Antibodies to Trypanosoma cruzi among blood donors in Buenos Aires, Argentina.

OBJECTIVES: The aim of this work was to study the prevalence of anti-Trypanosoma cruzi in the blood donor population in Buenos Aires, to compare the relative sensitivity and specificity of the two screening tests used and to confirm the results with a third assay. MATERIAL AND METHODS: Between May 1995 and July 1999, 64,887 blood donor consecutive samples were screened with the following commercial tests: indirect hemagglutination (IHA) (Polychaco, Buenos Aires, Argentina) and enzyme-linked immunosorbent assay (ELISA) (40,222 with Chagatek, Organon Teknika, Buenos Aires, Argentina, and 24,665 with Chagas EIA, Abbott, S?o Paulo, Brazil). Repeatedly reactive samples in one or both tests were analyzed with a third method: dot blot (Bio Chagas, Gador, Buenos Aires, Argentina) or particle agglutination (Serodia, Fujirebio, Tokyo, Japan). Sera that reacted in at least two tests were considered positive. RESULTS: The seroprevalence was 2.66% (1744 samples were reactive for one or both screening tests), and 1.46% (949 samples) were confirmed positive. The ELISAs proved to be more sensitive (relative sensitivity: 99.67-99.71%) whereas 192 samples (0.47%) were IHA false-negatives (relative sensitivity: 79.77%). Relative specificity for EIA was 98.47--99.23% and for IHA 99.85%. CONCLUSIONS: Results suggest the need of performing two screening tests for Chagas disease in blood banks from endemic areas and the importance of a third confirmatory assay to avoid unnecessary medical counseling.