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Dutra VDF, Bonet-Bub C, Sakashita AM, Kutner JM. Infectious diseases and the impact on transfusion medicine: A historical review and lessons for the future. Transfus Clin Biol 2023; 30:376-381. [PMID: 37328129 DOI: 10.1016/j.tracli.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/01/2023] [Accepted: 06/09/2023] [Indexed: 06/18/2023]
Abstract
Blood transfusion saves millions of lives each year. It is a well-established treatment, and many procedures are applied to avoid transmitted infections. However, throughout the history of transfusion medicine, many infectious diseases arose or were recognised, bringing up an impact on the blood supply, as the difficulties in diagnosing new diseases, the decrease in blood donors, the challenges for the medical team, the risks for the receptor and the related costs. This study aims to review historically the principal infectious diseases transmitted through the blood that circulated worldwide in the 20th and 21st centuries, considering the impact on the blood banks. Despite the current blood bank control of transfusion risks and the hemovigilance improvements, transmitted and emerging infections can still compromise the blood bank supply, as we have witnessed during the first waves of the COVID-19 pandemic. Moreover, new pathogens will continue emerging, and we must be prepared for the future.
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Sousa JD, Havik PJ, Müller V, Vandamme AM. Newly Discovered Archival Data Show Coincidence of a Peak of Sexually Transmitted Diseases with the Early Epicenter of Pandemic HIV-1. Viruses 2021; 13:v13091701. [PMID: 34578283 PMCID: PMC8472979 DOI: 10.3390/v13091701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/17/2021] [Accepted: 08/19/2021] [Indexed: 11/24/2022] Open
Abstract
To which extent STDs facilitated HIV-1 adaptation to humans, sparking the pandemic, is still unknown. We searched colonial medical records from 1906–1958 for Leopoldville, Belgian Congo, which was the initial epicenter of pandemic HIV-1, compiling counts of treated STD cases in both Africans and Europeans. Almost all Europeans were being treated, while for Africans, generalized treatment started only in 1929. Treated STD counts in Europeans thus reflect STD infection rates more accurately compared to counts in Africans. In Africans, the highest recorded STD treatment incidence was in 1929–1935, declining to low levels in the 1950s. In Europeans, the recorded treatment incidences were highest during the period 1910–1920, far exceeding those in Africans. Europeans were overwhelmingly male and had frequent sexual contact with African females. Consequently, high STD incidence among Europeans must have coincided with high prevalence and incidence in the city’s African population. The data strongly suggest the worst STD period was 1910–1920 for both Africans and Europeans, which coincides with the estimated origin of pandemic HIV-1. Given the strong effect of STD coinfections on HIV transmission, these new data support our hypothesis of a causal effect of STDs on the epidemic emergence of HIV-1.
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Affiliation(s)
- João Dinis Sousa
- Clinical and Epidemiological Virology, Rega Institute for Medical Research, Department of Microbiology, Immunology and Transplantation, KU Leuven, B-3000 Leuven, Belgium;
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, 1349-008 Lisbon, Portugal;
- Correspondence:
| | - Philip J. Havik
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, 1349-008 Lisbon, Portugal;
| | - Viktor Müller
- Institute of Biology, Eötvös Loránd University, 1117 Budapest, Hungary;
| | - Anne-Mieke Vandamme
- Clinical and Epidemiological Virology, Rega Institute for Medical Research, Department of Microbiology, Immunology and Transplantation, KU Leuven, B-3000 Leuven, Belgium;
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, 1349-008 Lisbon, Portugal;
- Institute for the Future, KU Leuven, B-3000 Leuven, Belgium
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Rambiritch V, Vermeulen M, Bell H, Knox P, Nedelcu E, Al-Riyami AZ, Callum J, van den Berg K. Transfusion medicine and blood banking education and training for blood establishment laboratory staff: A review of selected countries in Africa. Transfusion 2021; 61:1955-1965. [PMID: 33738810 PMCID: PMC8217161 DOI: 10.1111/trf.16372] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/05/2021] [Accepted: 03/05/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND Avoidable human error is a significant cause of transfusion adverse events. Adequately trained, laboratory staff in blood establishments and blood banks, collectively blood facilities, are key in ensuring high-quality transfusion medicine (TM) services. Gaps in TM education and training of laboratory staff exist in most African countries. We assessed the status of the training and education of laboratory staff working in blood facilities in Africa. STUDY DESIGN AND METHODS A cross-sectional study using a self-administered pilot-tested questionnaire was performed. The questionnaire comprised 26 questions targeting six themes. Blood facilities from 16 countries were invited to participate. Individually completed questionnaires were grouped by country and descriptive analysis performed. RESULTS Ten blood establishments and two blood banks from eight African countries confirmed the availability of a host of training programs for laboratory staff; the majority of which were syllabus or curriculum-guided and focused on both theoretical and practical laboratory skills development. Training was usually preplanned, dependent on student and trainer availability and delivered through lecture-based classroom training as well as formal and informal on the job training. There were minimal online didactic and self-directed learning. Teaching of humanistic values appeared to be lacking. CONCLUSION We confirmed the availability of diverse training programs across a variety of African countries. Incorporation of virtual learning platforms, rather than complete reliance on didactic, in-person training programs may improve the education reach of the existing programs. Digitalization driven by the coronavirus disease 2019 pandemic may provide an opportunity to narrow the knowledge gap in low- and middle-income countries (LMICs).
