Slavov Svetoslav Nanev, Otaguiri Katia Kaori, Pinto Mariana Tomazini, Valente Vanderléia Bárbaro, Ubiali Eugênia Maria Amorim, Covas Dimas Tadeu, Kashima Simone
Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
J Infect Dev Ctries. 2017 Mar 31;11(3):277-281. doi: 10.3855/jidc.8169.
American tripanosomiasis (Chagas disease), the second most neglected disease in the world, is caused by the protozoan parasite Trypanosoma cruzi. Though natural transmission by insect vectors has been controlled, there is significant risk of T. cruzi transmission by blood transfusion in non-endemic regions, generally due to immigration processes from endemic areas.
The objective of this study was to evaluate anti-T. cruzi seroprevalence in blood donors from the western part of São Paulo State, Brazil, by serologic and immunofluorescence confirmation tests for the period between 2012 and 2014. Currently, this region is regarded as a non-endemic area for Chagas disease.
The confirmed overall T. cruzi seroprevalence among blood donors was 0.10%, which can be considered low compared to other Brazilian regions. Nevertheless, the distribution of the anti-T. cruzi antibodies within the examined region was uneven, and some areas of significantly higher prevalence were observed.
We could consider two tendencies in the prevalence of T. cruzi: (i) residual older undiagnosed cases from São Paulo State, and (ii) immigration from endemic Brazilian or South American regions. The discordance obtained for T. cruzi prevalence by serologic and immunofluorescence methods demonstrates that more specific routine diagnosis is needed to diminish the cost of the assays and the loss of blood supply once all seropositive blood bags are immediately discarded.
美洲锥虫病(恰加斯病)是世界上第二大被忽视的疾病,由原生动物寄生虫克氏锥虫引起。尽管通过昆虫媒介的自然传播已得到控制,但在非流行地区,通过输血传播克氏锥虫的风险依然很大,这通常是由于来自流行地区的移民过程导致的。
本研究的目的是通过血清学和免疫荧光确认试验,评估2012年至2014年期间巴西圣保罗州西部献血者中抗克氏锥虫的血清阳性率。目前,该地区被视为恰加斯病的非流行地区。
献血者中经确认的克氏锥虫总体血清阳性率为0.10%,与巴西其他地区相比可认为较低。然而,在所检查区域内抗克氏锥虫抗体的分布并不均匀,观察到一些患病率显著较高的地区。
我们可以考虑克氏锥虫患病率的两种趋势:(i)圣保罗州残留的未确诊的老年病例,以及(ii)来自巴西或南美流行地区的移民。血清学和免疫荧光方法在克氏锥虫患病率上获得的不一致结果表明,需要更特异的常规诊断方法,以降低检测成本以及一旦所有血清阳性血袋立即被丢弃所造成的血液供应损失。