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Analysis of syphilis seropositive cases in blood donors from the Pró-Sangue Foundation (HSP) in the city of São Paulo


Introduction: Syphilis, an ancient disease, is still a public health problem throughout the world. The World Health Organization estimates that there are 12 million new cases of syphilis each year, with more than 90% of them occurring in developing countries. Recently, there has been a resurgence of syphilis that carries an increased risk for HIV coinfection. The sum of these agents can potentially increase the risk of bloodborne disease. Objective: To study epidemiological characteristics of blood donors with reactive Serological Tests for Syphilis (STS) at Fundação Pró-Sangue, located in the city of São Paulo. To characterize the serological profile of blood donors with STS reactive and determine the prevalence of active syphilis. To check prevalence of STS reactive along the study period. To strengthen quality control of blood and provide scientific evidence to develop strategies for syphilis prevention, and to improve transfusion safety. Materials and Methods: All samples of blood donors who donated in 2007 that presented serological screening tests reactive for syphilis (CMIA) will be additionaly tested withIgM-EIAtest for syphilis and VDRL.. Samples reactive for IgM-EIA and VDRL will be tested with a Real-time PCR for Syphilis. Rationale: Between 2015 and 2017, 327,536 blood donations were screened in our laboratory routine. The mean percentage of seropositivity for syphilis in this period was 0.73% (2,391 / 327,536). In 2017 a total of 532 positive samples for syphilis were detected by the CMIA test, of which 393 (74%) were VDRL negative and 139 (26%) were VDRL positive. We observed a progressive increase in the positivity of STS from 0.62% in 2015 to 0.73% in 2016 and 0.85% in 2017. Representing an increase of 37% (p <0.0000001). Continuous monitoring of the profile of donors infected with syphilis during the resurgence of the disease is extremely useful and important because reflects the epidemiological situation of the disease in the community and can contribute to the definition of health policies and measures to increase transfusion safety. Additionally, continuous surveillance of risk factors associated with syphilis may help improve recruitment and clinical screening of blood donors. (AU)