[Costs of Chagas' disease screening test in blood donors in two Colombian blood banks, 2015].

INTRODUCTION: Transfusion is a mechanism of transmission of Chagas' disease. There are no studies on the costs of the screening test in Colombian blood banks. OBJECTIVE: To estimate the costs of the screening test for Chagas' disease among blood donors in two Colombian blood banks, 2015. MATERIALS AND METHODS: We conducted a micro-costing study from the perspective of the health care provider to estimate the cost of Chagas' disease testing in two blood banks, Banco de Sangre de la Cruz Roja, Seccional Bolívar, and Banco de Sangre del Hospital de Yopal, Casanare, taking into account four cost categories: 1) Administrative costs: public services and insurance costs were calculated based on the blood bank area in square meters; 2) capital costs: building and equipment costs that were annualized using a 3% discount rate and a lifespan of 20 years for building and five for equipment; 3) costs of Chagas' disease test materials and reagents adjusted by blood bank production level, and 4) costs of staff in charge of Chagas' disease test processing. The costs of transfusion bagsand immunohematology tests are also reported. RESULTS: The cost of Chagas' disease test in the blood bank of Seccional Bolívar was COP$ 37,804 (USD$ 12), and the blood bag and immunohematology test costs were COP$ 25,941 (USD$ 8.2) and COP$ 6,800 (USD$ 2.2), respectively. In the blood bank of Yopal, Casanare, the costs were COP$ 77,384 (USD$ 24.6), COP$ 30,141 (USD$ 9.6) and COP$ 12,627 (USD$ 4), respectively. Personnel cost accounted for the highest percentage of the total cost for both blood banks (47.5% in Seccional Bolívar, and 55.7% in Yopal, Casanare). CONCLUSION: Our results are an important input for the planning of services and cost-effectiveness studies for screening tests for Chagas' disease in Colombian blood banks.

Costos de la prueba de tamización para la enfermedad de Chagas en donantes de dos bancos de sangre de Colombia, 2015 / Costs of Chagas' disease screening test in blood donors in two Colombian blood banks, 2015

Resumen Introducción . La transfusión es un mecanismo de transmisión de la enfermedad de Chagas. No se han hecho estudios de costos de la prueba de tamización en bancos de sangre de Colombia. Objetivo. Estimar los costos de la prueba de tamización para la enfermedad de Chagas en donantes de bancos de sangre de Colombia, 2015. Materiales y métodos. Se hizo un estudio de costos desde la perspectiva del prestador de servicios en los bancos de sangre de la Cruz Roja, seccional Bolívar, y del Hospital de Yopal, Casanare, que incluyó: 1) gastos administrativos, es decir, costos de servicios públicos y seguros asignados según los metros cuadrados de las instalaciones del banco de sangre; 2) costos de capital, es decir, edificación y equipos, anualizados con una tasa de descuento de 3 % y considerando una vida útil de 20 y cinco años, respectivamente; 3) costos de insumos y materiales ajustados al nivel de producción, y 4) costos del recurso humano encargado del procesamiento de las pruebas. Se reportó, asimismo, el costo de las bolsas y de las pruebas de inmunohematología. Resultados. En el banco de sangre de la Cruz Roja, seccional Bolívar, el costo de la prueba fue de COP$ 37.804 (USD$ 12), mientras que la bolsa y la prueba de inmunohematología costaron COP$ 25.942 (USD$ 8,2) y COP$ 6.800 (USD$ 2,2), respectivamente. En el banco de sangre del Hospital de Yopal, los costos ascendieron a COP$ 77.384 (USD$ 24,6), COP$ 30.141 (USD$ 9,6) y COP$ 12.627 (USD$ 4), respectivamente. La mayor participación en el costo de la prueba correspondió al recurso humano (47,5 % en Cartagena y 55,7 % en Yopal). Conclusiones. Estos resultados son importantes para la planificación de los servicios y los análisis de costo-efectividad de la prueba de tamización para la enfermedad de Chagas en los bancos de sangre.

