Abstract
Background:
So that an improvement in the selection of donors can be achieved and the risk to the recipient of transfused blood can be reduced, prospective donors are submitted to clinical and serological screening.
Objective:
This study investigated the blood discard rate and the rate of infectious and contagious diseases in blood donors from provincial towns of the state of Paraná, Brazil.
Methods:
This study was an exploratory cross-sectional descriptive investigation with a quantitative approach of donations between January and December 2011.
Results:
In the study period the Regional Blood center in Maringá, Brazil received 8337 blood donations from people living in the city and neighboring towns. However, 278 (3.33%) donations were discarded during serological screening owing to one or more positive serological markers. A total of 46.4% of the discarded blood units were confirmed positive by serology with anti-HBc being the most common (66.7%), followed by syphilis (22.5%), HBsAg (4.7%), anti-hepatitis C virus (3.1%), human immunodeficiency virus (1.5%) and Chagas' disease (1.5%). The rate of infectious-contagious diseases that can be transmitted by blood transfusions was 1.55% (129/8337) of the donor population with a frequency of 1.03% for anti-HBc and 0.35% for syphilis.
Conclusion:
This study demonstrates a high prevalence of the anti-HBc marker in prospective blood donors from provincial towns in the state of Paraná, Brazil.
Hemotherapy service; Serology; Blood bank; Quality control; Blood donors/statistics & numerical data; Blood safety; Hepatitis C/blood; Biological markers; Brazil
Introduction
Blood donation is one of the noblest gestures a human can make when its purpose is to save lives(11. Gomes FV, Eleutério Junior J. HTLV-II in blood donors at the Blood Center Net of Ceará - HEMOCE. Rev Assoc Med Bras. 2011;57(3):309-12.). Although blood transfusions were seen as a mere transmission of physiological material, changes occurred that made the screening of donors highly relevant to the quality of blood. Since the start of the practice, blood donation in Brazil has changed from donors being paid to life-saving volunteers(22. Almeida Neto C, Mendrone Júnior A, Salles NA, Chamone DA, Sabino EC. The role of the doctor in the reduction of residual risk of the virus transmission of human immunodeficiency (HIV) for blood transfusion and blood constituent. Diagn Tratamento. 2009;14(2):57-61.).
Blood donation in Brazil is currently regulated by the Health Ministry through the
National Health Surveillance Agency (ANVISA) by Resolution number 57 of the Collegiate
Directory published on December 16th, 2010 and by Decree 1353 of the Health
Ministry of June 13th, 2011 that standardize the technical norms for
procedures in blood centers. These regulations support all the activities of blood
centers in Brazil according to the principles and guidelines of the Brazilian policy for
the transfusion of blood, components and blood-derived compounds. In fact, the
regulations aim to protect donor and recipient, control collection, processing, storage,
distribution and the transfusion of blood and its components and derivatives of human
venous and arterial blood and establish essential institutional norms for the adequate
execution of these activities(33. Brasil. Ministério da Saúde. Agência Nacional de Vigilância
Sanitária. Resolução - RDC n° 12, de 2 de janeiro de 2001. Aprova o regulamento
técnico sobre padrões microbiológicos para alimentos [Internet]. Brasília; ANVISA;
2001. [cited 2001 Mar 3]. Available from:
http://www.anvisa.gov.br/legis/decretos/3990_01.html
http://www.anvisa.gov.br/legis/decretos/...
). So that an improvement in the selection of donors can be
achieved and the risk to the recipient of transfused blood can be reduced,prospective
donors are submitted to clinical and serological screening(44. Carrazzone CF, Brito AM, Gomes YM. The importance of
pre-transfusional serological screening in blood transfusion recipients. Rev Bras
Hematol Hemoter. 2004;26(2):93-8.
5. Caram C, Monteiro-de-Castro MS, Caiaffa WT, Oliveira CD, Proietti AB,
Almeida MC, et al. [Spatial-temporal distribution of potential blood donors at the
Hemominas Foundation, Belo Horizonte, Minas Gerais State, Brazil, in 1994 and 2004].
Cad Saude Publica. 2010;26(2):229-39.-66. Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde.
