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

Development of a risk prediction score for screening for HBV, HCV and HIV among migrants in France: results from a multicentre observational study (STRADA study)

OBJECTIVES

Migrants from high HIV, hepatitis B virus (HBV) or hepatitis C virus (HCV) endemicity regions have a great burden of these infections and related diseases in the host countries. This study aimed to assess the predictive capacity of the Test Rapide d'Orientation Diagnostique (TROD) Screen questionnaire for HIV, HBV and HCV infections among migrants arriving in France.

DESIGN

An observational and multicentre study was conducted among migrants. A self-questionnaire on demographic characteristics, personal medical history and sexual behaviours was completed.

SETTING

The study was conducted in the centres of the French Office for Immigration and Integration (OFII).

PARTICIPANTS

Convenience sampling was used to select and recruit adult migrants between January 2017 and March 2020.

OUTCOME MEASURES

Participants were tested for HIV, HBV and HCV with rapid tests. For each infection, the test performance was assessed using receiver operating characteristics curves, using area under the curve (AUC) as a measure of accuracy.

RESULTS

Among 21 133 regular migrants seen in OFII centres, 15 343 were included in the study. The participants' mean age was 35.6 years (SD±11.1). The prevalence (95% CI) of HBV, HCV and HIV was 2.0% (1.8% to 2.2%), 0.3% (0.2% to 0.4%) and 0.3% (0.2% to 0.4%), respectively. Based on the sensitivity-specificity curve analysis, the cut-off points (95% CI) chosen for the risk score were: 2.5 (2.5 to 7.5) for HBV infection in men; 6.5 (0.5 to 6.5) for HBV infection in women; 9.5 (9.5 to 12.5) for HCV infection; and 10.5 (10.0 to 18.5) for HIV infection. Test performance was highest for HIV (AUC=82.15% (95% CI 74.54% to 87.99%)), followed by that for HBV in men (AUC=79.22%, (95% CI 76.18% to 82.26%)), for HBV in women (AUC=78.83 (95% CI 74.54% to 82.10%)) and that for HCV (AUC=75.95% (95% CI 68.58% to 83.32%)).

CONCLUSION

The TROD screen questionnaire showed good overall performance for predicting HIV, HBV and HCV infections among migrants in OFII centres. It could be used to optimise screening for these infections and to propose rapid screening tests to those who are at high risk.

TRIAL REGISTRATION NUMBER

NCT02959684.

A case-control study of risk factors for incident hepatitis B virus infection in South African blood donors

OBJECTIVES

Hepatitis B virus (HBV) infection remains a global health problem. Risk factors for HBV infection are usually assessed in prevalent rather than incident infections. To identify demographic and behavioral risks associated with incident HBV among South African blood donors.

METHODS

A case-control study was performed between November 2014 and January 2018. Cases were blood donors testing positive for HBV DNA with or without hepatitis B surface antigen but negative for antibody to hepatitis B core antigen. Participants completed an audio computer-assisted structured interview on exposures during the previous 6 months. Sex-specific multivariable logistic regression yielded independent associations between risks and HBV infection.

RESULTS

56 females and 37 males with incident HBV were compared to 438 female and 439 male controls, respectively. For females, risk factors were accepting money or goods for sex, using agents to prepare one's anus prior to anal sex, penetrating injury, non-Black race, and lower educational status. Men reporting homosexual or bisexual orientation or sex with other men, previous injury, referral for HBV testing, or lack of medical insurance were at increased risk. For both sexes, having more than two male sexual partners increased risk.

CONCLUSIONS

Sexual behaviors predominated over parenteral exposures as risks for incident HBV in both female and male blood donors.

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.

Seroprevalence of Human Immunodeficiency Virus, Hepatitis C Virus, and Hepatitis B Virus Among Blood Donors in Sidi Bel Abbes, West Algeria

