RISK FOR TRANSFUSION-TRANSMITTED INFECTIOUS-DISEASES IN CENTRAL AND SOUTH-AMERICA

We report the potential risk for an infectious disease through tainted transfusion in 10 countries of South and Central America in 1993 and in two countries of South America in 1994, as well as the cost of reag ents as partial estimation of screening costs. Of the 12 countries inc luded in the study, nine screened all donors for HIV; three screened a ll donors for hepatitis B virus (HBV); two screened all donors for Try panosoma cruzi; none screened all donors for hepatitis C virus (HCV); and six screened some donors for syphilis. Estimates of the risk of ac quiring HIV through blood transfusion were much lower than for acquiri ng HBV, HCV, or T. cruzi because of significantly higher screening and lower prevalence rates for HIV. An index of infectious disease spread through blood transfusion was calculated for each country. The highes t value was obtained for Bolivia (233 infections per 10,000 transfusio ns); in five other countries, it was 68 to 103 infections per 10,000. The risks were lower in Honduras (nine per 10,000), Ecuador (16 per 10 ,000), and Paraguay (16 per 10,000). While the real number of potentia lly infected units or infected persons is probably lower than our esti mates because of false positives and already infected recipients, the data reinforce the need for an information system to assess the level of screening for infectious diseases in the blood supply. Since this i nformation was collected, Chile, Colombia, Costa Rica, and Venezuela h ave made HCV screening mandatory; serologic testing for HCV has increa sed in those countries, as well as in El Salvador and Honduras. T. cru zi screening is now mandatory in Colombia, and the percentage of scree ned donors increased not only in Colombia, but also in Ecuador, El Sal vador, and Paraguay. Laws to regulate blood transfusion practices have been enacted in Bolivia, Guatemala, and Peru. However, donor screenin g still needs to improve for one or more diseases in most countries.