Wallace James A, Miller Linda, Beavis Andrew, Baptista Carlos A C
The University of Toledo College of Medicine, Toledo, OH, USA.
Prog Transplant. 2013 Sep;23(3):272-7. doi: 10.7182/pit2013712.
Chagas disease is caused by the parasite Trypanosoma cruzi. The disease is difficult to detect because of the asymptomatic pathogenesis after infection. Chagas disease is endemic throughout much of Mexico, Central America, and South America, but human migration patterns are bringing the pathogen to the United States. The disease currently affects 16 to 18 million people with approximately 50 000 deaths annually in these countries. In the United States, national screening of the blood supply was instituted in early 2007, and more than 1000 donors with T cruzi infection have been identified within the past 3 years of testing. It was observed that out of the 58 organ procurement organizations in the United States, only 4 required mandatory testing of every donor for Chagas disease. It was estimated that as of 2009, approximately 409 000 residents are living with Chagas disease, and in a 22-year span, approximately 300 patients may have contracted Chagas disease through transplant. Proposed solutions to the current testing method include automatic testing based on the medical social history questionnaire, testing of all recipients for Chagas disease, testing all persons of Latin descent, or testing of all organ donors.
恰加斯病由克氏锥虫寄生虫引起。由于感染后存在无症状发病机制，该病难以检测。恰加斯病在墨西哥、中美洲和南美洲的大部分地区流行，但人类迁移模式正将这种病原体带到美国。目前，这些国家有1600万至1800万人受该病影响，每年约有5万人死亡。在美国，2007年初开始对血液供应进行全国筛查，在过去3年的检测中已发现1000多名克氏锥虫感染者。据观察，在美国的58个器官采购组织中，只有4个要求对每个捐赠者进行恰加斯病强制检测。据估计，截至2009年，约有40.9万居民感染恰加斯病，在22年的时间里，约有300名患者可能通过移植感染恰加斯病。针对当前检测方法提出的解决方案包括基于医疗社会史问卷的自动检测、对所有接受者进行恰加斯病检测、对所有拉丁裔进行检测或对所有器官捐赠者进行检测。
