{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T06:15:47Z","timestamp":1791526547869,"version":"4.3.4"},"reference-count":57,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2021,12,17]],"date-time":"2021-12-17T00:00:00Z","timestamp":1639699200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003593","name":"National Council for Scientific and Technological Development","doi-asserted-by":"publisher","award":["490452\/2008-6"],"award-info":[{"award-number":["490452\/2008-6"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Transfusion transmissible infections (TTIs), caused by hepatitis B virus (HBV), human immunode-ficiency virus (HIV), hepatitis C virus (HCV), and syphilis, have a high global impact, especially in sub-Saharan Africa. We evaluated the trend of these infections over time in blood donors in Angola. A retrospective cross-sectional study was conducted among blood donors in Angola from 2005 to 2020. Additionally, frozen samples obtained from blood donors in 2007 were investigated to identify chronic HCV carriers and possible occult HBV infection (OBI). The overall prevalence of HBV, HCV, HIV, and syphilis was 8.5, 3, 2.1, and 4.4%, respectively, among 57,979 blood donors. HBV was predominant among male donors, while the remaining TTIs were predominant among women. Donors &gt;50 years had a significantly high prevalence for all TTIs. Chronic HCV infection was ab-sent in 500 samples tested and OBI was present in 3%. Our results show the continued high prev-alence of TTIs among blood donors in Angola. Most infections showed a significantly low preva-lence in years with campaigns seeking voluntary blood donors, thus, reinforcing the importance of this type of donor to ensure safe blood. Africa, with a high prevalence of diverse pathogens, should consider cost-effective pathogen reduction technologies, once they are commercially accessible, to increase the availability of safe blood.<\/jats:p>","DOI":"10.3390\/pathogens10121633","type":"journal-article","created":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T02:50:18Z","timestamp":1639968618000},"page":"1633","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Transfusion Transmissible Infections in Blood Donors in the Province of Bi\u00e9, Angola, during a 15-Year Follow-Up, Imply the Need for Pathogen Reduction Technologies"],"prefix":"10.3390","volume":"10","author":[{"given":"Luis Bai\u00e3o","family":"Peliganga","sequence":"first","affiliation":[{"name":"Viral Hepatitis Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21040-900, Brazil"},{"name":"Disease Control Department, National Directorate of Public Health, Ministry of Health, Luanda, Angola"},{"name":"Internal Medicine Investigation Department, Faculdade de Medicina da Universidade Agostinho Neto, Luanda, Angola"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7705-5921","authenticated-orcid":false,"given":"Vinicius Motta","family":"Mello","sequence":"additional","affiliation":[{"name":"Viral Hepatitis Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21040-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo Sergio Fonseca","family":"de Sousa","sequence":"additional","affiliation":[{"name":"Viral Hepatitis Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21040-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco Aurelio Pereira","family":"Horta","sequence":"additional","affiliation":[{"name":"NB3 Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21040-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1lvaro Domingos","family":"Soares","sequence":"additional","affiliation":[{"name":"Hospital Geral do Bi\u00e9, Cuito, Angola"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2505-1931","authenticated-orcid":false,"given":"Jo\u00e3o Pedro da Silva","family":"Nunes","sequence":"additional","affiliation":[{"name":"Laboratory of Experimental Vaccines, Paulista School of Medicine, Federal University of S\u00e3o Paulo, S\u00e3o Paulo 04039-032, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Nobrega","sequence":"additional","affiliation":[{"name":"Independent Researcher, Brooklyn, NY 11201, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3447-4621","authenticated-orcid":false,"given":"Lia Laura","family":"Lewis-Ximenez","sequence":"additional","affiliation":[{"name":"Viral Hepatitis Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21040-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,17]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2021). Global Progress Report on HIV, Viral Hepatitis and Sexually Transmitted Infections, 2021. Accountability for the Global Health Sector Strategies 2016\u20132021: Actions for Impact, World Health Organization. Licence: CC BY-NC-SA 3.0 IGO."