Asymptomatic Leishmania Infection among Blood Donors in a Southern Province of Thailand

Phunlerd Piyaraj Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand;

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Lertwut Bualert HIV Clinic Trang Hospital, Trang Hospital, Trang Province, Thailand;

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Areerat Kalrat Blood Donation Unit, Trang Hospital, Trang Province, Thailand

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Saovanee Leelayoova Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand;

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Toon Ruang-areerate Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand;

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Nisaichol Theprin Blood Donation Unit, Trang Hospital, Trang Province, Thailand

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Tawee Naaglor Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand;

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Mathirut Mungthin Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand;

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Leishmaniasis poses significant public health challenges in endemic regions. Understanding the prevalence of asymptomatic Leishmania infection and identifying risk factors among blood donors is crucial. This study addressed a knowledge gap by evaluating the prevalence of asymptomatic Leishmania infection and pinpointing associated risk factors among blood donors in an endemic area in Thailand and aimed to enhance blood donation safety protocols and reduce the risk of transfusion-transmitted Leishmania infection. A cross-sectional study and a longitudinal follow-up were conducted among 500 blood donors in Trang Province, southern Thailand. A serological test was performed using the direct agglutination test (DAT), and DNA detection was performed using nested polymerase chain reaction (nPCR) to screen for Leishmania infection. Potential risk factors associated with the infection were also assessed. The study identified a 19.0% prevalence of asymptomatic Leishmania infection among blood donors, with nPCR proving more effective in detecting infections (13.0%) than DAT (6.4%). Notably, Leishmania martiniquensis was the predominant species identified, highlighting the local epidemiological profile of Leishmania infection. Furthermore, using multivariate analysis, living in stilt houses was independently associated with Leishmania infection (adjusted odds ratio = 1.85; 95% CI = 1.04–3.28; P = 0.035). A high prevalence of asymptomatic Leishmania infection among blood donors underscores the need for integrating comprehensive Leishmania screening protocols into blood donation processes, particularly in endemic regions. It advocates for using molecular diagnostics to enhance detection accuracy. Furthermore, living in stilt houses as a risk factor emphasizes the importance of environmental management in leishmaniasis control efforts.

Author Notes

Authors’ contributions: P. Piyaraj: conceptualization, formal analysis, funding acquisition, methodology, project administration, writing—original draft preparation. L. Bualert: investigation. A. Kalrat: investigation. S. Leelayoova: conceptualization, funding acquisition, methodology, supervision, writing—review & editing. T. Ruang-Areerate: investigation, methodology. N. Theprin: investigation. T. Naaglor: investigation. M. Mungthin: conceptualization, funding acquisition, methodology, supervision, writing—review & editing.

Financial support: P. Piyaraj was funded by the Phramongkutklao College of Medicine Research Fund. The funding bodies played no part in the study’s design, the collection, analysis, and interpretation of data, the decision to publish, or the preparation of the manuscript, ensuring the integrity and independence of the research.

Current contact information: Phunlerd Piyaraj, Saovanee Leelayoova, Toon Ruang-areerate, Tawee Naaglor, and Mathirut Mungthin, Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand, E-mails: p_phunlerd@yahoo.com, sleelayoova@gmail.com, toonr@pcm.ac.th, k.wiratree@pmk.ac.th, and mathirut@pcm.ac.th. Lertwut Bualert, Department of Medicine, Trang Hospital, Trang Province, Thailand, E-mail: dr_lertwut_clinic@yahoo.com. Areerat Kalrat and Nisaichol Theprin, Blood Donation Unit, Trang Hospital, Trang Province, Thailand, E-mails: aod_bbtrang@hotmail.com and bloodbanktrang@gmail.com.

Address correspondence to Phunlerd Piyaraj, Department of Parasitology, Phramongkutklao College of Medicine, 317 Ratchawithi Rd, Thung Phaya Thai, Ratchathewi, Bangkok 10400, Thailand. E-mail: ppiyaraj@pcm.ac.th
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