Introduction Blood transfusions can transmit various viruses. Among them, the most common are hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). These viruses can cause fatal and life-threatening diseases. Worldwide, many people are infected with these viruses. Blood safety has made major progress in recent years. Yet, blood-borne viruses continue to be a major concern for patients, physicians, and policymakers. The aim of this study was to assess the prevalence of HIV, HBV, and HCV in blood donors. Methods A cross-sectional study was performed to assess HIV, HBV, and HCV seropositivity in blood donors. This research was carried out at the blood bank of Sidi Bel Abbes University Hospital. This was a retrospective study based on records of blood donors. All data of 10,386 donors were analyzed from January 2015 to December 2015. Biological screening was performed by enzyme-linked immunosorbent assay (ELISA) using antibodies and/or antigens. The combined HCV and HIV antigen and antibody ELISA test was utilized. To confirm the results, the blood bank and the virology laboratory used the same technique in duplicate. Results The overall seroprevalence of blood-borne viral infections (HIV, HBV, and HCV) in blood donors was 0.8%. The prevalence of HIV was found to be 0.1%, while the prevalence of HBV and HCV was 0.4%. Coinfection was rare with only one case of HBV with HIV. There was a significant difference in seroprevalence rates among blood donors compared to the general population. Significant variations were observed between the prevalence of this study and those conducted in West, East, Central, and South African countries but not with those of neighboring North African countries. The study found no association between seropositivity in blood donors and factors like age, gender, donor status, type of donation, or site. Besides, HIV, HBV, or HCV prevalence was not influenced by ABO and Rhesus blood group. Conclusion The study showed that blood donors in Algeria have a lower prevalence of blood-borne viral infections than the general population. The seropositivity rate of viral markers was similar throughout North African countries. This rate remained low compared to other African countries. Residual risk of infection persists. There is a need to increase blood safety for recipients. This report is the first comprehensive overview of blood-borne viruses among Algerian blood donors. There is a need for further nationwide studies to get a whole picture of the situation.

Prevalence of hepatitis B and C virus infections in Lao People's Democratic Republic: The first national population-based cross-sectional survey

Population-based seroprevalence of chronic hepatitis B and C infections has not been examined in Lao People's Democratic Republic (PDR). Therefore, this study aimed to estimate the seroprevalence of these infections in the general population of Lao PDR and perform subgroup analysis. A nationwide seroprevalence survey was conducted in Lao PDR in June 2019 using the multistage cluster sampling method. Dried blood spot samples were collected onto WhatmanTM 903 filter paper by finger prick. A chemiluminescent microparticle immunoassay was used to measure the levels of hepatitis B surface antigen (HBsAg) and hepatitis C antibody (HCV-Ab). Samples in which the HBsAg level was above 0.05 IU/ml and HCV-Ab was above the signal/cutoff ratio of 1.0 were considered positive based on comparisons with the relative light unit value of a calibration sample. A total of 1,927 samples (male: 47.3%, mean age: 23.0 years) were included in the analysis. The prevalence was estimated to be 4.2% (95% confidence interval [CI]: 2.7-6.3) for HBsAg and 1.6% (95% CI: 0.5-5.3) for HCV-Ab. Multivariable analysis revealed that those aged 20-24 years (adjusted odds ratio (AOR): 2.3, 95% CI: 1.1-4.6), those aged 25-29 years (AOR: 2.7, 95% CI: 1.3-5.6), those from the Northern region (AOR: 2.8, 95% CI: 1.2-6.6), and those who were Khmu (AOR: 3.6, 95% CI: 2.0-6.8) or Hmong (AOR: 5.0, 95% CI: 3.3-7.5) were significantly more likely to be positive for HBsAg. Although there were no statistically significant differences in the HCV-Ab prevalence according to each variable, males (2.9%, 95% CI: 0.7-10.7), those aged ≥40 years (6.1%, 95% CI: 2.1-16.8), and those from the Southern region (3.3%, 95% CI: 0.6-15.3) tended to have a higher prevalence. This novel population-based survey found differences in the prevalence of chronic hepatitis B and hepatitis C virus infections in Lao PDR according to sex, age group, region, and ethnicity; however, the results of this study should be confirmed in future studies, and relevant responses tailored for each target also need to be determined to control the transmission of hepatitis B and C infections.

Time to Recovery from Covid-19 and Its Predictors Among Patients Admitted to Treatment Centers of Southern Nations Nationalities and Peoples Region (SNNPR), ETHIOPIA: Multi-Center Retrospective Cohort Study

Background

The world is currently facing a pandemic of Coronavirus Disease 2019 (Covid-19). It has caused significant morbidity and mortality. So far little is known about recovery time (prolonged hospital stay) from Covid-19 and its determinants in Ethiopia as well as in the study area. Therefore, the aim of this study was to determine time to recovery from Covid-19, and identify predictors of time to recovery among patients admitted to treatment centers of Southern Nations Nationalities and Peoples Region (SNNPR).

Methods and Materials

A facility-based retrospective cohort study was conducted among Covid-19 patients admitted to care centers of SNNPR from May 30, 2020 to October 15, 2021. A sample of 845 patients was included in the study. Summarization of the data was done using mean (standard deviation) and median (inter quartile range). Kaplan–Meier Survival Curve was used to estimate recovery time from Covid-19 and the independent effects of covariates on recovery time was analyzed using multivariable Cox-proportional hazard model.

