Regional Blood Transfusion Centre Research Articles

Abnormalities of Serum Protein Fractions in Hemodialysis Patients with Chronic Renal Failure at Ouagadougou, Burkina Faso

Introduction: The main objective of this study was to investigate abnormalities of serum protein fractions in hemodialysis patients with chronic renal failure (CRF) in Ouagadougou, Burkina Faso. Methods: This was a descriptive cross-sectional study of 48 hemodialysis patients with chronic renal failure (CRF) recruited at the Yalgado Ouedraogo Teaching Hospital (YO-TH), and 48 controls declared fit to donate blood by the Regional Blood Transfusion Center (RBTC) of Ouagadougou. Urea, creatinine, uric acid, and serum proteins were measured on the ARCHITECT C4000 equipment (ABOTT®), while the separating of the different protein fractions was performed on the Helena SAS 3 & 4 automated system. Results: A total of 96 individuals were included in the study. Protein levels were on average higher in controls (75.19 ± 6.56 g/L) than in hemodialysis patients (71.44 ± 12.33 g/L). Low blood albumin was significantly associated with the CRF hemodialysis groups compared to controls (p < 0.000). In terms of globin fractions, a significant increase in alpha-globulin 1, alpha-globulin 2 and gamma-globulin was present in the CRF hemodialysis group compared to controls (p < 0.000); while beta-globulin was on average lower in the CRF hemodialysis group compared to controls without significant difference (p = 0.509). Analysis of the electrophoretic profiles identified 57.17% polyclonal hypergammaglobulinaemia, 33.33% inflammatory profile, 10.42% undernutrition profile and 2.08% nephrotic syndrome in the CRF hemodialysis group. Conclusion: Serum protein electrophoresis is rapidly feasible and low cost. In hemodialysis CKD patients, it can be used to guide therapeutic management and predict morbidity and mortality related to variations in the various protein fractions.

Impact of the COVID-19 pandemic on blood transfusion systems: International review and the Moroccan blood transfusion system experience

Introduction: Transfusion systems worldwide have had to face many challenges against the emergence or the re-emergence of numerous infectious diseases. Some of those viruses have posed significant impacts on blood transfusion activities. Several scientific and transfusion experts consider the current COVID-19 pandemic to present a potential risk of reducing and compromising the supply of blood products. Blood establishments had to activate their emergency plans and to propose appropriate response measures. Method: It is an international review where we used key terms search strategy to identify necessary information about: (i) the impact of some previous emergent viruses on the availability and the safety of blood products and (ii) the impact of the current COVID-19 pandemic on the blood transfusion activities worldwide. Additionally, we presented the impact of the COVID-19 pandemic on the Moroccan transfusion system activities and the measures established by the Moroccan National Centre of Blood Transfusion and Hematology (MNCBTH) to ensure management of this health crisis on the availability and the safety of blood products in Morocco. Results: Viruses like Zika, Influenza A (H1N1), Chikungunya, SARS-CoV, MERS-CoV, and Ebola have been of great concern in terms of virulence, modes of transmission, and impact on blood transfusion activities. The COVID-19 pandemic has impacted the availability of blood products in blood establishments worldwide. In Morocco, the COVID-19 pandemic affected blood collections and caused a significant decrease in the number of blood donors nationally. Data provided from all regional blood transfusion centers and blood banks in Morocco show that the total number of blood donations made in 2020 was 297,841 blood donations nationally compared to 334,510 blood donations made in 2019, with a decrease of 36,669 blood donations. The number of LBP produced in 2020 was 455,805 units compared to 695,974 units produced in 2019, which corresponds to a reduction of 57,654 units. The number of Labile Blood Products (LBP) delivered in 2020 is 455,805 units against 451,736 delivered in 2019, with an increase of 4069 units. The pandemic impacted other activities of the blood transfusion system in Morocco like continuing education programs, meeting activities, technical missions, and the Moroccan plasma removal for the fractionation. Conclusion: The COVID-19 pandemic has had a significant impact on blood transfusion activities worldwide. The MNCBTH has expressed continued adaptability to ensure proper management of the impact of the COVID-19 pandemic on the availability and safety of blood products in Morocco.

