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Title:
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Strategies for reducing the risk of transfusion-transmitted leishmaniasis in an area endemic for Leishmania infantum: a patient- and donor-targeted approach
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Author:
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Jimenez-Marco, Teresa; Riera Lizandra, Ma. Cristina; Girona-Llobera, Enrique; Guillen, Carmen; Iniesta González, Laura; Alcover Amengual, Maria Magdalena; Berenguer, Diana; Pujol Brugués, Alba; Tomás Pérez, Míriam; Cancino Faure, María Beatriz; Serra, Teresa; Mascaró, Martín; Gascó, Joan; Fisa Saladrigas, Roser
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Other authors:
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Universitat de Barcelona |
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Abstract:
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Background. In the Balearic Islands, as in other areas of the Mediterranean basin, there is a significant proportion of asymptomatic Leishmania (L.) infantum-infected blood donors, who may represent an important threat to transfusion safety. The Balearic Islands blood bank, located in an area endemic for L. infantum, carried out a study of donors and patients to investigate the impact of this infectious disease on blood safety in the region. Materials and methods. Twenty asymptomatic Leishmania-infected blood donors were followed-up between 2008 and 2011 to investigate the evolution of Leishmania infection in asymptomatic carriers. Their blood was periodically tested for anti-Leishmania antibodies by western blot and for Leishmania DNA by quantitative polymerase chain reaction (qPCR). Additionally, the prevalence of L. infantum infection was investigated in a group of 68 multiply transfused patients to ascertain the risk of transfusion-transmitted leishmaniasis (TTL) in the region, taking into account regular blood component production practices such as pre-storage leucodepletion and pathogen reduction technology. Results. All 20 donors remained asymptomatic over the study period (2008-2011). Most donors had repeatedly positive qPCR results, either persistently or intermittently, but showed no symptoms of Leishmaniasis. Levels of parasitaemia were remarkably low in asymptomatic donors, with values ≤1 parasite/mL. Despite multiple transfusions received over 15 years, no transfused patient studied was infected with L. infantum. Discussion. L. infantum-infected donors can remain asymptomatic for at least 3 years. In our region, no cases of TTL were detected, despite an active search in multiply transfused patients. This seems to be related to two independent variables: (i) a low concentration of the parasite in the peripheral blood of asymptomatic carriers and (ii) the application of methods with proven efficacy against TTL, such as leucodepletion and pathogen reduction technology. |
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Subject(s):
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-Leishmania infantum
-Donants de sang
-Transfusió de sang
-Illes Balears
-Leishmania infantum
-Blood donors
-Blood transfusion
-Balearic Islands |
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Rights:
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(c) Edizioni SIMTI, 2017
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Document type:
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Article
Article - Published version |
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Published by:
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Edizioni SIMTI
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