Estimation of sensitivity and specificity of several Trypanosoma cruzi antibody assays in blood donors in Argentina.
BACKGROUND
The absence of a gold standard test for Trypanosoma cruzi antibodies represents a problem not only for the evaluation of screening tests, but also for appropriate blood donor counseling. The aim of this study was to estimate the sensitivity and specificity of multiple blood donor screening tests for T. cruzi antibodies in Argentina.


METHODS
From June 2006 to March 2007 a sample of 1455 blood donors was recruited from two blood banks in Chaco province, an area of Argentina with highly endemic T. cruzi infection. Samples were tested by three epimastigote lysate enzyme immunoassays (EIAs), one recombinant antigen EIA, two indirect hemagglutination assay (IHA) tests, a particle agglutination assay (PA), and a research trans-sialidase inhibition assay (TIA). Sensitivity and specificity were estimated using latent class analysis (LCA).


RESULTS
LCA estimated the consensus prevalence of T. cruzi infection at 24.5%. Interassay correlation was higher among the four EIA tests and TIA compared to IHA tests. Assay sensitivities varied from 96 to 99.7 for different EIAs, 91% for TIA, 84% for PA, and 66 to 74% for IHA tests. Relative to the LCA, assay specificities were from 96% to almost 100%.


CONCLUSIONS
Based on the comparison of several tests in a large population from an endemic area for T. cruzi infection, our data showed an adequate sensitivity for EIA tests in contrast to PA and IHA assays. The latter tests should no longer be used for blood donor screening.
Remesar
Mirta C
MC
Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina. mremesar@garrahan.gov.ar
Gamba
Cecilia
C
Colaianni
Ivana F
IF
Puppo
Mónica
M
Sartor
Paula A
PA
Murphy
Edward L
EL
Neilands
Torsten B
TB
Ridolfi
María A
MA
Leguizamón
M Susana
MS
Kuperman
Silvina
S
Del Pozo
Ana E
AE
D000913:Antibodies, Protozoan; D001118:Argentina; D001681:Biological Assay / Q000379:methods*; D001782:Blood Donors; D014355:Chagas Disease / Q000175:diagnosis*; D006023:Glycoproteins / Q000378:metabolism; D006386:Hemagglutination Tests; D006801:Humans; D007124:Immunoenzyme Techniques; D009439:Neuraminidase / Q000378:metabolism; D015203:Reproducibility of Results; D014349:Trypanosoma cruzi / Q000276:immunology* / Q000302:isolation & purification
D000913:Antibodies, Protozoan; D006023:Glycoproteins; C069715:trans-sialidase; D009439:Neuraminidase