Risk Of Transfusion-transmissible Infections Research Articles

Exploring the determinants of risk behavior for transfusion transmissible infections among first-time blood donors in Mandalay General Hospital, Myanmar.

Blood donation is vital to healthcare, but it must be kept safe by mitigating the risk of transfusion transmissible infections (TTIs). The objective of this study was to investigate the factors that influence risk behavior for transfusion transmissible infections among first-time blood donors at Mandalay General Hospital, Myanmar. This study utilized a cross-sectional study design using secondary data. Mandalay city and Mandalay Blood Bank in Mandalay General Hospital were purposely selected and a total of 406 first-time blood donors participated. A structured questionnaire administered by an interviewer was used. The questionnaire contained background characteristics, knowledge on TTIs, attitude toward TTIs, and TTIs risk behaviors. To examine the determinants (background characteristics, knowledge, and attitude) that affect risk behavior, inferential statistics techniques that included the chi-squared test, bivariable logistic regression, and multivariable logistic regression were applied. A p-value of less than 0.05 signified statistical significance. Among 406 first-time blood donors, 52.9% were under 20 years old, and 53.7% were male. Most had undergraduate education (77.6%), were married (84.2%), and were students (55.7%). Additionally, 76.8% hadn't received the hepatitis B vaccine. Blood groups were distributed as follows: B (40.0%), O (33.8%), A (23.4%), AB (8.9%). About 15.8% showed high knowledge level, and 63.6% had high attitude. Notably, 29.3% exhibited high-risk behavior for TTIs. Age was associated with lower risk behavior (OR = 1.54, 95% CI: 0.99, 2.38, p = 0.049), but lost significance in multivariable regression (p = 0.214). Knowledge on TTIs didn't show significance. However, high attitudes were significantly associated with lower risk behavior (OR = 11.4, 95% CI: 1.25, 103.83, p = 0.017, retained in multivariable regression, p = 0.012). Findings of this study contribute in the development of programs that ensure a safe and reliable blood supply chain. To improve blood safety standards among first-time blood donors, this study highlights the value of targeted education and screening processes, placing particular emphasis on acquiring knowledge and positive attitude toward blood donation and risk behavior.

Qualitative analysis of Canadian blood and plasma donors' views on expanding donor screening eligibility for gay, bisexual, and other men who have sex with men.

In many countries, sexually active gay, bisexual and other men who have sex with men (gbMSM) continue to be screened based on their sex or genderand the sex or gender of their sexual partner. However, there is growing support that screening based on specific sexual behaviors that pose risk of transfusion transmissible infection is a better approach to donor screening. This paper reports results from Phase 1 (qualitative) of a mixed-methods study on Canadian blood and plasma donors' views on expanding eligibility for gbMSM by changing to sexual behavior-based screening. Semistructured interview data with 40 donors (whole blood = 20, plasma = 20; male = 21, female = 18, nonbinary = 1; mean age = 46.2; 10% participation rate) in Canada were analyzed using a thematic approach. All participants, except one, supported the change as they anticipated that at least one of three outcomes would be achieved: increasing blood supply, enhancing equity, and improving or maintaining the safety of blood supply. One donor who was more skeptical of the change questioned the scientific evidence for the change and indicated mistrust of state institutions. The discussion considers implications for blood operators' communication strategies that can be used to reduce donor discomfort with the changes to donor screening. In a nonrandom, purposive sample of 40 Canadian blood and plasma donors, most participants held favorable views regarding expanding the eligibility of gbMSM donors based on sexual risk behavior. Understanding donors' views on increasing eligibility may inform Canadian Blood Services and other blood operators as they develop their communications plans.

The impact of pre-donation viral markers screening of new blood donors on blood safety.

