Prevalence Of Transfusion Transmitted Infections Research Articles

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 transmitted infections among blood donors of Kamenge Teaching Hospital blood bank in Burundi

Background: The current risk of contracting a transfusion transmitted infections (TTIs) is unknown in Burundi. Objectives: The aim of this study was to assess sociodemographic profiles of blood bank donors at Kamenge Teaching Hospital, the prevalence and associated risk factors of HIV, syphilis, HBV and HCV from 2015 to 2020. Methods: We conducted a cross-sectional study including all blood donors of Kamenge Teaching Hospital blood bank. During this study, 1370 blood samples were screened for HIV, Syphilis, HBV and HCV. We calculated prevalence of TTIs and performed logistic regression to know associated risk factors. Results: Blood donors were males at 77% and 23% females. They were mostly students (54.2%). On screening, 83 blood samples (6.06%) were seropositive for at least one TTI. The overall prevalence rate of HIV, Syphilis, HBV and HCV among blood donors was 1.3%, 0.2% ,1.6%, 2.9% respectively. There was difference in distribution of the four TTIs among blood donors which is statistically significant (x2=33.997, ρ-value<0.001). Private donors were associated with a high risk of syphilis and being a first-time donor was associated with a high HBV risk factor. Conclusion: The prevalence of TTIs found still to be high; mandatory and continuous screening is necessary. Keyswords: Transfusion transmitted infections; prevalence; blood donors; blood bank; Burundi.

Prevalence of transfusion-transmitted infections in hospitalized patients before transfusion and volunteer blood donors in Zhejiang Province, China.

ObjectivesTo assess the need for screening of transfusion-transmitted infections (TTIs) in blood products, we assessed TTI seroprevalence in blood donors and hospitalized patients. MethodsWe collected 2760 serum samples from three regions of Hangzhou, Ningbo and Huzhou from April 2021 to March 2022, and they tested by enzyme-linked immunosorbent assay (ELISA) for Hepatitis B surface antigen (HBsAg), Hepatitis C (HCV), Treponema pallidum (TP), Cytomegalovirus (CMV), Epstein-Barr virus (EBV), Hepatitis E virus (HEV) and Human T-cell lymphotropic virus type 1/2 (HTLV-1/2) antibody levels. ResultsScreening test results showed that the positive rates for HBsAg, anti-HCV and anti-TP were 3.01 %, 0.39 % and 0.18 %, respectively. The positive rates for CMV IgM and CMV IgG were 0.76 % and 96.96 %, while the positive rates for EB VCA-IgM and EB EA-IgG were 1.88 % and 10.47 %; those for HEV IgM and HEV IgG were 1.16 % and 26.05 %, while the HTLV-1/2 antibody positive rate was 0.04 %. The positive rates for CMV IgG, EB EA-IgG and HEV IgG in hospitalized patients before transfusion were higher than in volunteer blood donors, and the difference was statistically significant (P < 0.05). The overall co-infection rate was 0.29 %. The positive rates for EB VCA-IgM in the males were significantly higher than in females, and EB VCA-IgM and HEV IgG prevalence varied significantly by age. ConclusionOur data demonstrate the risk of TTI exposure and TTI transmission in the Zhejiang population, which poses a threat to blood safety. It is hoped that expansion of pathogen categories (CMV, EBV, HEV and HTLV-1/2) and blood screening programs will contribute to the future adoption of scientific blood transfusion methods.

Transfusion Transmitted Infections in Blood Donors of Pakistan Red Crescent Lahore: A Mixed Method Study

