Deferral of blood donors who have ever stayed in a Trypanosoma cruzi endemic area: An international survey.

IF 1.8 4区 医学 Q3 HEMATOLOGY Vox Sanguinis Pub Date : 2024-09-01 Epub Date: 2024-06-13 DOI:10.1111/vox.13692
Antoine Lewin, Laura Tonnetti, Christian Renaud, Steven J Drews, Evan M Bloch, Sheila F O'Brien
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Abstract

Background and objectives: Trypanosoma cruzi is the etiologic agent of Chagas disease (CD), an anthropozoonosis from the American continent that progresses from an acute phase to an indeterminate phase, followed by a chronic symptomatic phase in around 30% of patients. In countries where T. cruzi is not endemic, many blood transfusion services test blood donors who have stayed in an endemic country ('at-risk stay')-even if they do not present with other risk factors. However, the efficiency of this approach has been questioned.

Materials and methods: On 18 September 2023, a worldwide survey was distributed among employees of blood transfusion services. The questions mainly pertained to CD's endemicity in the blood services' region, the current testing policy for T. cruzi and the number of confirmed positive results among donors with a prior at-risk stay alone (i.e., without other risk factors for T. cruzi infection).

Results: Twenty-six recipients completed the survey. Of the 22 (84.6%) blood services that operated in a non-endemic region, 9 (42.9%) tested donors for T. cruzi, including 8 (88.9%) that considered the travel history or the duration of the stay (alone) in their testing algorithm ('study blood services'). Over 93 years of observation among all study blood services, 2 donations from donors with an at-risk stay alone and 299 from those with other risk factors were confirmed positive for T. cruzi.

Conclusion: The study findings question the utility of testing blood donors who have stayed in an endemic country without other risk factors.

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曾在克鲁斯锥虫流行地区逗留过的献血者暂缓献血:一项国际调查。
背景和目的:克鲁兹锥虫是恰加斯病(CD)的病原体,恰加斯病是一种来自美洲大陆的炭疽病,大约 30% 的患者会从急性期发展到不确定期,然后进入慢性症状期。在 T. cruzi 没有流行的国家,许多输血服务机构都会对曾在 T. cruzi 流行国家逗留过的献血者进行检测("高危逗留"),即使他们没有其他风险因素。然而,这种方法的效率受到了质疑:2023 年 9 月 18 日,向输血服务机构的员工发放了一份全球调查问卷。调查问题主要涉及输血服务机构所在地区的 CD 流行情况、现行的 T. cruzi 检测政策以及在之前仅停留在高危地区(即不存在其他 T. cruzi 感染风险因素)的献血者中确诊阳性结果的数量:26 名受者完成了调查。在 22 家(84.6%)在非流行区运营的血站中,9 家(42.9%)对献血者进行了 T. cruzi 检测,其中 8 家(88.9%)在检测算法中考虑了旅行史或停留时间(单独)("研究血站")。在所有研究血站 93 年的观察中,有 2 例来自仅有高危逗留史的献血者的捐献和 299 例来自有其他风险因素的献血者的捐献被证实对 T. cruzi 呈阳性:研究结果质疑了对在无其他风险因素的情况下在流行国家逗留过的献血者进行检测的实用性。
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来源期刊
Vox Sanguinis
Vox Sanguinis 医学-血液学
CiteScore
4.40
自引率
11.10%
发文量
156
审稿时长
6-12 weeks
期刊介绍: Vox Sanguinis reports on important, novel developments in transfusion medicine. Original papers, reviews and international fora are published on all aspects of blood transfusion and tissue transplantation, comprising five main sections: 1) Transfusion - Transmitted Disease and its Prevention: Identification and epidemiology of infectious agents transmissible by blood; Bacterial contamination of blood components; Donor recruitment and selection methods; Pathogen inactivation. 2) Blood Component Collection and Production: Blood collection methods and devices (including apheresis); Plasma fractionation techniques and plasma derivatives; Preparation of labile blood components; Inventory management; Hematopoietic progenitor cell collection and storage; Collection and storage of tissues; Quality management and good manufacturing practice; Automation and information technology. 3) Transfusion Medicine and New Therapies: Transfusion thresholds and audits; Haemovigilance; Clinical trials regarding appropriate haemotherapy; Non-infectious adverse affects of transfusion; Therapeutic apheresis; Support of transplant patients; Gene therapy and immunotherapy. 4) Immunohaematology and Immunogenetics: Autoimmunity in haematology; Alloimmunity of blood; Pre-transfusion testing; Immunodiagnostics; Immunobiology; Complement in immunohaematology; Blood typing reagents; Genetic markers of blood cells and serum proteins: polymorphisms and function; Genetic markers and disease; Parentage testing and forensic immunohaematology. 5) Cellular Therapy: Cell-based therapies; Stem cell sources; Stem cell processing and storage; Stem cell products; Stem cell plasticity; Regenerative medicine with cells; Cellular immunotherapy; Molecular therapy; Gene therapy.
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