The risk of transfusion-transmissible infections (TTIs) remains a concern in transfusion medicine. Since the rate of infection among first-time blood donors is higher than repeated donors, strategies to enhance blood safety can focus on new donors. The aim of the study was to investigate the effect of pre-donation viral screening of new donors on blood safety. The pre-donation screening of new donors was implemented in the Kurdistan blood center. In this program, new donors who met the blood donation criteria were informed about the program and only a blood sample was donated for HBs Ag, HCV Ab, and HIV Ab testing. New donors with negative results were invited to donate blood after 12weeks. A unit of blood was collected from eligible returned donors. Laboratory tests were performed again using the same methods. Finally, the prevalence of confirmed positive TTI results among donated blood in Kurdistan blood center was compared before and after the establishment of program. During the study, 4,434 new donors were screened for viral markers. A total of 41 new donors (0.92%, 95% CI, 0.007-0.13) had repeatedly reactive results and infection was confirmed in blood sample of 24 donors (0.54%, 95% CI, 0.003-0.008). Overall, 56% of new donors returned for blood donation. Prevalence of confirmed TTIs markers in collected blood units was 0.27% and 0 before and after implementing program, respectively. This study indicated that Pre-donation screening can reduce the risk of TTI transmission by identifying infected donors at the pre-donation phase.

SEROPREVALENCE OF TRANSFUSION TRANSMISSIBLE INFECTIONS IN BLOOD DONORS OF A NEWLY ESTABLISHED TERTIARY CARE TEACHING HOSPITAL NEAR SUNDARBAN REGION OF WEST BENGAL

Objective – To study the socio-demographic profile of blood donors and to determine the seroprevalence of transfusion transmissible infections (TTIs) among them.
 
 Materials and methods – It is a retrospective cross-sectional study for 3 years from January 2020 to December 2022. Records of the blood donors were collected from the blood bank of a tertiary care teaching hospital and were analyzed through epi info7 to find out the seroprevalence of TTIs.
 
 Results – Among the donors majority were male (76.74%) and 1.11% were found to be seropositive for TTIs. Seroprevalence was highest for hepatitis B (0.72%) followed by hepatitis C (0.18%), syphilis (0.13%) and least for human immunodeficiency virus (0.08%); however, no donor was found to be positive for malaria. Seropositivity was highest among the age group of 31-40 years of age (47.12%).
 
 Conclusion – Increase in public awareness regarding voluntary blood donation, meticulous donor screening and regular use of highly sensitive tests are essential to reduce the risk of TTIs.

Transfusion-transmissible infections among blood donors in Bejaia, Algeria: ten years retrospective and comparative study

Introduction: Blood transfusion saves millions of lives year around the world; it is the most important life-saving option for blood recipients. However, this act is not without risks as contaminated blood may be the source of transfusion-transmissible infections (TTI). This is a retrospective and comparative study on the prevalence of acquired human immunodeficiency syndrome, viral hepatitis B, C and syphilis in blood donors from Bejaia province (Algeria). Methodology: This study is designed to estimate the risk of TTIs among blood donors and the demographic associated factors. It was carried out in the serology laboratories of Bejaia blood transfusion center and Khalil Amrane university hospital. Data were collected from the archived results of screening tests for HBV, HCV, HIV and syphilis, mandatory for all blood donations, from January 2010 to December 2019. The association was considered statistically significant at p < 0.05. Results: Among 140,168 donors from Bejaia province, 78,123 represent the urban population and 62,045 the rural population. Over 10 years, results of serological tests revealed a prevalence of 0.077%, 0.083%, 0.102%, and 0.132%, respectively for HIV, HCV, HBV, and Treponema pallidum. Trends of hepatitis B and syphilis were decreasing; however, hepatitis C was increasing. Conclusions: HIV and syphilis prevalence have been variable, with significant peaks in 2013 and 2014, respectively. Globally, the low rates reported in this study confirm the effectiveness of the preventive policy applied by the health authorities. However, among the rural population, special attention is required to stem any resurgence of hepatitis C and syphilis.