Background: According to Punjab Blood Transfusion Authority, blood donors are screened for five “Transfusion Transmitted Infections (TTIs). But lack of adequate screening methods threatens the rapid spread of TTIs. Objective: This study aimed at adding to the surveillance data about TTIs in Pakistan and explored blood banking phenomenon to find workable ways for minimizing their spread. Methods: It was a mixed method study, with retrospective cross-sectional design to find out the frequency of TTIs amidst the blood donors of “Pakistan Red Crescent Punjab” during 2015 to 2019, and with phenomenological design to explore reasons for any changes in the trends of TTIs. Records were analysed for descriptive statistics of the five TTIs, and reasons for the observed changes in the trends were explored through semi-structured interviews from the blood bank’s managers. The qualitative data was analysed by deductive thematic analysis. Results: Among 6380 blood donors, 2.19% (n=140) were positive for at least one of five TTIs. Out of total donors, 1.12 % (n= 72) were HCV positive, 0.83 % (n= 53) HBV positive, 0.2 % (n= 13) Syphilis positive, and 0.03% (n = 2) HIV positive, whereas none was positive for Malaria. 61.34% (n= 3914) of donors were males, and 38.65% (n= 2466) were females. Of the total, 86.52% (n= 5520) were mobile blood camp donors, and 13.47% (n= 860) were walk-in donors. The reasons for the observed increasing number of Syphilis cases and other observed trends were found to be due to differences in sensitivity of screening method used and other blood bank processes like Donor recruitment. Conclusion: TTI prevalence among donors of said blood bank in private sector is more in male donors in comparison to female ones and is more in “mobile blood camp donors” than in “walk-in donors”.

A cross sectional study on seroprevalence of transfusion-transmitted infections among blood donors at tertiary care hospital

Background: Transfusion transmitted infections (TTIs) are the major problem associated with blood transfusions, and accurate projections of TTI risk are essential for tracking the safety of the blood supply. This research recognized the seroprevalence trends and shifting patterns of TTIs, in a multispecialty hospital. The aim of the study was to assess the prevalence of TTI infections among blood donors and to compare the changing seroprevalence trends in blood donors. Materials and methods: A cross sectional study was conducted from January 2017 to December 2022 at KIMS Blood Centre, Secunderabad, India. All donors reporting to the blood centre during the period were screened for human immunodeficiency virus (HIV) 1 &amp; 2, hepatitis C viruses, hepatitis B surface antigen (HBsAg), total hepatitis B core antibody (aHBC) and hepatitis B surface antibody (aHBs), malaria and syphilis. Screening of HIV, hepatitis B and hepatitis C viruses were done by chemilumiencies, while syphilis and malaria were screened by RPR method. Results: A total of 69741 voluntary blood donors were screened, of which 68857 were males and 1083 were females. Seropositivity of HIV, hepatitis B, hepatitis C viruses, malaria, syphilis were 0.36 %, 0.59%, 0.48%,0.01% and 0.07% respectively. Addition tests were aHBC and aHBs which showed among all the potential donors, the most common TTI prevalence at our centre was hepatitis B followed by HCV, HIV, syphilis and malaria. Conclusion: Public awareness, careful donor selection, vigilance, and adoption of newer techniques for early detection are needed to reduce the incidence of TTIs. Keywords: human immunodeficiency virus; HIV; hepatitis B; hepatitis C; seroprevalence; transfusion transmitted infections

Seroprevalence with epidemiological determinants of hepatitis C virus and Treponema pallidum infection in blood donors of a teaching hospital in southwest Punjab, India: A 5-year study

ABSTRACT Background: A high seroprevalence of various transfusion-transmitted infections (TTIs) in donated blood is the main safety concern, especially in low- and middle-income countries. As per the World Health Organization (WHO) recommendation, all blood donations must be tested for human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), Treponema pallidum infection, and malaria, which mainly comprises the major bulk of TTIs. Aims: The purpose of this study is to observe the seroprevalence of hepatitis C virus and Treponema pallidum infection over the period of 5 years in blood donors of our blood center along with their epidemiological determinants with respect to age, sex, residence, occupation, and type of donors Materials and Methods: Retrospective study was conducted for the period of 5 years, from 1st January 2017 to December 2021, estimating the seroprevalence of hepatitis C and Treponema pallidum infection in the blood donors along with their epidemiological determinants Results: Out of 19,689 donations in 5 years, 690 (3.50%) units were positive for transfusion-transmissible infections with 1.67% donors seropositive for HCV, 1.23% for Treponema pallidum infection, 0.42% for HBV, and 0.18% for HIV. The prevalence of TTIs was found to be highest in 2020 (4.52%) and least in 2017 (2.57%). Out of a total of 330 HCV cases detected in 5 years, 84.85% of cases were seen in voluntary donors. Rural donors constituted 71.21% of cases. The majority of cases were seen in the age group of 18–30 years, i.e., 61.82%, and a maximum number of cases were seen in the farmers (31.21%), followed by laborers and construction workers (21.21%). Out of a total of 242 cases of Treponema pallidum infection, 84.29% were seen in voluntary blood donors. Demographic data showed 70.24% of cases in rural donors. Occupational data revealed a maximum number of cases in farmers (34.29%), followed by laborers (21.90%). Conclusion: Higher seroprevalence of HCV and Treponema pallidum infection in our region as compared with other areas is a matter of great concern about the growing infection rate of these in our area. Stringent use of donor selection criteria and more vigorous donor screening is utmost need of the hour for reducing the burden of TTIs in blood transfusion services.

