Avaliação de desempenho diagnóstico dos testes laboratoriais para sífilis em doadores de sangue de Santa Catarina em 2009 a 2012

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Programa de Pós-Graduação em Saúde Coletiva, Florianópolis, 2013.Introdução: A triagem sorológica, em doadores de sangue, representasignificado estratégico para garantir a segurança e qualidade doshemocomponentes a serem transfundidos. No rastreamento da sífilis éutilizada uma combinação de testes não treponêmicos e treponêmicos,sendo o segundo usado para confirmar o resultado da sorologia inicial.Recentemente, laboratórios passaram a adotar o chamado ?algoritmoreverso?, onde a triagem inicial é realizada com o teste específico paratreponema (ELISA, FTA-ABS), e confirmada com testes nãotreponêmicos (VDRL, RPR). O Hemocentro de Santa Catarina(HEMOSC), a partir de julho de 2011, passou a adotar o novo métodosorológico para sífilis, na triagem dos doadores de sangue, depois deverificar discordâncias nos resultados com o método tradicionalmenteusado. Objetivo: Teve-se como objetivo principal avaliar os protocolosdiagnósticos utilizados pelo Hemocentro de Santa Catarina, verificandoa ocorrência de resultados falsos positivos na população de doadores desangue do HEMOSC. Método: Esta pesquisa avaliou o protocolosorológico de julho de 2011 a setembro de 2012, e o comparou com operíodo anterior a sua adoção (janeiro de 2009 a junho de 2011).Resultados: Os resultados demonstraram uma diminuição de 57,9% deresultados falsos positivos com o uso do algoritmo reverso, além de umaumento de 84% na confirmação sorológica para sífilis. Conclusão: Atriagem sorológica para sífilis com o uso do método reverso se mostroueficaz no diagnóstico da doença em doadores de sangue do HEMOSC. Abstract : Introduction: Serological screening in blood donors is of strategicsignificance to ensure the safety and quality of blood products fortransfusion. In most cases, a combination of nontreponemal andtreponemal tests is used, with the latter used to confirm initial testresults. Recently, some laboratories have adopted the so-called "reversealgorithm" where initial screening is carried out with a specific test fortreponemal (ELISA, FTA-ABS), and confirmed with a nontreponemaltests (VDRL, RPR). In the state of Santa Catarina, southern Brazil,blood banks adopted the reverse algorithm to screen blood donors forsyphilis in July 2011. Objective: Had as main objective to evaluate thediagnostic protocols used by the Blood Center of Santa Catarina,verifying the occurrence of false positive results in the population ofblood donors Hemosc. Method: This study evaluated the screeningperformance of the reverse algorithm between from July 2011 toSeptember 2012, and compared it with the period prior to its adoption(January 2009 to June 2011). Results: The results showed a decrease of57.9% in false positive results with the use of the reverse algorithm andan 84% increase in the serologic confirmation of screen-positive testresult. Conclusion: Serological screening for syphilis using the reversealgorithm was proved effective in reducing the false positive rate inblood donors in Santa Catarina

Syphilis seroprevalence estimates of Santa Catarina blood donors in 2010

Introduction Knowledge of blood donor characteristics is essential to better guide clinical and serological screening for hemotherapy. The objective of this study was to determine the syphilis seroprevalence and the associated factors of blood donors in the State of Santa Catarina, Brazil. Methods This population-based study from the State of Santa Catarina used information obtained from blood donation records. We analyzed 83,396 blood donor records generated from donors who were considered eligible to donate between January and August 2010. The aim of the study was to estimate the syphilis seroprevalence and its relationship with educational level, age, gender, geographical region and having donated blood in the past 12 months. We used descriptive analyses and a Poisson regression to calculate the prevalence ratios for the variables of interest. Results We found a 0.14% overall seroprevalence and significant differences among the following: first-time blood donors (0.19%) versus repeat donors (0.03% to 0.08%); low educational levels (0.30%) versus medium and high educational levels (0.08% to 0.19%); and donors who did not report their residence (0.88%) or age (6.94%) versus those who did. Increased syphilis seroprevalence was also significantly associated with increased age. Conclusion High syphilis seroprevalence was associated with lower educational level, age, first-time donation and the failure to provide age or residence information