Abstract Introduction: Transfusion is a mechanism of transmission of Chagas' disease. There are no studies on the costs of the screening test in Colombian blood banks. Objective: To estimate the costs of the screening test for Chagas' disease among blood donors in two Colombian blood banks, 2015. Materials and methods: We conducted a micro-costing study from the perspective of the health care provider to estimate the cost of Chagas' disease testing in two blood banks, Banco de Sangre de la Cruz Roja, Seccional Bolívar, and Banco de Sangre del Hospital de Yopal, Casanare, taking into account four cost categories: 1) Administrative costs: public services and insurance costs were calculated based on the blood bank area in square meters; 2) capital costs: building and equipment costs that were annualized using a 3% discount rate and a lifespan of 20 years for building and five for equipment; 3) costs of Chagas' disease test materials and reagents adjusted by blood bank production level, and 4) costs of staff in charge of Chagas' disease test processing. The costs of transfusion bags and immunohematology tests are also reported. Results: The cost of Chagas' disease test in the blood bank of Seccional Bolívar was COP$ 37,804 (USD$ 12), and the blood bag and immunohematology test costs were COP$ 25,941 (USD$ 8.2) and COP$ 6,800 (USD$ 2.2), respectively. In the blood bank of Yopal, Casanare, the costs were COP$ 77,384 (USD$ 24.6), COP$ 30,141 (USD$ 9.6) and COP$ 12,627 (USD$ 4), respectively. Personnel cost accounted for the highest percentage of the total cost for both blood banks (47.5% in Seccional Bolívar, and 55.7% in Yopal, Casanare). Conclusion: Our results are an important input for the planning of services and cost-effectiveness studies for screening tests for Chagas' disease in Colombian blood banks.

First Colombian consensus on congenital Chagas and clinical approach for women of child-bearing age diagnosed with Chagas / Primer consenso colombiano sobre Chagas congénito y orientación clínica a mujeres en edad fértil con diagnóstico de Chagas

Congenital transmission of Chagas disease has not been extensively studied in Colombia, and there are no standardized processes in the health system regarding the specific diagnosis, treatment and follow-up of this disease. To generate recommendations on congenital Chagas disease and Chagas in women of childbearing age in Colombia, a consensus of experts was developed. An extensive literature search through the Medline database was carried out using the MeSH terms: «Chagas disease/congenital¼, «prevention and control¼, «diagnosis¼, «therapeutics¼ and «pregnancy¼. Appropriate abstracts were selected and the full texts were analyzed. The relevant information was synthesized, classified, and organized into tables and figures and was presented to a panel of experts, which was composed of 30 professionals from various fields. Based on the Delphi methodology, three rounds of consultation were conducted. The first and second rounds were based on electronic questionnaires that measured the level of consensus of each question among the participants. The third round was based on a face-to-face discussion focusing on those questions without consensus in the previous consultations. The evidence was adapted to national circumstances on a case-by-case basis, and the content the final document was approved. These recommendations are proposed for use in routine medical practice by health professionals in Colombia.

La transmisión congénita de la enfermedad de Chagas ha sido poco estudiada en Colombia y existen pocos procedimientos rutinarios en el sistema de salud para el manejo de esta enfermedad. Por ello se desarrolló un consenso de expertos dirigido a generar recomendaciones de diagnóstico y tratamiento de Chagas con- génito y orientación a mujeres en edad fértil. Con ese propósito se realizó una búsqueda extensiva de la literatura, empleando una combinación de términos Mes (Chagas, Chagas congénito, prevención, control, diagnóstico, tratamiento y embarazo) para reflejar el estado del arte en cada tema de interés. Después de ello, se leyeron los resúmenes y aquellos seleccionados para análisis del texto completo. La literatura relevante se sintetizo, clasifico y organizo en tablas y se presentó al panel de expertos, el cual estaba constituido por 30 profesionales en diferentes áreas. Mediante la metodología Delphi se realizaron 2 rondas de cuestionarios virtuales y una reunión presencial en los cuales se evaluaron los niveles de acuerdo entre los participantes. Los puntos con falta de consenso durante las 2 rondas virtuales se expusieron durante las mesas de discusión en la ronda presencial. La evidencia utilizada se adaptó a las particularidades nacionales según el caso y se aprobó el contenido del documento final. Se propone que estas recomendaciones sean usadas por profesionales de la salud en Colombia.

