Risk Factors and Screening for Trypanosoma cruzi Infection of Dutch Blood Donors.

Ed Slot,Aldert Bart,Boris M Hogema,Michel Molier,Hans L Zaaijer

doi:10.1371/journal.pone.0151038

Abstract

BackgroundBlood donors unaware of Trypanosoma cruzi infection may donate infectious blood. Risk factors and the presence of T. cruzi antibodies in at-risk Dutch blood donors were studied to assess whether specific blood safety measures are warranted in the Netherlands.MethodologyBirth in a country endemic for Chagas disease (CEC), having a mother born in a CEC, or having resided for at least six continuous months in a CEC were considered risk factors for T. cruzi infection. From March through September 2013, risk factor questions were asked to all donors who volunteered to donate blood or blood components. Serum samples were collected from donors reporting one or more risk factors, and screened for IgG antibodies to T. cruzi by EIA.ResultsRisk factors for T. cruzi infection were reported by 1,426 of 227,278 donors (0.6%). Testing 1,333 at-risk donors, none (0.0%; 95%, CI 0.0–0.4%) was seroreactive for IgG antibodies to T. cruzi. A total of 472 donors were born in a CEC; 553 donors reported their mother being born in a CEC; and 1,121 donors reported a long-term stay in a CEC. The vast majority of reported risk factors were related to Suriname and Brazil. Overall, the participants resided for 7,694 years in CECs, which equals 2.8 million overnight stays. Of those, 1.9 million nights were spent in Suriname.Conclusions/SignificanceAsymptomatic T. cruzi infection appears to be extremely rare among Dutch blood donors. Blood safety interventions to mitigate the risk of T. cruzi transmission by transfusion would be highly cost-ineffective in the Netherlands, and are thus not required.

Highlights

Chagas disease is a systemic, chronic disease caused by the protozoan parasite Trypanosoma cruzi, which is transmitted to humans on the Latin American continent by blood-feeding triatomine bugs followed by autoinoculation, through mother-tochild transmission, via transfusion and transplantation, and by ingestion of contaminated food [1,2]
Risk factors and the presence of T. cruzi antibodies in at-risk Dutch blood donors were studied to assess whether specific blood safety measures are warranted in the Netherlands
To assess whether interventions to prevent T. cruzi transmission by blood products are warranted in the Netherlands, we prospectively studied risk factors for T. cruzi infection among Dutch blood donors, and the presence of antibodies to T. cruzi in at-risk donors

Summary

Introduction

Chagas disease (or American trypanosomiasis) is a systemic, chronic disease caused by the protozoan parasite Trypanosoma cruzi, which is transmitted to humans on the Latin American continent by blood-feeding triatomine bugs followed by autoinoculation, through mother-tochild transmission, via transfusion and transplantation, and by ingestion of contaminated food [1,2]. Most of them do not show clinical symptoms for a period of years or decades after being infected During this period, a person can present to donate blood in seemingly good health, and subsequently may donate an infectious unit of blood. Over the past decades millions of people migrated from Latin America to countries with sporadic or no vectorial transmission of T. cruzi [5], having a negative impact on transfusion and transplantation safety levels in at least some non-endemic countries [6,7,8,9]. There are concerns in non-endemic countries about the safety of blood collected from donors who visited Latin America, irrespective of the person’s country of origin.

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