<scp><i>Babesia microti</i></scp> seroprevalence in <scp>M</scp>innesota blood donors

Tonnetti, Laura; Thorp, Aaron M.; Deisting, Barbara; Bachowski, Gary J.; Johnson, Stephanie T.; Wey, Andrew; Hodges, James S.; Leiby, David A.; Mair, David

doi:10.1111/j.1537-2995.2012.03948.x

Cited by 26 publications

(26 citation statements)

References 13 publications

(18 reference statements)

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“…Prior studies of B. microti testing in endemic areas using predominantly research IFAs yielded seroprevalence rates of 1.2% to 1.8% in the highly endemic counties of Middlesex and New London, CT, which were also evaluated in this study, and that those rates were stable over 8 years of study . Higher rates (2%) were recently documented in endemic counties of MN using a similar research IFA, with a single PCR‐positive sample identified of 2150 donors tested . The same investigators reported a seroprevalence rate of 2.5% in the two highly endemic counties of CT .…”

Section: Discussionsupporting

confidence: 54%

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Investigational screening for Babesia microti in a large repository of blood donor samples from nonendemic and endemic areas of the United States

et al. 2014

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Section: Discussionsupporting

confidence: 54%

“…) is broader (including 26 states) than the locations of the six regional blood centers included in this study. Moreover, the large sample size contributes a sizable amount of data to those already available in the literature 20‐24. This study also includes donor data from nonendemic areas, which have not previously been reported.…”

Section: Discussionmentioning

confidence: 99%

Investigational screening for Babesia microti in a large repository of blood donor samples from nonendemic and endemic areas of the United States

et al. 2014

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“…In this initial study in endemic and nonendemic blood donor populations, the overall rates of EIA seroreactivity were similar to those reported in several previous studies based on IFA methods . A comparison of the sample sets identified as reactive by EIA versus IFA suggests that the two methods detect overlapping, but not identical subsets (corroborated by the kappa value of 0.38, interpreted as “fair” agreement).…”

Section: Discussionsupporting

confidence: 84%

Determination of Babesia microti seroprevalence in blood donor populations using an investigational enzyme immunoassay

Levin

Williamson²,

Erwin

et al. 2014

Transfusion

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Background Transfusion-transmitted babesiosis caused by Babesia microti has emerged as a significant risk to the US blood supply. This study estimated the prevalence of B. microti antibodies in blood donors using an investigational enzyme immunoassay (EIA). Study Design and Methods A peptide-based EIA that detects both IgG and IgM antibodies to B. microti was developed and validated. Donor samples randomly selected from areas defined as high-risk endemic, lower-risk endemic and non-endemic for B. microti were de-identified and tested using the investigational EIA. Samples that were EIA repeat reactive were further tested by B. microti immunofluorescent assay (IFA), PCR on RBC lysates and peripheral blood smear examination (PBS). A random subset of 1,272 samples from high-risk endemic areas was tested by IFA, PCR and PBS in parallel with EIA. Results Among 15,000 donations tested with the investigational B. microti EIA, EIA repeat reactive rates were 1.08% (54/5,000) in a high-risk endemic area, 0.74% (37/5,000) in a lower-risk area, and 0.40% (20/5000) in a non-endemic area. Following application of a revised cut-off, these values were reduced to 0.92%, (46/5,000), 0.54% (27/5,000) and 0.16% (8/5,000). Overall concordance between EIA and IFA among donor samples was 99.34%. One seropositive sample was positive by PCR.. Conclusion The seroprevalence of B. microti in blood donors in a high-risk area measured by an investigational EIA was about 1%. The EIA shows promise as an efficient high-throughput blood donor screening assay for B. microti.

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“…Over the past decade the geographic range of B. microti has expanded and more tick and transfusion‐transmitted cases have been documented . In endemic states, donor seroprevalence can be as high as 2%, with incidence ranging from 1 in 604 to 1 in 100,000 cases per RBC units transfused …”

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Cost‐effectiveness of blood donor screening for Babesia microti in endemic regions of the United States

et al. 2013

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Background Babesia microti is the leading reported cause of red blood cell (RBC) transfusion-transmitted infection in the United States (US). Donor screening assays are in development. Study Design and Methods A decision analytic model estimated the cost-effectiveness of screening strategies for preventing transfusion-transmitted babesiosis (TTB) in a hypothetical cohort of transfusion recipients in Babesia-endemic areas of the US. Strategies included: (1) No screening, (2) Uniform Donor Health History Questionnaire (UDHQ), “status quo”, (3) Recipient risk-targeting using donor antibody (Ab) and polymerase chain reaction (PCR) screening, (4) Universal endemic donor Ab screening, (5) Universal endemic donor Ab and PCR screening. Outcome measures were TTB cases averted, costs, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios ($/QALY). We assumed a societal willingness to pay of $1 million/QALY based on screening for other transfusion-transmitted infections. Results Compared to no screening, the UDHQ avoids 0.02 TTB cases per 100,000 RBC transfusions at an incremental cost effectiveness ratio (ICER) of $160,000/QALY whereas recipient risk-targeted strategy using Ab/PCR avoids 1.62 TTB cases per 100,000 RBC transfusions at an ICER of $713,000/QALY compared to the UDHQ. Universal endemic Ab screening avoids 3.39 cases at an ICER of $760,000/QALY compared to the recipient-risk targeted strategy. Universal endemic Ab/PCR screening avoids 3.60 cases and has an ICER of $8.8 million/QALY compared to universal endemic Ab screening. Results are sensitive to blood donor Babesia prevalence, TTB transmission probability, screening test costs, risk and severity of TTB complications, and impact of babesiosis diagnosis on donor quality of life. Conclusion Antibody screening for Babesia in endemic regions is appropriate from an economic perspective based on the societal willingness to pay for preventing infectious threats to blood safety.

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Babesia microti seroprevalence in Minnesota blood donors

Cited by 26 publications

References 13 publications

Investigational screening for Babesia microti in a large repository of blood donor samples from nonendemic and endemic areas of the United States

Investigational screening for Babesia microti in a large repository of blood donor samples from nonendemic and endemic areas of the United States

Determination of Babesia microti seroprevalence in blood donor populations using an investigational enzyme immunoassay

Cost‐effectiveness of blood donor screening for Babesia microti in endemic regions of the United States

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