A systematic review and meta-analysis of the prevalence of Leishmania infection in blood donors

BackgroundThe risk of transfusion transmitted leishmaniasis (TTL) from apparently healthy persons or asymptomatic individuals, should not be ignored. Lack of a comprehensive review, encouraged us to design a systematic review with meta-analysis approach to assess the prevalence of Leishmania infection in healthy blood donors.MethodsFor this purpose, 6 English databases (PubMed, Scopus, Web of Sciences, Science Direct, EMBASE and CINAHL) were browsed from January 1990 to July 2016.ResultsDue to significant heterogeneity, the random-effects model was used (I2 = 98.04% and 94.68%, for serological and molecular methods, respectively). A total of 496 papers were found through searching in which 17,816 apparently healthy blood donors were examined for Leishmania infection. The weighted overall prevalence of Leishmania infection in this group was estimated 4% (95% CI = 2-7) and 8.7% (95% CI = 4.2-14.3) using serological and molecular methods, respectively.ConclusionsHigh serological prevalence does not justify widespread donor screening. Leukodepletion filters would substantially decrease the risk of TTL, hence they are potentially proposed in endemic areas specifically for high-risk recipients. To better enlighten the epidemiological aspects of Leishmania infection in blood donors, it is suggested to perform high-level stewardship and more precise studies with regard to involved risk factors.