Systematic review of prevalence and risk factors of transfusion transmissible infections among blood donors, and blood safety improvements in Southern Africa.

Blood and blood products are listed as one of the essential medicines by the World Health Organization (WHO). In addition to inadequate supply, most sub-Saharan Africa (SSA) nations fail to meet their blood needs because many donated blood units are discarded because they are contaminated with transfusion-transmitted infections (TTIs). We sought to estimate the prevalence of TTIs, identify the risk factors for TTIs among blood donors, and identify the efforts and interventions that have been made to improve blood safety in Southern African nations, particularly the nations of the South African Development Community (SADC). We investigated the prevalence and risk factors for TTIs, blood safety interventions, and blood quality improvement in the SADC region from major PubMed/MEDLINE, Cochrane Library, and HINARI databases from 1 January 2011 to 31 April 2021. All investigations followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). In meta-analysis, we estimated the pooled TTIs prevalence and summarised the same using forest plots. A total of 180 articles published from the SSA region were identified covering our three targeted themes: TTI prevalence, risk factors for TTIs, and blood safety improvements. Of these 180 articles, only 27 (15%) focused on the SADC region. The overall pooled TTI prevalence estimate was 2.0% (95% CI: 1.0-3.0) and hepatitis B was the most prevalent TTI in the region (prevalence = 3.0; 95% CI: 2.0-5.0). The prevalence of HIV, HCV, and syphilis was 2.0% (95% CI: 1.0-4.0), 1.0% (95% CI: 0.0-2.0), and 2.0% (95% CI: 0.0-8.0), respectively. In general, replacement donors and first-time donors were more likely to be infected with TTIs than repeat donors. Twelve articles explored blood safety research in the region; however, they vary greatly highlighting the need for consistent and more comprehensive research. Few publications were identified that were from the SADC region, indicating lack of research or resources towards improving both quantity and quality of blood donation. TTI prevalence remains one of the highest in the world and blood safety recommendations vary across the region. More effort should be directed towards developing a cohesive regional blood transfusion policy and effective blood monitoring and evaluation strategies.

Comment on: Prevalence of transfusion-transmitted infections in Saudi Arabia blood donors: A nationwide, cross-sectional study.

To the Editor We have read with interest the article published in Saudi Medical Journal on Prevalence of transfusion-transmitted infections in Saudi Arabia blood donors nationwide; cross-sectional study.[1][1] Safe blood supply has always been considered fundamental to the modern healthcare

Effectiveness of Using Nucleic Acid Amplification Test to Screen Blood Donors for Hepatitis B, Hepatitis C, and HIV: A Tertiary Care Hospital Experience From Pakistan.

