Seroprevalence of transfusion-transmissible infections among blood donors at National Blood Transfusion Service, Eritrea: a seven-year retrospective study

Exploring the determinants of risk behavior for transfusion transmissible infections among first-time blood donors in Mandalay General Hospital, Myanmar

INTRODUCTION

Blood donation is vital to healthcare, but it must be kept safe by mitigating the risk of transfusion transmissible infections (TTIs). The objective of this study was to investigate the factors that influence risk behavior for transfusion transmissible infections among first-time blood donors at Mandalay General Hospital, Myanmar.

METHODS

This study utilized a cross-sectional study design using secondary data. Mandalay city and Mandalay Blood Bank in Mandalay General Hospital were purposely selected and a total of 406 first-time blood donors participated. A structured questionnaire administered by an interviewer was used. The questionnaire contained background characteristics, knowledge on TTIs, attitude toward TTIs, and TTIs risk behaviors. To examine the determinants (background characteristics, knowledge, and attitude) that affect risk behavior, inferential statistics techniques that included the chi-squared test, bivariable logistic regression, and multivariable logistic regression were applied. A p-value of less than 0.05 signified statistical significance.

RESULTS

Among 406 first-time blood donors, 52.9% were under 20 years old, and 53.7% were male. Most had undergraduate education (77.6%), were married (84.2%), and were students (55.7%). Additionally, 76.8% hadn't received the hepatitis B vaccine. Blood groups were distributed as follows: B (40.0%), O (33.8%), A (23.4%), AB (8.9%). About 15.8% showed high knowledge level, and 63.6% had high attitude. Notably, 29.3% exhibited high-risk behavior for TTIs. Age was associated with lower risk behavior (OR = 1.54, 95% CI: 0.99, 2.38, p = 0.049), but lost significance in multivariable regression (p = 0.214). Knowledge on TTIs didn't show significance. However, high attitudes were significantly associated with lower risk behavior (OR = 11.4, 95% CI: 1.25, 103.83, p = 0.017, retained in multivariable regression, p = 0.012).

CONCLUSION

Findings of this study contribute in the development of programs that ensure a safe and reliable blood supply chain. To improve blood safety standards among first-time blood donors, this study highlights the value of targeted education and screening processes, placing particular emphasis on acquiring knowledge and positive attitude toward blood donation and risk behavior.

COVID-19 impact on blood donor characteristics and seroprevalence of transfusion-transmitted infections in southern Thailand between 2018 and 2022

Blood safety is a critical aspect of healthcare systems worldwide involving rigorous screening, testing, and processing protocols to minimize the risk of transfusion-transmitted infections (TTIs). The present study offers a comprehensive assessment of the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and syphilis among blood donors in southern Thailand. It explores the consequences of the COVID-19 pandemic on the blood transfusion service, donor characteristics, and the prevalence of TTIs. A retrospective analysis of 65,511 blood donors between 2018 and 2022 was conducted at Songklanagarind Hospital, Thailand. The socio-demographic characteristics of the donors were examined using the Chi-square test to assess the relationship between TTIs serological positivity and donor characteristics. The donors were divided into pre-COVID-19 (2018-2019) and during COVID-19 (2020-2022) groups to evaluate the impacts of COVID-19. The study found that HBV had the highest overall prevalence at 243 per hundred thousand (pht), followed by syphilis (118 pht), HCV (32 pht), and HIV (31 pht) over a five-year period of study. After COVID-19, the prevalence of HBV decreased by 21.8%; HCV decreased by 2.1%; HIV increased by 36.4%; and syphilis increased by 9.2%. The socio-demographic characteristics and TTIs prevalence were significantly altered over time. This study provides insights into blood donor characteristics and TTIs prevalence in southern Thailand, highlighting the understanding of the impact of COVID-19 on the spread of TTIs.

Assessment of prevalence and risk factors associated with Hepatitis B virus infection among blood donors in Mogadishu Somalia

BACKGROUND

The Hepatitis B virus (HBV) is transmitted through contaminated blood or bodily fluids. Globally, over 81 million blood units are donated annually, a crucial therapeutic procedure without alternatives. However, blood-borne infections, including HBV, pose a significant hurdle to safe transfusions, especially in HBV-endemic regions like Somalia with limited screening. Therefore, this study aims to estimate the prevalence of Hepatitis B virus infection and identify risk factors associated with it among blood donors in Mogadishu, Somalia.

METHOD

A hospital-based cross-sectional study was conducted between February and April 2023. Research tools included a 5-ml blood sample and a structured questionnaire. The presence or absence of HB markers was determined using a multi-HB rapid test and CDC's HB marker interpretation guideline. Logistic regression was used in univariate and multivariate models to identify risk factors associated with HBV infection, with significance set at a p-value < 0.05 in the final model.

RESULT

A total of 494 blood donors were recruited for this study; 93.9% were male, with a mean age of 31.5 (SD = 8.11). The prevalence of Hepatitis B virus (HBV) infection among blood donors was 9.7%, with a 95% CI of 7.1-12.3. In multivariable logistic regression, those with a monthly income of less than 200 USD (AOR = 5.20, 95% CI = 1.61-16.79), those with an income between 200 and 400 (AOR = 3.59, 95% CI = 1.38-9.34), Jobless blood donors (AOR = 3.78, 95% CI = 1.17-12.20), those in business occupations (AOR = 3.35, 95% CI = 1.24-9.08), those with a history of STDs (AOR = 4.83, 95% CI = 2.03-11.50), those without a history of HB vaccine (AOR = 13.81, 95% CI = 2.46-77.41), those with a history of tooth extraction (AOR = 6.90, 95% CI = 2.66-17.88), and those who shared sharp equipment (AOR = 2.90, 95% CI = 1.07-7.82) were more likely to become infected with the Hepatitis B virus (HBV) compared to their counterparts.