Effect of SARS-CoV-2 pandemic on blood product usage at the University of Pécs

The impact of COVID-19 pandemic on patient care is pronounced also in Hungary. Blood supply was hindered by the reduction of public blood donation events, the reduced willingness to donate, and the difficult predictability of blood product demand as a result of the epidemiological regulations. The wider application of Patient Blood Management guidelines in the medical practice will promote optimal blood product utilization by avoiding transfusions where possible. The aim of our study was to assess the changes in the usage of blood products in the first five months of 2020 at the Clinical Center of the University of Pécs, Janus Pannonius Clinical Building. In the period following the epidemiological measures, we found reduction in the number of hospitalized patients (34.08%), in the number of patients requiring transfusion (39.69%) and in the number of red blood cell products used (46.41%). The number of transfused red blood cell concentrates per patient was also significantly reduced (from 2.61 to 1.97) in this period. The number of transfused fresh frozen plasma units and platelet concentrates also decreased by approximately 30%. After the implementation of the strict restrictions, despite the difficulties, it was possible to provide patients with sufficient blood products. Due to the efforts of both the Regional Blood Transfusion Center of Pécs of the Hungarian National Blood Transfusion Service and of the clinicians, a new balance was established between the demand and the supply of blood products, which provided adequate care for the necessary transfusions. Orv Hetil. 2021; 162(43): 1717-1723.

Seroprevalence and trends of transfusion transmissible infections among retrospective blood donors in Western Azerbaijan Regional Blood Transfusion Center, Iran: A ten-years evaluation

Transfusion transmissible infections (TTIs) have been a public health challenge for the accessibility, quality and safety of blood transfusion. The present study aimed to consider the prevalence and the trends of hepatitis B virus (HBV), hepatitis C virus (HCV), Human T-cell leukemia virus type 1 (HTLV-1), human immunodeficiency virus (HIV) and syphilis across the ten years among retrospective blood donors. A retrospective investigation of blood donors’ data covering the period from 22 May 2009 to 22 May 2019 was done. Data was accumulated and analyzed from Blood Transfusion Center records, pertaining to all donors who were screened for various TTIs using respective immunological techniques. Out of the 682,171 screened donors in the 2009–2019 study period, 2470 (0.36 %) were infected with at least one infectious agent. The overall prevalence of HBV, HCV, HTLV-1, HIV and syphilis were 1700 (0.25 %), 184 (0.027 %), 335 (0.05 %), 4 (0.0.05 %) and 247 (0.036 %), respectively. The study showed male dominated donor pool (96.79 %) with higher prevalence (0.34 %) of TTIs compared to female donors (0.02 %) with 3.21 % population. Despite the low prevalence of TTIs in our study, HBV, HCV, syphilis and HIV have remained a big threat to safe blood transfusion in Iran. Strict adherence to selection criteria, algorithm of donor screening, use of highly sensitive and specific methods for detection of TTIs, regular consultation and health education programs, prevention and sanitization strategies to reduce the risk of TTIs are recommended to reduce the risk of TTIs and ensure the safety of blood transfusion for recipient.

Risk of hepatitis-E virus infections among blood donors in a regional blood transfusion centre in western India.

Hepatitis-E virus (HEV) is an emerging infectious threat to blood safety. The enormity of the transmission of HEV and its clinical consequence are issues currently under debate. This study aimed to evaluate the prevalence of HEV-RNA in blood donors in western India. We screened 13 050 blood donors for HEV using HEV-RNA screening of 10 mini-pools using RealStar HEV RT-PCR Kit (95% limit of detection (LOD): 4.7IU/ml). Furthermore, all HEV-RNA-positive donors were investigated for the presence of IgM/IgG antibody along with liver function tests. Of the 13 050 blood donations, 7 (0.53%) were found to be HEV-RNA positive, and the prevalence of HEV nucleic acid testing yield cases among blood donors was 1 in 1864. All seven HEV-RNA-positive samples were tested with anti-HEV IgM and anti-HEV IgG antibodies; this resulted in two (28.5%) positive anti-HEV IgM and two (28.5%) positive anti-HEV IgG antibodies. Hepatic activity was measured, with two of seven HEV-RNA-positive donors demonstrating abnormal serum glutamic oxaloacetic transaminase (SGOT) andserum glutamic pyruvic transaminase (SGPT). Two HEV-RNA-positive blood donors who had abnormal SGOT and SGPT were found to have a high HEV viral load. Furthermore, we were able to follow up two HEV-RNA donors, and both were HEV-RNA positive and had anti-HEV IgM and anti-HEV IgG antibodies; moreover, their liver function tests were also abnormal. One of the HEV-RNA donors with high viral load did show hepatitis-E-like virus on electron microscopy. Our studies indicate that there is a significant risk of blood-borne transmission of HEV. This finding may help to provide a direction towards the safety of blood transfusions in clinical settings in countries like India, which fall under the endemic category for HEV infection.