Background Ensuring blood safety is the primary goal of transfusion medicine. Despite extensive serological tests and strict safety measures, the risk of transfusion-transmitted infections (TTIs) still exists. As applied to blood screening, Nucleic Acid Amplification Test (NAT)offers much higher sensitivity for detecting viral infections. It is, however, currently available to a handful of centers due to the high cost. This study aims to establish the Effectiveness of NAT by assessing the NAT yield and residual risk of transmission of Hepatitis B virus (HBV), hepatitis C virus (HCV)and HIV with and without NAT testing. Material and method This prospective cross-sectional study recruited blood donors from January 2020 to November 2022. All donors underwent routine serologic screening. Only serologically negative donors were tested for HBV, HCV, and HIV by NAT. The NAT yield and residual risk (RR) per million donors were computed for viral infections in seronegative blood donors and calculated using the incidence/window period model. Result A total of 59708 donors were included during the study period. The overall prevalence of TTI's were: For HCV 1.7% (n = 1018), HBV 1.5% (n = 918), HIV 0.07% (n = 47), Syphilis 1.2% (n = 758) and malaria 0.3% (n = 218). Out of 57759 seronegative donors, thirty-four NAT-reactive samples were identified, with 3 cases of HCV, 31 cases of HBV, and Nil HIV cases. NAT yield of HBV was 1 in 1863 with an RR of 8.6 per million, followed by HCV with a NAT yield of 1 in 19253 and RR of 0.8 per million donations. NAT testing reduced RR for HBV by 48.9% and HCV by 94.5%. Conclusion Our study showed that NAT detected 34 out of 57759 cases initially missed by serological tests. The study suggests that the parallel use of serology and NAT screening of donated blood would be beneficial.

Time Trend and Prevalence Analysis of Transfusion Transmitted Infections among Blood Donors: A Retrospective Study from 2001 to 2016.

Transfusion-transmitted infections (TTIs) remain a major threat to the patients receiving blood. The incidence of the transmission of various infectious agents has reduced ever since the introduction of various molecular techniques for detection. The study tried to figure out accurate estimates of risk and trend of TTI over a period of sixteen years, essential for monitoring the safety of blood supply and evaluating the efficacy of the currently employed screening procedures. A total of 57942 blood donors' records were analyzed for the period from January 2001 to December 2016. Chi-square test (χ2) was used to evaluate the relationship between serological positivity and particular donor characteristics. A P value of less than 0.05 was considered statistically significant. Of the 57942 donations, overall prevalence of TTI was 2.7%. Of these, the reactivity rate of hepatitis B (HBV), hepatitis C, HIV, syphilis, and malaria was 1.8%, 0.42%, 0.2%, 0.31%, and 0.017%, respectively with significant P value (P < 0.05, CI: 95%). Overall prevalence was higher in replacement donors as compared to voluntary blood donors. Trend of TTI prevalence decreased from 2001 to 2016. This epidemiological research on TTI is important for the region, as estimated disease burden based on comprehensive epidemiological research provides the foundation for public policy to ensure an easily accessible and adequate supply of safe and quality blood and blood components to the needy patients.

The Prevalence of Transfusion-Transmitted Infection Markers among Blood Donors at Saudi Hospital, Makkah.

Testing of blood donors for markers of transfusion-transmitted infections (TTIs) such as HBV, HCV, HIV, HTLV, syphilis, and malaria is mandatory in Saudi Arabia. This study determined the prevalence of all tested TTIs among blood donors in the western region of Saudi Arabia. This retrospective study included 5,473 blood donors who attended the blood donation center at the Security Force Hospital (SFH) located in the western region of Saudi Arabia from January 1, 2015 to December 31, 2018. The prevalence of TTIs was determined and classified as per year, gender, age, type of donors (first-time vs. returned donors), category of donation (replacement vs. volunteer), and blood group. All donors (100%) were screened for TTIs by serological assays and nucleic acid tests (NATs). "Reactive" samples to serological assays were as follow: 57 (1.07%) HBsAg, 292 (5.34%) HBsAb, 388 (7.1%) HBcAbs, 13 (0.24%) HCV, 5 (0.09%) HIV, 8 (0.15%) HTLV-I and -II, 21 (0.83%) syphilis, and 0 (0%) malaria. The NAT results for HBV, HCV, and HIV revealed 50 (0.91%), 1 (0.0002%), and 3 (0.05%) reactive samples, respectively. Reactive donations to screening serology tests of syphilis and HTLV-I/-II were neither confirmed nor declined by their corresponding confirmatory assays. Most "reactive" samples to TTI tests were associated with male gender, first-time donor, replacement donation, and O+ blood group. This study highlights the strong adherence to TTI testing policy and low prevalence of TTI markers among blood donors in the western region of Saudi Arabia.

