RESUMEN
No abstract available.
RESUMEN
Classical serological screening assays for Chagas' disease are time consuming and subjective. The objective of the present work is to evaluate the enzyme immuno-assay (ELISA) methodology and to propose an algorithm for blood banks to be applied to Chagas' disease. Seven thousand, nine hundred and ninety nine blood donor samples were screened by both reverse passive hemagglutination (RPHA) and indirect immunofluorescence assay (IFA). Samples reactive on RPHA and/or IFA were submitted to supplementary RPHA, IFA and complement fixation (CFA) tests. This strategy allowed us to create a panel of 60 samples to evaluate the ELISA methodology from 3 different manufacturers. The sensitivity of the screening by IFA and the 3 different ELISA's was 100%. The specificity was better on ELISA methodology. For Chagas disease, ELISA seems to be the best test for blood donor screening, because it showed high sensitivity and specificity, it is not subjective and can be automated. Therefore, it was possible to propose an algorithm to screen samples and confirm donor results at the blood bank.
Os testes sorológicos clássicos utilizados na triagem de doadores de sangue são trabalhosos e subjetivos. O objetivo do presente trabalho é o de avaliar a metodologia imuno-enzimática (ELISA) e propor um algorítmo para doença de Chagas em bancos de sangue. Foram estudados 7999 doadores de sangue e/ou componentes cujas amostras foram testadas com o objetivo de tria-las sorologicamente para doença de Chagas utilizando hemaglutinação passiva reversa (RPHA) e imunofluorescência indireta (IFA). As amostras reativas em pelo menos uma destas metodologias, foram retestadas com reativos diferentes por RPHA, IFA e fixação de complemento (CFA). Esta estratégia nos permitiu criar um painel de 60 amostras com as quais tornou-se possível a avaliação do método imunoenzimático (ELISA). A sensibilidade da triagem dos doadores pelos métodos ELISA e IFA foi de 100%. A especificidade foi melhor para a metodologia imunoenzimática. O teste ELISA parece ser o ideal para triagem em bancos de sangue pois é altamente sensível, específico, não é subjetivo e pode ser automatizado. Desta forma, torna-se possível a formulação de um algorítimo a ser utilizado na triagem sorológica e confirmação de resultados em doadores de bancos de sangue.
Asunto(s)
Humanos , Animales , Algoritmos , Donantes de Sangre , Consejo , Enfermedad de Chagas/prevención & control , Tamizaje Masivo , Anticuerpos Antiprotozoarios/sangre , Brasil , Sensibilidad y Especificidad , Trypanosoma cruzi/inmunología , Población UrbanaRESUMEN
Blood samples collected from individuals belonging to an endemic area in Uttar Pradesh, were tested for plasmodial antigen specific immunoglobulin A (IgA) by enzyme immuno assay using soluble extract of Plasmodium falciparum from culture. Among 773 (20·18%, P < 0·0001) samples 156 sera demonstrated a detectable seropositivity for antigen specific IgA. IgA levels were higher among individuals who experienced repeated attacks of malaria compared to acute infected patients. Among seropositive individuals the IgA titers were found increased with the age. Immunoglobulin isolated from sera having high level of IgA showed growth inhibitory effect in Plasmodium falciparum in vitro. A group of sera with high IgA antibody against Plasmodium falciparum crude antigen showed seronegativity with specific peptides. Statistically, no positive or negative correlations were observed between antigen specific IgG and IgA. However, there was a tendency towards negative correlation between IgA and IgM. Mechanisms for the parasite specific IgA production remain to be established.