PATTERNS OF SEROPREVALENCE FOR TRANSFUSION-TRANSMISSIBLE INFECTIONS AMONG BLOOD DONORS IN A BLOOD CENTRE OF NORTHEAST INDIA

Introduction: Transfusion– Transmissible Infections (TTIs) are the infections resulting from the introduction of a pathogen into a person through blood transfusion. In an attempt to mitigate the inherent risk of TTIs, the demographic information of blood donors including knowledge on local prevalence of infections and its pattern in the donor population is important for formulating recruitment strategies and planning other precautionary measures. Materials & Methods: This cross-sectional study was conducted in the Blood Centre, Jawaharlal Nehru Institute of Medical Sciences, Imphal between January 2019 and December 2022. All donated blood units were tested for the mandatory TTI markers for HIV 1 & 2, Hepatitis B, Hepatitis C, Syphilis and Malarial parasite. The prevalence and patterns of seropositivity for TTIs were studied based on the donor demographic characteristics such as donation type, gender and age group. Results: The overall seroprevalence among blood donors (n=31,563) was 1.79%. The seroprevalence was lower among voluntary donors (1.08%) than the replacement donors (2.10%). Seropositivities among female and male donors were 0.79% and 1.93% respectively. The lowest TTI seropositivity was seen among female voluntary donors (0.59%) and highest among male replacement donors (2.24%). The seroprevalence for specic TTI markers among the blood donors were 0.15% for HIV; 0.57% for HBV; 0.93% for HCV; 0.14% for Syphilis and no donor was found positive for Malaria. The frequency of TTI seropositivity was increased with increase in the age groups of donors in both sexes. There were 9 (0.029%) donors who had co-infection of TTIs. The patterns of TTI markers for co-infections were HCV+HIV=3; HCV+HBV=3; HCV+Syphilis=2 and HIV+ Syphilis=1. Conclusion: The measures to provide safe blood may include collection of blood from the targeted low risk donor population, using more sensitive testing methods, implementing pathogen reduction technologies and other public health measures.

SEROPREVALENCE OF TRANSFUSION TRANSMISSIBLE INFECTIONS AMONG BLOOD DONORS AT A TERTIARY CARE TEACHING HOSPITAL IN AJMER, RAJASTHAN: A 5 YEAR STUDY

Objective: The objective of the study was to study the seroprevalence of TTIs (transfusion transmissible infections) among blood donors from the records (June 2017–May 2022) at blood center, JLN Hospital and associated group of Hospital, Ajmer, Rajasthan. Methods: A cross-sectional study was carried out over a period of 5 years from June 2017 to May 2022. Serum samples were screened for hepatitis B virus (HBV), hepatitis C virus (HCV) (III generation ELISA), antibodies to human immunodeficiency virus (HIV) Type 1 and 2 (IV generation ELISA kits), Syphilis and Malaria parasite using modified Treponema pallidum hemagglutination test and rapid card test, respectively. Results: A total of 75,034 healthy donors were included out of which majority of donors were male (97.4%). The overall seroprevalence of HIV, HBV, HCV, Syphilis, and Malaria were 0.07%, 0.71%, 0.06%, 0.29%, and 0.05%, respectively. Conclusion: Methods to ensure a safety blood supply should be encouraged. The increase in public awareness regarding voluntary blood donation, meticulous donor screening, counseling and use of highly sensitive tests can help in reducing the risk of TTIs.

Personal Freedom and Public Responsibility: Remaining Questions after First Case of HIV Transmission via Blood Transfusion in North Serbia.

The reduction in the risk of transfusion-transmissible infections (including HIV infection) is an essential part of transfusion patient care. Here, we report the first incident of HIV transmission via transfusion in north Serbia due to blood donor dishonesty, and the failure of the laboratory screen tests to detect the presence of HIV particles in his blood. Infected blood products were distributed to two recipients, and HIV infection was confirmed in one. This incident finally led to the implementation of Nucleic Acid Amplification Technology as mandatory testing of blood donors for HIV infection in Serbia and raised many questions related to the responsibility and ethics of all the participants in the blood transfusion supply chain. There is a need for the implementation of modern and non-discriminative laws in Serbia in order to reduce transfusion-transmissible infections. In addition, transfusion institutes in Serbia need to be obliged to pursue the constant upgrade of their diagnostic capacities in order to prevent similar incidents and to provide the best possible care for blood donation recipients.

