Kg. Luz et al., PREVALENCE OF ANTI-LEISHMANIA DONOVANI ANTIBODY AMONG BRAZILIAN BLOOD-DONORS AND MULTIPLY TRANSFUSED HEMODIALYSIS-PATIENTS, The American journal of tropical medicine and hygiene, 57(2), 1997, pp. 168-171
Citations number
16
Categorie Soggetti
Public, Environmental & Occupation Heath","Tropical Medicine
The prevalence of anti-leishmania donovani antibodies was investigated
in 1,500 Brazilian blood donors and multiply transfused hemodialysis
patients. Sera were tested using the fucose-mannose ligand (FML) ELISA
, which was shown to have 100% sensitivity and 96% specificity for kal
a-azar. Among 1,194 volunteer blood donors, seroreactivity was 9%, inc
reasing to 25% in a periurban kala-azar focus. However, higher positiv
ity (37%) was found in multiply transfused hemodialysis patients from
Natal, where kala-azar is constantly present in low numbers (endemic),
with sporadic outbreaks in localized regions (endemic and epidemic).
Risk factors included blood transfusion, which was significantly assoc
iated with the presence of anti-leishmania antibodies (chi(2) = 8.567,
P < 0.005), but did not include potential exposure to sandfly bites (
chi(2) = 0.033, P > 0.1). The prevalence significantly decreased to 7%
in hemodialysis patients from Rio de Janeiro, where kala-azar is only
occasionally seen, and was 0% in patients undergoing continuous ambul
atorial peritoneal dialysis. The prospective analysis of 27 FML-serore
active donors from Natal revealed amastigotes of Leishmania in the bon
e marrow of one subject while four had clinical complaints, including
splenomegaly and hepatosplenomegaly. Our results point to the need for
control of blood transfusion as a possible route for transmission of
kala-azar in endemic areas.