The Rising Threat of Transfusion-Transmitted Infections in Latin America

Introduction to Arboviruses and Their Public Health Impact

Latin America and the Caribbean are increasingly recognized as hotspots for arboviruses, which are transmitted by arthropods such as mosquitoes. The primary vectors, including Aedes aegypti and Aedes albopictus, transmit several viruses such as dengue (DENV), Zika (ZIKV), and Chikungunya (CHIKV). These infections not only pose direct health risks, leading to severe conditions such as microcephaly during Zika outbreaks but also indirectly affect public health by straining healthcare resources and increasing morbidity rates (Moreira-Soto et al., 2025).

The emergence of new viruses, particularly Oropouche virus (OROV), has raised significant concerns about transfusion-transmitted infections (TTIs) in the region. Current estimates indicate that in 2024, there were over 20,000 documented cases of OROV across multiple countries in Latin America, highlighting the urgent need for improved surveillance and blood safety measures (Moreira-Soto et al., 2025).

Current Screening Practices and Their Limitations

Most countries in Latin America have established blood screening protocols focusing on well-known pathogens such as HIV, hepatitis B and C, and syphilis. However, screening for arboviruses remains largely unregulated, leading to significant gaps in blood safety. Specifically, while countries like Brazil and Ecuador have implemented molecular tests for viral RNA detection, many others still rely on serological testing, which often lacks sensitivity and specificity due to cross-reactivity between different viruses (Moreira-Soto et al., 2025).

Table 1: Summary of Current Blood Screening Practices in Latin America

Socioeconomic Factors Influencing Blood Donation Rates

Socioeconomic factors play a crucial role in blood donation rates across Latin America. Countries with higher gross domestic product (GDP) tend to have more robust voluntary blood donation systems. For example, Cuba, while having a lower GDP, boasts the highest blood donation rate in the region due to its significant health expenditure (Moreira-Soto et al., 2025).

Table 2: Correlation Between Economic Factors and Blood Donation Rates

The correlation data indicates a r = 0.53 (p = 0.0021) between GDP and blood donation rates, demonstrating that economic stability directly influences the healthcare system’s ability to mobilize voluntary blood donations (Moreira-Soto et al., 2025).

Risk Factors for Transfusion-Transmitted Infections

Various arboviral infections pose significant risks for TTIs, particularly during periods of high viremia. Dengue, Zika, and Oropouche viruses are noted for their potential to be transmitted through blood transfusions (Moreira-Soto et al., 2025). Each virus has distinct characteristics that influence the risk of TTIs:

• Dengue (DENV): High incidence in endemic regions, with symptomatic disease rates often exceeding 30%.
• Zika Virus (ZIKV): Linked to severe birth defects; even low viral loads can pose a risk during transfusion.
• Oropouche Virus (OROV): Rising incidence and potential for severe disease highlight the importance of surveillance.

Table 3: Risk Estimates for Arboviral Transfusion-Transmitted Infections

Strategies for Mitigating Risks of Arboviral TTIs

To address the risks posed by arboviruses, it is essential to implement comprehensive blood safety strategies that include:

1. Enhanced Surveillance: Regular monitoring of arboviral infections, particularly during peak transmission seasons.
2. Molecular Testing: Adoption of nucleic acid testing (NAT) for early detection of viral RNA in blood donations, particularly in high-risk areas.
3. Public Awareness Campaigns: Educating the public about the importance of voluntary blood donation and the risks associated with TTIs.

Table 4: Recommended Strategies for Mitigating Arboviral TTI Risks

FAQ Section

What are transfusion-transmitted infections (TTIs)? TTIs are infections that can be transmitted through blood transfusions, including viruses, bacteria, and parasites.

Why are arboviruses a concern for blood safety in Latin America? Arboviruses can lead to severe health outcomes, and their potential for transfusion transmission is largely unregulated in many countries.

How do socioeconomic factors affect blood donation rates? Higher GDP and health expenditure correlate with increased voluntary blood donations, impacting the availability of safe blood products.

What strategies can mitigate the risks of TTIs? Strategies include enhanced surveillance, molecular testing for early detection, and public awareness campaigns to encourage voluntary blood donations.

References

1. Moreira-Soto, A., Postigo-Hidalgo, I., Tabares, X., Roell, Y., Fischer, C., Gotuzzo, E., Jaenisch, T., Levi, J. E., Lustig, Y., & Drexler, J. F. (2025). Transfusion-transmitted infections: risks and mitigation strategies for Oropouche virus and other emerging arboviruses in Latin America and the Caribbean. Lancet Regional Health - Americas, 4, 381-391. https://doi.org/10.1016/j.lana.2025.101089

2. Centers for Disease Control and Prevention. (2020). Blood safety: Transfusion-transmitted infections

3. Pan American Health Organization. (2020). Blood donation and transfusion safety

4. World Health Organization. (2021). Global status report on blood safety and availability 2020

5. The World Bank. (2021). World development indicators

6. National Institutes of Health. (2021). Understanding the impact of COVID-19 on blood donations