},{"key":"ref_2","unstructured":"(2021, September 26). UNAIDS 2020. Available online: https:\/\/www.unaids.org\/en\/resources\/documents\/2020\/unaids-data."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.tmrv.2014.09.003","article-title":"The Use of Rapid Diagnostic Tests for Transfusion Infectious Screening in Africa: A Literature Review","volume":"29","author":"Pruett","year":"2015","journal-title":"Transfus. Med. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1111\/voxs.12597","article-title":"Donation testing and transfusion transmissible infections","volume":"15","author":"Roman","year":"2020","journal-title":"ISBT Sci. Ser."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.tracli.2019.06.191","article-title":"Transfusion in the WHO African Region","volume":"26","author":"Loua","year":"2019","journal-title":"Transfus. Clin. Et Biol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1111\/trf.14949","article-title":"Blood transfusion safety in sub-Saharan Africa: A literature review of changes and challenges in the 21st century","volume":"59","author":"Weimer","year":"2018","journal-title":"Transfusion"},{"key":"ref_7","unstructured":"World Health Organization (2021, September 09). Regional office for \u00c1frica. Blood Safety. Fact Sheet June 2021. Available online: https:\/\/www.google.com.br\/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwj6tfP7h_XzAhV6HbkGHYwlC7YQFnoECAsQAQ&url=https%3A%2F%2Fwww.afro.who.int%2Fhealth-topics%2Fblood-safety&usg=AOvVaw2Tl-PxO1NB3Az3nG2iZ97s."},{"key":"ref_8","unstructured":"World Health Organization (2017). Global Hepatitis Report 2017, World Health Organization. License CC BY-NC-SA 3.0 IGO."},{"key":"ref_9","unstructured":"World Health Organization (2018). Report on Global Sexually Transmitted Infection Surveillance, 2018, World Health Organization. Available online: https:\/\/www.who.int\/reproductivehealth\/publications\/stis-surveillance-2018\/en\/."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1038\/s41586-019-1200-9","article-title":"Mapping HIV prevalence in sub-Saharan Africa between 2000 and 2017","volume":"570","author":"Cork","year":"2019","journal-title":"Nature"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1159\/000496749","article-title":"History and Future of Nucleic Acid Amplification Technology Blood Donor Testing","volume":"46","author":"Roth","year":"2019","journal-title":"Transfus. Med. Hemotherapy"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2461","DOI":"10.1111\/j.1537-2995.2010.02704.x","article-title":"The cost-effectiveness of pathogen reduction technology as assessed using a multiple risk reduction model","volume":"50","author":"Custer","year":"2010","journal-title":"Transfusion"},{"key":"ref_13","unstructured":"Beth, H., Shaz, B.H., Hillyer, C.D., and Gil, M.R. (2019). Pathogen Reduction Technologies. Transfusion Medicine and Hemostasis: Clinical and Laboratory Aspects, Elsevier Science. [3rd ed.]. Available online: https:\/\/www.sciencedirect.com\/book\/9780128137260\/transfusion-medicine-and-hemostasis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"81","DOI":"10.11604\/pamj.2018.31.81.16331","article-title":"Trends of blood-borne infectious diseases in a rural blood donation center of southeast Gabon (Koula-Moutou)","volume":"31","author":"Bisseye","year":"2018","journal-title":"Pan Afr. Med. J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"947","DOI":"10.15585\/mmwr.mm6842a3","article-title":"Proficiency Testing of Viral Marker Screening in African Blood Centers\u2014Seven African Countries, 2017","volume":"68","author":"Drammeh","year":"2019","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"18035","DOI":"10.1038\/nrdp.2018.35","article-title":"Hepatitis B virus infection","volume":"4","author":"Yuen","year":"2018","journal-title":"Nat. Rev. Dis. Prim."