CONCLUSION

This study highlights a high prevalence of Hepatitis B virus (HBV) infection. Implementation efforts against HBV infection should specifically focus on low-income individuals, the jobless, and donors with a history of STD to mitigate the burden of HBV infection and promote safer blood donation. In addition, discouraging the sharing of sharp equipment, improving infection control practices during tooth extraction procedures, and enhancing HB vaccination uptake, particularly among individuals lacking a history of HB vaccine, is highly recommended.

Real-world treatment outcome of direct-acting antivirals and patient survival rates in chronic hepatitis C virus infection in Eritrea

Reliable real-world data on direct acting anti-retroviral (DAA) uptake and treatment outcomes are lacking for patients with hepatitis C virus (HCV) in sub-Saharan Africa. This study provides data on HCV DAA-based treatment outcomes, mortality, loss-to-follow up, and associated factors among patients in Eritrea. A multicenter retrospective observational cohort study was conducted in two tertiary hospitals in Asmara, Eritrea. A structured checklist was used to collect data from patient's cards. Descriptive and inferential statistics used included means (± Standard deviation (SD), medians (Interquartile range (IQR), chi-squire (χ2), Kaplan-Meier estimates, and multivariate Cox proportional hazard models. A total of 238 patients with median age of 59 years (IQR 50-69 years) were enrolled in the study. Out of the 227 patients initiated on treatment, 125 patients had viral load measurements at 12 weeks after end of treatment (EOT) whereas 102 patients had no viral load measurements at 12 weeks EOT. Among the patients with HCV RNA data post-EOT 12, 116 (92.8%) had sustained viral response (SVR). The prevalence of death and loss-to-follow up (LTFU) were (7.5%, 95% CI 1.7-4.1) and 67 (28.1%, 95% CI 22.3-33.9) translating into an incidence of 1.1 (95% CI 0.8-1.5) per 10,000 person days. Independent predictors of LTFU included the enrollment year (2020: aHR = 2.2, 95% CI 1-4.7; p value = 0.04); Hospital (Hospital B: aHR = 2.2, 95% CI 1-4.7; p value = 0.03) and the FIB-4 score (FIB-Score < 1.45: aHR = 3.7, 95% CI 1.2-11.5; p value = 0.02). The SVR rates achieved in this cohort were high. However, high LTFU and high mortality driven largely by late presentation and suboptimal population screening/case finding, were uncovered. These challenges can be addressed by test-and-treat programs that simultaneously prioritize programmatic screening, decentralization of care, and better patient tracking in the HCV care cascade.

Transfusion transmissible infections among blood donors in Ghana: A 3-year multicentered health facility-based retrospective study

Transfusion transmissible infections (TTIs) remain a major health challenge particularly in developing countries. Here, we present a multicentered hospital-based retrospective study on the prevalence, distribution, and risk factors of TTIs in Ghana. Data on blood donors from four health facilities, namely Nkwanta South Municipal Hospital (Oti region), Weija-Gbawe Municipal Hospital (Greater Accra region), SDA Hospital (Northern region) and Wa Municipal Hospital (Upper West region) were extracted and analyzed. Descriptive statistics and multinomial logistic regression were applied to compare sociodemographic data with TTI status. A total of 6094 blood donors were included in this study, and 2% were females. The overall prevalence of TTIs was 21.0% (1232/5868). Specifically, the prevalence of HBV, HCV, HIV, and Syphilis was 6.6% (385/5868), 4.9% (286/5830), 2.9% (168/5867), and 6.8% (393/5739), respectively. Wa dominated in all the viral agents considered in this study, while the Oti region recorded the highest prevalence in T. pallidum. The odds of HBV infection was 3.1 (p = 0.008) among first-time donors, while that for HCV was 2.8 (p = 0.042). For rural dwellers, donors significantly had T. pallidum (p < 0.001; OR = 2.8), HCV (p < 0.001; OR = 2.9), and HIV (p = 0.028; OR = 1.5) infections. Generally, the recipients of transfused blood were predominantly pregnant mothers, followed by children and accident victims. This study has revealed significant disparities and relatively high prevalence of TTIs in Ghana, specifically HBV, HCV, HIV and T. pallidum infections. The variations suggest the presence of unique health challenges per study area, hence the need for a tailored intervention for each study site.

Comparison of the effects of autologous and non-autologous blood transfusions on the advantages, disadvantages, extubation time and bleeding after coronary bypass

Purpose

Blood transfusion; is considered an organ transplant. In coronary bypass surgery, large volumes of homologous blood transfusion may be required due to excessive bleeding. The large number of use of homologous blood transfusion in open heart surgery and the awareness of its various harmful effects have prompted researchers to conduct research on the use of autologous blood. With autologous transfusion, blood diseases, incompatibility, immunosuppression and organ damage can be prevented and the patient can be extubated earlier in the postoperative period.

Methods

Between January 2020 and January 2016, a total of 176 patients, 56 in the treatment group (with autologous blood transfusion) and 120 in the control group, whose information could be reached from hospital records were investigated retrospectively.

Results

No statistical difference was found between the mean intubation SO2 and PO2 values of the groups. On the contrary, considering the mean intubation times in the intensive care unit of both groups, the patients who underwent autologous blood transfusion were extubated at a statistically significant earlier time.

Conclusion

Autologous blood transfusion is a safe method in selected patients as well. Thanks to this method, patients are protected from complications associated with homologous blood transfusion. It is believed that performing autologous blood transfusion in selected patients undergoing open-heart surgery can decrease the number of postoperative transfusions, frequency of transfusion-related complications (especially in the lungs), and mean intubation times.

Demographic Factors Among HIV Confirmed Blood Donors from 2013 to 2021 in Shenzhen

Background

New HIV (Human immune deficiency virus) infections are continuously increasing in China and it remains a huge challenge to blood donation. As access to health services has affected by COVID-19 (Corona virus disease 2019) pandemic, a drop in new diagnoses (especially HIV) was observed worldwide.