Prevalence of Transfusion-Transmitted Infections in Multi-Transfused Thalassemia and Sickle Cell Disease Patients: A Single Center Experience from Southern Odisha, India

ABSTRACT Background: Repeated transfusion in sickle cell disease (SCD) and transfusion-dependent thalassemia (TDT) patients lead to transfusion-transmitted infections (TTIs). The prevalence, as well as various risk factors for TTIs in these patients, is found to be inconsistent. This study aimed to observe the prevalence, types of infections as well as risk factors for TTIs in a tertiary health care center. Materials and Methods: This observational study was undertaken on both SCD and TDT patients admitted to the hospital for a transfusion. In all patients, the enzyme-linked immunosorbent assay-based test kit was used for the diagnosis of hepatitis C virus (HCV), hepatitis B virus (HBV), and human immunodeficiency virus 1 and 2 (HIV 1 and 2). However, a rapid test kit was used for the diagnosis of malaria and syphilis. Detailed information on age of the patients, duration of transfusion, and number of transfusion as risk factors were recorded. The association of factors with various infections was analyzed statistically. Results: A total of 153 patients were recruited including 49 SCD and 104 TDT patients. Of 153 patients, 25 patients were found to have infections including HCV in 22 (14.38%) patients, HBV in 2 (1.31%) patients, and HIV in 2 patients (1 patient was positive for both HCV and HBV). Out of 25 TTIs patients, 7 patients had SCD and 18 patients had TDT. On the association, only an increased number of transfusion per year was found to be significantly associated with TTIs (P = 0.008) in SCD patients. However, all the risk factors were found to be associated with TTIs except gender in TDT patients. Conclusion: The occurrence of TTIs was found to be associated with older patients, increased number of transfusion per year, and large duration of transfusion. The increasing trend in the TTIs in these patients calls for a shift toward preventive and comprehensive care to reduce the health burden.

Seroprevalence of hepatitis B, hepatitis C, and human immunodeficiency virus in hemophilia A patients: A descriptive study

Background: Hemophilia A (Factor VIII deficiency) is a X-linked coagulopathy that affects approximately 1/10,000 male live births. In the past, the treatment of hemophilia A consisted of cryoprecipitated plasma and purified factor preparations. As a result, they experienced unusually high incidence of hepatitis and human immunodeficiency virus (HIV) seroconversion. Aims and Objectives: The aims of this study were to find out the seroprevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV infection, among hemophiliacs attending a tertiary care center in Kerala, southern India. Materials and Methods: A cross-sectional study was conducted on hemophilia A patients who attended the departments of medicine and pediatrics. Demographic details and treatment history were obtained by questionnaire. Enzyme-linked immunosorbent assay was used to detect HBV surface antigen, HCV antibodies, and HIV. The statistical data analysis was performed using SPSS software version. Results: Out of 90 hemophilia A patients who underwent testing for the seroprevalence of transfusion-transmitted viral infections, one (1.1%) patient tested positive for HIV, two (2.2%) for HCV, and one (1.1%) for HBV. Among patients with hemophilia A, the prevalence of transfusion-transmitted infection was 4.4%. Patients with HIV- and HCV-positive tests belonged to the severe hemophilia A group. Moreover, the HBV-positive patient belonged to moderate hemophilia A. Conclusion: The present paradigm of management of hemophilia A patients is with plasma-derived or recombinant Factor VIII concentrates, cryoprecipitates, and fresh frozen plasma. Due to the risk, however remote, of transfusion-transmitted viral infections, all hemophiliacs should receive the hepatitis B vaccine and undergo routine testing for HIV, HCV, and HBV viruses.

Prevalence of transfusion-transmitted infections in Saudi Arabia blood donors: A nationwide, cross-sectional study.