Results

The incidence density of recovery was 8.24 per 100 person-days (95% CI: 7.67, 8.85). The overall median recovery time was 10 days (IQR: 8–16 days). Critical stage of Covid-19 (aHR = 0.19, 95% CI: 0.12, 0.29), severe stage of Covid-19 (aHR = 0.40, 95% CI: 0.29, 0.56), mechanical ventilation (aHR = 0.20, 95% CI: 0.073, 0.56) and treatment center (aHR = 0.68, 95% CI: 0.51, 0.90) were significant predictors of recovery rate among Covid-19 patients.

Conclusion

The median time to recovery from Covid-19 was relatively short. The incidence density of recovery was 8.24 per 100 person-days. The hazard of recovery was lower for patients at higher levels of Covid-19 severity and for patients in need of mechanical ventilation. Early identification of severity levels of the patients is required at the time of admission. Special attention, critical follow–up and management is warranted for patients at higher levels of Covid-19 severity.

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 Hepatitis C Viral Infection in Ethiopia: A Systematic Review and Meta-Analysis

Background

Hepatitis C virus is a highly genetically heterogenous bloodborne pathogen that is responsible for acute and chronic hepatitis. Globally, an estimated 71 million population is chronically infected with this virus from which 399,000 people die every year. Its prevalence is high in Ethiopia and varies from region to region, even among different studies within a region.

Methods

Electronic databases, including Science Direct, Medline, HINARI, African Journals Online, TRIP database, African Index Medicus, and Directory of Open Access Journals, searched from 2010 to 2020 and published articles were included. Due to evidence of considerable heterogeneity, the pooled prevalence of anti-HCV was analyzed using the random-effects model. The possible sources of heterogeneity were analyzed through subgroup analysis, sensitivity analysis, and meta-regression. Funnel plots and Egger's test statistics were used to determine the presence of publication bias.

Results

The analysis of 56 articles showed that the prevalence of anti-HCV in Ethiopia ranged from 0% to 22%. The pooled prevalence estimated was 2% (95% CI 2.0–3.0), and the meta-regression statistics indicated that the diagnostic method (p=0.037), study group (p=0.005), and level of bias (p=0.035) showed statistically significant association with the outcome variable. The sensitivity analysis claims no influence on the overall effect estimate while removing a single study from the analysis at a time. Egger's test statistics (p ≤ 0.001) declare the presence of publication bias that is handled using time and fill analysis.

Conclusions

The pooled prevalence of anti-HCV in Ethiopia was high. Predictor variables, including the diagnostic method, study group, and level of bias, showed a statistically significant relationship with the outcome variable. Strengthening the scope of existing prevention and control programs and implementing novel approaches, including screen-and-treat, could significantly help to tackle this critical public health issue. The study provides a current estimate which is valuable for policymakers and other responsible bodies.

Distribution and Incidence of Blood-Borne Infection among Blood Donors from Regional Transfusion Centers in Burkina Faso: A Comprehensive Study

There is a high prevalence of blood-borne infections in West Africa. This study sought to determine the seroprevalence of blood-borne infections, including hepatitis B virus (HBV), hepatitis C virus (HCV), HIV, and syphilis, in blood donors in Burkina Faso. Blood donors were recruited from 2009 to 2013 in four major cities in Burkina Faso of urban area (Ouagadougou) and rural area (Bobo Dioulasso, Fada N’Gourma, and Ouahigouya). Serology tests including hepatitis B surface antigen, anti-HCV, anti-HIV, and rapid plasma reagin test were used for screening and were confirmed with ELISA. Disease prevalence was calculated among first-time donors. Incidence and residual risk were calculated from repeat donors. There were 166,681 donors; 43,084 had ≥ 2 donations. The overall seroprevalence of HBV, HCV, HIV, and syphilis were 13.4%, 6.9%, 2.1%, and 2.4%, respectively. The incidence rates (IRs) of HBV, HCV, HIV, and syphilis infection were 2,433, 3,056, 1,121, and 1,287 per 100,000 person-years. There was lower seroprevalence of HBV and HCV in urban area than in rural area (12.9% versus 14.0%, P < 0.001; and 5.9% versus 8.0%, P < 0.001), and no difference in HIV (2.1% versus 2.1%, P = 0.25). The IRs of new HBV, HCV, HIV, and syphilis were 2.43, 3.06, 1.12, and 1.29 per 100,000 person-years, respectively. The residual risk was one per 268 donations for HBV, one per 181 donations for HCV, and one per 1,480 donations for HIV, respectively. In conclusion, this comprehensive study from four blood donation sites in Burkina Faso showed high HBV and HCV seroprevalence and incidence with high residual risk from blood donation.