Methods

During 2013-2021, 735,247 specimens from unpaid blood donors collected by Shenzhen Blood Center underwent ELISA (Enzyme -linked immunosorbent assay) and NAT (Nucleic acid test). Samples with reactivity results were sent to the Shenzhen Center for Disease Control and Prevention for WB (Western blot). All data were statistically analyzed by the Chi-Square test.

Results

From 2013 to 2021, the prevalence of HIV among male blood donors was higher than in females (P < 0.01). During the COVID-19 pandemic, the prevalence of HIV among repeat blood donors decreased significantly compared to 2019 (P < 0.05), and the characteristics of blood donors changed in 2020 compared to 2019 and 2021.

Conclusion

The high proportion of female blood donors would help prevent HIV from getting into the blood supply. The COVID-19 pandemic affected the demographics of blood donors as well as the prevalence of HIV among repeat blood donors. An increased number of repeat blood donors can help decrease the risk of HIV transfusion transmission during the epidemic.

HIV, HTLV, and Hepatitis B and C Infection in Blood Donors in Bahia, Brazil from 2008 to 2017

Although blood transfusion is an important therapeutic resource, transfusion-transmitted infections (TTIs) are still a cause for concern. Measures to mitigate this risk involve improvement of donor screening criteria and improvements in laboratory tests, especially the use of nucleic acid test (NAT). In this retrospective study we evaluated HIV, HTLV, HCV and HBV infection rates in blood donors of the Hematology and Hemotherapy Foundation of Bahia (Hemoba), Brazil, through serological and NAT results and the characteristics of donors. From February/2008 to December/2017, 777,446 blood donations were made. Most donors were male, aged 25-44 years, black and mixed race, and single or divorced. The density-type incidence (DTI; per 100,000) for each virus was 91.1 for HBV; 66.5 for HCV; 54.3 for HIV; and 33.9 for HTLV, with a decreasing trend observed over the period studied, except in the last biennium. NAT detected only 1 donor in immunological window for HIV (0.46/100,000 donations) and 3 donors in immunological window for HBV (1.8/100,000 donations). Serological positivity for all viruses studied was higher in the metropolitan region of Salvador, the state capital. Conclusion: DTI rates show a decreasing trend over the years studied, with a predominance of HBV infection. NAT allowed the detection of donors in immunological window periods, having an important role in improving transfusion safety.

Frequency of transfusion transmissible infections among blood donors of Rawalpindi District, Pakistan

Background

Transmissible Infections (TTI's) are a cause of significant burden on health care facilities by imposing a threat of infection transmission through disease reservoirs in asymptomatic donors. This eventually leads to a serious challenge in acquiring blood bags in a country like Pakistan where transfusion dependent disease are of high prevalence. The objective of this study is to determine the seroprevalence of TTI's in blood donors in Rawalpindi District through a multi-center approach.

Materials and Methods

This is an observational descriptive retrospective study based on 6 transfusion centers in the Rawalpindi District. The time frame of the study was from January 2015 to December 2018. A total of 223,242 donors were consecutively included and data on donor type, the purpose of transfusion, and seroprevalence (HBV, HCV, HIV, Syphilis, and Malaria) were collected through a structured questionnaire and laboratory investigation results. The collected data were entered in SPSS version 21.0 for analysis.

Results

The seroprevalence of blood borne infections was 7,897 (3.537%) of which HBV, HCV, HIV, Syphilis and Malaria accounted for 2410 (1.080%), 3105(1.391%), 0(0.000%), 2017 (0.933%) and 365 (0.171%), respectively. Reactive samples reduced from 4.850% to 3.537% over 4 years, while there was a rise of 37.478% of blood donors from 2015 to 2018. The total number of voluntary donors and replacement donors was 22079 (9.890%) and 201156 (90.107%), with a rising incidence in voluntary donors from 2015 to 2018. A considerable number of donor bags were transfused to Thalassemia, Anemia, Leukemia and Hemophilia patients, 28156 (12.612%). This number also showed increasing rates from 11.654% to 14.017%.

Conclusion

In conclusion, our study suggests that the risk of transmission through transfusion is still considerable. Targeting donors with a low-risk profile, a screening questionnaire, an ample supply of quality screening tests, and awareness campaigns for the diseases in question must be carried to further decrease the risk of transmission of TTIs in Pakistan.

Genotyping and sero-virological characterization of hepatitis B virus-infected blood donors in Central Eritrea

Aim: To determine the serological markers and genotype profiles of hepatitis B virus (HBV) isolates in Central Eritrea. Materials & methods: A total of 191 hepatitis B surface antigen (HBsAg)-positive sera were randomly selected for the study. ELISA was used to perform HBV seromarker screening, genotypes were determined using multiplex-nested PCR. Results: Of 191, 77.5% (148/191) were positive for HBcAb (total), among which 99.3% (147/148) and 0.7% (1/148) were positive for HBsAg and hepatitis B surface antibody, respectively. Of the 147 positive HBcAb/HBsAg, 16 (10.9%) and 131 (77.9%) were positive for HBeAg and HBeAb, respectively. A total of 73 HBV isolates were successfully genotyped: 39 (53.4%) D; 10 (13.7%) E; 6 (8.2%) A; 6 (8.2%) C/D; 4 (5.5%) C; 3 (4.1%) C/D/E; 2 (2.7%) A/D; 2 (2.7%) D/E; and 1 (1.4%) B/D. Conclusion: HBV genotype D is the predominant genotype among blood donors in Eritrea.

