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[Control of Chagas disease in blood banks in Colombia]
Markus Behrend1, Mauricio Beltrán, Marcos Restrepo
1Latin American Centre for Health Research, Liverpool School of Tropical Medicine, Liverpool, U.K.
Insights
Colombian blood banks screened nearly all donated blood for Chagas disease (Trypanosoma cruzi), finding a 1.2% seroprevalence rate. Recommendations were made to improve screening protocols and confirmatory testing for Trypanosoma cruzi.
Area of Science:
- Infectious Diseases
- Parasitology
- Public Health
Context:
- Chagas disease, caused by Trypanosoma cruzi, is a significant public health concern in Latin America.
- Blood transfusion is a potential route of Trypanosoma cruzi transmission.
- Effective screening programs are crucial for ensuring blood supply safety.
Purpose:
- To evaluate the Chagas disease screening programs in Colombian blood banks.
- To identify procedural improvements in screening strategies, techniques, and actions for seropositive donors.
- To assess the prevalence of anti-T. cruzi antibodies in blood donors across Colombia.
Summary:
- A survey of 103 Colombian blood banks (66.6% of national collection in 1997) revealed that 99.6% of 287,048 screened blood units were tested for Trypanosoma cruzi.
- A seroprevalence of 1.2% (3,321 units) for anti-T. cruzi antibodies was detected, with significant geographical variations (0% to 12.6%).
- ELISA was the primary screening method, but only 33.2% of positive samples underwent confirmatory testing, primarily via indirect immunofluorescent assay. Quality control measures were generally in place.
Impact:
- Highlights the need for standardized and robust screening protocols for Chagas disease in blood banks.
- Identifies gaps in confirmatory testing, emphasizing the importance of accurate diagnosis to prevent transfusion-transmitted infections.
- Provides essential data for public health policy and interventions aimed at controlling Chagas disease transmission through the blood supply in Colombia.
Abstract:
The screening programs for the Chagas disease agent, Trypanosoma cruzi, were examined in Colombian blood banks and, as a consequence, several procedural improvements in the blood bank network were recommended. Screening strategies and techniques were examined, as well as the action taken when seropositive donors were discovered. From a total of 180 blood banks in 33 departments, 103 banks in 20 departments answered the survey. The 103 banks collected 291, 105 units of blood, corresponding to 66.6% of all units collected in the country in 1997. Of these blood units, 99.6% were screened for Chagas trypanosomes; 3,321 (1.2%) of 287,048 were found positive for anti-T. cruzi. The data were grouped by department; geographical differences for seroprevalence rates varied markedly between 0% and 12.6%. The most commonly used serological technique was ELISA, but only 33.2% of the positive samples for anti-T. cruzi underwent further confirmatory testing, mainly through indirect immunofluorescent test. Most (95.1%) of the blood banks used basic, internal quality control procedures, and 73.8% sent positive samples to other laboratories for external quality control.
