Saudi Blood Donors Research Articles

Seroprevalence of transfusion-transmitted infections among blood donors in Makkah, Saudi Arabia.

Blood donation is vital for healthcare; however, transfusion-transmitted infections (TTIs) pose a serious risk. This study investigated the seroprevalence of TTIs among Saudi blood donors. This retrospective study included male blood donors aged ≥ 18 years who donated blood at Al-Noor Specialist Hospital in Makkah from January 2017 to December 2022. The blood units were screened for hepatitis B surface antigen (HBsAg) and core antibodies (HBc-IgG), hepatitis C antibodies (HCV-Abs), syphilis, HIV-1 antigen/antibody (HIV-1 Ag/Ab), human T-lymphotropic virus 1, 2 (HTLV-1/2), and malaria. There were 40,287 donors with an average age of 44.33 ± 18.12 years, and 62.3% (n = 25103) were Saudis. The overall rate of TTIs seropositivity was 7.4% (n = 2953); HBc-IgG (6.1%; n = 2473) was the most common, followed by HCV-Abs (0.4%; n = 177), and syphilis (0.34%; n = 136). All cases were negative for malaria, whilst HIV and HTLV positive donors were 0.06% (n = 24) and 0.13% (n = 52), respectively. Syphilis was more prevalent among non-Saudis (0.24%; n = 83) than among Saudis (0.1%; n = 53), whereas anti-HBc antibodies seropositivity was significantly higher among Saudi (3.4%; n = 1373) than non-Saudi donors (2.7%; n = 1100). Hepatitis B virus was the most frequently detected bloodborne pathogen, followed by hepatitis C virus and syphilis. Hepatitis B virus was also more prevalent among Saudi donors, whilst expatriates had higher rates of syphilis. Additional prospective multicenter studies are needed to accurately determine the prevalence of TTIs in Saudi Arabia.

Impact of Regular Blood Donation on Body Iron Stores at Saudi Blood Donors

Impact of Regular Blood Donation on Body Iron Stores at Saudi Blood Donors

ABO, Rh, and Kell Blood Group Antigen Frequencies in Blood Donors of Taif City, Saudi Arabia.

The ABO, Rh, and Kell blood group antigens are clinically significant. Knowledge of antigen frequencies is important to assess the risk of alloimmunization and to guide the probability of finding antigen-negative donor blood. Patients that lack such antigens may produce antibodies that may cause transfusion reaction. The frequencies of ABO, Rh, and Kell antigens in Taif city, Saudi Arabia have not yet been determined. This study aims to assess the frequencies of ABO, Rh, and Kell blood group antigens among Saudi donors in Taif city, Saudi Arabia. A retrospective study was conducted on 2,073 Saudi blood donors of both genders from May 2016 to May 2019. The data were collected, and calculations were done to determine the frequencies of ABO, Rh, and Kell blood group antigens. Of the 2,073 donors, the ABO blood groups of the donors were O (53.8%), A (24.9%), B (16.4%), and AB (4.6%). Rh-positive samples were (87.8%) and (12.1%) were Rh-negative. The most common Rh antigen was e (95.8%), followed by the c and C antigens (81.7% and 62.3%, respectively). The lowest Rh antigen frequency was E (31.3%). DCce was the most prevalent phenotype (29.5%). The KEL1 (K) antigen was determined in (22.1%) of the donors. This is the first study conducted in Taif city to assess the frequency of ABO, Rh, and Kell antigens among Saudi blood donors. This study provides the first step to create a regional donor database to obtain negative antigen blood units for patients with unexpected antibodies and to offer compatible bloods for multi-transfused cases by designing red cell panels.

Blood donation in different regions of Saudi Arabia: acceptance and rejection

Background: Regular blood donations are crucial for hospitals to keep a sufficient supply of all blood types on hand. For this study we compared the no of rejected donors to total donors, to compare no of rejected male to female, and to most frequent cause of rejection in six different centers around Saudi Arabia. Methods: This cross-sectional study analyzed data from Saudi donors at six different sites between January and December of 2019. The results of male and female blood donors, as well as rejected donors from the same geographic region, were compared using SPSS analysis. Results: Males were significantly larger than females’ donors and the number of accepted donors was significantly larger than rejected donors (P <0.0001; respectively). Low blood pressure and lack of sleep were the two most prevalent causes of rejection (12 %). Recent travel to malaria area was the second-most common cause of rejection (12%). The Hijama and tattoos (12%) played a role in the refusal. Only 5% of the donors who had convulsions were refused. Conclusion: In conclusion, the vast majority of the Saudi blood donors were men. Finding out the causes of rejection will help in donation process.