Factors Associated with Antigen HBs Seroconversion among Blood Donors in Ouagadougou from 2008 to 2017

Introduction: The risk of transmission of pathogens such as hepatitis B virus threatens the safety of transfused patients especially in high endemic areas. The aim of this study was to determine the incidence and factors associated with hepatitis B virus surface antigen (HBsAg) seroconversion in blood donors at the Regional Blood Transfusion Centre of Ouagadougou. Methods: A retrospective cohort study of voluntary non-remunerated blood donors (VNRBD), was conducted from 2008 to 2017. Data on HBsAg seroconversion were collected. The Kaplan-Meier method and the Log-Rank test were used to estimate the survival curves. Cox’s regression identified the factors associated with this seroconversion. Results: Of 23,494 donors, 559 had HBsAg seroconversion. The number of donor years was 58,637.50 and the HBV incidence rate was 9.53 per 1000 donor years. The median seroconversion time was 75.73 months with extremes of 2.7 months and 107.12 months. The risk of seroconversion was 1.30 times higher among donors aged 21 to 24 years old (p = 0.007) and 2.49 times higher among those over 24 years old (p < 0.0001) than among donors under 21 years old. Female donors were 1.11 times more likely to seroconvert than male donors (p = 0.33). Donor residence was not significantly associated with HBsAg seroconversion (Hazard ratio = 1.12; p = 0.36). The risk of seroconversion decreased significantly with the number of blood donations (Hazard ratio = 0.58; p = 0.006). Conclusion: The incidence of HBsAg remains high among blood donors, which could have a negative impact on transfusion safety. The age of the blood donor was significantly associated to AgHBs seroconversion.

Vox Sanguinis International Forum on Hospital Transfusion Services' Response to COVID‐19: Responses

Question 1Demographics:a. Beer Yaakov, Israel.b. Large academic medical center.c. 956 beds.d. 9034 RBC units issued in 2019, approximately 9000.e. 4831 confirmed SARS‐CoV‐2 cases and 17 deaths (March 31, 2020, 12:40 pm, data from the Israeli Ministry of Health).f. 9,136,000 inhabitants.g. The spread of SARS‐CoV‐2 in Israel is still increasing, but as of yesterday the rate of increase is declining sharply (from almost 30% of samples tested per day at the peak to 12% yesterday).

Retrospective analysis of selected aspects of public blood transfusion service as a starting point for assessment of the status of transfusion medicine in Poland Part 1: Demographic characteristics of the donor population reporting for blood donation

