Blood transfusion and iatrogenic risks in Mexico city: anti-Trypanosoma cruzi seroprevalence in 43,048 blood donors, evaluation of parasitemia, and electrocardiogram findings in seropositive

Hernández-Becerril, Nidia; Mejía, Ana María; Ballinas-Verdugo, Martha A; Garza-Murillo, Verónica; Manilla-Toquero, Elsa; López, Ruth; Trevethan, S; Cárdenas, Manuel; Reyes, Pedro A.; Hirayama, Kenji; Monteón, Vı́ctor

doi:10.1590/s0074-02762005000200002

Cited by 30 publications

(20 citation statements)

References 14 publications

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“…Although hemoculture always indicates the low sensitivity of such methods, a great deal of disagreement is found in its results when different studies are analyzed, which may be related to the nature of the culture medium, the technique employed, the volume of blood used or the number of test repetitions in each patient [46][47][48][49]. Concerning xenodiagnosis, the experiences of different authors also disagree, and that may be related to the different vector species used, the method of nymphs visualization and the amount of blood utilized [7,50].…”

Section: Discussionmentioning

confidence: 99%

Definition of a diagnostic routine in individuals with inconclusive serology for chagas disease

Picka¹,

Meira²,

Carvalho³

et al. 2007

Braz J Infect Dis

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Despite the existence of highly sensitive tests, inconclusive serological results are frequent in chronic chagasic infection. This study aimed to define a diagnostic conduct for 30 individuals with inconclusive serology (G3) for chagasic infection assisted at the Outpatient Unit for Infectious and Parasitic Diseases of the Botucatu School of Medicine. Twenty-one individuals with negative serology (G1) and 33 with positive serology (G2) were also studied. Serological methods ELISA, HAI, IFI and immunoblotting TESA-cruzi were used for G1, G2 and G3, and parasitological methods xenodiagnosis, hemoculture and PCR-LIT were used for G2 and G3 individuals. ELISA, HAI and IFI were performed in 5 different blood samples in G2 and G3. TESA-cruzi was carried out only once in G1, G2 and G3 and, since it is the most sensitive, it was utilized as standard. In G3, positivity for ELISA reached 86% in the fifth blood sample; the ELISA+HAI+IFI combination showed a maximum of 44.8% in the second sample; and TESA-cruzi, 76% in one single sample. Xenodiagnosis positivity was 9.4%; hemoculture showed 15.2%; and PCR-LIT exhibited 22% positivity in G2. Nevertheless, in G3, positivity percentage was 3.4% for xenodiagnosis, 6.7% for PCR-LIT, and no positive result was found for hemoculture. In G3, PCR-LIT resolved one case which was still inconclusive according to serology tests. In order to define inconclusive diagnoses, the results suggest the combined use of ELISA+HAI+IFI in 2 blood samples, decreasing the occurrence of false positive/negative results. If results remain inconclusive, the performance of TESA-cruzi and PCR-LIT, if necessary, is recommended.

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Section: Discussionmentioning

confidence: 99%

Definition of a diagnostic routine in individuals with inconclusive serology for chagas disease

Picka¹,

Meira²,

Carvalho³

et al. 2007

Braz J Infect Dis

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“…Blood transfusion has been considered the second most important mode of transmission of Chagas disease in Mexico [68]. In 1998, the screening of almost 65,000 blood donors from 18 government-run transfusion centers showed a 1.5% prevalence of anti- T. cruzi antibodies in blood donors [69].…”

Section: Discussionmentioning

confidence: 99%

Estimating the current burden of Chagas disease in Mexico: a systematic review of epidemiological surveys from 2006 to 2017

