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Home arrow Economics arrow American Trypanosomiasis Chagas Disease, Second Edition: One Hundred Years of Research

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Blood transfusion

Due to the persistence of the parasite in the organism, infected individuals may be responsible for parasite transmission by blood donation throughout their life, even when they are asymptomatic carriers and unaware of their infection. Fever is the most common and sometimes the only manifestation of acute Chagas disease following transfusion of infected blood, but in the most severe cases (lymphadenopathy, hepatospleno- megaly, and cardiac arrhythmia), central nervous system involvement may be present.1

Current situation in endemic countries

In the past, the risk of transmission of T. cruzi during blood transfusion was high in endemic areas because of the lack of controls in blood banks. The first cases of people who acquired the infection by blood transfusion were described in 1952 in Brazil.2 It was only with the spread of HIV in the 1980s that effective blood control programs were implemented in most Latin American countries.3 This opened the way to preventing other widespread infectious diseases and in many of the endemic countries, blood transmission of T. cruzi dramatically decreased in the 1990s after the implementation of mandatory blood bank controls.4—12 The blood banks of Brazil and Uruguay are now totally controlled for Chagas disease and Chile is finishing this control.13

However, despite these successes, blood bank control remains a great challenge, because some endemic countries have not yet introduced complete controls of their blood donors or have done so only recently, and there is no consensus on the methods to apply.7 For example, in Mexico, one of the countries with the lowest level of screening coverage in Latin America, cases of T. cruzi transmission by blood transfusion have been described in the last decade and great efforts have been necessary to increase the donor T. cruzi screening coverage of 36.5% in 2005 to 92% in 2012.12,14

 
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