Prevalence and Association of Transfusion Transmitted Infections with ABO and Rh Blood Groups among Blood Donors in the Western Region of Saudi Arabia: A 7-Year Retrospective Analysis

This study was aimed at determining the prevalence estimate and association of transfusion-transmitted infections (TTIs) with ABO and Rh blood groups among blood donors at the King Faisal Specialist Hospital and Research Center (KFSH & RC) in the western region of Saudi Arabia. A retrospective study was conducted at the blood bank center of KFSH and RC from 1 January 2013 to 31 December 2019. Data on ABO and Rh blood group testing, serological testing, molecular investigations, serological assays, nucleic acid testing (NATs), and socio-demographic information were gathered. During the study period, there were 959,431 blood donors at the KFSH and RC. The overall 7-year cumulative prevalence estimate of blood transfusion-transmitted infections among blood donors was low at 7.93%, with an average prevalence estimate of 0.66%. Donors with the O blood group, the O RhD +ve blood group, in particular, were more at risk of developing TTIs, whereas donors with the AB blood group, the AB RhD −ve blood group, in particular, were at the lowest risk of developing TTIs. In total, 96.9% of the blood donors were males (n = 916,567). Almost half of the blood donors belong to the O blood group (49.4%). A total of 861,279 (91.0%) donors were found to be RhD positive. The percentages of TTIs were found to be higher in RhD +ve donors compared with RhD −ve donors. The prevalence estimate of the hemoglobin C (HbC) infection was the most common TTI among the blood donors being 3.97%, followed by malaria being 2.21%. The least prevalence estimate of TTI in the present study was for NAT HIV being 0.02%. Significant associations were observed between RhD +ve and RhD −ve among the malaria-infected donors (A: χ2 = 26.618, p = 0.001; AB: χ2 = 23.540, p = 0.001; B: χ2 = 5.419, p = 0.020; O: χ2 = 68.701, p = 0.001). The current 7-year retrospective study showed a low level of TTIs among blood donors. However, we urge that more research encompassing the entire country be conducted in order to obtain more representative results in terms of the prevalence estimate and association of transfusion-transmitted infections with ABO and Rh blood groups in communities.

Prevalence of Transfusion-Transmitted Infections (HCV, HIV, Syphilis and Malaria) in Blood Donors: A Large-Scale Cross-Sectional Study

Blood plays a major role in transmitting infectious diseases such as hepatitis C virus (HCV), human immunodeficiency virus (HIV), hepatitis B virus (HBV), syphilis, malaria, and many others. Thus, this study sought to evaluate the distribution of HCV, HIV, syphilis, and malaria among blood donors in Yemen. This is a cross-sectional study, conducted on blood donors at the national center in Yemen. Blood donors’ specimens were serologically tested for the presence of anti-HCV and anti-HIV antibodies, as well as anti-Treponema pallidum, anti-Plasmodium falciparum, and anti-Plasmodium vivax. A total of 16,367 donors were included in this study. Based on the donor’s occupation, the study showed that the relative seroprevalence of anti-HCV Ab among the donors was statistically significant, and relatively high prevalence was found among military donors (2.8%). Positive HIV antibody tests were only reported in 33 male donors (0.2%), who were mostly manual workers. A remarkably high prevalence of anti-Treponema pallidum was observed among manual workers (3.1%). There was a statistically significant difference in the distribution of anti-malaria Ab based on residency and age groups. This study revealed that the prevalence of HCV, HIV, syphilis, and malaria among donors was 2.0%, 0.2%, 2.4%, and 0.7%, respectively. Further genotyping studies are necessary to provide a complete picture of the prevalence of transfusion-transmitted infections (TTIs).

Donor Blood Procurement, Safety, and Clinical Utilization: A Study of Blood Transfusion Services in a Tertiary Care Hospital in Nigeria

Background

Donated blood is an essential component of the management of many diseases, and hospital-based blood banks in Nigeria are saddled with the responsibility of provision of safe blood and coordination of its appropriate utilization for patient care.

Objective

This study reviewed the extent to which the hospital blood transfusion service ensures adequate safe blood supply and utilization. Materials/Methods. This was a retrospective study of 2 years record of the blood bank service of Alex Ekwueme Federal University Teaching. Methods of donor blood procurement, transfusion transmissible infection status, the pattern of blood, and blood component usage across the hospital's clinical departments were evaluated. Statistical analysis was conducted using IBM SPSS, and data were presented as percentages. Fisher's tests were used to test significance, and p value <0.05 is significant.

Results

The highest proportion of donors was male family replacement donors aged 26–35 years (3634 (39.68%)) while total voluntary donors were 315 (2.65%). Hepatitis B had the highest seroprevalence 267 (2.22%) among blood-borne diseases screened. National Blood Transfusion Service (NBTS) supplied only 3 (0.03%) of total blood units used. The accident and emergency department had the highest proportion of persons who utilized whole blood; 4568 (99.96%).

Conclusion

The hospital blood bank relies heavily on family replacement donors with little or no assistance from the National Blood Transfusion Service. Family replacement donors have the highest risk of TTIs, and hepatitis B infection has the highest prevalence. The high cost of blood component therapy increases the need for whole blood.

First Report from Afghanistan on the Prevalence of Blood-Borne Infections: A Retrospective Cross-Sectional Multicentre Study for an Epidemiological Assessment

Background

The transfusion of blood and blood components has a significant role in healthcare services. However, it remains a possible risk factor for blood-borne infections. The present study was conducted to assess the prevalence of serological markers of common blood-borne infections among the blood donor population of Afghanistan.

Methodology

This was a cross-sectional study based on retrospectively collected data over a period of six years from 284 blood centres across 34 provinces of Afghanistan. Every blood donor’s sample was tested by rapid immunoassays for the serological markers of blood-borne infections namely hepatitis B surface antigen (HBsAg), anti-hepatitis C virus (anti-HCV), anti-human immunodeficiency virus 1/2 (anti-HIV1/2), and anti-Treponema pallidum (anti-TP).

Results

All blood donors during the study period were males. The majority of blood donations were from the family replacement category 56.93% (n = 544,568). The overall pooled prevalence of blood-borne infections was 4.36% with a comparatively higher percentage in family replacement donors 4.88%. The seropositivity for HBsAg, anti-HCV, anti-HIV1/2, and anti-TP was 2.95%, 0.81%, 0.04%, and 0.54%, respectively.

