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献血者内脏利什曼原虫感染的全球状况:系统评价与荟萃分析。

Global status of visceral leishmanial infection among blood donors: A systematic review and meta-analysis.

作者信息

Asfaram Shabnam, Fakhar Mahdi, Soosaraei Masoud, Hosseini Teshnizi Saeed, Mardani Ahmad, Banimostafavi Elham Sadat, Ziaei Hezarjaribi Hajar

机构信息

Student Research Committee, Department of Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.

Molecular and Cell Biology Research Center, Department of Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.

出版信息

Transfus Apher Sci. 2017 Oct;56(5):748-754. doi: 10.1016/j.transci.2017.09.007. Epub 2017 Sep 21.

Abstract

INTRODUCTION

Transmission of Leishmania through transfusion has been reported from various Visceral leishmaniasis (VL) endemic areas of the world. The true burden of Leishmania infection in blood donors remains generally unknown. Thus, the present systematic review attempted to determine the global prevalence of Leishmania infection among blood donors.

METHODS

Data were extracted through five English and five Persian databases during the period from 1997 to 2016. Overall, 16 articles fulfilled the inclusion criteria and were used for data extraction in this systematic review.

RESULTS

In total, 13,743 blood donors from different regions of world were examined. The prevalence rate of Leishmania infection according to seropositivity obtained 7% (95%CI: 5%, 8%). The lowest and the highest prevalence were related to Bangladesh 0.25% (95%CI: 0.0%, 1.0%) and Brazil, 16% (95%CI: 12%, 19%). Seroprevalence rate of leishmaniasis among females was more (4.60%) than males. Of 15 studies included in the meta-analysis, the pooled prevalence rate of molecular tests was obtained 2% (95%CI: 1%, 3%) in which Iran and Spain had the lowest and the highest prevalence, 0.05% and 7%, respectively. Our analysis showed that L. infantum was more common than L. donovani as etiological agent of VL among all donors.

CONCLUSION

Our data confirms the presence of asymptomatic carriers of VL in endemic areas and supplies as an attentive to the likelihood of these carriers acting as blood donors. Moreover, we conclude that molecular tests for screening in asymptomatic blood donor provide an accurate estimate of the rate of infection over serological tests.

摘要

引言

世界上各个内脏利什曼病(VL)流行地区均有通过输血传播利什曼原虫的报道。献血者中利什曼原虫感染的真实负担通常仍不为人所知。因此,本系统评价试图确定全球献血者中利什曼原虫感染的患病率。

方法

在1997年至2016年期间通过五个英文数据库和五个波斯文数据库提取数据。总体而言,有16篇文章符合纳入标准,并用于本系统评价的数据提取。

结果

总共检查了来自世界不同地区的13743名献血者。根据血清学阳性得出的利什曼原虫感染患病率为7%(95%置信区间:5%,8%)。最低和最高患病率分别与孟加拉国的0.25%(95%置信区间:0.0%,1.0%)和巴西的16%(95%置信区间:12%,19%)相关。女性利什曼病血清阳性率高于男性(4.60%)。在纳入荟萃分析的15项研究中,分子检测的合并患病率为2%(95%置信区间:1%,3%),其中伊朗和西班牙的患病率最低和最高,分别为0.05%和7%。我们的分析表明,在所有献血者中,婴儿利什曼原虫作为VL的病原体比杜氏利什曼原虫更常见。

结论

我们的数据证实了流行地区存在VL无症状携带者,并提醒注意这些携带者作为献血者的可能性。此外,我们得出结论,对无症状献血者进行筛查的分子检测比血清学检测能更准确地估计感染率。

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