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Affiliation(s)
| | | | - Hazel Bell
- South African National Blood Service, Roodepoort, South Africa
| | - Patricia Knox
- South African National Blood Service, Roodepoort, South Africa
| | | | - Arwa Z. Al-Riyami
- Department of Hematology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Jeannie Callum
- Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre
- Department of Laboratory Medicine and Pathobiology, University of Toronto
| | - Karin van den Berg
- South African National Blood Service, Roodepoort, South Africa
- Division of Clinical Haematology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa
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Vance MA. Conflicting Views in Narratives on HIV Transmission via Medical Care. J Int Assoc Provid AIDS Care 2020; 18:2325958218821961. [PMID: 30798671 PMCID: PMC6748459 DOI: 10.1177/2325958218821961] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Molecular studies suggest that HIV arose in Africa between 1880 and 1940. During this period, there were campaigns by European colonial governments that involved unsterile injections of large numbers of Africans. That, along with other unsafe therapeutic interventions, may have propelled the evolution of HIV from SIV. Since subtype B in Africa may have been concentrated in white African homosexuals, it is possible that Westerners rather than Haitians introduced the virus to the New World. Amplification of HIV subtype B took place in Haiti, where transmission was facilitated by hazardous medical procedures including plasmapheresis. Representations in the media, however, largely ignore Western contributions to the spread of AIDS. This article focuses on the value of alternative narratives in fostering a balanced view that is less stigmatizing on developing nations.
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Affiliation(s)
- Michael A Vance
- 1 College of Pharmacy and Health Sciences, Butler University, Indianapolis, IN, USA
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Marí Sáez A, Ronse M, Delamou A, Haba N, Bigey F, van Griensven J, Peeters Grietens K. The Plasma Mobile, 'A gift from heaven': The impact of health technology transfer on trial perceptions and expectations during the Ebola-Tx Trial, Conakry. PLoS Negl Trop Dis 2020; 14:e0008206. [PMID: 32320398 PMCID: PMC7176081 DOI: 10.1371/journal.pntd.0008206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 03/10/2020] [Indexed: 01/22/2023] Open
Abstract
During the West African Ebola Virus Disease (EVD) epidemic from 2014 to 2016, a variety of technologies travelled considering the context of the emergency: a highly contagious fast-killing disease outbreak with no known remedy and a rapidly increasing number of cases. The Ebola-Tx clinical trial tested the efficacy of Convalescent Plasma (CP) as a treatment for EVD in Guinea. This paper is based on ethnographic research in the Ebola-Tx trial and focuses on the introduction of a mobile plasma collection centre, referred to as the 'Plasma Mobile', equipped with plasmapheresis and pathogen inactivation technologies, as well as how the transfer itself of this technology entailed complex effects on CP donors as trial participants (i.e. providers of the therapeutic product), directly involved staff and more broadly on the trial implementation as a whole. The transfer led to the emergence of a dimension of hope as CP donors hoped that the plasma would cure and, as providers of the therapeutic, hoped it would decrease their stigmatization and the economic impact of the disease. We conclude that, in light of the intricate effects that the transfer of such health technology can entail-in the localization to the specific context, as well as in the consequences they can have on actors involved in the implementation of such technologies-global health technologies should be put at the services of next epidemic and pandemic (preparedness) on condition that they are accompanied by an understanding of the technologies' own cultural meanings and social understandings.