Conclusion

Complete reliance on voluntary blood donors and screening with quality assured highly sensitive assay is recommended to ensure blood safety in the country.

Transfusion Transmissible Infections in Blood Donors in the Province of Bié, Angola, during a 15-Year Follow-Up, Imply the Need for Pathogen Reduction Technologies

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 >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.

Seroprevalence of the Serological Markers of Transfusion-Transmissible Infections among Volunteer Blood Donors of Kosti Obstetrics and Gynecology Hospital

Background: Transfusion-transmissible infections are well-known global health challenges. The present study is proposed to investigate the seropositivity of anti-HIV1/2, anti-HCV, HBsAg, and anti-T.pallidum among volunteer blood donors of Kosti Obstetrics and Gynecology Hospital. Methods: Our study was conducted in a cross-sectional retrospective manner. The data of donors who attended Kosti Obstetrics and Gynecology Hospital throughout 2016 to 2018 were reviewed and retrieved manually from blood bank records. Results: Out of 8139 donors, 22.52% were seropositive for serological markers of TTIs and 1.67% were seropositive for at least two serological markers of TTIs. The overall seropositivity rate of anti-HIV1/2, HBsAg, anti-HCV, and anti-T.pallidum was 1.77%, 6.07%, 1.14%, and 11.87%, respectively (p < 0.000). Anti-T.pallidum was the most frequently detected (p < 0.05) marker across all study variables. TTIs seroprevalence was significantly (p < 0.05) varied according to the age, residence, occupations, and blood groups. Notably, there was a rising trend in the rate of anti-HIV1/2 and seropositivity for more than one marker with age (p < 0.000). Regionally, rural area residents had a higher rate of anti-HIV1/2 (2.20%), HBsAg (6.31%), anti-HCV (1.42%), anti-T.pallidum (18.38%), and multiple markers seropositivity (2.28%) compared to urban areas. Between occupations, the highest rate of anti-HIV1/2 (p = 0.483), HBsAg (p = 0.003), anti-HCV (p = 0.408), anti-T.pallidum (p < 0.000), and multiple markers seropositivity (p < 0.000) were detected in farmers. Regarding the screening, we also found that the frequency of anti-T.pallidum was significantly (p = 0.003) higher in donors who carry the AB+ve blood group, whereas anti-HCV (1.83%) was more frequent in donors carry O−ve blood group (p = 0.255). As seen, anti-T.pallidum+HBsAg was the most frequently (1.22%) co-occurring markers. In contrast, anti-T.pallidum+anti-HIV1/2+HBsAg was the lowest frequency one (p < 0.000). Conclusions: The study showed an alarming rate of TTIs, which suggests the requirement for comprehensive surveillance and health education programs.

Seroprevalence of Transfusion-Transmitted Infections among Voluntary and Replacement Blood Donors at the Peshawar Regional Blood Centre, Khyber Pakhtunkhwa, Pakistan

Introduction  Blood transfusion is linked to several risks, most notably the transmission of transfusion-transmitted infections (TTIs), including hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), syphilis, and malaria. The risk posed by these blood-borne infectious agents is high in developing countries, including Pakistan. This fact stresses the need for regular surveillance of TTIs. Therefore, the present study was undertaken to assess the seroprevalence of TTIs at a regional blood center.

Material and Methods  This was a retrospective 4-year descriptive study undertaken at the Regional Blood Centre in Peshawar, Khyber Pakhtunkhwa Province of Pakistan, on the blood donor data from June 2016 to May 2020. A total of 41,817 donors donated blood during the study period and were screened for HBV, HCV, HIV, syphilis, and malaria. To ensure donor privacy, donors were identified via codes and no personal information was available. The data were extracted from the ZAAVIA blood transfusion information system database.

Results  The study included a total of 41,817 donors—41,493 (99.22%) males and 324 (0.78%) females. Of them, 22,343 (53.43%) were voluntary donors while 19,474 (46.57%) were replacement donors. An overall TTI prevalence rate of 4.61% was found. The TTI prevalence rate in voluntary donors was 3.90% while 5.42% in replacement donors. The overall prevalence of HBV, HCV, HIV, syphilis, and malaria was 1.95, 1.38, 0.23, 0.91, and 0.14%, respectively.

Conclusion  The current study documented a high prevalence (1,929 out of 41,817, 4.61%) of TTIs, especially in replacement donors (1,057 out of 19,474, 5.42%), and low participation of female donors. The recommendations include the promotion of voluntary blood donors, enrolment of female blood donors, and screening of donated blood through highly sensitive screening assay (i.e., nucleic acid testing).

Human Immunodeficiency Virus and Syphilis Among Blood Donors at Western Oromia, Ethiopia

Background

Blood transfusion saves lives and improves health, but many patients requiring transfusion do not have timely access to safe blood. Human immunodeficiency virus and syphilis are the commonest transfused transmitted infections and threats to blood recipients. Proper donor selection and screening of the donated blood for major transfusion-transmitted infections evidently reduced challenge in blood safety. Therefore, the objective of this study was to determine the sero-prevalence HIV and syphilis infections among blood donors at East Wollega, West Ethiopia.

Patients and Methods

A five-year (from January 2015 to December 2019) retrospective study was conducted by reviewing blood donor laboratory test results from Nekemte blood bank which is serving hospitals in Western Oromia. Blood donor data were analyzed by Statistical Package for Social Sciences version 20 software.

Results

The total of 17,810 individual’s blood was screened during the study period. The overall prevalence of HIV, syphilis, and their co-infection was 222 (1.25%), 142 (0.80%), and 5 (0.03%), respectively. The prevalence of HIV was associated with unmarried (AOR: 2.4; 95% CI: 1.5, 5.2), male (AOR: 2.1; 95% CI: 1.5, 2.9), and blood donors resident in a rural area (AOR: 1.5; 95% CI: 1.5, 5.9). Besides, the prevalence of syphilis was associated with education, age, marital status and residence of study participant.