Correlates of transfusion transmissible infections among patients with sickle cell disease in Nigeria: case-control study

ABSTRACT Transfusion transmissible infections (TTIs) such as Hepatitis B Virus (HBV), Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) are among the most frequent complications in individuals with Sickle Cell Disease (SCD). We investigated factors associated with TTIs in SCD patients and controls in South-west Nigeria. A total of 2,034 participants with or without SCD were recruited in a matched case-control study. HIV, HBV and HCV infections were diagnosed using commercialy available ELISA kits (Biorad, Paris). Samples positive for HIV ELISA were further confirmed using Western blot. Data were analyzed using descriptive statistics, paired/independent t-test and logistic regression at p = .05. Proportion with HBV was higher among those with multiple sexual partners (12.7%), tattoo/body incision (11.8%), and sharing of sharp objects (7.3%), but HIV was only higher among participants with history of tattoo/body incision (1.5%). Prevalence of TTIs was similar among participants with or without transfusion. History of sharing sharp objects (adjusted odds ratios (aOR) = 1.72; 95%CI:1.11–2.66) and tattoo/body incision (aOR = 1.89; 95%CI:1.22–2.94) almost doubled the risk of HBV. TTIs are endemic in the studied area. Certain lifestyles predispose people to TTIs than having blood transfusion. Population-based intervention targeting lifestyle changes may reduce the risk of TTIs in the study area. Abbrveviations AA: Hemoglobin AA; AC: Hemoglobin AC; aOR: adjusted Odds Ratios; AS: Hemoglobin AS; CHOP: Children Outpatient; CI: Confidence Interval; EDTA: Ethylenediamine Tetraacetic Acid; GOP: General Outpatient; HBV: Hepatitis B Virus; HCV: Hepatitis C Virus; HIV: Human Immunodeficiency Virus; HPLC: High Performance Liquid Chromatography; IAMRAT: Advanced Medical Research & Training; IDU: Injection Drug Use; MOP: Medical Outpatient; SC: Hemoglobin SC; SCD: Sickle cell disease; SD: Standard Deviation; SF: Hemoglobin SF; SS: Hemoglobin SS; STDs: Sexually Transmitted Diseases; TTI: Transfusion transmissible infections; UCH: University College Hospital Ibadan; UI: University of Ibadan;

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.

Optimal portfolios of blood safety interventions: test, defer or modify?

A safe supply of blood for transfusion is a critical component of the healthcare system in all countries. Most health systems manage the risk of transfusion-transmissible infections (TTIs) through a portfolio of blood safety interventions. These portfolios must be updated periodically to reflect shifting epidemiological conditions, emerging infectious diseases, and new technologies. However, the number of available blood safety portfolios grows exponentially with the number of available interventions, making it impossible for policymakers to evaluate all feasible portfolios without the assistance of a computer model. We develop a novel optimization model for evaluating blood safety portfolios that enables systematic comparison of all feasible portfolios of deferral, testing, and modification interventions to identify the portfolio that is preferred from a cost-utility perspective. We present structural properties that reduce the state space and required computation time in certain cases, and we develop a linear approximation of the model. We apply the model to retrospectively evaluate U.S. blood safety policies for Zika and West Nile virus for the years 2017, 2018, and 2019, defining donor groups based on season and geography. We leverage structural properties to efficiently find an optimal solution. We find that the optimal portfolio varies geographically, seasonally, and over time. Additionally, we show that for this problem the approximated model yields the same optimal solution as the exact model. Our method enables systematic identification of the optimal blood safety portfolio in any setting and any time period, thereby supporting decision makers in efforts to ensure the safety of the blood supply.

Assessment of the Knowledge, Perception and Practice of Voluntary Blood Donation among Physicians in a Tertiary Health Facility, Uyo, South-South Nigeria.