Investigation of Dombrock Blood Group Alleles and Genotypes among Saudi Blood Donors in Southwestern Saudi Arabia.

The Dombrock (DO) blood group system has two primary antigens, Doa and Dob, which can cause delayed hemolytic transfusion reactions. The paucity of specific monospecific antibodies can hamper the typing based on these antigens. Thus, blood group genotyping (BGG) was investigated as a possible solution. Sequence-specific primers were designed to target a single nucleotide polymorphism (rs11276) on the ART4 gene encoding the DO*A and DO*B alleles. Blood samples (n = 150) from randomly selected volunteer donors were used. DNA was extracted and resulting PCR products were purified and sequenced. The allelic frequencies of DO*A and DO*B were (n = 122, 40.67%) and (n = 178, 59.33%), respectively. The distributions of DO genotypes were as follows: DO*A/DO*A (n = 20), 13.33%; DO*B/DO*B (n = 48), 32.00%; and DO*A/DO*B (n = 82), 54.67%. In conclusion, this study reports on the allelic frequencies of DO*A and DO*B of the DO blood group system in Jazan Province, Kingdom of Saudi Arabia. Furthermore, this study reports on the prevalence of each genotype, of which DO*A/DO*B was the most abundant. This study contributes significantly to build the current blood donor database in Southwestern Saudi Arabia. Moreover, it may assist in providing safe blood to polytransfused patients and reduce the risk of the red cell alloimmunization.

Prevalence of Rh and K phenotypes among blood donors from different ethnicities in Samtah (Southwestern Region) Saudi Arabia.

Rh and Kell blood group systems are amongst the most important blood group systems; being highly immunogenic after ABO system. The aim of this study was to evaluate the frequencies of Rh antigens, haplotypes and K antigen among blood donors belonging to various ethnicities in Samtah, Jazan, Saudi Arabia. This study was conducted during January 2019 and August 2020 at Samtah General Hospital, Samtah. Records of all blood donors recruited during this period were included for data acquisition. A total of 4977 blood donors' records were reviewed and data were analysed. A total of 3863 donors' results were considered in the final analysis. In comparison to Saudi blood donors, C antigen was less frequent in Sudanese donors (69.7% and 34.0%), the c antigen was less frequent in Indian (79.2% and 59.3%) and Philippine (79.2% and 40.0%) donors and more frequent in Sudanese (79.2% and 97.9%) donors, the E antigen was less frequent in Yemini (27.0% and 19.5%) and the e antigen was more frequent in Yemini (96.7% and 99.2%) donors. The DcE haplotype was less frequent (3.1% and 0.7%) and the ce haplotype was more frequent (4.3% and 7.6%) in Yemini donors. The K antigen was less frequent in Pakistani (11.9% and 4.1%; p = .041) and Indian (11.9% and 1.9%; p = .023) donors. Rh and K antigens showed marked variations in their frequencies among blood donors of different ethnicities. Utilization of blood from various ethnicities warrant extended phenotyping of Rh and K antigens to avoid the risk of alloimmunization in multiply transfused patients.

Low levels of soluble DPP4 among Saudis may have constituted a risk factor for MERS endemicity.

