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We suggest possible reasons. Almost all blood donations from Kurdistan come from the capital of the Kurdistan province, Sanandaj the Sanandaj Blood Centre. The motivation of Sanandaj residents to donate blood is very high, and the loyal regular donors living in urban areas are aware of their health status. The geographical range of infected individuals suggests that most cases were resident in urban areas. This could be due to the fact that the number of blood donors from rural areas is very low; To our knowledge, brucellosis seroprevalence among Iranian blood donors was previously evaluated in small-scale studies.

Khorasgani et al. A larger sample size and the focus on provinces with a higher incidence of infection in the general population are the strengths of this study. In 4 previous studies carried out in Iran with research methods similar to ours, the seroprevalence rate was 0. We found a significant association between exposure to manure products and seropositvity.

Human Brucellosis: Risks and Prevalence among Iranian Blood Donors Residing in Endemic Areas

Usually, transmission by ingestion of contaminated dairy products is noticed. It should thus be re-emphasized that other routes of transmission including contact with manure products must be kept in mind. The prevalence of brucellosis among blood donors varies from 0. The study in Turkey on blood donors of a non-endemic region implemented a molecular detection method real-time PCR and found 0.

The authors concluded that this risk was nonsignificant, but that the organism should be evaluated as a threat for blood transfusion. Another study run in northwestern China revealed that 3. None were bacteremic by the culture method, and STA-positivity was detected in the circulating DNA of all donors [ 13 ]. This data re-emphasizes that most STA positivity in blood donors from endemic regions is not bacteremic and occurs due to past exposure rather than true infection.

A positivity rate of 0. Another Indian evaluation observed 3. A study in southern Ethiopia showed a high seroprevalence Contact with domestic animals and husbandry practices at home were the main risk factors [ 32 ]. Although a diverse range of brucellosis seroprevalence in Iranian blood donors exist, there have been no reports of blood transfusion-transmitted brucellosis in Iran.

In current practice, the transfusion of red blood cells or blood products is more common and whole blood is rarely used.

Therefore, the ability of blood components to transmit the disease is the scope of the further investigation. As there are no tests yet approved for Brucella screening in blood donors and only an imprecise known role of leukoreduction, the following recommendations can be made for further blood transfusion safety in highly endemic areas: pre-donation screening concerning the history of animal contact, the signs and symptoms of acute or chronic febrile disease, and exposure to contaminated dairy products can be considered as the only measure to reduce the risk of transfusion-transmitted brucellosis.

It is suggested that blood donors should be questioned about the nonspecific symptoms of brucellosis. Moreover, asking about the habits of using the dairy products taken directly from ranchers and modifications applied to possibly contaminated products, along with probing other routes of exposure like direct contact to manure, would be helpful. In addition, we suggest close communication with provincial veterinary organizations to hear about districts with outbreaks of Brucella in livestock, and with local health authorities so as to keep informed of outbreaks in high-risk groups.

However, it is difficult to evaluate the usefulness of risk-reduction strategies for brucellosis.

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It seems that routine deferral of those considered to be at risk has an impact on blood supply in highly endemic areas, but the potential effect would likely not be impressive. In conclusion, we report a summary of blood donors according to significant serological markers that might pose a risk to blood safety.

Iran/Hamadan Market (grape harvest) Part 86

Further evaluation is recommended to establish the related risk factors, especially in provinces practicing animal husbandry and among donors with a professional contact history. Evaluations for transfusion-transmitted brucellosis, especially in endemic areas, will be helpful for policy-makers. We also recommend further studies using molecular testing on at-risk donors living in endemic areas.

We acknowledge all physicians in the blood donation, sampling, and transportation sections of local provincial centres of the IBTO. We also appreciate the cooperation of the CDC-related laboratory technicians in the given provinces. All subjects signed an informed consent. Author Contacts Gharib Karimi. Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.

Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions.

Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor s. The publisher and the editor s disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

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