Coordenação-Geral de Sangue e Hemoderivados. Sangue e hemoderivados: produção
hemoterápica [Internet] . 5th ed. Brasília; MS; 2011. [cited 2012 Mar 21]. Available
from:
http://bvsms.saude.gov.br/bvs/publicacoes/caderno_informacao_sangue_hemoderivados_2011.pdf
http://bvsms.saude.gov.br/bvs/publicacoe...
)
The Brazilian Health Ministry determined that all blood centers must apply highly
sensitive tests for transmissible infections to decrease the risk of disease and to
maintain the quality of donated blood. The laboratory tests that should be performed are
for syphilis, Chagas' disease, hepatitis B virus (HBV), hepatitis C virus (HCV),
acquired immunodeficiency syndrome (AIDS) and human T cell lymphotropic virus (HTLV)
types I and II(66. Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde.
Coordenação-Geral de Sangue e Hemoderivados. Sangue e hemoderivados: produção
hemoterápica [Internet] . 5th ed. Brasília; MS; 2011. [cited 2012 Mar 21]. Available
from:
http://bvsms.saude.gov.br/bvs/publicacoes/caderno_informacao_sangue_hemoderivados_2011.pdf
http://bvsms.saude.gov.br/bvs/publicacoe...
).
The blood unit discard rate in Brazil ranges between 10 and 20%. Infectious diseases are the main cause of this high percentage, which exceeds that of developed countries(77. Salles NA, Sabino EC, Barreto CC, Barreto AM, Otani MM, Chamone DF. [The discarding of blood units and the prevalence of infectious diseases in donors at the Pro-Blood Foundation/Blood Center of São Paulo, São Paulo, Brazil]. Rev Panam Salud Publica. 2003;13(2-3):111-6. Portuguese.,88. Valente VB, Covas DT, Passos AD. [Hepatitis B and C serologic markers in blood donors of the Ribeirão Preto Blood Center]. Rev Soc Bras Med Trop. 2005;38(6):488-92. Portuguese.). The current research investigated the frequency of discarded blood and the prevalence of infectious-contagious diseases identified by positive serological markers in blood donors of the Regional Blood center in Maringá, Paraná, Brazil in 2011.
Methods
The current cross-sectional descriptive investigation with a quantitative approach
collected data from the HEMOVIDA system which is used to store all the information about
donated blood. Data were collected between 1st January and 31st December 2011. The
variables investigated were age, gender, ethnic group, schooling, marital status, place
of residence, profession and the serological tests for infectious diseases as defined by
the Brazilian Health Ministry(66. Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde.
Coordenação-Geral de Sangue e Hemoderivados. Sangue e hemoderivados: produção
hemoterápica [Internet] . 5th ed. Brasília; MS; 2011. [cited 2012 Mar 21]. Available
from:
http://bvsms.saude.gov.br/bvs/publicacoes/caderno_informacao_sangue_hemoderivados_2011.pdf
http://bvsms.saude.gov.br/bvs/publicacoe...
).
Within the context of serological screening by the Blood Center,Decree 153/2011 of the Health Ministry states that each donation must be evaluated using highly sensitive tests for determined serological markers that would impair the health of the recipient. These tests include markers that detect the HBV surface antigen (HBsAg) and antibodies against HBV capsid (anti-HBc - IgG or IgG + IgM), HCV markers that identify antibodies against HCV or detect the antibody and antigen combined and two distinct tests are made for AIDS, one to detect the antibody against HIV I and II and the other to detect the antibody against HIV and the p24 antigen. Moreover, the test for the anti-Trypanosoma cruzi antibody which causes Chagas' disease is carried out as are tests for syphilis to determine the anti-Treponema pallidum antibody or non-treponemal antibody and tests to detect antibodies against HTLV-I and -II. All methods of serological screening followed the manufacturer's instructions.
The inclusion criterion for the current study was all discarded blood due to confirmed positive markers during serological screening. Serology with undetermined results and the absence of the donor for a repeat collection of blood to confirm initially positive serological tests were valid criteria for sample exclusion.
Data was collected between January and February 2012. Data were organized on a Microsoft Office Excel sheet in tables.
This study was developed according to the Decree of the National Health Council 196/1996, after approval of the Commission that Regulates Academic Activities in the Hospital Regional de Maringá and of the Ethics Committee on Research on Human Beings of the Universidade Estadual de Maringá (UEM: # 211/2011).
