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The validity of serologic tests for Trypanosoma cruzi and the effectiveness of transfusional screening strategies in a hyperendemic region

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dc.contributor.author Pirard, M. en_US
dc.contributor.author Iihoshi, N. en_US
dc.contributor.author Boelaert, M. en_US
dc.contributor.author Basanta, P. en_US
dc.contributor.author López, F. en_US
dc.contributor.author Van der Stuyft, P. en_US
dc.date.accessioned 2007-12-06T14:47:56Z
dc.date.available 2007-12-06T14:47:56Z
dc.date.issued 2005 en_US
dc.identifier.issn 0041-1132 en_US
dc.identifier.other ITG-M1A en_US
dc.identifier.other ITG-H3A en_US
dc.identifier.other ITG-HLA en_US
dc.identifier.other MICRO en_US
dc.identifier.other U-HIVSTD en_US
dc.identifier.other HEALTH en_US
dc.identifier.other U-EPID en_US
dc.identifier.other JIF en_US
dc.identifier.other MULTI en_US
dc.identifier.other ABSTRACT en_US
dc.identifier.uri http://hdl.handle.net/10390/1916
dc.description.abstract BACKGROUND: This study aims at obtaining unbiased estimates of the sensitivity and specificity of existing screening tests for Trypanosoma cruzi and at simulating the effectiveness of alternative screening strategies at different prevalence rates. STUDY DESIGN AND METHODS: A systematic random sample of 400 was taken from 1200 banked serum samples of donors screened between August 1998 and January 1999 in Santa Cruz, Bolivia. Samples were tested with indirect hemagglutination test (IHA), indirect immunofluorescence assay (IFA), and four enzyme-linked immunosorbent assays (ELISAs). Sensitivity and specificity of tests were estimated through latent class analysis. RESULTS: The sensitivity of individual tests ranged from 96.5 to 100 percent, and their specificity from 87.0 to 98.9 percent. Combinations of two tests used in parallel would, even at 40 percent prevalence, only miss approximately 1 infected unit per 10,000 screened. At 5 percent prevalence, however, they would yield 75 to 120 false-positive units per 1000 units screened. Parallel testing with IHA plus ELISA or with IHA plus IFA is marginally more cost-effective, compared to single IHA testing, than single ELISA or single IFA testing, regardless of the T. cruzi prevalence. CONCLUSIONS: Routine blood donor screening for T. cruzi with a single test results in unacceptable numbers of false-negative samples in highly endemic areas or in at risk population groups. Adding a second test seems mandatory, but which one to choose depends on local cost components and feasibility. en_US
dc.language English en_US
dc.subject Protozoal diseases en_US
dc.subject Trypanosoma cruzi en_US
dc.subject Blood donors en_US
dc.subject Screening en_US
dc.subject Serological en_US
dc.subject Laboratory techniques and procedures en_US
dc.subject Sensitivity en_US
dc.subject Specificity en_US
dc.subject False-negative en_US
dc.subject Cost-effectiveness en_US
dc.subject Latent class analysis en_US
dc.subject LCA en_US
dc.subject America, Latin en_US
dc.title The validity of serologic tests for Trypanosoma cruzi and the effectiveness of transfusional screening strategies in a hyperendemic region en_US
dc.type Article en_US
dc.citation.jtitle Transfusion en_US
dc.citation.volume 45 en_US
dc.citation.pages 554-561 en_US
dc.identifier.pmid http://www.ncbi.nlm.nih.gov/pubmed/15819677
dc.citation.jabbreviation Transfusion en_US


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