Risk factors for Trypanosoma cruzi infection among blood donors in Central Brazil

Abstract

Characteristics and possible risk factors associated with Trypanosoma cruzi infection among blood donors were assessed within a routine screening programme in blood banks in an endemic area of Chagas disease. 6,172 voluntary blood donors were interviewed and tested for anti-T. cruzi antibodies by Haemagglutination and Complement Fixation tests in six blood banks in Goiânia-Central Brazil from October 1988 to April 1989. An overall prevalence of 2.3% for T. cruzi infection was obtained, being 3.3% for first-time blood donors and 1.9% for regular ones (p < 0.01). Considering this seropositivity among regular blood donors, selection of candidates relying only on the history of previous donation was found to be inadequate. The risk of infection increased inversely with the degrees of education and monthly income. There was a 9.2 risk of infection (95% CI 3.8-22.6) for those who had lived more than 21 years in an endemic area compared to subjects who had never lived in rural settings, after multivariate analysis. These informations may help to review the criteria of selection of donors in order to improve quality of blood products in endemic areas.

Dealing with initial inconclusive serological results for chronic Chagas disease in clinical practice

“…Many risk factors or predictors were explored and found to be associated with chronic Chagas disease among blood donors [9,12,[17][18][19][20][21][22] and in rural area settings [23][24][25][26][27][28].…”

Does my patient have chronic Chagas disease? Development and temporal validation of a diagnostic risk score

“…Past studies investigated the use of several potential determinants of Chagas disease, such as recognizing the kissing bug or reporting living in places with kissing bugs (22) (23) (24) (25) (26) (27) , previous knowledge of the vector (28) (29) , reporting being bitten by the kissing bug (24) , reporting living in mud houses or in rural areas (22) (23) (28) (29) (30) (31) , Latin America as a place of birth or destination of previous travel (22) (32) , reporting receiving blood transfusions in the past (27) (33) , reporting blood donations in the past (26) (30) , education (22) (28) (30) (33) , social condition or income (22) (30) , reporting siblings or relatives with Chagas disease (23) (26) (27) , sex (26) (31) , and age (26) (28) (30) (31) (33) . However, they were all investigated under different conditions (blood bank screening, vertical transmission screening, and in rural area inhabitants) for different purposes, resulting in substantially different results from this research.…”

Avaliação de possíveis fatores de risco para a infecção pelo Trypanosoma cruzi em crianças: estudo caso-controle em area rural do estado de Goiás

“…Por exemplo, pacientes hemofílicos constituem um grupo considerado de alto risco para aquisição de infecção pelo T. cruzi por via sanguínea devido às numerosas e freqüentes transfusões a que são submetidos, conforme observado por Cerisola et al (1972). Martelli et al (1992) (Bronfen & Chiari, 1988). Uma outra variável a ser considerada diz respeito à viabilidade e virulência do T. cruzi por 2 ou 3\ semanas no sangue, plasma ou papa de hemácias estocadas (Cerisola et al, 1972).…”

“…Zicker et al (1989) detectaram 13% de soroprevalência entre trabalhadores urbanos sem qualificação técnica, em Goiânia. Zicker et al (1990b) e Martelli et al (1992), estudando doadores de sangue da mesma cidade e mesmo período, mostraram que a maior parte destes indivíduos eram trabalhadores braçais, de baixo nível sóCio-econômico e migrantes de áreas rurais onde a doença é endêmica.…”

“…Desta forma, a-transmissão do T. cruzi por transfusão de sangue vem adquirindo, sem dúvida, importância crescente na América Latina. A magnitude da transmissão pelo T. cruzi por sangue infectado pode ser avaliada pela quantidade de trabalhos que vêm sendo realizados em bancos de sangue, nas décadas de 80 e 90 Bronfen & Chiari, 1988;Souza, 1989;Brener, 1989;Carrasco et al, 1990;Zicker et al, 1990b;Martelli et al, 1992;Andrade et al, 1992a).…”