Results
The Blood center of Maringá received 8337 blood donations from people living in the city of Maringá and in neighboring towns between 1st January and 31st December 2011. However, 278 blood units (3.33%) failed serological screening as they were positive for one or more serological markers. Data were collected at two distinct stages, namely, selection and confirmation of exclusion as shown in Tables 2 and 3.
Method, manufacturer and assay used for to identify serological markers used in the Regional Blood center of Maringá, 2011
Blood discard due to positive serology of blood donors at the Regional Blood center of Maringá, Maringá, Paraná, Brazil in 2011
Discarded blood unit confirmation due to positive serological type and infectious-contagious diseases in blood donors at the Regional Blood center of Maringá, 2011
During the screening stage, the Anti-HBc marker was the cause of 52.5% of the discarded
blood units during serologicalscreening, followed by syphilis (20.9%), anti-HCV (14.0%),
HIV(5.80%), HBsAg (3.60%), Chagas' disease (2.10%) and HTLV-I and -II (1.10%). The
confirmation of exclusion due to serological results was based on specific criteria
listed in Decree 1353/2011 of the Brazilian Health Ministry(66. Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde.
Coordenação-Geral de Sangue e Hemoderivados. Sangue e hemoderivados: produção
hemoterápica [Internet] . 5th ed. Brasília; MS; 2011. [cited 2012 Mar 21]. Available
from:
http://bvsms.saude.gov.br/bvs/publicacoes/caderno_informacao_sangue_hemoderivados_2011.pdf
http://bvsms.saude.gov.br/bvs/publicacoe...
).
Table 3 shows the absolute frequency of confirmed serological types, the positivity of the marker and the prevalence of infectious-contagious diseases of blood donors.
This analysis shows that 129 (46.4%) out of 278 discarded blood units were confirmed positive by serology. Anti-HBc (66.7%) was the greatest cause of discard followed by syphilis(22.5%), HBsAg (4.7%), anti-HCV (3.1 %), HIV (1.5%) and Chagas' disease (1.5%).
The prevalence of infectious and contagious diseases among donors of the Regional Blood Center was 1.55% (129/8337). The epidemiological profile of donors with positive serology was evaluated after confirmation (Table 4). The data relate to 122 donors, but there were 129 confirmed positive serology tests as more than one positive blood sample was submitted by some donors.
Epidemiological data of donors (n = 122) with positive serology in the Blood center of Maringá, Maringá, Paraná, Brazil in 2011
Discussion
The Regional Blood center of Maringá is part of the state of Paraná's network of blood centers called HEMEPAR. It collects blood from the 30 towns of the 15th Regional Health Area. The serology laboratory tests approximately 12,000 donors per year: 8500 donors are seen in the Blood Center and 3500 donors are seen in the Blood Collection and Transfusion Service of Cianorte. On average, some 100,000 tests/year are carried out (70,000 at the Regional Blood Center of Maringá and 30,000 at the Cianorte unit).
As blood centers have, as a rule, great difficulties in maintaining an ideal blood stock for emergencies and blood specificities, they adopt strategies to recruit donors(99. Rodrigues RS, Reibnitz KS. [Strategies for attracting blood donors: an integrative literature review]. Texto Contexto Enferm. 2011;20(2):384- 91. Portuguese.). Consequently, it is very important to know the profile of people who donated blood but were considered inappropriate for donation so that blood donation safety is ensured. In fact, such knowledge is the basis to develop specific strategies to improve the technology in the selection of donors and to improve blood quality(1010. Rohr JI, Boff D, Lunkes DS. [Profile of ineligible candidates for blood donation in the hemotherapy service of Santo Ângelo Hospital, RS, Brazil]. Rev Patol Trop. 2012;41(1):27-35. Portuguese.).
It is mandatory that blood centers have pre-transfusion strategies for the proper conditioning of blood products to reduce health risks to both donors and recipients alike(77. Salles NA, Sabino EC, Barreto CC, Barreto AM, Otani MM, Chamone DF. [The discarding of blood units and the prevalence of infectious diseases in donors at the Pro-Blood Foundation/Blood Center of São Paulo, São Paulo, Brazil]. Rev Panam Salud Publica. 2003;13(2-3):111-6. Portuguese.).