},{"key":"ref_17","unstructured":"Machado, O. Director of the National Institute of Blood, Luanda, Angola. Personal Communication."},{"key":"ref_18","unstructured":"Martins, J. National Coordinator of the Malaria Control and Combat Program, Luanda, Angola. Personal Comunication."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1016\/S0140-6736(05)67176-0","article-title":"South East Asian Quinine Artesunate Malaria Trial (SEAQUAMAT) group Artesunate versus quinine for treatment of severe falciparum malaria: A randomised trial","volume":"366","author":"Dondorp","year":"2005","journal-title":"Lancet"},{"key":"ref_20","unstructured":"World Health Organization (2015). Guidelines for the Treatment of Malaria, World Health Organization. Available online: https:\/\/apps.who.int\/iris\/handle\/10665\/162441."},{"key":"ref_21","unstructured":"Chicomo, J.A. (2021, October 10). A resist\u00eancia de um povo, Editora Nzila, 2008. Available online: https:\/\/books.google.com\/books\/about\/Kuito.html?id=HL2icQAACAAJ."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"385","DOI":"10.11604\/pamj.2014.19.385.4328","article-title":"Factors for viral infection in blood donors of South Kivu in the Democratic Republic of Congo","volume":"19","author":"Kabinda","year":"2014","journal-title":"Pan Afr. Med. J."},{"key":"ref_23","first-page":"419","article-title":"Seroprevalence of human immunodeficiency virus, hepatitis B and C viruses and syphilis among blood donors in Koudougou (Burkina Faso) in 2009","volume":"9","author":"Nagalo","year":"2011","journal-title":"Blood Transfus."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Xie, D.-D., Li, J., Chen, J.-T., Eyi, U.M., Matesa, R.A., Obono, M.M.O., Ehapo, C.S., Yang, L.-Y., Yang, H.-T., and Lin, M. (2015). Seroprevalence of Human Immunodeficiency Virus, Hepatitis B Virus, Hepatitis C Virus, and Treponema pallidum Infections among Blood Donors on Bioko Island, Equatorial Guinea. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0139947"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/2052-1839-14-5","article-title":"HIV, HBV, HCV and T. pallidum infections among blood donors and Transfusion-related complications among recipients at the Laquintinie hospital in Douala, Cameroon","volume":"14","author":"Moukoko","year":"2014","journal-title":"BMC Hematol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"118","DOI":"10.4314\/mmj.v31i2.3","article-title":"Seroprevalence and trends in transfusion transmissible infections among voluntary non-remunerated blood donors at the Malawi Blood Transfusion Service-a time trend study","volume":"31","year":"2019","journal-title":"Malawi Med. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"44","DOI":"10.11604\/pamj.2018.30.44.14663","article-title":"Hidden dangers-prevalence of blood borne pathogens, hepatitis B, C, HIV and syphilis, among blood donors in Sierra Leone in 2016: Opportunities for improvement: A retrospective, cross-sectional study","volume":"30","author":"Yambasu","year":"2018","journal-title":"Pan Afr. Med. J."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Mremi, A., Yahaya, J.J., Nyindo, M., and Mollel, E. (2021). Transfusion-Transmitted Infections and associated risk factors at the Northern Zone Blood Transfusion Center in Tanzania: A study of blood donors between 2017 and 2019. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0249061"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12879-019-4699-3","article-title":"Seroprevalence and risk factors for HIV, HCV, HBV and syphilis among blood donors in Mali","volume":"19","author":"Jary","year":"2019","journal-title":"BMC Infect. Dis."},{"key":"ref_30","first-page":"529","article-title":"Hepatitis B and C viral infections among blood donors","volume":"4","author":"Nkrumah","year":"2011","journal-title":"A retrospective study from a rural community of Ghana. BMC Res. Notes"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Boushab, B.M., Limame, O.C.M.M., Zahra, F.