point-of-care diagnostic test for T. cruzi (Chagas) infection (5R44AI136172-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10817826. Licensed CC0.

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