Provision of safe, affordable and adequate supply of blood and blood products is a daunting public health issue in developing countries. In Nigeria, there is an inadmissibly high dependence on family surrogate and remunerated blood donors which carries an attendant increased risk of transfusion transmissible infections. Physicians represent a potential, stable and sustainable safe donor pool. Assessment of the blood donation practices of these health professionals is essential in engendering effective strategy for sustaining adequate and safe blood supply in the hospitals. To assess the knowledge, attitude and practice of voluntary blood donation among physicians, to identify, recruit and retain potential voluntary blood donors among them and to determine the associations between blood donation and gender, marital status, duration of practice and professional cadre of the physicians. This was a descriptive cross-sectional study carried out at the University of Uyo Teaching Hospital, Uyo. Pre-tested questionnaire were administered to 110 physicians in the tertiary hospital. Majority of the respondents (95.1%) had a good knowledge of the risk of transmission of infections by blood transfusion. The risk of transmission of HIV, HBV, HCV and Syphilis was affirmed by 99.8%, 95.6%, 80.1% and 48.2% respectively. Forty-five(40.9%) physicians had donated blood in the past, with 32 (71.1%) donating less than once a year, 10(22.2%) between 1-3 times a year and 3(6.7%) more than thrice a year. Most (56.9%) donated voluntarily, 34.3% donated for friends and relatives, 5.7% donated in order to know their HIV, HBV and HCV status and 3.1% for financial gratification. There was significant association between blood donation practice and gender but not with marital status, duration of practice and professional cadre of the physicians as P values were 0.002, 0.767, 0.135 and 0.625 respectively. Physicians in the study expressed good knowledge of voluntary blood donation and had a positive attitude towards donation but there were inconsistencies in their practice of blood donation. Thus, regular and rigorous motivational and educational campaign should be intensified among physicians to improve their overall blood donation practice.

Indications for transfusion of blood components

Indications for transfusion of blood components

Prevalence of Transfusion Transmissible Infections in Beta-Thalassemia Major Patients of Pakistan: A Systematic Review

Introduction: β-thalassemia major (TM) is one of the most prevalent inherited hemoglobinopathies in Pakistan. It has one of the highest prevalence of transfusion-dependent TM patients globally, with an estimated greater than 100,000 active cases. Each year, an estimated 5000-9000 new cases of TM are being diagnosed in the country. Blood transfusions (BT) are essential in the management of severe TM; it is critical to have a safe BT to reduce the risk of transfusion transmissible infections (TTIs). Frequent blood transfusions in these patients increase their risk of acquiring TTIs compared to the general population. In this systematic review, we aimed to identify the prevalence of TTIs in transfusion-dependent β -thalassemia major patients in Pakistan. Methods & Material: We performed a systematic literature search to identify studies related to the TTIs and transfusion-related infections in Pakistan from January 1, 2010, to January 31, 2020. The search was conducted using PubMed and PakMediNet (Largest medical database of Pakistan), with initial search retrieved 981 studies. Among these, 166 studies met the inclusion criteria. After further screening by reviewing the articles for relevance and availability of full-length articles, only 14 studies met the final criteria for qualitative synthesis. Results Analysis of 14 studies (n=3786) showed that the seroprevalence of Hepatitis B virus (HBV) of 3.13% (0.66 % to 7.4%) and Hepatitis C virus (HCV) of 26 % (5.56% to 68.2%). There were only two studies reported HIV seroprevalence of 0 % & 0.5% (n=6). The rate of seropositivity for HBV and HCV was directly related to the number of transfusions, higher ferritin levels, and older age groups. There was an increase in the HCV rate with the increasing age of patients. Thalassemia patients who were older than ten years of age had a greater HCV compared to those who were less than ten years of age, i.e., 22% vs. 8.4%, p:0.005, respectively. The mean age was higher in HCV reactive children than non-reactive children. A comparison of HCV in healthy donors vs. thalassemia patients showed a rate of 1.9% vs. 13.1% for T.M. patients. There was HCV infection rate of 74% in the group with greater than 100 BTs compared to 33 % in a group with fewer than 35 BTs. The rate of HCV increased to 75% for the patients who had more than 100 BTs. The majority of the patients were males (51% to 88%). The seroprevalence of TTIs was higher in males than in females (73.4% vs. 26.6%). On average, a single TM patient is exposed to at least 17 different donors annually, requiring 1-2 transfusions every month. The free BT is accessible only in 1 out of 4 thalassemia centers. The majority of patients either need to bring their donors or are dependent on an external source of financial aid as they could not afford the cost of BT treatment. More than half of thalassemia patients (57.2%) need to contact multiple BT centers to search for required blood products. About 42.1% of parents of TM patients did not know about TTIs, whereas 31.6% of them did not know about the bloodborne transmission of HBV and HCV. The majority of parents of TM children had a low income, with 75% of them having income less than 10,000 Pakistani rupees (PKR) per month. The prevalence of TTIs in TM patients was significantly higher (96% vs. 4%) compared to the patients requiring multiple transfusions due to other causes such as leukemia, aplastic anemia, and thrombocytopenia. Conclusion: Our data highlights that the prevalence of transfusion-transmitted infections, especially HCV, is alarmingly higher (26%) in the TM population than in the general population. This is because of a lack of resources, inadequate safety measures, and a fragmented blood transfusion system. These findings warrant the urgent need for better public health measures, safe blood transfusion practices, voluntary remunerated blood-based transfusions, and universal quality-assured donor screening. Without these positive interventions, the current transfusion system can lead to a further worsening of the situation. Large prospective multi-centered clinical trials are required to understand better the high prevalence of TTIs in patients with TM. Disclosures Anwer: Incyte, Seattle Genetics, Acetylon Pharmaceuticals, AbbVie Pharma, Astellas Pharma, Celegene, Millennium Pharmaceuticals.:Honoraria, Research Funding, Speakers Bureau.