Detection of Trypanosoma cruzi antibodies in multitransfused patients in Colombia.

INTRODUCTION: Chagas disease is a public health problem in Latin America. Even though vector-borne infection is the most important transmission mode for this disease, other modes such as transfusions require evaluation. OBJECTIVE: To describe the prevalence of T. cruzi infection in multitransfused patients. MATERIALS AND METHODS: We detected IgG antibodies against T. cruzi by two immunoassays in samples from multitransfused patients in four hospitals located in Bogotá and Medellín, Colombia. We analyzed the association with known risk factors, and we calculated the odds ratios (OR) with 95% confidence intervals using Stata 11™ statistical software. RESULTS: In total, 479 samples were tested. Overall, T. cruzi antibody prevalence was 1.88% (nine patients). Five were onco-hematological patients, two were hemodialyzed, one had thalassemia, and one had suffered acute blood loss. We found no hemophilia patients. There was no association between known risk factors for transfusion-transmitted infection (such as the number of transfusion events, number of blood units and type of blood component) and the presence of anti-T. cruzi antibodies in this study. Only the hepatitis C virus infection showed a positive association with the presence of anti-T. cruzi antibodies (OR=5.68, 95% CI: 1.36-23.63). CONCLUSIONS: The results of this study showed a low frequency of T. cruzi infection in multitransfused patients, suggesting that the risk of transfusion infection in Colombia is low. Known risk factors for transfusion-related infection were not associated with the presence of anti-T. cruzi antibodies.

Detección de anticuerpos contra Trypanosoma cruzi en pacientes multitransfundidos, Colombia / Detection of Trypanosoma cruzi antibodies in multitransfused patients in Colombia

Resumen Introducción. La enfermedad de Chagas es un problema de salud pública en Latinoamérica y, aunque la transmisión vectorial es la más importante, deben evaluarse otras formas de transmisión, como la de las transfusiones. Objetivo. Describir la prevalencia de infección con Trypanosoma cruzi en pacientes sometidos a múltiples transfusiones o multitransfundidos. Materiales y métodos. Se detectaron anticuerpos IgG contra T. cruzi mediante dos inmunoensayos en muestras tomadas de pacientes sometidos a múltiples transfusiones en cuatro hospitales de Bogotá y Medellín, Colombia. Se analizó la asociación de factores de riesgo conocidos y se calcularon las razones de momios (odds ratio, OR) con un intervalo de confianza de 95 % (IC) utilizando el programa Stata 11(tm). Resultados. Se evaluaron 479 muestras. La prevalencia de anticuerpos contra T. cruzifue de 1,88 % (nueve pacientes): cinco pacientes remitidos de oncohematología, dos de hemodiálisis, uno tenía talasemia y uno había sufrido pérdida súbita y abundante de sangre. No se halló ningún paciente con hemofilia que resultara positivo, ni relación de los factores de riesgo de infección asociados con la transfusión de componentes sanguíneos, como el número de transfusiones, la cantidad de unidades de sangre y el tipo de componente, con la presencia de anticuerpos anti-T. cruzi. Solo se encontró relación entre la infección con el virus de la hepatitis C y la presencia de anticuerpos anti-T. cruzi (OR=5,68; IC95% 1,36-23,63). Conclusión. La frecuencia de infección por T. cruzi hallada en este grupo de pacientes sugiere que el riesgo de infección por transfusiones en Colombia es bajo. No se encontró relación entre los factores de riesgo asociados con la transfusión y la presencia de anticuerpos anti-T. cruzi.

