Serologic testing for chagas'disease and HIV in Counseling Programs and blood banks in Midwest Brazil

RESUMO

For many years it has been the practice in Brazil to question donors and to test blood to be used in blood banks for HIV, Chagas 'disease, hepatitis B and C, and syphilis. Counseling and blood testings programs have recently been established to assist in identifying and treating those with HIV. In a blood bank center in Campo Grande, Mato Grosso do Sul State (MS), we evaluated the frequence and age of patients with positives tests for T.cruzi in order to determine whether the frequence and age distribution indicated that this infection should be added to the counseling and testing programs. A group of 476 first time blood donors were enrolled to answer a questionnaire and to be tested serologically for Chagas'disease, HIV, hepatitis B and C, and syphilis. A standard ELISA and an Ifa test were used for Chagas'disease patients. Five patients (1.1 percent) were serologically positive for T.cruzi infection. All five were male between 22 and 35 years of age. None of the five had been born in Mato Grosso do Sul State. Four donors donated blood in order to obtain serologic test results, only one donated blood as a social responsability. One was HIV positive and related previous STD, and one had received a blood transfusion between 1980 and 1986. Each had had only one sexual partner in yhe last six motnths. The age range and the frequency of 1.1 percent suggest that it would be beneficial to include this disease in counseling and testing program in Bazil. The limitations of this approach are the relatively low attendance at such centers in Mato Grosso do Sul(1.7 people/day compared to a national average of 2.9 people/day), the slow reporting time for results (1 week compared to 1 day for the blood bank reporting), and the absence of a standard disease-specific testing procedure. We recommend increasing the use of serologic tests for T.cruzi and designing appropriate questionnaires in counseling and testing programs now used primarily for HIV, assuming the existing limitations can be overcome.