Background: The ongoing demographic changes in Poland affect the number of donors and donations with direct impact on provision of blood and blood components for transfusion. With predicted population-decline, the number of potential donors is likely to decrease while the demand for blood is bound to increase as more people will require blood therapy. The structure of the Polish donor population reporting for blood donation is not uniform, moreover it has undergone additional changes within the study period. So it seems justified to perform in-depth analysis of the dynamics of changes in the number and structure of donor group as well as determine the direction and intensity of these changes in spatial and temporal terms. Identification of the possible causes of change is also important. Aim: presentation of the structure characteristics of the donor group who reported at the Polish regional blood transfusion centers (RBTCs) in the period 2005–2017 with the intention of donating blood/ blood components. Materials and methods: Analyses of available data-sets — annual reports from 21 Polish RBTCs forwarded to the IHTM. The following tools were used for statistical analysis: Microsoft Office: Access and Excel, Microsoft Power Business Intelligence (Power BI) software and STATISTICA version 13.3 software (TIBCO Software Inc.). Results: In 2005–2017 the total number of donors amounted to 8 691 611 including 2 542 621 (29.3%) women and 6 148 990 (70.7%) men. Voluntary non-remunerated donors were estimated at 8 684 069 (99.9%). The average annual number of donors per RBTC was 31 837 and included 31 809 voluntary non-remunerated donors; 22 524 men and 9314 women. Countrywide, the highest number was reported for the period 2011–2013; 701 882 (8.08%), 707 578 (8.14%) and 706 246 (8.13%) for respective years and for the period 2015–2016 the numbers were 718 887 (8.27%) and 706 476 (8.13%) respectively. The highest number for the period was reported by 5 RBTCs: Warsaw (951 068 — 10.94%), Katowice (748 841; 8.62%), Poznan (702 087; 8.08%), Krakow (651 057; 7.49%) and Wroclaw (556 357; 6.40%). In the number of 2 352 099 donors who have recently reported for blood donation at the RBTCs the 25–44 age group was the largest (48%). The least numerous was the 45–65 age group — 548 885 (ca. 11%). There were 2 030 692 donors in the 18–24 age category ( > 41% of the total donor-population).Trend-analysis demonstrated an upward tendency for the category of 25–44 age donors and a downward one for the 18–24 age category. No explicit trend was observed for the 45–65 age group. Conclusion: The number of blood donations in Poland has recently reached the limit of approximately 1 200 000 donations per year. To exceed this limit will be no easy task. All efforts must therefore be focused on promoting people’s willingness to donate blood. The analysis indicates a falling tendency for the 18–24 age group and a rising one for higher age groups, which only raises concern for the future. The priority is therefore to motivate people of all agegroups to donate blood and become multiple donors with special emphasis however on the very young people as they are the potential source for many years to come. Promotion of voluntary non-remunerated blood-donation among children is equally important; in several years’ time transfusion medicine will depend on their willingness to donate blood.

Red cell alloantibodies in beta-thalassaemia major patients' blood referring to the regional blood transfusion center of Tehran, Iran.

Introduction: Thalassemia is associated with a genetic decline in the rate of synthesis of one or more types of natural hemoglobin polypeptide chains. One of the major complications in thalassemia patients is alloimmunization, which is antibody production by the patient against transfused red blood cells (RBCs). These RBCs are unknown by the recipient and the formed antibodies against them are called alloantibodies. This study aimed to evaluate the frequency of alloantibodies against RBCs in beta-thalassemia patients referred to Tehran Regional Blood Transfusion Center. Methods: In this study, antibody screening tests (Dia-cell I, II, and III) were performed on 184 thalassemia patients. An identification test by the Dia panel consisting of 11 different O RBCs groups to examine sera with Dia cells (I, II, or III) was performed. Results: In our study, males and females patients comprised 66 (35.87%) and 118 (64.13%), respectively, of whom 116 (63%) had alloimmunization. In addition, 68 thalassemia subjects (37%) lacked alloantibodies. Among 184 patients with beta-thalassemia major, anti-K (Kell system), anti-D, and anti-E (Rhesus system) had the most abundant alloantibody variants with an incidence of 24 (13%), 11 (5.98%), and 10 (5.4%), respectively. Conclusion: Before RBC transfusion, regular RBC antigen phenotypes, as well as problem-solving of alloantibody production by receiving compatible blood for Kell and RH subgroups, are suggested for all cases of transfusion-derived thalassemia.

Postulating a positive predictive value for HIV, HBV, and HCV screening tests using electrochemiluminescent assay by comparing with ID-NAT results

