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Serologic Testing for Chagas' Disease and HIV in Counseling Programs and Blood Banks in Midwest Brazil
1Division of Infectious Diseases - Federal University of Mato Grosso do Sul.
Insights
Chagas
Area of Science:
- Infectious Diseases
- Public Health
- Epidemiology
Background:
- Blood banks in Brazil screen for HIV, Chagas' disease, hepatitis B and C, and syphilis.
- Counseling and testing programs are being established for HIV identification and treatment.
Purpose of the Study:
- To evaluate the frequency and age distribution of Trypanosoma cruzi infections among blood donors in Mato Grosso do Sul, Brazil.
- To determine if Chagas' disease screening should be integrated into existing counseling and testing programs.
Main Methods:
- A serological evaluation was conducted on 476 first-time blood donors.
- Standard ELISA and IFA tests were used to detect T. cruzi infection.
Main Results:
- Five donors (1.1%) tested positive for T. cruzi infection.
- All positive cases were males aged 22-35, not born in Mato Grosso do Sul.
- Some donors sought testing for T. cruzi, indicating potential demand.
Conclusions:
- The prevalence and demographic profile of T. cruzi infection suggest its inclusion in counseling and testing programs.
- Limitations include low attendance, slow result reporting, and lack of standardized testing.
- Recommendations include increased T. cruzi serologic testing and tailored questionnaires within HIV programs.
Abstract:
For many years it has been the practice in Brazil to question donors and to test blood to be used in blood banks for HIV, Chagas' disease, hepatitis B and C, and syphilis. Counseling and blood testing programs have recently been established to assist in identifying and treating those with HIV. In a blood bank center in Campo Grande, Mato Grosso do Sul State (MS), we evaluated the frequency and age of patients with positive tests for T.cruzi in order to determine whether the frequency and age distribution indicated that this infection should be added to the counseling and testing programs. A group of 476 first time blood donors were enrolled to answer a questionnaire and to be tested serologically for Chagas' disease, HIV, hepatitis B and C, and syphilis. A standard ELISA and an IFA test were used for Chagas' disease patients. Five patients (1.1%) were serologically positive for T.cruzi infection. All five were male between 22 and 35 years of age. None of the five had been born in Mato Grosso do Sul State. Four donors donated blood in order to obtain serologic test results, only one donated blood as a social responsibility. One was HIV positive and related previous STD, and one had received a blood transfusion between 1980 and 1986. Each had had only one sexual partner in the last six months. The age range and the frequency of 1.1% suggest that it would be beneficial to include this disease in counseling and testing program in Brazil. The limitations of this approach are the relatively low attendance at such centers in Mato Grosso do Sul (1.7 people/day compared to a national average of 2.9 people/day), the slow reporting time for results (1 week compared to 1 day for the blood bank reporting), and the absence of a standard disease-specific testing procedure. We recommend increasing the use of serologic tests for T.cruzi and designing appropriate questionnaires in counseling and testing programs now used primarily for HIV, assuming the existing limitations can be overcome.