nifurtimox and Transfusion-Reaction

In the last decades, increasing international migration and travel from Latin America to Europe have favoured the emergence of tropical diseases outside their "historical" boundaries. Chagas disease, a zoonosis endemic in rural areas of Central and South America represents a clear example of this phenomenon. In the absence of the vector, one of the potential modes of transmission of Chagas disease in non-endemic regions is through blood and blood products. As most patients with Chagas disease are asymptomatic and unaware of their condition, in case of blood donation they can inadvertently represent a serious threat to the safety of the blood supply in non-endemic areas. Since the first cases of transfusion-transmitted Chagas disease were described in the last years, non-endemic countries began to develop ad hoc strategies to prevent and control the spread of the infection. United States, Spain, United Kingdom and France first recognised the need for Trypanosoma cruzi screening in at-risk blood donors. In this review, we trace an up-to-date perspective on Chagas disease, describing its peculiar features, from epidemiological, pathological, clinical and diagnostic points of view. Moreover, we describe the possible transmission of Chagas disease through blood or blood products and the current strategies for its control, focusing on non-endemic areas.

Topics: Adult; Blood Donors; Blood Safety; Chagas Disease; Donor Selection; Emigration and Immigration; Enzyme-Linked Immunosorbent Assay; Europe; Female; Global Health; Health Services Needs and Demand; Humans; Infant, Newborn; Latin America; Male; Mass Screening; Nifurtimox; Nitroimidazoles; North America; Parasitemia; Pregnancy; Pregnancy Complications, Infectious; Transfusion Reaction; Travel; Trypanocidal Agents; Trypanosoma cruzi

Topics: Acute Disease; Aged; Blood Donors; Bolivia; Chagas Disease; Child; Drug Therapy, Combination; Female; Hodgkin Disease; Humans; Interferon-gamma; Nifurtimox; Transfusion Reaction; United States

Topics: Acute Disease; Adult; Animals; Antibodies, Protozoan; Blood Donors; Chagas Disease; Female; Humans; Indians, North American; Manitoba; Nifurtimox; Paraguay; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Transfusion Reaction; Trypanosoma cruzi

After observing a fatal chagasic infection in a renal transplant recipient we investigated Chagas disease in 84 recipients of renal transplants. The indirect hemagglutination test was used for screening and xenodiagnosis followed in positive cases, along with ECG and gastrointestinal X ray series. Nine cases were detected (10%); parasites were found in the blood of 6 of them (66%). No patient had cardiac or gastrointestinal involvement. Patients with a positive serology were treated with nifurtimox (2) or benzonidazol (7); xenodiagnosis every 6 months up to 67 months remains negative in these patients. Blood transfusions are suspected as the mechanism for infection in these cases.

Topics: Adolescent; Adult; Chagas Disease; Female; Humans; Immune Tolerance; Kidney Transplantation; Male; Nifurtimox; Nitroimidazoles; Serologic Tests; Transfusion Reaction; Trypanocidal Agents