To establish a nationwide epidemiological profile of transfusion-transmittable infection (TTI) markers among seemingly healthy blood donors to update policies required to ensure blood safety. A nationwide, cross-sectional study was designed to examine donor demographics and TTI prevalence during 2020 using data provided by the Ministry of Health, Saudi Arabia. Collectively, a total of 375,218 whole blood units were donated, of which 32,758 (8.7%) were excluded due to TTI-related risk. The exclusion was based on a positive nucleic acid amplification test (NAT) or seroreactivity to hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), human T-cell lymphotropic virus (HTLV-I/II), syphilis, or malaria. Notably, the central (37.6%) and southern (33%) regions were the epicenters of TTI-reactive blood donors. Hepatitis B virus markers accounted for 85.7% and were the overall most prevalent of TTI-positive donations, followed by HCV at 5.9% and syphilis at 5.6%. In particular, anti-HBc and HBsAg were most prevalent in the south, while HBV NAT was highest in the center. Hepatitis B virus, HCV, and syphilis carry the greatest risk of TTI in Saudi Arabia. Including HBsAg screening is a necessary precautious measure to maintain blood safety.

Exploring the unseen effect of COVID 19 pandemic on blood transfusion services in a tertiary care centre

BackgroundThe coronavirus pandemic confronted blood transfusion services with major challenges. The present study was conducted to explore the effect of the COVID-19 pandemic on blood transfusion services including seroprevalence of transfusion-transmitted infections. Material and MethodsA retrospective cross-sectional study was conducted and data on blood donation, utilization, camps, plateletpheresis and seroprevalence of transfusion-transmitted infections (TTI) was retrieved from software from March to September 2020 and 2021 and compared with corresponding time periods of three preceding non-pandemic years. ResultsThere was a decline of 53.79% and 34.4% in blood donations in 2020 and 2021 respectively with a significant reduction in voluntary donations from 91.8% in the pre-pandemic period to 72.2% in 2020 and 77.7% in 2021. Replacement donors increased by 60.81% and 72.89% in 2020 and 2021 respectively. There was a decline of 48.4% in the number of plateletpheresis procedures in 2020 which increased in 2021 during the dengue outbreak. The decline in total blood donations and issue of packed red blood cells was statistically significant but supply and demand were balanced with no deficit. TTI seroprevalence increased from 1.01% to 1.49%(p<0.001) and 1.51%(p<0.001) in 2020 and 2021 respectively. Replacement donors showed a significantly higher TTI prevalence as compared to voluntary donors(p<0.001). A significant increase in prevalence was observed for Syphilis (0.4%) in 2020 and HBsAg (0.54%), HCV(0.63%) and syphilis (0.25%) in 2021. ConclusionThe potential consequences of the COVID-19 pandemic on blood safety cannot be undermined. Developing a strong database of regular voluntary donors can be instrumental in dealing with future waves and surges in infections.

Seroprevalence of Transfusion Transmissible Infections and Associated Risk Factors in Hospitalized Patients before Transfusion in Jinling Hospital Nanjing University: A Three-Year Retrospective Study.

Transfusion-transmitted infections (TTIs), such as hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and treponema pallidum (TP), must be detected before blood transfusion. However, few studies have been conducted on the prevalence and accuracy of positive results in hospitalized patients. The purpose of this study was to investigate the real seroprevalence of TTIs among patients before blood transfusion and analyze the characteristics of false-positive results in Jinling Hospital, Nanjing University, China. TTI results were collected from medical records and analyzed retrospectively. Additionally, we also used confirmatory assays to verify the accuracy of positive results. The overall prevalence of TTI was 8.96%, which was related to gender and age. The real positive rates were 86.67% (HBV), 35.09% (HCV), 20.75% (HIV), and 100% (TP). Our results also showed that high-speed centrifugation can reduce the false-positive rate of HBsAg. In summary, the results demonstrated that the positive rates of TTIs in hospitalized patients are higher than those in the general population. We also confirmed the existence of false-positive results in serological screening for TTIs. The method of processing specimens through high-speed centrifugation could reduce the false-positive results of detecting antigens effectively.