According to ANVISA, the serological screening of potential blood donors is mandatory
due to the great variety of transmittable pathogens(1111. Brasil. Ministério da Saúde. Agência Nacional de Vigilância
Sanitária. Resolução -RDC No 57, de 16 de dezembro de 2010. Determina o regulamento
sanitário para serviços que desenvolvem atividades relacionadas ao ciclo produtivo do
sangue humano e componentes e procedimentos transfusionais [Internet]. Brasília:
Ministério da Saúde; 2010 [cited 2012 Mar 13]. Available from:
http://bvsms.saude.gov.br/bvs/saudelegis/anvisa/2010/res0057_16_12_2010.html
http://bvsms.saude.gov.br/bvs/saudelegis...
). The current study shows that 52.5% of discarded
blood units during the serological screening process were positive for the Anti-HBc
serological marker with 66.7% of these being confirmed. In fact, according to one study,
a blood center in the state of Acre,Brazil also had a high prevalence for HBV. In this
particular study,reactivity to anti-HBc reached 54.8% of discarded blood units which
confirms the high prevalence of the virus in the population(1212. Silva Rdo S, Ribeiro SA, Silveira RP, Freitas Mdos S. [Evaluation of
the sorologic pre-selection for the hepatitis B virus marker (total anti-HBc) in
candidates to blood donation in the State of Acre, 2002]. Rev Soc Bras Med Trop.
2006;39(2):179-82. Portuguese.). This fact has been corroborated by a
similar study in the Blood Center of Campo Mourão, Paraná, Brazil in which the
serological rate for HBV (anti-HBc) reached 71.3% of discarded blood
units(1313. Ramos VF, Ferraz FN. Perfil epidemiológico dos doadores de sangue do
hemonúcleo de Campo Mourão-PR no ano de 2008. SaBios: Rev Saúde Biol.
2010;5(2):14-21.).
Of the 129 confirmed serology tests, 4.7% were positive for HBsAg giving a prevalence of 0.07% in the population. This result fails to corroborate studies performed in the states of Rio Grande do Sul(1414. Rodriguez MD, Lara GM, Lazzarotto AR, Michelim L, Fracasso J, Lovatel R, et al. The prevalence of serologic markers at the Caxias do Sul Blood Center. Rev Panam Infectol. 2008;10(3):32-5.) and Maranhão, Brazil(1515. Viana GM, Diniz Neto JA, Binda Júnior JR, Rabelo EM, Costa MH, Sousa JG, et al. Hepatitis B and C serological markers in blood donors from Maranhão State, Brazil. Rev Panam Infectol. 2009;11(1):20-4.), with prevalences of 0.18% and 0.24%, respectively.
The prevalence of syphilis at the Regional Blood center of Maringá was 0.35%, lower than the mean of 0.65% in Caxias do Sul, Rio Grande do Sul, Brazil(1414. Rodriguez MD, Lara GM, Lazzarotto AR, Michelim L, Fracasso J, Lovatel R, et al. The prevalence of serologic markers at the Caxias do Sul Blood Center. Rev Panam Infectol. 2008;10(3):32-5.). Similar results were found in towns of the same state; Cruz Alta(1616. Boff D, Lunkes DS, Kunzler A, Rohr JI . Prevalência de VDRL reagente em doadores do hemocentro regional de Cruz Alta- RS, Brasil no período de 2003 a 2009. Rev Patol Trop. 2011;40(2):179-84.) and Santa Maria(1717. Machado MM, Zuravski L. Soroprevalência em doadores de sangue do Hospital Universitário de Santa Maria/RS no ano de 2005. NewsLab. 2007;80:108-12.) with prevalences of 0.3% and 0.48%, respectively. The positivity rate for the pathology in Guarapuava, Paraná(1818. Oliveira VM, Verdasca IC, Monteiro MC. Detecção de sífilis por ensaios de ELISA e VDRL em doadores de sangue do Hemonúcleo de Guarapuava, Estado do Paraná. Rev Soc Bras Med Trop. 2008;41(4):428-30.) according to the immune enzyme test was 2.1%, thus a higher rate than that reported in the current study. Research in blood centers of other states also showed a high positivity rate for syphilis tests, such as those in the Brazilian states of Amazonas(1919. Ferreira CM, Ferreira WA, Motta CL, Vasquez FG, Pinto AF. Reatividade do teste VDRL em bolsas de sangue da Fundação de Hematologia e Hemoterapia do Amazonas- HEMOAM, os custos decorrentes do descarte e estimativa de prevalência de sífilis em doadores de sangue do Estado do Amazonas. DST - J Bras Doenças Sex Transm. 2006;18(1):14-17.), São Paulo(77. Salles NA, Sabino EC, Barreto CC, Barreto AM, Otani MM, Chamone DF. [The discarding of blood units and the prevalence of infectious diseases in donors at the Pro-Blood Foundation/Blood Center of São Paulo, São Paulo, Brazil]. Rev Panam Salud Publica. 2003;13(2-3):111-6. Portuguese.) and Sergipe(2020. Santos EA, Marcellini PS, Ribeiro JP. Avaliação epidemiológica das rejeições dos doadores de sangue no HEMOLACEN/SE no período de 2004 a 2006. Rev Bras Anal Clin. 2008;40(4):251-6.).