Most of the cases of Middle East respiratory syndrome coronavirus (MERS-CoV) were reported in Saudi Arabia. Dipeptidyl peptidase-4 (DPP4) was identified as the receptor for the virus. The level of soluble DPP4 (sDPP4) was found to be reduced in MERS-CoV infected patients while high levels of sDPP4 were suggested to be protective against MERS-CoV in animal models. We investigated whether the Saudi population has lower levels of sDPP4 which makes them more susceptible to MERS-CoV infection and, therefore, could explain the larger number of cases from the country. Blood samples were collected from 219 Saudi blood donors and 200 blood donors from other ethnic groups. The plasma level of sDPP4 was measured by ELISA and the following SNPs in the DPP4 gene; rs35128070, rs1861978, rs79700168, and rs17574, were genotyped by TaqMan SNP genotyping assay. The average level of plasma sDDP4 was significantly lower in Saudis than other Arabs and non-Arabs (P value 0.0003 and 0.012, respectively). The genotypes AG of rs35128070 and GT of rs1861978 were significantly associated with lower sDPP4 among Saudis (P value 0.002 for each). While both genotypes AA and AG of rs79700168 and rs17574 were associated with significantly lower average sDPP4 level in Saudis compared to other ethnic groups (P value 0.031 and 0.032, and 0.027 and 0.014, respectively). Herein, we report that the Saudi population has lower levels of plasma sDPP4 than other ethnic groups, which is associated with genetic variants in the DPP4 gene. This may have contributed to increase the susceptibility of the Saudi population to MERS-CoV infection and could be a factor in the long-lasting persistence of the virus in the country.

Frequencies of MNS Blood Group Antigens and Phenotypes in Southwestern Saudi Arabia.

PurposeKnowledge of the prevalence of blood group antigens in a given population is important for the prevention of hemolytic reactions. The MNS blood group system (002) has four polymorphic antigens—M, N, S, and s. Anti-S and anti-s antibodies may result in immediate and delayed hemolytic transfusion reactions, and hemolytic disease of the fetus and newborn may occur. The present study investigated the frequencies of the main antigens and phenotypes of the MNS blood group system.Subjects and MethodsWe randomly obtained 149 samples from anonymous Saudi blood donors living in Jazan Province. Serotyping was conducted using a gel card to investigate (M, N, S, and s) antigens and phenotypes.ResultsThe frequencies of MNS antigens were as follows: M = 89.26%, N = 51.67%, S = 61.07%, and s = 82.55%. Regarding the MNS phenotypes, nine phenotypes were observed in the study population. The most common phenotype was M+N–S+s+ (n = 36, 24.16%), in contrast to the least common phenotype M+N–S–s– (n = 1, 0.67%). The prevalence of the MNS phenotypes in the current study population was highly and significantly different from that in Europeans (P = 0.044) and African Americans (P = 0.000).ConclusionIn summary, this study reports the frequencies of the MNS antigens and phenotypes in Jazan Province, Saudi Arabia. The most common phenotype was M+N–S+s+, whereas the least observed phenotype was M+N–S–s–. The outcomes of this study may assist the blood banks in Jazan Province to establish an extended phenotyping protocol including the MNS antigens, in particular S and s antigens, to preclude any alloimmunization events.

Frequency of ABO and Rhesus blood groups in Saudi healthy blood donors versus non-Saudi in a retrospective study in Makkah City

Purpose: to assess the frequency of ABO and Rh blood groups among Saudi and non-Saudi healthy blood donors and to compare between them. Methods: A retrospective study was conducted; in Makkah City, Saudi Arabia. It included 15,365 participants of 44 nationalities who have attended the blood bank of King Abdul Aziz Hospital. The collected data were age, sex, nationality, ABO, and Rhesus blood groups. Results: 46.8 % of the participants were O, 28.8 % A, 19.5 % B, and 4.9% AB. The nationalities with a higher frequency of blood group O were Saudi, Mauritanian, Yemeni, Thai, Malian, Sudanese, Jordanian, Indian, Moroccan, Somali, Malaysian, Indonesian, Myanmar, Nigerian, Pakistani, Bangladeshi, Algerian, Djibouti, Burkinabe, Eritrean, Ghanaian, Bahraini, Bosnian, Canadian, Gambian, Iraqi, and Sri Lankan. Those with a higher frequency of blood group A were Turkish, Palestinian, Syrian, Lebanese, Egyptian, Afghan, Chadian, French, Tunisian, Cameroonian, Ethiopian, and British. Those with a higher frequency of B were Nigerien, American, Nepalese, and two nationalities with higher AB frequency Filipino and Chinese. 91.6 % of all populations were Rh-positive, and 8.4% were Rh-negative. The Saudi participants were like some nationalities and differed from others. Conclusion: In Makkah city, the higher frequency of ABO blood group in Saudi and non -Saudi people is O followed by A, then B, and AB. The Rh-positive is predominant, and 8.4% of the participants are negative. The ABO and Rh blood groups' identifications are essential for providing suitable blood storage for individuals in need.

