Trypanosoma cruzi seroprevalence among solid organ donors in Ceará State, Brazil

Abstract

Introduction: The transmission of Chagas disease (CD) through blood transfusion, organ transplantation, and oral transmission has gained greater visibility as a result of intensified vector control activities in endemic regions and to control CD in nonendemic regions. In Brazil, Ceará is one of the states that perform the most organ transplants. Therefore, the objective of this study was to assess the prevalence of Trypanosoma cruzi infection in organ donor candidates. Methods: A retrospective analysis was performed on data from potential organ donors at the Center of Transplantation of the State of Ceará from 2010-2015. Results: Data from a total of 2,822 potential donors were obtained, of which 1,038 were effective donors and 1,784 were excluded, likely due to lack of family authorization or medical contraindication. The prevalence of T. cruzi infection among these potential donors was 1.3% (n = 29). The majority of infected donors were males aged 41-60 years, residing in the interior of the state. Interestingly, 72.4% (n = 21) had positive or inconclusive serology for additional infections, such as cytomegalovirus, hepatitis B and C, and toxoplasmosis. Probability analysis revealed that stroke was the most common cause of death among potential donors with CD. Conclusions: There was a high prevalence of CD and other coinfections among potential solid organ donors in Ceará, and statistical tests have shown that these individuals are at increased risk of stroke when compared to potential non-reactive donors. This work highlights the importance of screening DC infection in potential donors.

Trends of Seroprevalence of Chagas´s diseases in healthy blood donors, solid organ donors and heart transplant recipients: experience of a single health care center in Colombia.

“…In organ transplantation, there are several published case reports of the infection in both donors and recipients, but few available studies of cumulative seroprevalence in this population. One of them is the study by da Costa et al in Brazil, who found a seroprevalence in potential organ donors of 1.3%, which was different from ours [25]. It is also important to assess the risk of reactivation of the infection in the post-transplant stage.…”

“…However, several studies have shown a higher frequency of infection in men aged 25-49 years, not only in general population serosurveys but also in reactivity studies in blood donors. This suggests that there seems to be a differential risk that some authors have explained from an occupational point of view [13,[25][26][27]. As for women of childbearing age, the collection of reactive sera is very timely in preventing congenital disease, taking into account that this represents up to 5% of all forms of transmission [2,6].…”

Prevalência da Infecção pelo Trypanosoma cruzi em Doadores de Sangue

“…3,4 Com relação à transmissão da DC, as duas formas de maior importância epidemiológica são a vetorial e a transfusional. 2,5,6 A partir de 1940, a prática da transfusão de sangue se generalizou por toda a América Latina, o que contribuiu para aumentar o risco de doença de Chagas transfusional. [7][8][9][10][11][12] Diante disso, a transfusão de sangue começou a ter importância epidemiológica a partir de 1944 e passou a ser tecnicamente avaliada em 1951.…”

Chagas Disease, Leishmaniasis, and Malaria in Solid Organ Transplant Recipients

“…It is worth noting that in Argentina, the prevalence of T. cruzi infection among effective donors doubled (from 2.46% to 4.6%) from 2005 to 2009 [31]. A risk that is not negligible was also observed in Brazil, where among 2,822 potential organ donors, 1.3% had a positive T. cruzi serology, and the prevalence rate increased from 1.0% in 2010 to 1.6% in 2015 [32].…”

“…Reactivation of CD among seropositive recipients is currently diagnosed by detection of blood parasitaemia by polymerase chain reaction (PCR) or by endomyocardial biopsy (among HTx patients) which allows early preemptive therapy and improved survival [36,43]. The Chagas reactivation rate in patients who underwent HTx is reported on average to be 41%, ranging from 23% to 90%, depending on the study [32,34,[36][37][38][39][40][41][42][43][44][45][46]. Multiple episodes of reactivation (up to eight) have been described among patients who underwent heart transplantation [40].…”