Background: In India, blood units reactive by the initial screening assays are discarded. A significant number of these are falsely positive, leading to wastage of precious blood. Also of importance is the dilemma created when it comes to donor disclosure. Hence, it is important to evaluate the positive predictive value (PPV) of the initial screening assay to identify false-positive screening results and implement a more balanced algorithm for donor disclosure and counseling. The study was undertaken with an objective of comparing signal-to-cutoff ratio (S/Co) of positive results in HBV, HCV, and HIV screening of electrochemiluminescent (ECI) assay with the results of ID-NAT so as to predict a S/Co ratio of indicative of true positives. Methods: The retrospective study was conducted in the transfusion-transmissible infection Laboratory in a Regional Blood Transfusion Centre in South India. Consecutive blood donors from January 2015 to December 2019 were evaluated simultaneously for HBV, HCV, and HIV by ECI (Vitros 3600, Ortho Clinical Diagnostics) and ID-NAT (Procleix Panther System by Grifols), and the positive results either by one or both were analyzed. Results: A total of 163,596 voluntary donor samples were evaluated. In case of HBV, a S/Co ratio of 1000 predicts a true positive more than 94% of the time. In case of HCV, a S/Co ratio of 8 predicts a true positive more than 95% of the time. Finally, a S/Co ratio of 30 predicts a true positive as well as true negative 100% of the time in case of HIV. Conclusions: It is challenging to propose a standard S/Co ratio because the performance of each assay varies across laboratories. However, the study throws light on the role of the S/Co ratio in reducing the perplexity during donor notification.

Prevalence of sickle cell trait in blood donors at the regional blood transfusion center in the Haute Matsiatra Region, Madagascar

Introductionle trait drépanocytaire correspond à la forme hétérozygote de la drépanocytose. Les porteurs du trait drépanocytaire sont capables de synthétiser de l´hémoglobine A normale et de l´hémoglobine S. Cette affection est cliniquement inapparente de telle sorte que des porteurs du trait drépanocytaire, ignorant leurs statuts génétiques, peuvent se retrouver parmi les donneurs de sang. Cette situation peut avoir des conséquences sévères sur leurs propres états de santé ainsi qu´aux receveurs, particulièrement si ces derniers sont drépanocytaires. L´objectif de notre étude est de déterminer la prévalence du trait drépanocytaire chez les donneurs de sang.Méthodesnous avons réalisé une étude prospective descriptive sur 4 mois (de janvier à mai 2017) au Centre Régional de Transfusion Sanguine (CRTS) Haute Matsiatra. Tous les donneurs ont été dépistés par test d´Emmel et confirmation des cas positifs par électrophorèse de l´hémoglobine.Résultatsnous avons recruté 427 donneurs dont 332 hommes et 95 femmes avec un sex-ratio de 3,4. L´âge moyen des donneurs était de 32,72 ans allant de 18 à 64 ans. Le test d´Emmel s´est révélé positif chez 5 donneurs (1,17%), tous confirmés de génotype AS à l´électrophorèse de l´hémoglobine.Conclusionles résultats de cette étude révèlent l´existence de porteurs de trait drépanocytaire parmi les donneurs de sang du CRTS dont la plupart ignore leur statut drépanocytaire avant le don de sang. Afin d´assurer la sécurité transfusionnelle et la qualité des produits sanguins, le dépistage de la drépanocytose chez les donneurs de sang est désormais une question pertinente et d´actualité.

Prevalence and associated risk factors of transfusion transmissible infections among blood donors at Regional Blood Transfusion Center Nakuru and Tenwek Mission Hospital, Kenya.

IntroductionUnsafe transfusion practices can put millions of people at risk of Transfusion Transmissible Infections (TTIs). In Kenya the current blood transfusion scheme involves screening of blood for HIV, Hepatitis B virus (HBV), Hepatitis C virus (HCV) and syphilis. Malaria is also a blood-borne disease which is not currently screened for. In Kenya blood donor selection criteria were reviewed in 2009. Regular review of effectiveness of donor selection criteria can help reduce TTIs prevalence amongst donors and thus make the blood supply safer.MethodsA cross sectional study was conducted between November 2011 to January 2012 among 594 blood donors in the Regional Blood Transfusion Center Nakuru and Tenwek Mission Hospital. Socio-demographic characteristics and associated risk factors were collected using a standard blood transfusion service questionnaire. Donors were obtained through systematic sampling. Each donor sample was screened, for HIV-1 and HIV-2, HBV, HCV, syphilis and malaria parasites.ResultsThe overall prevalence of TTIs was 14.1%, which ranged from 0.7% for malaria to 5.6% for HBsAg. Blood donors who were married (P=0.0057), had non-formal or just primary education (P=0.0262), had multiple sexual partners (P=0.0144) and in informal occupation (P=0.0176) were at higher risk of HIV positivity. History of blood transfusion/blood products (P=0.0055), being married (P=0.0053) were high risk factors associated with positive syphilis. Being male (P=0.0479) was a high risk factor to HBV infection.ConclusionThe prevalence of TTIs indicates a need to review the questionnaire and apply it strictly for donor selection. The 0.7% prevalence of malaria, poses a serious health risk to non-immune recipients of transfusion. Malaria should be included among mandatory TTI tests in Kenya.