Prevalence of Transfusion Transmissible Infections in Beta-Thalassemia Major Patients in Pakistan: A Systemic Review

β-thalassemia major (TM) is one of the most prevalent inherited hemoglobinopathies in Pakistan. It has one of the highest prevalence of transfusion-dependent TM patients globally, with an estimated greater than 100,000 active cases. Blood transfusions (BT) are essential in the management of severe TM; it is critical to have a safe BT to reduce the risk of transfusion transmissible infections (TTIs). Frequent blood transfusions in these patients increase their risk of acquiring TTIs compared to the general population. We performed a systematic literature search to identify studies related to the TTIs and transfusion-related infections in Pakistan from January 1, 2010, to January 31, 2020. The search was conducted using PubMed and PakMediNet, with initial search retrieved 981 studies. Among these, 166 studies met the inclusion criteria, and only 14 studies met the final criteria for qualitative synthesis. Analysis of 14 studies (n = 3786) showed the seroprevalence of hepatitis B virus (HBV) of 3.13% (0.66% to 7.4%) and hepatitis C virus (HCV) of 26% (5.56% to 68.2%). There were only two studies that reported HIV seroprevalence of 0% and 0.5% (n = 6). The rate of seropositivity for HBV and HCV was directly related to the number of transfusions, higher ferritin levels, and older age groups. There was an increase in the HCV rate with the increasing age of patients. Thalassemia patients, who were older than ten years of age, had an HCV rate of 22% compared to only 8.4% in patients younger than ten years of age. A comparison of HCV in healthy donors vs. thalassemia patients showed a rate of 1.9% vs. 13.1% for TM patients. The majority of the patients were males (51% to 88%). The seroprevalence of TTIs was higher in males than in females (73.4% vs. 26.6%). On average, a single TM patient is exposed to at least 17 different donors annually, requiring 1-2 transfusions every month. Our study highlights that the prevalence of transfusion-transmitted infections, especially HCV, is alarmingly higher (26%) in the TM population than in the general population. There is limited data regarding the prevalence of HIV, syphilis, and malaria in this population. This is mainly due to a fragmented system of blood transfusion, weak regulations, and lower rates of voluntary blood donations. These findings warrant better health measures to improve the blood donation system and specialized care for TM patients.