The prevalence of anti-HCV was 0.04% in current study similar to that found by Perz(2121. Perz JF, Farrington LA, Pecoraro C, Hutin YJF, Armstrong GL. Estimated global prevalence of hepatitis C virus infection. In: 42nd Annual Meeting of the Infectious Diseases Society of America; 2004 Sept 30-Oct 3; Boston.) in the UK and Scandinavia (between 0.01% and 0.1%) and less than that reported in Rio de Janeiro (0.7%)(2222. Barcelos MW, Araujo L, Paula VS, Villar LM. Prevalência de anticorpos contra o vírus da Hepatite C e da imunodeficiência humana no Norte do Estado do Rio de Janeiro. NewsLab. 2010;102:90-3.).
The risk of HIV transmission by transfusion in Brazil has decreased from 4.4% at the
start of the epidemic to 2.7% in 1992 to 0.4% in 2007(2323. Brasil. Ministério da Saúde. Boletim Epidemiológico AIDS e DST
[Internet]. Brasília: MS; 2007. [cited 2012 Dec 21]. Available from:
http://bvsms.saude.gov.br/bvs/periodicos/Boletim2007_internet090108.pdf
http://bvsms.saude.gov.br/bvs/periodicos...
). The positivity rate in the current analysis was
0.02% for the same year as that of the study at the Regional Blood Center of Pelotas,
Rio Grande do Sul, Brazil (HEMOPEL) at 0.08% between 2004 and 2007(2424. Araújo AB, Nachtigal GC, Cerqueira MS, Ferreira AP, Almeida SE,
Silva CM. Blood donors HIV prevalence in southern of Rio Grande do Sul, Brazil. Rev
Panam Infectol. 2011;13(1):19-22.).
The prevalence for Chagas' disease among donors was relatively low (0.02%) when compared
to the 0.31% reported by Moraes-Souza(2525. Moraes-Souza H, Martins PR, Pereira GA, Ferreira-Silva MM, Abud MB.
Serological profile concerning Chagas' disease of blood donors at Uberaba Blood
Center. Rev Bras Hematol Hemoter. 2006;28(2):110-14.). This rate was corroborated by investigators in other regions
of Brazil that demonstrated significant progress in the control of Chagas' disease from
transfusions over the last forty years. The prevalence of donors with Chagas' disease in
the 1970s reached 11.08%; it decreased to 7.03% in the 1980s, to 0.73% in 2000 and to
0.17% in 2010(66. Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde.
Coordenação-Geral de Sangue e Hemoderivados. Sangue e hemoderivados: produção
hemoterápica [Internet] . 5th ed. Brasília; MS; 2011. [cited 2012 Mar 21]. Available
from:
http://bvsms.saude.gov.br/bvs/publicacoes/caderno_informacao_sangue_hemoderivados_2011.pdf
http://bvsms.saude.gov.br/bvs/publicacoe...
).