Seroprevalence of transfusion transmitted infections among blood donors in Gash Barka Zonal Blood Transfusion Center, Barentu, Eritrea, 2014 through 2017

BackgroundTransfusion-transmissible infections pose a major health risk in developing countries, including Eritrea. In the present study, we sought to determine the prevalence of specific transfusion transmitted infections (TTIs) and the associated risk factors among blood donors at a newly established regional blood transfusion center in Barentu, Eritrea.MethodsThe seroprevalence of markers for specific TTIs by sex, age, educational status, residence, occupation, and donor type was evaluated for donors who donated blood between July 2014 and April 2017. The relationship between TTIs and the stated factors was evaluated using the Pearson Chi-square test/Fishers exact test. Adjusted and unadjusted binary logistic regression models were employed to estimate the odds ratio (OR) and 95% confidence interval (CI) for the occurrence of TTIs. A two-sided p-value < 0.05 was considered statistically significant.ResultA total of 1939 donors were included in this study. Majority of the donors were males (88.2%), urban residents (68.8%), greater than 25 years of age (67%), and family replacement blood donors (FRBD) (59.7%). Two hundred and fifty (12.9%) donors were infected by at least one TTI. The cumulative seroprevalence of Human immunodeficiency virus, Hepatitis B virus, Hepatitis C virus and syphilis were 16 (0.8%), 97 (5%), 13 (0.7%) and 140 (7.2%), respectively. Out of the total 266 infected donors, the prevalence of co-infection was 16 (0.8%). In the adjusted model, the OR and 95% CI for the seropositivity for any TTI associated with age, no formal education, elementary school educational level, and junior school educational level were 1.02 (95% CI: 1.01–1.04), 4.4 (95% CI: 2.58–7.49), 2.67 (95% CI: 1.49–4.80), and 2.00 (95% CI: 1.14–3.52), respectively. In addition, blood from FRBD had an increased likelihood of contamination with at least one TTI, with an OR (95% CI) of 1.56 (1.10–2.21).ConclusionThe prevalence of transfusion-transmissible infections is relatively high. In particular, specific groups in the population appear to be disproportionally affected. Therefore, targeted sensitization campaigns should be implemented in the future.

ASSESSING NUCLEIC ACID TESTING VERSUS ELIZA FOR BLOOD VIRUSES DETECTION IN SOME BLOOD BANKS

INTRODUCTION: The goal of any transfusion service is to provide adequate and safe blood and blood products that meet the needs of patients. Transfusion-transmissible viral infections, such as hepatitis C virus (HCV), hepatitis B virus (HBV), and human immunodeficiency virus (HIV), remain a major public health problem in developing countries. Nucleic acid testing (NAT) is a molecular technique for screening blood donations to reduce the risk of transfusion transmitted infections (TTIs) in the recipients, thus providing an additional layer of blood safety. AIM OF THE WORK: To assess the importance of implementing NAT assay to detect donors during window period which are not detected with Enzyme-linked immunoassay (ELISA). SUBJECTS AND METHODS: This cross sectional study was conducted at the Egyptian Abbassia regional Blood Transfusion center (ARBTC) at Abbassia, Cairo. Blood donation collected from 10000 voluntary donors from January 2016 to June 2016 and tested with both ID NAT and ELISA assays for HBV, HCV and HIV. RESULTS: NAT testing has the potential to detect viral nucleic acids of HIV 1-2, HBV, and HCV earlier than current screening methods. CONCLUSION: The implementation of NAT screening for three viruses has improved blood safety and reduced transfusion-transmitted infections.

Assessment of the Prevalence of Chlamydia trachomatis Infection in Donated Blood at Regional Blood Transfusion Centre, Eldoret, Kenya

Assessment of the Prevalence of Chlamydia trachomatis Infection in Donated Blood at Regional Blood Transfusion Centre, Eldoret, Kenya

Residual risk of HIV, HCV, and HBV transmission by blood transfusion between 2015 and 2017 at the Regional Blood Transfusion Center of Ouagadougou, Burkina Faso.

