Abstract
BackgroundBlood transfusion has always been an important route for Chagas Disease (CD) transmission. The high prevalence of CD in Latin America and its lifelong asymptomatic clinical picture pose a threat for the safety of the blood supply. The outcome of measures designed to improve transfusion safety can be assessed by evaluating the prevalence of CD among multitransfused patientsMethodsIn order to assess the impact of CD control measures on the safety of the blood supply, an observational cross-sectional study was designed to determine the prevalence of CD in 351 highly transfused patients, in which vectorial transmission was excluded. This study compared patients that received transfusion products before (n = 230) and after (n = 121) 1997, when measures to control transfusion-transmitted CD were fully implemented in Brazil.ResultsThe study group consisted of 351 patients exposed to high numbers of blood products during their lifetime (median number of units transfused = 51, range 10–2086). A higher prevalence of transfusion-transmitted CD (1.30%) was observed among multitransfused patients that received their first transfusion before 1997, compared with no cases of transfusion-transmitted CD among multitransfused patients transfused after that year. The magnitude of the exposure to blood products was similar among both groups (mean number of units transfused per year of exposure = 25.00 ± 26.46 and 23.99 ± 30.58 respectively; P = 0.75, Mann-Whitney test).ConclusionMultiple initiatives aimed to control vector and parental transmission of CD can significantly decrease transfusion-transmitted CD in Brazil. Our data suggest that mandatory donor screening for CD represents the most important measure to interrupt transmission of CD by blood transfusions.
Highlights
Blood transfusion has always been an important route for Chagas Disease (CD) transmission
Despite major improvements in the control of vectorial transmission in endemic areas, CD still infects nearly 10 million people [2], and transfusions have always been an important route of transmission [3]
Since most patients with CD are asymptomatic and unaware of their condition, these potential blood donors represent a serious threat to the safety of the blood supply of non-endemic areas [4]
Summary
Blood transfusion has always been an important route for Chagas Disease (CD) transmission. The high prevalence of CD in Latin America and its lifelong asymptomatic clinical picture pose a threat for the safety of the blood supply. Despite major improvements in the control of vectorial transmission in endemic areas, CD still infects nearly 10 million people [2], and transfusions have always been an important route of transmission [3]. Since most patients with CD are asymptomatic and unaware of their condition, these potential blood donors represent a serious threat to the safety of the blood supply of non-endemic areas [4]. The questionnaire included questions about alternative routes for transmission of common blood-borne pathogens such as intravenous drug use and previous history of invasive medical interventions and/or alternative medical interventions. Patients were questioned about relatives or other household contacts with confirmed diagnosis of CD
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