Abstract Introduction: Chagas disease is a public health problem in Latin America. Even though vector-borne infection is the most important transmission mode for this disease, other modes such as transfusions require evaluation. Objective: To describe the prevalence of T. cruzi infection in multitransfused patients. Materials and methods: We detected IgG antibodies against T. cruzi by two immunoassays in samples from multitransfused patients in four hospitals located in Bogotá and Medellín, Colombia. We analyzed the association with known risk factors, and we calculated the odds ratios (OR) with 95% confidence intervals using Stata 11(tm) statistical software. Results: In total, 479 samples were tested. Overall, T. cruzi antibody prevalence was 1.88% (nine patients). Five were onco-hematological patients, two were hemodialyzed, one had thalassemia, and one had suffered acute blood loss. We found no hemophilia patients. There was no association between known risk factors for transfusion-transmitted infection (such as the number of transfusion events, number of blood units and type of blood component) and the presence of anti-T. cruzi antibodies in this study. Only the hepatitis C virus infection showed a positive association with the presence of anti-T. cruzi antibodies (OR=5.68, 95% CI: 1.36-23.63). Conclusions: The results of this study showed a low frequency of T. cruzi infection in multitransfused patients, suggesting that the risk of transfusion infection in Colombia is low. Known risk factors for transfusion-related infection were not associated with the presence of anti-T. cruzi antibodies.

Primer consenso colombiano sobre Chagas congénito y orientación clínica a mujeres en edad fértil con diagnóstico de Chagas / First Colombian consensus on congenital Chagas and clinical approach to women of fertile age diagnosed with Chagas

La transmisión congénita de la enfermedad de Chagas ha sido poco estudiada en Colombia y existen pocos procedimientos rutinarios en el sistema de salud para el manejo de esta enfermedad. Por ello se desarrolló un consenso de expertos dirigido a generar recomendaciones de diagnóstico y tratamiento de Chagas congénito y orientación a mujeres en edad fértil. Con ese propósito se realizó una búsqueda extensiva de la literatura, empleando una combinación de términos MeSH (Chagas, Chagas congénito, prevención, control, diagnóstico, tratamiento y embarazo) para reflejar el estado del arte en cada tema de interés. Después de ello, se leyeron los resúmenes y aquellos seleccionados para análisis del texto completo. La literatura relevante se sintetizó, clasificó y organizó en tablas y se presentó al panel de expertos, el cual estaba constituido por 30 profesionales en diferentes áreas. Mediante la metodología Delphi se realizaron 2 rondas de cuestionarios virtuales y una reunión presencial en los cuales se evaluaron los niveles de acuerdo entre los participantes. Los puntos con falta de consenso durante las 2 rondas virtuales se expusieron durante las mesas de discusión en la ronda presencial. La evidencia utilizada se adaptó a las particularidades nacionales según el caso y se aprobó el contenido del documento final. Se propone que estas recomendaciones sean usadas por profesionales de la salud en Colombia.

Congenital transmission of Chagas disease has not been extensively studied in Colombia, and there are no standardized processes in the health system regarding the specific diagnosis, treatment and follow-up of this disease. In order to generate recommendations on congenital Chagas disease and Chagas in women of childbearing age in Colombia, a consensus of experts was developed. An extensive literature search through the Medline database was carried out using the MeSH terms: " Chagas disease/congenital " , " prevention and control " , " diagnosis " , " therapeutics " and " pregnancy " . Appropriate abstracts were selected and the full texts were analyzed. The relevant information was synthesized, classified, and organized into tables and figures and was presented to a panel of experts, which was composed of 30 professionals from various fields. Based on the Delphi methodology, three rounds of consultation were conducted. The first and second rounds were based on electronic questionnaires that measured the level of consensus of each question among the participants. The third round was based on a face-toface discussion focusing on those questions without consensus in the previous consultations. The evidence was adapted to national circumstances on a case-by-case basis, and the content the final document was approved. These recommendations are proposed for use in routine medical practice by health professionals in Colombia.