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Affiliation(s)
- Almudena Marí Sáez
- Robert Koch Institute, Center for International Health Protection, Berlin, Germany
- Institute of Tropical Medicine, Medical Anthropology Unit, Department of Public Health, Antwerp, Belgium
| | - Maya Ronse
- Institute of Tropical Medicine, Medical Anthropology Unit, Department of Public Health, Antwerp, Belgium
| | - Alexandre Delamou
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinée
- Centre d’Excellence Africain pour la prévention et le contrôle des maladies transmissibles (CEA-PCMT), Faculty of health Sciences and Techniques, University Gamal Abdel Nasser of Conakry, Conakry, Guinea
| | - Nyankoye Haba
- Centre d’Excellence Africain pour la prévention et le contrôle des maladies transmissibles (CEA-PCMT), Faculty of health Sciences and Techniques, University Gamal Abdel Nasser of Conakry, Conakry, Guinea
- Centre National de Transfusion sanguine, Conakry, Guinea
| | - Frédéric Bigey
- Établissement Français du Sang Grand-Est, Strasbourg, France
| | - Johan van Griensven
- Institute of Tropical Medicine, HIV and Neglected Tropical Diseases Unit, Department of Clinical Sciences, Antwerp, Belgium
| | - Koen Peeters Grietens
- Institute of Tropical Medicine, Medical Anthropology Unit, Department of Public Health, Antwerp, Belgium
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Abstract
Ethnographic material dealing with the contemporary viral hepatitis B and C epidemics in Cameroon provide a window onto the acute constraints and shortcomings of hospital care for patients, families, and health care workers. Although viral hepatitis has long been an invisible epidemic in international and global public health regimes, in Cameroon, it is diagnosed, made visible, and felt as a financially daunting and feared disease. Building on Ann Stoler's framework of imperial ruins, I consider hepatitis as an iatrogenic disease, emerging from scarce and unsound hospital infrastructures, such as blood transfusion techniques, as well as colonial public health vaccination practices. Such hospital technologies continue to produce anxieties, risk and excessive health expenses and hence cast their shadows on the future.
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Affiliation(s)
- Fanny Chabrol
- Institute for Research on Sustainable Development (IRD), Centre Population et Développement (CEPED), Universités Paris Sorbonne Cités, ERL INSERM SAGESUD, Paris, France
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Sousa JD, Müller V, Vandamme AM. The epidemic emergence of HIV: what novel enabling factors were involved? Future Virol 2017. [DOI: 10.2217/fvl-2017-0042] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Humans acquired retroviruses from simians, mainly through bushmeat handling. All epidemically successful HIV groups started to spread in early 20th century, contrasting with the antiquity of T-cell lymphotropic viruses, implying that novel enabling factors were involved in HIV emergence. Here we review the Parenteral Serial Transmission and the Enhanced Heterosexual Transmission hypotheses for the adaptation and early spread of HIV. Epidemic start roughly coincides in time with peak genital ulcer disease in cities, suggesting a major role for sexual transmission. Only ill-adapted and rare HIV groups emerged after approximately 1950, when injections and transfusions attained their maximal levels, suggesting that if parenteral serial transmission was necessary for HIV adaptation, it had to be complemented by sexual transmission for HIV to reach epidemic potential. [Formula: see text]
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Affiliation(s)
- João Dinis Sousa
- Department of Microbiology & Immunology, Rega Institute for Medical Research, Clinical & Epidemiological Virology, KU Leuven - University of Leuven, B-3000, Leuven, Belgium
- Center for Global Health & Tropical Medicine, Unidade de Microbiologia Médica, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Viktor Müller
- Institute of Biology, Eötvös Loránd University, Budapest, Hungary
- Evolutionary Systems Research Group, MTA Centre for Ecological Research, Tihany, Hungary
| | - Anne-Mieke Vandamme
- Department of Microbiology & Immunology, Rega Institute for Medical Research, Clinical & Epidemiological Virology, KU Leuven - University of Leuven, B-3000, Leuven, Belgium
- Center for Global Health & Tropical Medicine, Unidade de Microbiologia Médica, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal
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Abstract
RésuméCet article mène une réflexion sur l’usage des métaphores expérimentales, et en particulier de la notion de « laboratoire », dans le domaine de l’histoire de la médecine et des études coloniales. Il s’appuie sur l’étude d’une expérimentation politique entreprise pendant la Seconde Guerre mondiale : l’attribution exclusive aux médecins coloniaux d’une région entière du Cameroun, le Haut-Nyong, pour y soumettre complètement l’administration aux impératifs de la santé publique. Cette utopie sanitaire rappelle que les colonies ont pu être un « champ d’expériences » biopolitiques. Mais l’expérience du Haut-Nyong révèle surtout, en tournant rapidement au désastre, le rôle constitutif de l’échec et de la démesure dans les logiques et les pratiques du gouvernement colonial. L’article propose ainsi des pistes pour une approche pragmatique des ambitions expérimentales des médecins coloniaux, et pour reconsidérer la question historiographique de l’écart entre « projet » et « réalité ».
