Schmunis G A, Zicker F, Pinheiro F, Brandling-Bennett D
Pan American Health Organization, Washington, D.C., USA.
Emerg Infect Dis. 1998 Jan-Mar;4(1):5-11. doi: 10.3201/eid0401.980102.
We report the potential risk for an infectious disease through tainted transfusion in 10 countries of South and Central America in 1993 and in two countries of South America in 1994, as well as the cost of reagents as partial estimation of screening costs. Of the 12 countries included in the study, nine screened all donors for HIV; three screened all donors for hepatitis B virus (HBV); two screened all donors for Trypanosoma cruzi; none screened all donors for hepatitis C virus (HCV); and six screened some donors for syphilis. Estimates of the risk of acquiring HIV through blood transfusion were much lower than for acquiring HBV, HCV, or T. cruzi because of significantly higher screening and lower prevalence.rates for HIV. An index of infectious disease spread through blood transfusion was calculated for each country. The highest value was obtained for Bolivia (233 infections per 10,000 transfusions); in five other countries, it was 68 to 103 infections per 10,000. The risks were lower in Honduras (nine per 10,000), Ecuador (16 per 10,000), and Paraguay (19 per 10,000). While the real number of potentially infected units or infected persons is probably lower than our estimates because of false positives and already infected recipients, the data reinforce the need for an information system to assess the level of screening for infectious diseases in the blood supply. Since this information was collected, Chile, Colombia, Costa Rica, and Venezuela have made HCV screening mandatory; serologic testing for HCV has increased in those countries, as well as in El Salvador and Honduras. T. cruzi screening is now mandatory in Colombia, and the percentage of screened donors increased not only in Colombia, but also in Ecuador, El Salvador, and Paraguay. Laws to regulate blood transfusion practices have been enacted in Bolivia, Guatemala, and Peru. However, donor screening still needs to improve for one or more diseases in most countries.
我们报告了1993年南美洲和中美洲10个国家以及1994年南美洲2个国家因输血感染传染病的潜在风险，以及试剂成本作为筛查成本的部分估算。在纳入研究的12个国家中，9个国家对所有献血者进行了HIV筛查；3个国家对所有献血者进行了乙型肝炎病毒（HBV）筛查；2个国家对所有献血者进行了克氏锥虫筛查；没有国家对所有献血者进行丙型肝炎病毒（HCV）筛查；6个国家对部分献血者进行了梅毒筛查。由于HIV的筛查率显著更高且患病率更低，通过输血感染HIV的风险估计远低于感染HBV、HCV或克氏锥虫的风险。为每个国家计算了通过输血传播传染病的指数。玻利维亚的指数最高（每10000次输血有233例感染）；在其他5个国家，该指数为每10000次输血68至103例感染。洪都拉斯（每10000人中有9例）、厄瓜多尔（每10000人中有16例）和巴拉圭（每10000人中有19例）的风险较低。由于存在假阳性和已感染受血者，实际潜在感染单位或感染人数可能低于我们的估计，但这些数据强化了建立一个信息系统以评估血液供应中传染病筛查水平的必要性。自收集这些信息以来，智利、哥伦比亚、哥斯达黎加和委内瑞拉已强制进行HCV筛查；这些国家以及萨尔瓦多和洪都拉斯的HCV血清学检测有所增加。哥伦比亚现在强制进行克氏锥虫筛查，不仅哥伦比亚，厄瓜多尔、萨尔瓦多和巴拉圭筛查献血者的比例也有所增加。玻利维亚、危地马拉和秘鲁已颁布规范输血行为的法律。然而，大多数国家对一种或多种疾病的献血者筛查仍需改进。