IntroductionIn sub-Saharan Africa, the high endemicity of blood-borne infections is a serious threat to transfusion safety. In order to improve transfusion safety, Burkina Faso has undertaken in recent years a reorganization of its blood-transfusion system through the creation of a National Blood Transfusion Center, which is the only blood operator in the whole country. This study aimed to estimate the residual risk of transmission of HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) by blood transfusion at the Regional Blood Transfusion Center (RBTC) of Ouagadougou.MethodsThis was a retrospective study conducted at the RBTC of Ouagadougou between 2015 and 2017. Prevalence of infectious markers was calculated for first-time donors and incidence rates calculated for repeat donors who had made at least two donations of blood over the study period. Residual risks were estimated for the three viruses (HIV, HBV, and HCV) by multiplying the incidence rate per 100,000 person-years by the respective durations of serological windows.ResultsBetween 2015 and 2017, of a total of 84,299 blood donors, 68,391 (81.13%) were first-time donors compared to 15,908 (18.87%) repeat donors. The seroprevalence of HBV (8.56%) was twice that of HCV (4.40%) and fourfold that of HIV (1.80%). Incidence rates were 1,215, 2,601, and 1,599 per 100,000 donations for HIV, HCV, and HBV, respectively. In contrast, the estimated residual risk for HCV (1 in 213 donations) was double that of HBV (1 in 408 donations) and four times that of HIV (1 in 1,366).ConclusionThe residual risk of transmission of these viruses by blood transfusion remains high in repeat donors. An effective donor-retention and education policy could help to reduce this residual risk.

Critical audit of fresh frozen plasma transfusion practices in obstetric and gynecology departments in a tertiary care hospital – Where and what needs to be improved?

Introduction: Fresh frozen plasma (FFP) prepared from whole blood contains plasma proteins and all the coagulation factors including factor V and factor VIII. Many FFP transfusion guidelines have been published till now. However, the administration is inappropriate without any scientific basis or clinical indication in many hospital settings. Aims and Objectives: A retrospective study was carried out between February 2016 and August 2016 in the regional blood transfusion center of our institution to assess the appropriate usage of FFP in obstetrics and Gynecology. It was done using the FFP transfusion guidelines based on the British Committee for Standards in Hematology and College of American Pathologists. Materials and Methods: Blood bank requisition forms received from patients of obstetrics and gynecology department during this period were screened. Indications for transfusion requests were studied and further divided into appropriate and inappropriate requests. Results: A total of 901 units of FFP were issued to 250 patients during this period. Appropriate usage of FFP was found in 67% and inappropriate usage in 33% of the 250 patients evaluated. Bleeding related to surgery with deranged coagulation profile constituted the most common appropriate indication for FFP infusion, and severe anemia was the most inappropriate indication for FFP use. Conclusion: The usage of FFP requires a proper understanding and knowledge about the appropriate and inappropriate usages. It also involves training and supervising the medical staff at regular intervals. Computerized audit programs are required to do a prospective monitoring of the FFP issue and usage in any clinical setting. Further studies are required on the usage of FFP specifically in obstetric and gynecology patients to improve the utilization of this precious blood product.

An extensive study: to assess the changing trends in prevalence and development of TTIs in non-remunerated blood donors at a tertiary care teaching hospital in Central India

Background: Transfusion transmitted infections (TTI) are a major challenge to the transfusion services all over the world. The problem of TTIs is directly proportionate to the prevalence of the infection in the blood donor community which represents the general population. The purpose of this study is to analyze the status of Transfusion transmitted infections among seemingly healthy donors, targeting the non-remunerated blood donors (voluntary and replacement) during the period 2009- 2017. Material and method: A total of 84,975 blood donors were screened for seropositivity of HBsAg, anti-HCV, HIV, VDRL and malaria antigen at Regional blood transfusion center, in central India. Result: Out of 84,975 donations, 1906 (2.24%) were sero-reactive for five blood transmitted infections. Among these, prevalence of HIV was 0.067% (57 donors), seroprevalence of HBsAg was 1.39% (1184 donors), HCV showed 0.068% (58 donors), VDRL showed 0.66% (564 donors) and malaria had 0.05% prevalence (43 donors). Conclusion: HBV is the most common infection among voluntary blood donors, followed by Syphilis. Replacement donors have higher prevalence of TTIs in overall donor population. A change to voluntary blood transfusion service would reduce the chances of post transfusion infections.