Dental care as a risk factor for transfusion transmissible infections in blood donors: a systematic review and meta-analysis.

The deferral policy for blood donation after dental care is based on the precautionary principle. The aim of this systematic review is to give an overview of the scientific evidence concerning the risk of transfusion transmissible infections (TTIs) after dental care. Four databases were searched: Medline, the Cochrane Library, Embase and Web of Science. Screening was independently performed by two reviewers. The quality of evidence was evaluated using the Grades of Recommendation, Assessment, Development and Evaluation principle. A meta-analysis was performed to assess the association between dental treatment and TTI markers. A total of 22 studies were included. Meta-analysis of 16 studies showed an increased association of TTIs with dental treatment, however with large heterogeneity. Subgroup analysis revealed a significant increased association of hepatitis B virus (HBV) with dental treatment [odds ratio 1.79, 95% confidence interval (1.48; 2.18)]. There was conflicting evidence concerning the risk of hepatitis C virus (HCV). One study could not demonstrate a statistically significant increased association of human T-lymphotropic virus type I with dental treatment. Three studies showed a significant increased association of HCV with tooth extraction [odds ratio 1.48, 95% confidence interval (1.11; 1.97)]. Finally, there is conflicting evidence concerning the risk of HBV or HCV after dental cleaning. One study could not demonstrate an association between HIV and dental cleaning. All evidence is of very low certainty and results cannot be considered precise. Studies of high quality concerning the risk of TTI after dental care in blood donors are scarce. An association of HBV after dental treatment and HCV after tooth extraction was demonstrated but evidence is of very low certainty. The currently identified studies are of too low certainty to make any suggestions regarding the value of deferral or deferral times.

Prevalence of Transfusion Transmissible Infections (HBV, HCV, HIV and Treponema pallidum in Volunteer Blood Donors in Shirajganj District

Blood and its components are essential for life and often required to be transfused in critical health condition. However, such transfusion is reported to be associated with the risk of transfusion transmissible infections (TTIs) with notable pathogens e.g. Hepatitis B virus (HBV), Hepatitis C virus (HCV), Human immunodeficiency virus (HIV) and Treponema pallidum. These pathogens are of major public health concern especially in developing countries like Bangladesh. Increase in the number of TTIs is found to be associated with improper management of safe blood transfusion protocol (SBTP) and unethical practices. This study focuses on the prevalence of such TTIs in volunteers’ blood collected between October and December 2018 from Sakhawath Memorial and Avicina Hospitals in Shirajgong district. Prevalence rate of HIV, HBsAg, HCV and Treponema pallidum were 1.2%, 6.8%, 0.8% and 1.6%, respectively. Among the infected individuals, 75% HIV positive cases were professionals, 70% HCV infected cases wwere from other professional groups and 50% of syphilis infected were homemakers. Male donors showed higher incidence rate of HBV (65%), HCV (72%) and HIV (85%) compared to the female donors. Although the findings of the study showed prevalence of TTIs in volunteer blood donors (VBDs) at an alarming rate, most of the infected individuals were not aware of their infections and potential risk of transmission from them. It is necessary to create awareness among blood donors about possible causes of transmission and prevention of infection . Such initiative from both governmental and non-governmental organizations can help reduce TTIs among VBDs.
 Bangladesh J Microbiol, Volume 36 Number 2 December 2019, pp 105-109

Is sexual risk behaviour associated with an increased risk of transfusion-transmissible infections in blood donors from Western and Pacific countries? A systematic review and meta-analysis.