Detección de hepatitis B oculta en donantes de bancos sangre, Colombia 2008-2009 / Absence of occult hepatitis B in Colombian blood donors

Introducción. En los bancos de sangre colombianos es obligatoria la tamización para el antígeno de superficie de la hepatitis B en todas las unidades recolectadas, mientras que no lo es para el anticuerpo contra el antígeno central, aunque este último puede ser útil para detectar donantes infectados con el virus de hepatitis B. Objetivo. Determinar la prevalencia de hepatitis B oculta, mediante la aplicación de un perfil serológico completo para el virus de la hepatitis B y pruebas de amplificación de ácidos nucleicos, en donantes de sangre de cuatro ciudades colombianas. Materiales y métodos. Entre abril de 2008 y octubre de 2009 se llevó a cabo un estudio prospectivo transversal que incluyó 628 muestras de donantes de cuatro bancos de sangre, ubicados en ciudades colombianas que registran distintas prevalencias para infección por el virus de la hepatitis B. Se hizo la tamización serológica completa para el virus y, posteriormente, pruebas de amplificación de ácidos nucleicos a los sueros con anti-HBc total reactivo y título de anti-HBs ≤30 mUI/ml. Resultados. En total, 129 muestras cumplieron con los criterios serológicos establecidos para ser sometidas a pruebas de amplificación de ácidos nucleicos. En ninguna de ellas se obtuvo amplificación de ácidos nucleicos del virus de la hepatitis B. Conclusiones. Éste es el primer estudio en Colombia que busca determinar la presencia de donantes de sangre portadores de hepatitis B oculta. No se documentó ningún caso de infección oculta en elestudio.

Introduction. In Colombian blood banks, screening for the surface antigen of hepatitis B is mandatory in all units collected. Testing of antibody against core antigens is not administered, although this method may be useful to detect donors infected with the hepatitis B virus. Objective. The prevalence of occult hepatitis B was determined by applying a full-serological profile of hepatitis B virus to blood samples of blood donors. Materials and methods. Between April 2008 and October 2009, a prospective cross sectional study was conducted using 628 samples from donors to blood banks located in four Colombian cities. Prevalence for hepatitis B had been previously recorded for these cities. Serological screening was performed for the complete virus; then nucleic acid amplification was tested in sera that were anti-HB creactive and with a titer of anti-HBs ≤30 mUI/ml. Results. Of the 628 samples tested, 129 met the serological criteria established to be tested nucleic acid amplification. None of them demonstrated evidence of nucleic acid amplification of hepatitis B virus. Conclusions. This is the first study in Colombia to detect the presence of blood donors that may be occult hepatitis B carriers. None was detected.

[Absence of occult hepatitis B in Colombian blood donors]. / Detección de hepatitis B oculta en donantes de bancos sangre, Colombia 2008-2009.

INTRODUCTION: In Colombian blood banks, screening for the surface antigen of hepatitis B is mandatory in all units collected. Testing of antibody against core antigens is not administered, although this method may be useful to detect donors infected with the hepatitis B virus. OBJECTIVE: The prevalence of occult hepatitis B was determined by applying a full-serological profile of hepatitis B virus to blood samples of blood donors. MATERIALS AND METHODS: Between April 2008 and October 2009, a prospective cross sectional study was conducted using 628 samples from donors to blood banks located in four Colombian cities. Prevalence for hepatitis B had been previously recorded for these cities. Serological screening was performed for the complete virus; then nucleic acid amplification was tested in sera that were anti-HBc reactive and with a titer of anti-HBs ≤30 mUI/ml. RESULTS: Of the 628 samples tested, 129 met the serological criteria established to be tested nucleic acid amplification. None of them demonstrated evidence of nucleic acid amplification of hepatitis B virus. CONCLUSIONS: This is the first study in Colombia to detect the presence of blood donors that may be occult hepatitis B carriers. None was detected.