Prevalence of and Factors Associated With Transfusion-Transmitted Infections Among Multi-transfused Patients, Sana'a City, Yemen, 2019

Background Multi-transfused patients (MTPs) are at higher risk of transfusion-transmitted infections (TTIs) due to their frequent need for blood transfusion. Nevertheless, little is known about the prevalence of TTIs among MTPs and its associated factors in Yemen. Objective We aimed to determine the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV and its associated factors among MTPs. Methods A cross-sectional study was conducted at the Yemeni Society for Thalassemia and at Pediatric Leukemia Unit in Sana’a City. The calculated sample size of 357 was increased to 405 to overcome any nonresponses. By using probability proportional to size sampling, 80 patients with thalassemia, 240 patients with sickle cell anemia, and 85 patients with leukemia were randomly selected. Data were collected through face-to-face interviews with patients or their caretakers by using a predesigned questionnaire covering demographic, socioeconomic characteristics and TTI-associated factors. Blood samples were drawn and were tested for HBsAg, anti-HCV, and HIV I and II by using an electrochemiluminescence immunoassay. Results The overall prevalence of TTIs among MTPs was 13.1% and was significantly highest (37.3%) among patients with leukemia. HBV (16.2%) and HCV (27.5%) prevalence were also highest among patients with leukemia. Only 2 (0.04%) patients were found to be HIV positive among patients with sickle cell anemia. Coinfection with HBV and HCV was only found in 5 patients with leukemia. There was a significant association between TTIs and the receipt of &gt;30 blood units. Only 35% of MTPs were found to be vaccinated against HBV. Conclusions Our findings raise an alarm for the existence of a high risk of TTIs among MTPs, especially among patients with leukemia and those who undergo an increasing number of transfusions. Using advanced technology in blood screening and strict infection prevention during transfusion should be adopted. The rational use of blood/blood substitutes and ensuring that MTPs are vaccinated against HBV are recommended.

The Analysis of Transfusion Transmitted Infections (TTIs) in Thalassemia Patients

Objective: To find out the analysis of transfusion transmitted infections (TTIs) in β-thalassemia patients at a tertiary care hospital of South Punjab, Pakistan. Study Design: A cross-sectional study. Place and Duration of the Study: The Department of Hematological Disorder, Thalassemia and Bone Marrow Transplantation Centre, and Department of Biochemistry, “Bahawal Victoria Hospital, Quaid e Azam Medical College”, Bahawalpur, Pakistan from February January 2020 to December 2021. Methodology: Patients of blood transfusion-dependent 𝛽-thalassaemia of both genders and aged 5 to 12 years were analyzed. Blood was collected from patients aseptically and serum separated in Eppendorf tubes and stored at –200C. Screening for hepatitis C virus (HCV), hepatitis B virus (HBV), syphilis and human immunodeficiency virus (HIV) were performed through Chemiluminescence Immunoassay (CLIA) technique. Results: In a total of 1212 patients, 745 (61.5%) were male. Overall, mean age was calculated to be 8.7±4.6 years while 874 (72.1%) patients were below 10 years of age. There were 866 (71.5%) patients who belonged to rural areas of residence. Parental consanguineous marriages were reported in 951 (78.5%) cases. There were 205 (16.9%) patients who were found to have TTIs. Out of these 205 patients, 169 (13.9%) were having HCV, 11 (0.9%) HBV, 20 (1.7%) syphilis whereas HIV was noted in 5 (0.4%) patients. Conclusion: Prevalence of TTIs was found to be high among multi-transfused patients of β-thalassemia. Most common types of TTIs were HCV which is consistent to what has previously been reported in the local literature. Identification of HIV in 0.5% cases in the present study is pointing towards disturbing development regarding spread of HIV in our region. Keywords: β-thalassemia, blood transfusion, hepatitis C, hepatitis B, human immunodeficiency virus.

Prevalence of transfusion-transmitted infections in multiple blood transfusion-dependent thalassemic patients in Asia: A systemic review.