The donor medical questionnaire is designed to aid blood establishments in supporting a safe blood supply. According to blood donor deferral policies, sexual risk behaviour (SRB) leads to a (temporary) deferral from blood donation. This systematic review aimed to scientifically underpin these policies by identifying the best available evidence on the association between SRB and the risk of transfusion transmissible infections (TTIs). Studies from three databases investigating the link between SRB (excluding men who have sex with men (MSM)) and TTIs (HBV, HCV, HIV, Treponema pallidum) in donors from Western and Pacific countries were obtained and assessed on eligibility by two reviewers independently. The association between SRB and TTIs was expressed by calculating pooled effect measures via meta-analyses. The GRADE methodology (Grades of Recommendation, Assessment, Development and Evaluation) was used to assess the quality of evidence. We identified 3750 references and finally included 15 observational studies. Meta-analyses showed that there is a significant (P<0·05) positive association between the following SRB and HBV and/or HCV infection: having sex with an intravenous drug user (high-certainty evidence), receiving money or goods for sex (moderate-high certainty evidence), having a sex partner with hepatitis/HIV (moderate-certainty evidence) and paid for sex or anal sex (low-certainty evidence). Sexual risk behaviour (including having sex with an intravenous drug user, receiving money or goods for sex or having a sex partner with hepatitis/HIV) is probably associated with an increased risk of HBV/HCV infection in blood donors from Western and Pacific countries.

Screening of Blood Donors for Transfusion Transmitted Infections in Tertiary Care Hospital of Faisalabad

Background: Blood transfusion saves millions of lives worldwide each year and reduces morbidity but at the same time is a source for potentially life threatening transfusion transmissible infections (TTIs). These TTIs are a threat to blood safety. Sensitive screening with advanced technologies reduces the risk of TTIs, but it still remains a major concern. Objective of this study was to determine the frequencies of various ABO blood groups and to screen the TTIs like Hepatitis B (HBV), Hepatitis C (HCV), Human Immunodeficiency Virus (HIV), Syphilis and Malaria among voluntary and replacement blood donors of Faisalabad.&#x0D; Methodology: This cross sectional study was conducted at Aziz Fatimah Hospital Faisalabad, from July 2018 to November 2018. After taking informed consent all replacement and voluntary blood donors were screened for HCV, HBV, HIV, syphilis and malaria.&#x0D; Results: During 5 months of study period, total 1942 patients, of age ranged 18-40 years, were screened for TTIs. All blood donors were male; no female came to donate blood during this duration. Highest percentage of study population were blood group B (36.9%), followed by blood group O (28.1), A (22.2%), and AB (9.2%) respectively. Frequencies and percentages of Rhesus blood groups exhibited the predominance of positive rhesus groups in the study population. Out of total donors, 78 (4%) were infected with HCV, 30 (1.5%) with HBV, 10 (0.5%) with HIV, 19 (1 %) with syphilis and 3(0.20%) were seropositive for Malaria. Therefore, 140 (7.2 %) blood donors out of total were seropositive for various TTIs.&#x0D; Conclusion: This study showed the seroprevalence of transfusion transmitted infections (TTIs) among the blood donors. Highest percentage of blood donors suffered from HCV, followed by HBV, syphilis, HIV and malaria.

Knowledge and attitude towards voluntary blood donation among students from Mumbai University

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Blood is scarce; its demand far outweighs the supply. In addition to limited supply, the issue of safety especially with regard to the risk of transfusion transmissible infection is also an issue of utmost concern especially in the developing countries. Blood transfusion services in India have gained special significance in recent years and forms a vital part of national health care system. Voluntary Non-Remunerated Blood Donation (VNRBD) is the safest of all types of blood donations. One of the potential sources that can be tapped for blood donation is the young and physically fit students from educational institutions across India.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A cross-sectional study was carried out among students from Mumbai University, India during May–June 2017. Two hundred and fifty students were approached to participate in the study of which 201 agreed to participate (males: 104; females: 97). Pretested questionnaire was distributed and collected data was analyzed using IBM SPSS version 23. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; High number of participants agreed about encouraging general public about voluntary blood donation (96%; 193/201), lack of awareness about VBD in general public (82%; 164/201). But not a single participant was able to respond to the knowledge part of the questionnaire with 100% accuracy. Almost all the participants had correct knowledge about blood groups (98%; 196/201) and blood matching need (195/201; 97%).&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Participants showed good attitude but demonstrated poor knowledge about voluntary blood donation. Details about blood donation should be incorporated in the undergraduate curriculum and periodic awareness programs should be organized for students.&lt;/p&gt;