Expression of IL-6, IL-8, TNF-alpha, IL-10, HSP-60, anti-HSP-60 antibodies, and anti-sperm antibodies, in semen of men with leukocytes and/or bacteria.

PROBLEM: Different cellular and biochemical markers have been proposed as indicators of infection-inflammation of male genital tract. METHOD OF STUDY: Semen samples from 80 men attending an andrologic clinic were evaluated to determine the presence of leukocyte, bacteria, antibodies against Chlamydia trachomatis, levels of IL-6, IL-8, IL-10, and TNF-alpha, HSP-60, anti-HSP-60 antibodies, and anti-sperm antibodies. RESULTS: Leukocytes in semen significantly correlated with an increase in IL-6, IL-8, and TNF-alpha. The simultaneous presence of pathogens and leukocytes was associated with high levels of IL-8 and TNF-alpha, whereas IL-6 was more associated with the presence of leukocytes. Anti-HSP-60 antibodies positively correlated with IL-6 and IL-8. The presence of anti-sperm antibodies highly associated with an increase in anti-HSP-60 antibodies. CONCLUSIONS: The type of cytokines present in the semen will depend on the single or simultaneous presence of leukocytes and/or pathogens. Chronic male genital tract infections could be associated with the development of anti-HSP-60 antibodies and anti-sperm antibodies.

Control de la infección por Trypanosoma cruzi en donantes de sangre de Colombia, 2003 / Control of infection for the Trypanosoma cruzi in blood donors

Introducción. La enfermedad de Chagas es un problema de salud pública en Latinoamérica. Después de la vectorial, la segunda fuente de transmisión es la transfusional; en Colombia el tamizaje para este marcador es obligatorio en los bancos de sangre desde 1995. Objetivo. Evaluar el comportamiento de algunas estrategias de control de la infección en donantes y estimar el riesgo transfusional por enfermedad de Chagas. Materiales y métodos. Se analizaron los datos de cobertura de tamizaje y reactividad para anticuerpos anti- Trypanosoma cruzi; los resultados de los bancos de sangre en el Programa de Evaluación Externa del Desempeño de Serología (PEED) y los reportes de los Laboratorios de Salud Pública sobre pruebas confirmatorias de serología en donantes. Resultados. En 2003, los bancos de sangre del país captaron 482.371 unidades, 99,91 por ciento fueron analizadas para anti- T.cruzi, resultando reactivas 0,42 por ciento. Casanare presentó la mayor reactividad con 107/1.487 (7,2 por ciento), de los cuales se confirmaron como positivos 75. En el PEED participaron 45,5 por ciento bancos, la totalidad de los cuales utilizó ELISA para tamizaje; se hallaron 1,1 por ciento resultados falsos positivos y ningún falso negativo. En 12 departamentos que analizaron 338.563 unidades para anti- T.cruzi, 1.298 casos fueron notificados como reactivos y 1.108 (85,4 por ciento) se confirmaron por la prueba de IFI, registrando una positividad de 0,33 por ciento. Conclusiones. Aunque la cobertura del tamizaje llegó a 99,91 por ciento, existe aún riesgo de infección por T.cruzi. Los casos de T.cruzi en donantes oscilan entre 0 y 50 por cada mil, y como ya se mencionó, Casanare es el departamento con mayor riesgo de adquirir Chagas transfusional. Los bancos participantes en el PEED no mostraron resultados falsos negativos

Incidencia e impacto de los efectos adversos en dos hospitales / Incidence and impact of adverse events in two hospitals