Arnal

Waleckx

Herrera

et al. 2018

Preprint

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BackgroundIn Mexico, estimates of Chagas disease prevalence and burden vary widely. Updating surveillance data is therefore an important priority to ensure that Chagas disease does not remain a barrier to the development of Mexico’s most vulnerable populations.Methodology/Principal FindingsThe aim of this systematic review was to analyze the literature on epidemiological surveys to estimate Chagas disease prevalence and burden in Mexico, during the period 2006 to 2017. A total of 2,764 articles were screened and 38 were retained for the final analysis. Epidemiological surveys have been performed in most of Mexico, but with variable geographic coverage. Based on studies reporting confirmed cases, i.e. using at least 2 serological tests, the national seroprevalence of Trypanosoma cruzi infection was 2.26% [95% Confidence Interval (CI) 2.12-2.41], suggesting that there are 2.71 million cases in Mexico. Studies focused on pregnant women, which may transmit the parasite to their newborn during pregnancy, reported a seroprevalence of 1.00% [95% CI 0.87-1.14], suggesting that there are 22,930 births from T. cruzi infected pregnant women per year, and 1,445 cases of congenitally infected newborns per year. Children under 18 years had a seropositivity rate of 1.49% [95% CI 1.20-1.85], which indicate ongoing transmission. Finally, cases of T. cruzi infection in blood donors have also been reported in most states, with a national seroprevalence of 0.51% [95% CI 0.49-0.53].Conclusions/SignificanceOur analysis suggests a disease burden for T. cruzi infection higher than previously recognized, highlighting the urgency of establishing Chagas disease surveillance and control as a key national public health priority in Mexico, to ensure that it does not remain a major barrier to the economic and social development of the country’s most vulnerable populations.Author summaryIn Mexico, estimates of Chagas disease prevalence and burden vary widely due to the ecology and epidemiology of this disease resulting of many geographical, ecological, biological, and social interactions. Better data are thus urgently needed to help develop appropriate public health programs for disease control and patient care. In this study we analyzed published data on T. cruzi seroprevalence infection in Mexico between 2006 and 2017. This systematic review shows a national seroprevalence of T. cruzi infection of 2.26% [95%CI 2.12-2.41], with over 2.71 million cases in Mexico, which is higher than previously recognized. The presence of T. cruzi infection in specific subpopulations such as pregnant women, children and blood donors also informs on specific risks of infection and call for the implementation of well-established control interventions. This work confirms the place of Mexico as the country with the largest number of cases, highlighting the urgency of establishing Chagas disease control as a key national public health priority.

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“…With respect to human infection, the National Seroepidemio-logical Survey (NSS) (Velasco et al 1992) carried out by the official Secretaría de Salud (SSa) showed a prevalence of 1.6%, whereas independent studies carried out mainly in rural areas have shown that between 20 and 30% of the population was infected by the pathogen (Monteon & Reyes-Lopez 1989, Tay et al 1992. Moreover, positive blood donors have been detected at percentages of 0.2-17% of infected persons (Ramos-Echevarria et al 1993, Guzman-Bracho et al 1998, Rangel et al 1998, Sánchez-Guillén et al 2002, Hernandez-Becerril et al 2005, Kirchhoff et al 2006). …”

Section: Discussionmentioning

confidence: 99%

Clinical forms of Trypanosoma cruzi infected individuals in the chronic phase of Chagas disease in Puebla, Mexico

Sánchez-Guillén

López‐Colombo²,

Ordóñez-Toquero³

et al. 2006

Mem. Inst. Oswaldo Cruz

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Blood transfusion and iatrogenic risks in Mexico city: anti-Trypanosoma cruzi seroprevalence in 43,048 blood donors, evaluation of parasitemia, and electrocardiogram findings in seropositive

Abstract: Iatrogenous transmission of Trypanosoma cruzi by blood transfusion was suggested as a potential risk by Pellegrino (1949

Cited by 30 publications

References 14 publications

Definition of a diagnostic routine in individuals with inconclusive serology for chagas disease

Definition of a diagnostic routine in individuals with inconclusive serology for chagas disease

Estimating the current burden of Chagas disease in Mexico: a systematic review of epidemiological surveys from 2006 to 2017

Clinical forms of Trypanosoma cruzi infected individuals in the chronic phase of Chagas disease in Puebla, Mexico

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