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

Seroprevalence of HIV, HBV, HCV and Syphilis among blood donors in a Nigerian tertiary medical centre

BACKGROUND

Transfusion-transmitted infections (TTIs), such as HIV, HBV, HCV, and Syphilis, present considerable difficulties in maintaining blood quality despite the critical role of blood transfusion in emergency medical care. This study aims to ascertain the prevalence of these infections and the factors that increase their risk among those who donate blood.

METHODS

A cross-sectional study was conducted at the Federal Medical Center in Azare, involving 400 blood donors. Serological tests were conducted for HBV, HCV, HIV, and syphilis, and sociodemographic data was collected through a structured questionnaire. The univariate and multivariate logistic regression tests were employed to detect associated risk factors, with a significance level set at P < 0.05.

RESULT

Of the total blood donors, 17.00% (68/400) tested positive for at least one TTIs. The presence of HIV, HBV, HCV, and syphilis was identified in 2.8% (11/400), 8.3% (33/400), 1.8% (7/400), and 4.3% (17/400) of the donors, respectively. Multivariate analysis, after adjustments with various variables, indicates only commercial blood donors [Adjusted Odds Ratio (AOR) (95% CI): 14.63 (1.76-121.27)] and multiple sexual partners [AOR (95% CI): 5.40 (1.28-22.70)] were associated with HIV, while blood transfusion and piercing or tattoo were associated with HBV. Multiple sexual partners and a history of STDs were associated with syphilis infection.

CONCLUSION

TTIs such as HIV, HBV, HCV, and syphilis were detected among the blood donors, with HBV being the most common. The findings highlight a gender disparity in blood donation, with voluntary donors comprising the majority; nevertheless, commercial donors had the highest prevalence of TTIs. Enhanced donor screening and public awareness are crucial for blood safety.

CLINICAL TRIAL NUMBER

Not applicable.

Prevalence of Non-Viral Bloodborne Pathogens Among Healthy Blood Donors in Western Mexico: Problems and Failures of Public Health Policy

BACKGROUND AND OBJECTIVES

Non-viral bloodborne diseases are a group of infections that are a public health problem worldwide. The incidence of diseases such as brucellosis and syphilis is increasing in the Americas and Europe. Chagas disease is an endemic problem in Latin America, the United States and Europe. This study aims to determine the prevalence of non-viral bloodborne diseases in blood donors and to discuss some issues related to federal regulations for the control and prevention of these infectious diseases in Mexico.

MATERIAL AND METHODS

A cross-sectional study was conducted in the Western National Medical Center Blood Bank, including 228,328 blood donors (2018-2023). Frequencies, percentages, means, standard deviation and confidence intervals (CI) were calculated for demographic data. Prevalences were expressed as rates per 100,000 with 95% CI.

RESULTS

Of 3949 seroreactive or undetermined blood donors at the first screening, a total of 682 (0.299%) completed their follow-up test and were positive for Treponema pallidum (478), Trypanosoma cruzi (83), or Brucella spp. (121). The overall prevalence for non-viral bloodborne diseases was 299 per 100,000 blood donors. The prevalence for syphilis, Chagas disease, and Brucella was 209, 36, and 53 per 100,000 respectively.

CONCLUSION

Federal regulations should be reviewed to formulate specific public health policies focused on controlling and preventing nonviral bloodborne diseases.

Prevalence and factors associated with transfusion-transmissible infections (HIV, HBV, HCV and Syphilis) among blood donors in Gabon: Systematic review and meta-analysis

BACKGROUND

Transfusion-transmissible infections (TTIs) remain a major public health problem in countries with limited resources, particularly in Gabon. Complete information on the prevalence in Gabon of the main TTIs among blood donors is still lacking in the national context. The purpose of this systematic review and meta-analysis was to determine the prevalence and factors associated with TTIs among blood donors in Gabon.

METHODS

This systematic review and meta-analysis was reported in accordance with the PRISMA 2020 guidelines. It was the result of data from several comprehensive studies published between 2014 and 2022, the purpose of which focused on the prevalence and factors associated with TTIs among blood donors in Gabon. The quality of the articles was assessed using the Joanna Briggs Institute critical appraisal checklist for studies reporting prevalence data. The overall prevalence of TTIs among blood donors was determined using the random effects model. Heterogeneity between studies was assessed using I2 statistics. Publication bias was assessed by visual inspection of the funnel plot and Egger's statistics.

RESULTS

A total of 175,140 blood donors from the nine eligible studies were admitted to this study. The combined prevalence of HIV, HBV, HCV and syphilis obtained in the random effects model was 3.0%, 6.0%, 4.0% and 3.0%, respectively. Moreover, being a male blood donor and aged between 25 and 44 years was significantly associated with HBV infection and being a female blood donor and aged 35 years and over was significantly associated with HIV infection. Family or replacement blood donors had a high infection burden for all four TTIs of study.

