Objective
To analyze the risk of Trypanosma cruzi transfusion and transplantation transmission in endemic countries in the Region of the Americas.
Methods
A descriptive and comparative study on the prevention of iatrogenic transmission of T. cruzi was conducted in 21 endemic countries in the Americas (2012–2023) using sources from the Pan American Health Organization, national reports, and scientific databases. The prevalence of antibodies in donors, the proportion of voluntary donors, screening coverage, and transmission events were analyzed. Trends were evaluated with the Mann-Kendall test, and differences between groups by voluntary donors with the Wilcoxon test, using Stata 14.0 and p<0.05.
Results
The median overall prevalence of T. cruzi in blood donors steadily declined between 2012 (0.45%) and 2023 (0.16%). There is an association between a higher percentage of voluntary donation and a lower prevalence of infection. Screening coverage between 2021 and 2023 is complete. Seventy-seven percent of countries that screen for T. cruzi have programs for external evaluation of local performance. The risk of infection in polytransfused patients ranged from 1.8% to 1.3% when screening was incomplete. In relation to transplantation, the prevalence of T. cruzi infection in organ and tissue donors was 0.9% in Argentina and 0.54% in organ donors in Colombia. Although the frequency of infected donors is low, the risk of parasite transmission through organ transplantation (with the exception of the heart) ranges from 18% to 23%. Early detection in recipients through PCR is essential for beginning treatment in a timely manner and preventing complications.
Conclusions
Increasing voluntary blood donations and implementing surveillance systems are the greatest challenges to eliminating Chagas disease in the Region by 2030.