Serological screening for HTLV-I and -II at blood centers became mandatory only in 1993 due to great risks of transmission by blood transfusions(2626. Brasil. Ministério da Saúde. Normas técnicas para coleta, processamento e transfusão de sangue, componentes e derivados. Brasília: Secretaria de Assistência à Saúde; 1994. 77 p.). No positivity occurred in the current study and it should be emphasized that infection by the virus is in sharp decline according to studies of blood donors in Uberaba, Minas Gerais which assessed the prevalence of HTLV-I and II between 1995 and 2008. The prevalence for 1995-2000 was 0.6%, whereas it declined to 0.1% during the 2002-2008 period(2727. Lima GM, Eustáquio JM, Martins RA, Josahkian JA, Pereira GA, Moraes- Souza H, et al. Declínio da prevalência do HTLV-1/2 em doadores de sangue do Hemocentro Regional da cidade de Uberaba, Estado de Minas Gerais, 1995 a 2008. Rev Soc Bras Med Trop. 2010;43(4):421-4.).
Conclusions
In conclusion, the frequency of discarded blood units due to positive serology is important to transfusion services as it allows the profiling of donors and identifies the prevalence of infectious diseases in a particular region. This study demonstrates the need for strict quality control that is able to minimize costs and increase the quality of services provided.
Acknowledgements
The authors would like to thank the University Hospital of Maringá, the Regional Blood center of Maringá, Conselho Nacional de Desenvolvimento Científico e Tecnológico and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior.
References
-
1Gomes FV, Eleutério Junior J. HTLV-II in blood donors at the Blood Center Net of Ceará - HEMOCE. Rev Assoc Med Bras. 2011;57(3):309-12.
-
2Almeida Neto C, Mendrone Júnior A, Salles NA, Chamone DA, Sabino EC. The role of the doctor in the reduction of residual risk of the virus transmission of human immunodeficiency (HIV) for blood transfusion and blood constituent. Diagn Tratamento. 2009;14(2):57-61.
-
3Brasil. Ministério da Saúde. Agência Nacional de Vigilância Sanitária. Resolução - RDC n° 12, de 2 de janeiro de 2001. Aprova o regulamento técnico sobre padrões microbiológicos para alimentos [Internet]. Brasília; ANVISA; 2001. [cited 2001 Mar 3]. Available from: http://www.anvisa.gov.br/legis/decretos/3990_01.html
» http://www.anvisa.gov.br/legis/decretos/3990_01.html -
4Carrazzone CF, Brito AM, Gomes YM. The importance of pre-transfusional serological screening in blood transfusion recipients. Rev Bras Hematol Hemoter. 2004;26(2):93-8.
-
5Caram C, Monteiro-de-Castro MS, Caiaffa WT, Oliveira CD, Proietti AB, Almeida MC, et al. [Spatial-temporal distribution of potential blood donors at the Hemominas Foundation, Belo Horizonte, Minas Gerais State, Brazil, in 1994 and 2004]. Cad Saude Publica. 2010;26(2):229-39.
-
6Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Coordenação-Geral de Sangue e Hemoderivados. Sangue e hemoderivados: produção hemoterápica [Internet] . 5th ed. Brasília; MS; 2011. [cited 2012 Mar 21]. Available from: http://bvsms.saude.gov.br/bvs/publicacoes/caderno_informacao_sangue_hemoderivados_2011.pdf
» http://bvsms.saude.gov.br/bvs/publicacoes/caderno_informacao_sangue_hemoderivados_2011.pdf -
7Salles NA, Sabino EC, Barreto CC, Barreto AM, Otani MM, Chamone DF. [The discarding of blood units and the prevalence of infectious diseases in donors at the Pro-Blood Foundation/Blood Center of São Paulo, São Paulo, Brazil]. Rev Panam Salud Publica. 2003;13(2-3):111-6. Portuguese.
-
8Valente VB, Covas DT, Passos AD. [Hepatitis B and C serologic markers in blood donors of the Ribeirão Preto Blood Center]. Rev Soc Bras Med Trop. 2005;38(6):488-92. Portuguese.
-
9Rodrigues RS, Reibnitz KS. [Strategies for attracting blood donors: an integrative literature review]. Texto Contexto Enferm. 2011;20(2):384- 91. Portuguese.
-
10Rohr JI, Boff D, Lunkes DS. [Profile of ineligible candidates for blood donation in the hemotherapy service of Santo Ângelo Hospital, RS, Brazil]. Rev Patol Trop. 2012;41(1):27-35. Portuguese.