CONCLUSION

The overall prevalence of transfusion-transmissible infections remains high in the country's blood banks. Improving current prevention (selection criteria) and screening strategies may be necessary in a global approach.

Self-reported high-risk behavior among first-time and repeat replacement blood donors; a four-year retrospective study of patterns

BACKGROUND

There is no replacement for blood, and patients requiring transfusion depend on human donors, most of whom are family donors. Family donors may deny engagement in high-risk activities, which threaten the safety of donated blood. This study determined frequency of self-reported high-risk behaviors among replacement donors.

METHODS

This retrospective study recruited 1317 donor records from 2017-2020, at Mankranso Hospital, Ghana. Data from archived donor questionnaires were extracted and analyzed with SPSS and GraphPad. Frequencies, associations, and quartiles were presented.

RESULTS

The donors were predominantly males (84.4%), 17-26 years old (43.7%), informal workers (71.8%), rural inhabitants (56.5%), first-time (65.0%), and screened in the rainy season (56.3%). Donation frequency was significantly associated with age, sex, occupation, and residence. Repeat donors were significantly older (p≤0.001). More males than females were deferred (p = 0.008), drug addicts (p = 0.001), had body modifications (p = 0.025), multiple sexual partners (p = 0.045), and STIs (p≤0.001), whereas, more females were recently treated (p = 0.044). Weight loss (p = 0.005) and pregnancy (p = 0.026) were frequent among 17-26-year group, whereas, tuberculosis was frequent among 37-60-year group (p = 0.009). More first-time donors were unwell (p = 0.005), deferred (p≤0.001), pregnant (p = 0.002), drug addicts, had impending rigorous activity (p = 0.037), body modifications (p = 0.001), multiple sexual partners (p = 0.030), and STIs (p = 0.008). STIs were frequent in the dry season (p = 0.010). First-time donors had reduced hemoglobin (p = 0.0032), weight (p = 0.0003), and diastolic pressure (p = 0.0241).

CONCLUSION

Donation frequency was associated with age, sex, occupation, and residence, with first-time donors younger than repeat donors. Deferral from donation, drug addiction, body modification, multiple sexual partners, and STIs were frequent among males, whereas, more females received treatment. Tuberculosis was frequently reported among older adults, whereas, weight loss and pregnancy were frequent among younger individuals. More first-time donors reported being unwell, deferred, drug addiction, body modifications, multiple sexual partners, STIs, and pregnant. Hemoglobin, weight, and diastolic BP were reduced among first-time donors.

Serological markers of transfusion transmissible infections and ABO blood groups in Najran, Saudi Arabia

OBJECTIVES

To ascertain the prevalence of transfusion transmissible infections (TTIs) across diverse donor groups in the Najran province. Additionally, to establish a potential association between the development of TTI and the donors' blood group, as determined by the ABO/Rh blood grouping system.

METHODS

Blood donation data of 4120 donors, spanning from January to December 2020, were retrospectively reviewed. The blood were screened for TTI markers, including hepatitis B surface antigen (HBsAg), anti-hepatitis B core (anti-HBc), anti-hepatitis C virus (anti-HCV), anti-human immunodeficiency viruses 1 and 2 (anti-HIV1&2), anti-human T-lymphotropic virus types 1 and 2 (anti-HTLV-1&2), and syphilis antigen.

RESULTS

Positive TTI markers were detected in 10.9% of the donors. The most detected TTI marker was anti-HBc (8.9%), followed by HBsAg (0.7%). Other markers were individually detected in <1% of the donors. Anti-HBc-positive was significantly elevated among non-Saudi blood donors. There was an association between age groups and anti-HCV (p=0.002), anti-HTLV (p=0.004) and syphilis antigen (p=0.02) markers positivity. The AB positive blood group exhibited the most positivity for TTI markers, followed by O positive blood group. Similarly, association was found between ABO group and HBsAg (p=0.01), anti-HBc (p=0.001), and anti-HCV (p<0.001) markers positivity.

CONCLUSION

Emphasis on implementing robust screening measures for donated blood is underscored by this study. There is the need for future study to extensively evaluate TTI status to enhance our understanding of the trend in TTI.

Seroprevalence of Hepatitis C Virus Among Blood Donors in a Tribal-Preponderant Region of India

INTRODUCTION

Hepatitis C is a global health burden with significant morbidity and mortality. It primarily affects the liver and causes acute hepatitis, chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma. Common modes of transmission of hepatitis C virus (HCV) infection are blood transfusion, needlestick injury, and mother-fetus transmission, among which transmission, blood transfusion is one of the most important causes. Blood transfusion is one of the pillars in the management of patients that saves lives and improves morbidity. Blood donation in India is done by voluntary and replacement blood donors of both sexes. The aim of this study is to determine the seroprevalence of HCV among blood donors in the Jharkhand state, a tribal-preponderant region of India, and to see the trend over the years.

