Abstract

Blood donation is not readily an altruistic sacrifice in sub-Saharan Africa where microbial infections, maternal haemorrhages, malaria and other tropical diseases that frequently require blood transfusion are daily diagnoses. Blood transfusion safety is hindered by the combined prevailing high rate of Transfusion-Transmissible Infections (TTIs) and poor screening techniques. This study determined the rate of Enzyme-Linked Immuno-Sorbent Assay (ELISA) positive reactions to transfusion-transmissible infections in rapid diagnostic test negative family replacement blood units, compared to the first time voluntarily donated blood. We studied records of blood units collected in a tertiary hospital from donors who scaled pre-donation Rapid diagnostic test (RDT) screening for the human immunodeficiency virus, hepatitis B and hepatitis C viruses and syphilis and rescreened by ELISA techniques at the National Blood Transfusion Service Centre in Jos, along with units from first-time voluntary blood donors. A total of 19562 blood units; 5945 (30.39%) rapid diagnostic tests negative from a linkage hospital and 13617 (69.61%) from first time voluntary donors were screened by ELISA methods for HIV, HBV, HCV, and syphilis. The overall TTIs detected by ELISA was 16.08%, significantly lower among pre-donation rapid screened family replacement blood donors [495(8.32%)] compared to 2651 (19.47%) among first-time voluntary donors; P=0.0001. Fifty-seven (0.96%) HIV, 166 (2.79%) HBV, 137 (2.31%) HCV and 137 (2.31%) syphilis were still detected respectively by ELISA in the pre-screened negative family replacement blood units. The outcome of ELISA screenings of blood collected from first-time volunteer donors were; 143 (1.05%) HIV, 1,486 (10.91%) HBV, 683 (5.02%) HCV, and 339 (2.49%) syphilis. Blood for transfusion should be screened negative at least with ELISA.

Highlights

  • The responsibility of the National Blood Transfusion Service is to provide sufficient quality blood in a timely manner, safe from the viral hepatitides, syphilis and the human immunodeficiency virus (HIV) for transfusion in Nigeria

  • We studied records of blood units collected in a tertiary hospital from donors who scaled pre-donation Rapid diagnostic test (RDT) screening for the human immunodeficiency virus, hepatitis B and hepatitis C viruses and syphilis and rescreened by Enzyme-Linked Immuno-Sorbent Assay (ELISA) techniques at the National Blood Transfusion Service Centre in Jos, along with units from first-time voluntary blood donors

  • The overall Transmissible Infections (TTIs) prevalence, detected by ELISA, was 16.08%, significantly lower among pre-donation rapid screened family replacement blood donors [495(8.32%)] compared to 2651(19.47%) among first-time voluntary donors; P=0.0001.Fifty-seven (0.96%) HIV, 166 (2.79%) HBV, 137 (2.31%) HCV and 137 (2.31%) syphilis were still detected respectively by ELISA in the 5,945prescreened negative blood units received from the linkage hospital

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Summary

Introduction

The responsibility of the National Blood Transfusion Service is to provide sufficient quality blood in a timely manner, safe from the viral hepatitides (hepatitis B and C viruses), syphilis and the human immunodeficiency virus (HIV) for transfusion in Nigeria. Buseri et al (2009) reported a high 18.6% sero-prevalence of hepatitis B virus, followed by Hepatits C virus, HIV and syphilis (1.1%) infections among blood donors in Osogbo, South West Nigeria.1Largely paid blood donors in Lagos, the cosmopolitan and most populous city of Nigeria, had a prevalence of 9.80% HIV, 1.37% HBV, 1.10% syphilis and 0.84% HCV.[2] Ejele and other co-workers (2005), using rapid diagnostic test kits, documented low rate of human immunodeficiency, hepatitis B and hepatitis C viruses among their largely male commercial and replacement donors.[3] Nwogoh et al (2011), working in South-South Nigeria demonstrated higher prevailing rates of viral TTIs among their commercial donors compared to replacement blood donors.4In the South-East Nigeria, Okocha and others (2015) recorded an equal prevalence of 2.0% for hepatitis B and hepatitis C They further observed varying sensitivity and rates of HIV positivity by using different test methods, the most sensitive being anti P24 antibody test.5Amiwero and partners (2013) working in the central region of Nigeria, reported 14.1% HBV, 3.9% HCV and 1.0% HIV among their blood donors in Bida.[6] Research reports from studies outside Nigeria show study populations that are predominantly volunteer blood donors. Major transfusion transmissible infections were rampant among Cameroonian blood donors in 2003, still reflected in 2013.8,9A 2011 A study report from Eritrea documented a 79.0% voluntary blood donor population with TTIs rate less than a digit except for hepatitis B that was detected in 2.58%.10 Ethiopian studies recorded high TTIs rates in Wolaitasodo university referral hospital and among blood donors at Hawassa blood bank centre, both in southern Ethiopia.[11,12] While HCV and HBV were detected in about 4% and 1% among Egyptian blood donors, HIV and syphilis were at less than single digit prevalence.13At the Namibian Blood

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