-
11Brasil. Ministério da Saúde. Agência Nacional de Vigilância Sanitária. Resolução -RDC No 57, de 16 de dezembro de 2010. Determina o regulamento sanitário para serviços que desenvolvem atividades relacionadas ao ciclo produtivo do sangue humano e componentes e procedimentos transfusionais [Internet]. Brasília: Ministério da Saúde; 2010 [cited 2012 Mar 13]. Available from: http://bvsms.saude.gov.br/bvs/saudelegis/anvisa/2010/res0057_16_12_2010.html
» http://bvsms.saude.gov.br/bvs/saudelegis/anvisa/2010/res0057_16_12_2010.html -
12Silva Rdo S, Ribeiro SA, Silveira RP, Freitas Mdos S. [Evaluation of the sorologic pre-selection for the hepatitis B virus marker (total anti-HBc) in candidates to blood donation in the State of Acre, 2002]. Rev Soc Bras Med Trop. 2006;39(2):179-82. Portuguese.
-
13Ramos VF, Ferraz FN. Perfil epidemiológico dos doadores de sangue do hemonúcleo de Campo Mourão-PR no ano de 2008. SaBios: Rev Saúde Biol. 2010;5(2):14-21.
-
14Rodriguez MD, Lara GM, Lazzarotto AR, Michelim L, Fracasso J, Lovatel R, et al. The prevalence of serologic markers at the Caxias do Sul Blood Center. Rev Panam Infectol. 2008;10(3):32-5.
-
15Viana GM, Diniz Neto JA, Binda Júnior JR, Rabelo EM, Costa MH, Sousa JG, et al. Hepatitis B and C serological markers in blood donors from Maranhão State, Brazil. Rev Panam Infectol. 2009;11(1):20-4.
-
16Boff D, Lunkes DS, Kunzler A, Rohr JI . Prevalência de VDRL reagente em doadores do hemocentro regional de Cruz Alta- RS, Brasil no período de 2003 a 2009. Rev Patol Trop. 2011;40(2):179-84.
-
17Machado MM, Zuravski L. Soroprevalência em doadores de sangue do Hospital Universitário de Santa Maria/RS no ano de 2005. NewsLab. 2007;80:108-12.
-
18Oliveira VM, Verdasca IC, Monteiro MC. Detecção de sífilis por ensaios de ELISA e VDRL em doadores de sangue do Hemonúcleo de Guarapuava, Estado do Paraná. Rev Soc Bras Med Trop. 2008;41(4):428-30.
-
19Ferreira CM, Ferreira WA, Motta CL, Vasquez FG, Pinto AF. Reatividade do teste VDRL em bolsas de sangue da Fundação de Hematologia e Hemoterapia do Amazonas- HEMOAM, os custos decorrentes do descarte e estimativa de prevalência de sífilis em doadores de sangue do Estado do Amazonas. DST - J Bras Doenças Sex Transm. 2006;18(1):14-17.
-
20Santos EA, Marcellini PS, Ribeiro JP. Avaliação epidemiológica das rejeições dos doadores de sangue no HEMOLACEN/SE no período de 2004 a 2006. Rev Bras Anal Clin. 2008;40(4):251-6.
-
21Perz JF, Farrington LA, Pecoraro C, Hutin YJF, Armstrong GL. Estimated global prevalence of hepatitis C virus infection. In: 42nd Annual Meeting of the Infectious Diseases Society of America; 2004 Sept 30-Oct 3; Boston.
-
22Barcelos MW, Araujo L, Paula VS, Villar LM. Prevalência de anticorpos contra o vírus da Hepatite C e da imunodeficiência humana no Norte do Estado do Rio de Janeiro. NewsLab. 2010;102:90-3.
-
23Brasil. Ministério da Saúde. Boletim Epidemiológico AIDS e DST [Internet]. Brasília: MS; 2007. [cited 2012 Dec 21]. Available from: http://bvsms.saude.gov.br/bvs/periodicos/Boletim2007_internet090108.pdf
» http://bvsms.saude.gov.br/bvs/periodicos/Boletim2007_internet090108.pdf -
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Publication Dates
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Publication in this collection
2013
History
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Received
24 Sept 2012 -
Accepted
18 Dec 2012