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Muzembo BA, Akita T, Matsuoka T, Tanaka J. Systematic review and meta-analysis of hepatitis C virus infection in the Democratic Republic of Congo. Public Health 2016; 139:13-21. [PMID: 27450441 DOI: 10.1016/j.puhe.2016.06.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 04/25/2016] [Accepted: 06/16/2016] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Hepatitis C virus (HCV) infection is endemic in the Democratic Republic of the Congo (DRC), where the prevalence of HCV antibodies (anti-HCV) is reported to range from 0.2% to 13.7%. However, the reported prevalence rates have been inconsistent. Therefore, a meta-analysis of observational studies was conducted to provide updates on the prevalence of HCV infection in the DRC. STUDY DESIGN Systematic review and meta-analysis. METHODS Medline, EMBASE and Google Scholar were searched for publications reporting on HCV infection in the DRC up to autumn 2015. In addition, a manual search was undertaken to detect relevant papers. Studies performed in groups at low risk of HCV (blood donors and pregnant women) were used for the meta-analysis. The random effects model was used to estimate the pooled prevalence of anti-HCV. RESULTS Sixteen studies with 13,799 participants (aged 6 months-71 years) met the inclusion criteria. The studies were performed in blood donors, pregnant women, military personnel, individuals with human immunodeficiency virus, children, commercial sex workers, Congolese patients living in Canada, patients with sickle cell disease and hospitalized patients. The reviewed studies revealed the presence of anti-HCV in almost all studied age groups and did not differ between sexes. The pooled prevalence of anti-HCV was 2.9% [95% confidence interval 1.5-4.3%]. Subgroup analyses revealed that the prevalence rates of anti-HCV in blood donors and pregnant women were 2.7% (95% confidence interval: 1.1-4.4%) and 3.3% (1.4-5.1%), respectively. CONCLUSIONS HCV infection remains an issue of public concern in the DRC, demonstrating a need for adequate hepatitis control programmes. Efforts must be made to virtually eliminate transfusion-transmitted HCV throughout the country.
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Affiliation(s)
- B A Muzembo
- Department of Epidemiology, Infectious Disease Control and Prevention, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - T Akita
- Department of Epidemiology, Infectious Disease Control and Prevention, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - T Matsuoka
- Department of Epidemiology, Infectious Disease Control and Prevention, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - J Tanaka
- Department of Epidemiology, Infectious Disease Control and Prevention, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
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Tennekoon V, Rosenman R. 'Behold, a virgin is with HIV!' misreporting sexual behavior among infected adolescents. HEALTH ECONOMICS 2014; 23:345-358. [PMID: 23576487 DOI: 10.1002/hec.2918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2012] [Revised: 11/25/2012] [Accepted: 02/08/2013] [Indexed: 06/02/2023]
Abstract
In four Southern African countries where the HIV prevalence rate is among the highest in the world, 46.4% of a sample of female adolescents infected with HIV report having never engaged in sex. This would indicate either the dominance of non-sexual modes of HIV transmission or rampant misreporting of sexual behavior in the sample. We propose a method to estimate the extent of misreporting and calculate that the true percentages of virgins among the sample of HIV-infected adolescent women is 32.1%. After accounting for misreporting, the contribution of sexual modes of HIV transmission is projected as 50.4%, compared with an estimate of 35.5% if we assume no misreporting.
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Abstract
This review considers whether HIV prevalence data on children in sub-Saharan Africa support the hypothesis that blood exposures account for a large proportion of HIV infections in Africa. Data from a systematic search on HIV-infected children support two analyses. In 25 studies where the mothers' HIV status was not matched with data on each child (excluding non-representative samples of children), the observed prevalence in children in 20 studies was greater than expected from vertical transmission. The population-weighted difference – 1.3% – was approximately one-third of observed prevalence in children. In 32 studies that match HIV-positive children with HIV-negative mothers, 406 discordant mother–child pairs were identified, and in studies identifying at least five non-vertical infections in children, 17.5% of HIV-positive children had HIV-negative mothers. In discussing an important role for unsafe health care in exceptionally rapid HIV transmission in Africa, leading AIDS researchers cite low HIV prevalence in children not yet sexually active. The assumption that childhood HIV prevalence would increase with age in children, if injections transmitted HIV is shown to be erroneous; it fails to account for early mortality in HIV-positive children. Evidence of child-to-child HIV transmission supports the theory that nosocomial infections are important to the AIDS pandemic, and procedures more prevalent than blood transfusions, such as injections, are likely involved.
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Affiliation(s)
- S Reid
- School of Community Health Sciences, University of Nevada at Las Vegas, Las Vegas, NV, USA
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