Conclusion

In the current study, the sero-prevalence of HIV and syphilis among blood donors was low, when it was compared to other sub-Saharan Africa country. However, to ensure the health of all recipients screening blood using standard methods is highly recommended.

Seroprevalence and trends of transfusion transmissible infections among retrospective blood donors in Western Azerbaijan Regional Blood Transfusion Center, Iran: A ten-years evaluation

Transfusion transmissible infections (TTIs) have been a public health challenge for the accessibility, quality and safety of blood transfusion. The present study aimed to consider the prevalence and the trends of hepatitis B virus (HBV), hepatitis C virus (HCV), Human T-cell leukemia virus type 1 (HTLV-1), human immunodeficiency virus (HIV) and syphilis across the ten years among retrospective blood donors. A retrospective investigation of blood donors' data covering the period from 22 May 2009 to 22 May 2019 was done. Data was accumulated and analyzed from Blood Transfusion Center records, pertaining to all donors who were screened for various TTIs using respective immunological techniques. Out of the 682,171 screened donors in the 2009-2019 study period, 2470 (0.36 %) were infected with at least one infectious agent. The overall prevalence of HBV, HCV, HTLV-1, HIV and syphilis were 1700 (0.25 %), 184 (0.027 %), 335 (0.05 %), 4 (0.0.05 %) and 247 (0.036 %), respectively. The study showed male dominated donor pool (96.79 %) with higher prevalence (0.34 %) of TTIs compared to female donors (0.02 %) with 3.21 % population. Despite the low prevalence of TTIs in our study, HBV, HCV, syphilis and HIV have remained a big threat to safe blood transfusion in Iran. Strict adherence to selection criteria, algorithm of donor screening, use of highly sensitive and specific methods for detection of TTIs, regular consultation and health education programs, prevention and sanitization strategies to reduce the risk of TTIs are recommended to reduce the risk of TTIs and ensure the safety of blood transfusion for recipient.

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

Background

Blood transfusion saves many people every year that would otherwise have died. The present study aimed to provide an update and insightful information regarding prevalence of the common Transfusion-Transmitted Infections (TTIs) and associated factors among blood donors in Tanzania.

Methods

This was a cross-sectional study involving retrospectively collected data of blood donors from the Tanzania Northern Zone Blood Transfusion Center between 2017 and 2019. Descriptive statistics were performed to describe characteristics of the blood donors. Univariable and multivariable logistic regression analyses were performed to determine association between prevalence of TTIs and socio-demographic factors. P-value <0.05 was considered statistically significant.

Results

A total of 101, 616 blood donors were included in the present study of which 85,053(83.7%) were males while 16,563 (16.3%) were females. Of all participants, the majority 45,400 (44.7%) were aged between 18 and 25 years; 79,582 (78.3%) were voluntary non-remunerated donors while 22,034 (21.7%) were replacement donors. The vast majority of them 99,626 (98%) were first time blood donors while 1990 (2%) were multiple donors. The overall prevalence of TTIs was 10.1% (10,226 out of 101,616) of which the leading was HBV accounting for 5.1% (5,264 out of 101,616). Being a replacement donor was associated with all the four types of TTIs: HIV (AOR = 1.22, 95% CI = 1.10–1.35), HBV (AOR = 1.35, 95% CI = 1.27–1.44), HCV (AOR = 1.28, 95% CI = 1.12–1.46), and syphilis (AOR = 1.33, 95% CI = 1.20–1.48).

Conclusions

Our study has demonstrated that Tanzania has relatively high prevalence of TTIs compared to some countries in Sub-Saharan Africa. HBV infection seems to be the most common infection among blood donors and replacement blood donors are at a higher risk of harboring the commonest TTIs among blood donors.

Coping with COVID-19 pandemic in blood transfusion services in West Africa: the need to restrategize

Introduction

The West African region has been lagging in terms of the availability of, and accessibility to, safe blood. According to the 2016 World Health Organization (WHO) Global Status Report on Blood Safety and Availability, none of the West African countries met the WHO benchmark of 10 blood units per 1000 inhabitants. This study is aimed at discussing the blood transfusion status of West African countries in the pre-COVID-19 period and analyze the capacity to respond to the COVID-19 blood crisis, as well as to outline the panacea.

Methods

Secondary data were extracted from published reports, journal articles and web pages, reviewed and analyzed.

Result

All the West African countries have recorded confirmed COVID-19 cases and deaths. The confirmed cases have reached 55,697, with 1069 deaths and a fatality rate of 1.9%, as of June 17, 2020. The assessed countries lagged in most of the WHO benchmarks for effective blood transfusion services.

Conclusion

Blood transfusion services in the West African region lacked the basic benchmark practice and policy, are not coordinated and may find it hard to tackle the blood transfusion crisis created by the COVID-19 pandemic.

Seroprevalence of Hepatitis B Virus Infection Among Patients Attending at Addis Alem Primary Hospital, Bahir Dar, Northwest Ethiopia

Background

Hepatitis B virus (HBV) causes severe liver disease, such as hepatocellular carcinoma (HCC) and life-threatening liver disease. Hepatitis B virus infection is one of the most dominant public health problems these days. Therefore, this study aimed to determine the seroprevalence of HBV infection among patients attending Addis Alem Hospital, Bahir Dar, Northwest Ethiopia.

Methods

A retrospective study was conducted from January to February 2019 on HBV registered from January 2016 to December 2018 for three years period. The presence of HBsAg in serum was detected using the One Step Cassette Style HBsAg test kit. Data were analyzed using SPSS version 20. Descriptive statistics were used to describe the characteristics of participants with HBV infection. Statistical association of the determinants with HBV infection was determined by the X² test.