-M.F., Mamoudou, S., Darnycka, B.M.R., and Saliou, S.M. (2017). Estimation of seroprevalence of HIV, hepatitis B and C virus and syphilis among blood donors in the hospital of A\u00efoun, Mauritania. Pan Afr. Med. J., 28.","DOI":"10.11604\/pamj.2017.28.118.12465"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Okoroiwu, H.U., Okafor, I.M., Asemota, E.A., and Okpokam, D.C. (2018). Seroprevalence of transfusion-transmissible infections (HBV, HCV, syphilis and HIV) among prospective blood donors in a tertiary health care facility in Calabar, Nigeria; an eleven years evaluation. BMC Public Health, 18.","DOI":"10.1186\/s12889-018-5555-x"},{"key":"ref_33","unstructured":"World Health Organization (2020, February 11). Blood Safety and Availability, World Health Organization Fact Sheet 14 June 2019. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/blood-safety-and-availability."},{"key":"ref_34","unstructured":"World Health Organization (2017). WHO Guidelines on Hepatitis B and C Testing, World Health Organization. Available online: http:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/254621\/9789241549981-eng.pdf."},{"key":"ref_35","first-page":"613","article-title":"Centers for Disease Control and Prevention (CDC). Progress toward prevention of transfusion-transmitted hepatitis B and hepatitis C infection\u2014sub-Saharan Africa, 2000\u20132011","volume":"63","author":"Apata","year":"2014","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"153","DOI":"10.4314\/ejhs.v26i2.9","article-title":"Seroprevalence of Human Immunodeficiency Virus, Hepatitis B Virus, Hepatitis C Virus, and Syphilis among Blood Donors at Jigjiga Blood Bank, Eastern Ethiopia","volume":"26","author":"Abate","year":"2016","journal-title":"Ethiop. J. Health Sci."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"35","DOI":"10.4297\/najms.2011.335","article-title":"A Survey of prevalence of serum antibodies to human immunodeficiency deficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) among blood donors","volume":"3","author":"Dirisu","year":"2011","journal-title":"North Am. J. Med. Sci."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Mavenyengwa, R.T., Mukesi, M., Chipare, I., and Shoombe, E. (2014). Prevalence of human immunodeficiency virus, syphilis, hepatitis B and C in blood donations in Namibia. BMC Public Health, 14.","DOI":"10.1186\/1471-2458-14-424"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Fong, I.W. (2020). Blood Transfusion-Associated Infections in the Twenty-First Century: New Challenges. Current Trends and Concerns in Infectious Diseases. Emerging Infectious Diseases of the 21st Century, Springer. Chapter 8.","DOI":"10.1007\/978-3-030-36966-8_8"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Abdella, S., Berheto, T.M., Tolera, G., Belete, W., Deressa, T., Feleke, A., H\/silassie, A., Gezahegn, N., Tadesse, D., and Tefera, M. (2020). Sero-prevalence of transfusion transmittable infections: HIV, Hepatitis B, C and Treponema pallidum and associated factors among blood donors in Ethiopia: A retrospective study. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0241086"},{"key":"ref_41","unstructured":"Comunidade dos Pa\u00edses de Lingua Oficial portuguesa (2021, August 04). Relat\u00f3rio Final, Angola 2017. Available online: https:\/\/www.google.com.br\/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwikzq69tPDzAhXFqpUCHak4D3kQFnoECAgQAQ&url=https%3A%2F%2Fsaude.cplp.org%2Fmedia%2F1922%2Fcplp_angola_2018-1.pdf&usg=AOvVaw2jI2VD54_q16l80ccc3Bh."},{"key":"ref_42","unstructured":"World Health Organization (2016). WHO Guidelines for the Treatment of Treponema Pallidum (Syphilis), World Health Organization. Available online: https:\/\/www.who.int\u203artis\u203asyphilis."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"671","DOI":"10.2147\/JBM.S310329","article-title":"Human Immunodeficiency Virus and Syphilis Among Blood Donors at Western Oromia, Ethiopia","volume":"ume 12","author":"Abebe","year":"2021","journal-title":"J. Blood Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1560","DOI":"10.3201\/eid2309.161594","article-title":"For the NHLBI Recipient Epidemiology and Donor evaluation Study-III (REDS-III) International Component Use of Blood Donor Screening to Monitor Prevalence of HIV and Hepatitis B and C Viruses, South Africa","volume":"23","author":"Vermeulen","year":"2017","journal-title":"Emerg. Infect. Dis."