Comparative evaluation of bivalent malaria rapiddiagnostic tests versus traditional microscopy method in assessment of malaria in blood donors at a tertiary care teaching hospital and regional blood transfusion centre in central India

Background: Global malaria control efforts are based on 2 broad components: vector control and improved diagnosis and treatment of patients with clinical malaria. Until recently, conventional diagnosis of malaria has been based on either clinical diagnosis or use of microscopic examination of peripheral blood smears. The microscopic detection of blood though considered the gold standard for malaria diagnosis, it is quite laborious and require adequate technical skill and man power. This had urged the development of other microscopic malarial and rapid detection test based on the detection of malarial parasite antigen in the blood. The purpose of this study is to evaluate results of Rapid diagnostic tests for malaria and to corroborate the results with microscopy. Material and Method: This study targeted 10,310 units of donor blood, which were screened for malaria by RDT during the period of February, 2017 to April, 2018 at Tertiary Care Teaching Hospital and Blood Transfusion Centre, R D Gardi Medical College, Ujjain. Peripheral smears were analyzed to confirm the malaria parasite. Result: Nineteen (0.18%) donors were found to be malaria antigen positive, of which only three (15.8%) were confirmed by microscopy. None of the donor had given a history of fever/malaria during pre-donation screening. Seasonal variations were observed. Conclusion: Although RDT is an important tool for malaria testing in rural settings, we suggest the diagnosis must be confirmed with microscopy method. RDTs can be an important tool for malaria testing, peripheral smear microscopy continues to be the gold standard diagnostic test for malaria diagnosis.RDT can be an important tool for malaria testing, peripheral smear microscopy continues to be the gold standard diagnostic test for malaria diagnosis.

The Prevalence of Transfusion-Transmitted Infections (TTIs) and Distribution Pattern of ABO Rh Blood Group in Blood Donors and Possible Correlation of TTIs with ABO and Rh Blood Groups – A Study at RBTC (North-West) Delhi

Hepatitis B, Hepatitis C and HIV infections represent global health problems of significant magnitude. There are studies and hypothesis which suggest that genetic predispositions like ABO and Rh blood group may affect occurrence of these diseases. The aim of this study was to find the prevalence of ABO blood groups, seroprevalence of hepatitis B, hepatitis C, HIV, syphilis, and malaria infections in healthy blood donors in our center, and to determine any association between different blood groups and seroreactivity. Blood donors are ideal for this purpose, as all donors are routinely subjected to ABO blood group phenotyping and screening for all these infective markers. This was a retrospective cross sectional study conducted at Regional Blood Transfusion Center at Dr. BSA Hospital for the years 2016 and 2017. All the donor samples were mandatorily tested for HBsAg, HIV 1&2 Ag-Ab and 2 Ag-A band HCV Ag-Ab using fourth-generation kits. TPHA method was used to test for syphilis. Malaria was tested using rapid-pan malaria card. Blood group was determined by forward and reverse grouping of donor sample using gel card method. Results of total 21,876 donors registered in the year 2016 and 2017 were analyzed. Total 320 (1.462%) samples were found to be reactive for HBsAg, 62 (0.283%) samples were found reactive for HCV and 47 (0.215%) samples were found reactive for HIV. 0.027% samples tested reactive for syphilis. Group-wise seroreactivity was also analyzed and it was found that the highest percentage of HBsAg and HCV reactivity was found in O positive donors and highest percentage of HIV reactivity was found in A-positive donors. Lowest seroreactivity amongst Rh-positive donors was found in AB-positive donors. Amongst Rh-negative donors, highest seroreactivity for HBsAg and HCV was found in B-negative donors. O-negative, AB-negative and A-negative showed no seroreactivity for either HCV, HIV or syphilis infection. All donors tested negative for malaria.