Results

In this study, a total of 2010 participants of HBsAg rapid test records in the laboratory logbook were included. The median age of women was 25 years. The overall seroprevalence of HBsAg was 78 (3.9%). There was a general increment of HBV infection from 2016 to 2018, X² =7.52; P=0.023. Age (X² =8.19; P= 0.042) and sex (X² =37.77; P <0.001) were associated with HBsAg positivity.

Conclusion and Recommendations

An intermediate seroprevalence of HBV infection was detected among participants in our study area. This figure raises significant public health concerns. Therefore, implementing strategies for routine screening of women for HBV and hospital attendants would be critical.

Prevalence of Hepatitis B Virus and Hepatitis C Virus Among Blood Donors in Nekemte Blood Bank, Western Oromia, Ethiopia: Retrospective 5 Years Study

Background

Hepatitis B virus and hepatitis C virus are the greatest threats to blood safety for the recipient. This study aimed to determine the seroprevalence and trends of HBV and HCV infections among blood donors over a period of 5 years at Nekemte blood bank, Ethiopia.

Methods

A retrospective study was conducted from January 2015 to December 2019 at Nekemte blood bank. The recorded blood donors' history and laboratory tests were reviewed by data collectors analyzed with Statistical Package for the Social Sciences version 20 software. A p-value of less than 0.005 was considered statistically significant.

Results

A total of 17,810 consecutive blood donors were screened between January 2015 and December 2019. The seroprevalence of HBV and HCV was 3.06% and 0.64%, respectively. The prevalence of HBV was significantly associated with male (AOR: 2.51; 95% CI: 1.17, 2.91), unmarried (AOR: 2.81; 95% CI: 1.79, 2.51) and rural (AOR: 2.11; 95% CI: 1.17, 3.05) blood donors. The prevalence of HCV was significantly associated with blood donor those were male (AOR: 3.01; 95% CI: 1.17, 3.91), within 45-65 years of age (AOR: 3.56: 95% CI: 1.14, 3.99) and unmarried (AOR: 3.14; 95% CI: 1.65, 3.96).

Conclusion

The current study shows the prevalence of hepatitis B virus was higher among study participants. However, the prevalence of HCV was low compared to the study conducted in other countries in Africa, a substantial percentage of the blood donors harbor HCV infections. Therefore, it is recommended to increase awareness of people (particularly on unmarried, male and rural resident) on modes of transmission and prevention of infection could help in reducing the burden of both HBV and HCV.

Transfusion Transmissible Infections Among Voluntary Blood Donors at Dessie Blood Bank, Northeast Ethiopia: Cross-Sectional Study

Background

The prevalence of transfusion transmitted infections (TTIs) among blood donors varies across different geographical populations. Establishing the sero-prevalence of the disease among blood donors is important to informing the direction of preventive and control strategies.

Objective

The aim of this study was to determine the sero-prevalence of transfusion transmitted infections among voluntarily blood donors at Dessie Blood Bank, North East Ethiopia.

Methods and Materials

A cross-sectional study was conducted from November 10 to December 12, 2018. A total of 384 blood donors were conveniently included in this study. Socio-demographic data and other factors were collected using a pre-tested structured questionnaire. Five milliliters of venous blood was collected using a sterile test tube from each blood donor and the blood was allowed to clot; then, serum was separated by centrifugation for laboratory investigation. Serum samples from blood donors were tested by enzyme-linked immunosorbent assays (ELISA) for the presence of hepatits B surface antigen (HBsAg), and antibodies to human immunodeficiency virus (HIV-1/2), hepatits C virus (HCV), and Treponema pallidum. Logistic regression was used to explore risk factors associated with each transfusion transmissible infection.

Results

From a total of 384 blood donors, 24 (6.25%) of them had serological evidence for at least one infection. The overall sero-prevalence rates of HBV, HCV, HIV, and syphilis among blood donors were 4.2%, 0%, 0.26%, and 1.82%, respectively. Educational status was significantly associated with HBV infection. Multiple sexual behaviors had statistically significant association with syphilis.

Conclusion

In conclusion, 6.25% of blood donors still harbor transfusion transmissible infections despite recent blood donation safety improvements with the greater majority (4.2%) of cases caused by HBV infection.

Transfusion transmitted infections among male blood donors of White Nile State, Sudan: Screening of the current seroprevalence and distribution

Objective

Our study planned to investigate the current positivity rate and distribution of the serologic markers of TTIs among male blood donors of the White Nile state, Sudan.

Results

The overall reported seropositive cases of TTIs was 15.91%, and percentages of anti-Human immunodeficiency virus 1/2 (anti-HIV1/2), Hepatitis B virus surface antigen (HBVsAg), anti-Hepatitis C virus (anti-HCV), and anti-Treponema palladium (anti-T. palladium) were 2.61%, 5.57%, 1.40%, and 5.72%, respectively. Out of 10897 donors examined, 0.59% had a serological sign of multiple infections. Furthermore, the odds of testing positive for TTIs were higher in the 28–37 age group (OR: 2.620, 95% CI: 2.324–2.955) and lower in the 38–47 age group (OR: 0.671, 95% CI: 0.567–0.794) compared to individuals of 18–27 years old. Likewise, it is more in individuals of Kosti (OR: 1.122, 95% CI: 0.987–1.277) and Rabak (OR: 1.354, 95% CI: 1.188-1.543) localities compared to Al Douiem locality. Anti-HIV/anti-T. palladium (27.70%) and anti-HIV/HBVsAg (23.07%) were the most frequently detected serologic markers of co-infections, P = 0.002.