BackgroundThalassemia is a hereditary hemolytic anemia marked by a defect in synthesizing one or more globin chains in hemoglobin. In Pakistan, approximately 10,000 patients with thalassemia are primarily dependent on blood transfusions. The β-thalassemia patients require blood transfusions and iron chelation therapy. Patients who need blood transfusions are at an increased risk of contracting transfusion-transmitted infections (TTIs) such as hepatitis B and C viruses (HBV and HCV, respectively), as well as the human immunodeficiency virus (HIV).ObjectiveThis systemic review aims to assess the prevalence of TTIs in transfusion-dependent β-thalassemia patients in Asia.MethodsThe data for the systematic review were gathered from PubMed, Google Scholar, the Directory of Open Access Journals (DOAJ), and ScienceDirect using the following keywords: “prevalence, HBV, HCV, HIV, thalassemia, and transfusion-transmitted infections (TTIs)," and so on. This review includes the research articles that address the prevalence of viral infections in thalassemic patients following blood transfusion.ResultsA preliminary search of various databases identified 231 potential studies. 157 duplicate studies were eliminated, and the eligibility of 59 full-length articles was determined. Only 43 studies met the inclusion criteria. Among the 43 studies analyzed, 11 reported a high prevalence of HCV alone in thalassemic patients, while 21 reported a high prevalence of HCV and HBV infection in thalassemic patients. Eight studies reported the prevalence of all three TTIs examined, namely, HCV, HBV, and HIV, in patients with transfusion-dependent thalassemia.ConclusionPreventable transfusion-transmitted infections occur frequently, and robust national policies and hemovigilance are required to detect and mitigate the infection risk.

English

BACKGROUND Blood transfusion has been a boon to medical science, but at the same time, it exposes millions of people to transfusion transmitted infections (TTI). TTI are the infections that are transmissible from one person to another through parenteral administration of blood / blood products. Various TTIs are hepatitis C (HCV), hepatitis B (HBV), syphilis, human immunodeficiency viruses (HIV) and malaria. With increasing use of blood transfusion, chances of transmission of TTIs is very common but proper screening of donor blood has reduced the chances of TTI. The present study was done to know the seroprevalence of HCV, HBV, HIV and syphilis and their coinfections. METHODS A retrospective study was conducted by reviewing the records from January 2015 to December 2019 at a blood bank of Guru Ram Das Institute of Medical Sciences and Research at Amritsar, Punjab. Number of donors included in the study were 43,037. All the donors who came to blood bank were tested for TTIs by enhanced chemiluminescent immunoassay. METHODS A retrospective study was conducted by reviewing the records from January 2015 to December 2019 at a blood bank of Guru Ram Das Institute of Medical Sciences and Research at Amritsar, Punjab. Number of donors included in the study were 43,037. All the donors who came to blood bank were tested for TTIs by enhanced chemiluminescent immunoassay. RESULTS Number of donors tested for TTI was 43,037. Out of 43037, 1739 patients had serological evidence of TTIs, out of which 1669 (96.19 %) had mono-infection and 70 (4.04 %) had coinfections. HCV &amp; HBV (28 / 70) was the most common combination, followed by HCV &amp; HIV (20 / 70), HCV &amp; syphilis (9 / 70), HIV &amp; syphilis (5 / 70), HBV &amp; syphilis (3 / 70) and HBV &amp; HIV (1 / 70). Two donors had HIV, HCV &amp; syphilis coinfections and two donors had HIV, HBV &amp; HCV coinfections. CONCLUSIONS The present study documents the high prevalence of TTI out of which hepatitis C is the most common followed by hepatitis B. Among coinfections, two most prevalent coinfections are HCV &amp; HBV and HCV &amp; HIV and it is important to screen for these coinfections due to their impact on the course of disease as well as quality of life. This shows the increasing evidence of transfusion transmissible infection in blood donors in spite of advanced and vigilant screening of donated blood prior to transfusion. So, strategies should be devised for monitoring the implementation of post donation counselling for recruitment of safe donors. KEYWORDS Coinfections, Transfusion Transmitted Infections, Seroprevalence