MATERIAL AND METHODS

This is a nine-year retrospective observational study from 2015 to 2023 that screened for anti-HCV antibodies (third-generation kit: Abbott Diagnostics) using the chemiluminescence technique.

RESULTS

In this study, in total, 249,461 units of blood were collected, of which the majority of donations were by male and replacement donors (RDs) comprising 230,757 (92.50%) and 188,047 (75.38%), respectively. The mean number of blood donations by replacement and male donors (MDs) was more than for voluntary donors (VDs) and female donors (FDs) (20894.11 ± 3041.71 RDs vs. 6823.77 ± 2332.96 VDs, p < 0.0001 and 25639.66 ± 2810.08 MDs vs. 2078.22 ± 828.16 FD, p < 0.0001), respectively. The overall prevalence of HCV was 0.63%, and all seropositive donors were male.

CONCLUSION

Replacement blood donation contributes to the major part of blood donation and is primarily done by males in this tribal population-dominant region of India. Seroprevalence of HCV is high in the population of this part of India, and there is a constant or slightly upward trend in hepatitis C infection among individuals.

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.

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.

Follow-up of Military Blood Donors Who Test Positive for Syphilis

BACKGROUND

Several large studies have demonstrated that syphilis carries a risk of future sexually transmitted infections (STI), such as human immunodeficiency virus. There are limited data on outcomes of syphilis infections that occur in populations that undergo universal syphilis screening, such as blood donors. Military trainees who donate blood can be followed through their military career to determine the future risk of STIs.

METHODS

Blood donor data were gathered from the Armed Services Blood Bank Center-San Antonio for those with positive Treponema pallidum antibodies between 2014 and 2021. The medical chart of each case was compared with 6 sex- and military accession date-matched controls with negative T. pallidum antibodies to determine the risk of STI in the 3 years after donation.

RESULTS

A total of 63,375 individuals donated blood during the study period. A total of 23 military trainees (0.36 per 1000 donors) had positive T. pallidum antibodies. A minority (n = 7; 30%) of cases were treated for early syphilis. Only 6 cases (26%) received a follow-up nontreponemal test within 1 year. Donors who tested positive had a significantly higher risk of developing an STI within 3 years after blood donation compared with blood donors who tested negative (relative risk, 3.8; 95% confidence interval, 1.3-10.5; P = 0.01) including gonorrhea (9% vs. 0%, P = 0.02) and syphilis (9% vs. 0%, P = 0.02).

CONCLUSIONS

This study shows the presence of T. pallidum antibodies in blood donors was associated with an increased risk of future STIs. These cases support the need for close follow-up and broad STI testing in blood donors with positive T. pallidum antibodies.

Development and clinical validation of a one-step pentaplex real-time reverse transcription PCR assay for detection of hepatitis virus B, C, E, Treponema pallidum, and a human housekeeping gene

BACKGROUND

With the safety of blood transfusion being a major public health concern, the development of a rapid, sensitive, specific, and cost-effective multiplex PCR assay for simultaneous detection of hepatitis B virus(HBV), hepatitis C virus (HCV), hepatitis E virus (HEV), and Treponema pallidum(T. pallidum) in blood is crucial.

METHODS

Five primer pairs and probes were designed towards conserved regions of target genes and used to establish a one-step pentaplex real-time reverse transcription PCR(qRT-PCR) assay for simultaneous detection of HBV, HCV, HEV, T. pallidum, and RNase P(housekeeping gene), providing sample quality check. The clinical performance of the assay was further determined with 2400 blood samples from blood donors and patients in Zhejiang province, and compared the results with commercial singleplex qPCR and serological assays.

RESULTS

The 95% limit of detection(LOD) of HBV, HCV, HEV, and T. pallidum were 7.11 copies/µL, 7.65 copies/µL, 8.45 copies/µL, and 9.06 copies/µL, respectively. Moreover, the assay has good specificity and precision. Compared to the singleplex qPCR assay, the novel assay for detecting HBV, HCV, HEV, and T. pallidum presented 100% clinical sensitivity, specificity, and consistency. Several discrepant results between serological and pentaplex qRT-PCR assays were found. Of 2400 blood samples, there were 2(0.08%) HBsAg positive samples, 3(0.13%) anti-HCV positive samples, 29(1.21%) IgM anti-HEV positive samples and 6(0.25%) anti-T. pallidum positive samples proven negative in nucleic acid detection. 1(0.04%) HBV DNA positive sample and 1(0.04%) HEV RNA positive sample were detected negative by serological testing.

CONCLUSIONS

The developed pentaplex qRT-PCR is the first assay on simultaneous, sensitive, specific, and reproducible detection of HBV, HCV, HEV, T. pallidum, and RNase P in a single tube. It could detect pathogens in blood during the window period of infection and is a good tool for effectively screening blood donors and early clinical diagnosis.