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"S6","DOI":"10.1016\/0264-410X(90)90206-2","article-title":"Hepatitis B: The disease","volume":"8","author":"Sherlock","year":"1990","journal-title":"Vaccine"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"e30","DOI":"10.1038\/emi.2015.30","article-title":"Is mother-to-infant transmission the most important factor for persistent HBV infection?","volume":"4","author":"Li","year":"2015","journal-title":"Emerg. Microbes Infect."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12879-018-3174-x","article-title":"Seroprevalence of transfusion-transmissible infections among blood donors at National Blood Transfusion Service, Eritrea: A seven-year retrospective study","volume":"18","author":"Siraj","year":"2018","journal-title":"BMC Infect. Dis."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Onyango, C.G., Ogonda, L., Guyah, B., Okoth, P., Shiluli, C., Humwa, F., and Opollo, V. (2018). Seroprevalence and determinants of transfusion transmissible infections among voluntary blood donors in Homabay, Kisumu and Siaya counties in western Kenya. BMC Res. Notes, 11.","DOI":"10.1186\/s13104-018-3276-y"},{"key":"ref_49","unstructured":"World Health Organization (2020). Training Modules on Hepatitis B and C Screening, Diagnosis and Treatment, World Health Organization. Licence: CC BY-NC-SA 3.0 IGO."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1747","DOI":"10.1093\/cid\/cit602","article-title":"High Frequency of False-Positive Hepatitis C Virus Enzyme-Linked Immunosorbent Assay in Rakai, Uganda","volume":"57","author":"Mullis","year":"2013","journal-title":"Clin. Infect. Dis."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Oluyinka, O.O., Tong, H., Tien, S.B., Fagbami, A.H., Adekanle, O., Ojurongbe, O., Bock, C.-T., Kremsner, P.G., and Velavan, T.P. (2015). Occult Hepatitis B Virus Infection in Nigerian Blood Donors and Hepatitis B Virus Transmission Risks. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0131912"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1097\/01.EPX.0000427065.73965.c8","article-title":"Detection of occult hepatitis B virus infection among blood donors in Sudan","volume":"88","author":"Mahmoud","year":"2013","journal-title":"J. Egypt. Public Health Assoc."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1854","DOI":"10.1182\/blood-2018-11-833996","article-title":"Prevention of transfusion-transmitted infections","volume":"133","author":"Busch","year":"2019","journal-title":"Blood"},{"key":"ref_54","first-page":"1","article-title":"Prevalence, incidence and residual risk of transfusion-transmitted hepatitis C virus and human immunodeficiency virus after the implementation of nucleic acid testing in Italy: A 7-year (2009\u20132015) survey","volume":"16","author":"Velati","year":"2018","journal-title":"Blood Transfus. Trasfus. Del Sangue"},{"key":"ref_55","first-page":"287","article-title":"Health Technology Assessment of pathogen reduction technologies applied to plasma for clinical use","volume":"14","author":"Cicchetti","year":"2016","journal-title":"Blood Transfus."},{"key":"ref_56","first-page":"151","article-title":"Progress towards an appropriate pathogen reduction technology for whole blood in Africa","volume":"15","author":"Lanteri","year":"2019","journal-title":"ISBT Sci. Ser."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1854","DOI":"10.3201\/eid2210.160818","article-title":"Resurgence of Yellow Fever in Angola, 2015\u20132016","volume":"22","author":"Grobbelaar","year":"2016","journal-title":"Emerg. Infect. Dis."}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/10\/12\/1633\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:50:16Z","timestamp":1760169016000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/10\/12\/1633"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,17]]},"references-count":57,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["pathogens10121633"],"URL":"https:\/\/doi.org\/10.3390\/pathogens10121633","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,17]]}}}