Objetivos: Presentar los resultados preliminares del proyecto IDEA relativos a la incidencia e impacto de los efectos adversos (EA) en dos de los hospitales incluidos en el estudio. Material y método: Diseño: estudio de cohortes prospectivo realizado durante el primer trimestre de 2004 en dos servicios de dos hospitales de la Comunidad Valenciana. Muestreo consecutivo. Sujetos: pacientes de más de 14 años, ingresados más de 24 h en los servicios seleccionados, en total, 673 sujetos. Medidas principales: proporción de alerta de EA (formulario de cribado positivo) e incidencia acumulada de EA identificados (cuestionario modular para su confirmación y caracterización). Resultados: La incidencia de alertas fue de un 34,7% para el hospital A (servicio de cirugía general) y de un 31% en el hospital B (servicio de medicina interna). La incidencia de EA fue del 16,1 y el 5,6%, respectivamente. El 42,1% de los EA del hospital A y el 16,7% del hospital B fueron considerados evitables, independientemente de la gravedad de sus consecuencias. Conclusiones: Los sistemas de vigilancia de alerta de los EA se han mostrado muy diferentes en los servicios estudiados. La variabilidad en la práctica clínica condiciona la identificación de los EA al revisar las historias clínicas

Objectives: To present the preliminary results of the IDEA project relating to the effect and impact of adverse events in two of the hospitals included in the study. Material and method: Design: prospective cohort study carried out in the first quarter of 2004 in two wards of two hospitals of the Autonomous Community of Valencia (Spain). Sampling: consecutive. Subjects: patients more than 14 years old, hospitalized for more than 24 hours in the selected wards. The total number of subjects was 673. Main measurements: proportion of adverse event alerts (positive detection questionnaire) and the accumulated incidence of identified adverse events (modular questionnaire for confirmation of AE and their characterization). Results: The incidence of alerts was 34.7% in hospital A (general surgery ward) and 31% in hospital B (internal medicine ward). The incidence of adverse events was 16.1% and 5.6% respectively. A total of 42.1% of the adverse events in hospital A and 16.7% of those in hospital B were avoidable, independently of the seriousness of their consequences. Conclusions: The adverse event surveillance systems differed between the two wards studied. Variability in clinical practice affects identification of adverse events on reviewing medical records

[Control of Trypanosoma cruzi infection in blood donors in Colombia, 2003]. / Control de la infección por Trypanosoma cruzi en donantes de sangre de Colombia, 2003.

INTRODUCTION: Chagas disease is a public health problem in Latin America. Whereas the primary source of transmission is the insect vector, the second is by blood transfusion. Consequently, in Colombia, screening for trypanosomiasis has been obligatory for blood donors since 1995. OBJECTIVE: The effectiveness ot current strategies for infection control in donors was evaluated in order to estimate the risk of blood stock contamination with Chagas disease. The screening data came from the blood banks in the Program of External Evaluation in the Performance of Serology and the reports of the Laboratories of Public Health on confirming donor serology tests. RESULTS: In 2003, 482,371 units of blood were collected in all of Colombia. Of these, 99.9% were analyzed for anti-T. cruzi reactivity, with a positives of 0.42% detected. The Casanare Province presented the biggest number of reactive donors 107/1487 (7.2%), with 75 confirmed positive. In the Program of External Evaluation in the Performance of Serology, 45.5% of all banks participated-all used ELISA for screening of anti-T. cruzi. 1.1% false positives and nofalse negatives were indicated in 12 provinces, where 338,563 units were analyzed for anti- T.cruzi, 1298 units were reactive and 1108 (85.4%) were confirmed by the IFI test. This indicated a rate of Chagas positives of 0.33%. CONCLUSIONS: Although the analysis covered arrived at 99.9% of the blood units, a small degree of infection risk for T. cruzi still remains. The cases of T. cruzi in donors oscillate between 0 and 50 per thousand. This rate is highest in Casanare with a concomitantly high risk for acquisition of transfusional Chagas. ot show negative false results.