Sero-prevalence of transfusion transmittable infections: HIV, Hepatitis B, C and Treponema pallidum and associated factors among blood donors in Ethiopia: A retrospective study

Background

Blood transfusion is a therapeutic procedure that has proven to be effective in saving millions of lives. However, its safety is still a crucial issue that needs due attention. Unsafe blood transfusion is one of the sources of transmission for infectious agents. Therefore, the objective of this study was to assess the sero-prevalence of Transfusion Transmittable Infections (TTIs) such as Human immunodeficiency virus (HIV), Hepatitis B Virus (HBV), Hepatitis C virus (HCV), Treponema pallidum, and associated factors among blood donors in Ethiopia.

Methods

A retrospective cross-sectional study design was used to measure the prevalence of transfusion transmittable infections using data collected from 2014 to 2019 in fourteen blood bank facilities in Ethiopia. Screening of HIV, HBV and HCV was done by using the Enzyme-Linked Immunosorbent Assay (ELISA). Presence of Treponema pallidum infection was assessed using rapid plasma reagin (RPR). Records of blood donors were collected using a checklist from Central Blood Bank Laboratory (BBL) electronic database and reviewed. Data was entered, cleaned and analyzed using SPSS version 23. Logistic regression was fitted to identify factors associated with cumulative TTIs positivity, and for each of the transfusion transmittable infection. P value < 0.05 was considered statistically significant.

Result

A total of 554,954 blood donors in the fourteen blood bank facilities from 2014–2019 was included in the study. The overall sero-prevalence of HBV, Treponema pallidum, HIV and HCV, was 2.4%, 0.9%, 0.4% and 0.4% respectively. The prevalence of TTIs was comparatively higher in 2014, 5.70% and lowest in 2019, 3.40%. The odds of screening HBV in blood donors in age group of 35–39 and 40–44 were 1.2 [1.1, 1.3] and 1.3 [1.1, 1.5] respectively. The odds of screening HCV in blood donors in the age group of 25–34, 35–44 and 45–54 were 1.3 [1.1, 1.5], 1.3 [1.1, 1.7] and 1.7 [1.2, 2.2] respectively. The likelihood of having at least one infection among blood donors was 1.2 [1.1, 1.3] times in male blood donors compared to female. The odds of getting at least one TTI and Treponema pallidum in unemployed blood donors were 2.4 [2.0, 2.8] and 8.1 [6.1, 10.7] respectively. The probability of getting those who have at least one TTIs, HBV and Treponema pallidum were higher in blood donors those who live in Semi Urban and Rural parts of the country than those who live in Urban areas. The odds of having at least one TTI, HBV and HCV in blood donors with mobile mode of blood donation were 1.4 [1.3, 1.6], 1.6 [1.4, 1.8], and 1.6 [1.1, 2.2].

Conclusion

The current magnitudes of TTIs are lower when compared to other previous studies conducted in Ethiopia. Older age, male, occupation, donations from mobile sites, residents of semi urban and rural settings were found to be strongly associated with sero-positivity of TTIs. Hence, strict donor screening and testing particularly taking the above factors into consideration is strongly recommended.

Blood transfusion-transmissible malaria and its cost analysis in Hawassa regional blood bank, Southern Ethiopia

Background:

Blood transfusion is an intervention used to save life particularly for those patients who survive only with receiving blood. Establishing effective diagnostic test menus concerning the screening of transfusion-transmissible infections in the blood banks play a vital role to safeguard recipients from transfusion-transmissible infections.

Objective:

The aim of this study was to assess blood transfusion-transmissible malaria and its screening cost analysis in Hawassa regional blood bank, Hawassa, Sothern Ethiopia.

Methods:

An institutional-based cross-sectional study was conducted from April to May 2018 among 414 voluntary blood donors. Each participant’s blood sample was screened for most transfusion-transmissible infections using antigen/antibody tests, while rapid diagnostic test and microscopy were used for malaria screening and confirmation. In addition, the cost screening of transfusion-transmissible infections was calculated using activity-based costing method.

Results:

The overall seropositivity of transfusion-transmissible infections was 7.0% and the positivity rate of hepatitis B virus, syphilis, and Plasmodium falciparum was 5.6%, 1.0%, and 0.5%, respectively. The cost per test of each transfusion-transmissible infection was US$5.04 for human immunodeficiency virus, US$4.61 for hepatitis B virus, US$5.11 for hepatitis C virus, and US$4.75 for syphilis, while the cost per test of malaria rapid diagnostic test was US$4.74 and this is comparatively lower than the cost per test of other transfusion-transmissible infections except for hepatitis B virus. In addition, total cost of laboratory incurred for transfusion-transmissible infections screening is estimated to be US$213,634.5 per year, while it becomes US$265,537.5 if the malaria screening cost is added. This means 19.54% of the total cost of laboratory incurred per year or US$51,903.

Conclusion:

The positivity rate of malaria parasites among voluntary blood donors was 0.5%, and it might be increased if the study was conducted in high transmission seasons. A cost of malaria screening is comparatively lower than costs of other transfusion-transmissible infections except for hepatitis B virus. Therefore, the screening of malaria parasites should be considered as one of the test menus of transfusion-transmissible infections in blood banks, especially in malaria-endemic areas.

Blood Transfusion-Associated Infections in the Twenty-First Century: New Challenges

Blood transfusions are vital components of modern medical treatment to which there is no viable alternative despite efforts to create artificial blood. Each year thousands of lives are saved by blood transfusions in every country of the world. However, blood and blood products can result in significant adverse events including immunologic reactions, infections, inefficacy, and others which can sometimes result in death and severe disability. Thus, the sustainability of safe blood systems and costs are considered to be at crisis level. In industrialized countries, the risk of transfusion-transmitted infections such as HIV, syphilis, hepatitis viruses B and C are very low [generally [<1 in a million units], but in developing countries [especially in Africa] blood safety is still not assured. Compounding the problem of blood/product safety with respect to infectious agents are new emerging infectious microbes that are not being routinely tested for in blood that are donated. This chapter reviews the infectious risk of blood transfusions, types, mode and geographic variation, and the methods being used by blood services to attenuate and prevent these risks.