The frequencies of Kidd blood group antigens and phenotypes among Saudi blood donors in Southwestern Saudi Arabia.

BackgroundThe patients who require transfusion are prevalent in the Jazan Province, Saudi Arabia. Therefore, it is essential to know the frequency of blood group antigens in such a population. The Kidd blood group system (JK) has two antithetical antigens, Jka and Jkb. Antibodies to these antigens may result in delayed hemolytic transfusion reactions. The present study investigated the frequencies of Jka and Jkb and the phenotypes among Saudi blood donors living in the Jazan Province.MethodsOne hundred and forty-three samples from anonymous Saudi volunteer blood donors in the Jazan Province were serotype to detect Jka and Jkb using gel card technology and determine the phenotypes of the JK blood group system.ResultsThe prevalence of Jka and Jkb antigens were 90.64% (n = 126) and 69.40% (n = 93), respectively. The JK phenotypes were 34.96% Jk(a + b − ) (n = 51), 12.59% Jk(a − b + ) (n = 18), 52.45% Jk(a + b + ) (n = 75), and 0% Jk(a − b − ). The frequencies of the JK phenotypes in the Jazan population were significantly different from those in the Asian population (P < 0.05).ConclusionsWe reported the frequencies of the Jka and Jkb antigens and the distribution of the JK phenotypes in a group of Saudi blood donors in the Jazan Province, Saudi Arabia. The phenotype Jk(a + b + ) was the most common among the study population. Furthermore, this study emphasizes the significance of identifying the frequency of JK antigens and phenotypes in the provinces of Saudi Arabia.

Prevalence of Duffy Blood Group Antigens and Phenotypes among Saudi Blood Donors in Southwestern Saudi Arabia.

Knowing the prevalence of blood group antigens in a given population is important to prevent hemolytic reactions. The Duffy blood group system (FY) has two main antigens, Fya and Fyb. Antibodies binding these antigens can cause immediate/delayed hemolytic transfusion reactions as well as hemolytic disease of the fetus and newborn. In this study, frequencies of Fya and Fyb antigen expression and FY phenotypes were determined in a cohort of Saudi blood donors. For this study, 143 samples were collected from randomly selected volunteer Saudi blood donors living in Jazan Province. Serological analysis, using gel card technology, was performed to detect Fya and Fyb antigens among the samples. The frequencies of Fya and Fyb antigens were 12.58% and 11.18%, respectively. The numbers and frequencies of FY phenotypes were as follows: Fy(a+b-), 15 (10.48%); Fy(a-b+), 13 (9.10%); Fy(a+b+), 3 (2.10%), and Fy(a-b-), 112 (78.32%). The frequencies of the FY phenotypes were highly and significantly different in Jazan Saudis compared to other ethnicities (< 0.01). This study reports the frequencies of the Fya and Fyb antigens and phenotypes of the FY blood group system in the Kingdom of Saudi Arabia's Jazan Province. The null phenotype Fy(a-b-) was the most prevalent among this population. This study highlights the importance of investigating FY alleles in different provinces of the Kingdom of Saudi Arabia.

Natural immunity to influenza A and B among Saudi blood donors in Al Madinah Al Munawarah, Saudi Arabia.

Objectives:To investigate the seroprevalence of influenza viruses (A and B) among blood donors in Kingdom of Saudi Arabia.Methods:The present investigation was conducted between April 2019 and July 2019. Participants were healthy adults recruited from the central blood bank Al Madinah Al Munawarah, Kingdom of Saudi Arabia. Immunoglobulin G (IgG) levels against influenza A and B were measured in serum samples using ELISA.Results:The results showed that 29.2% of the sample had significant concentrations of influenza A IgG antibody, whereas 38.6% had significant concentrations of influenza B IgG antibody. A strong correlation was found between the levels of influenza A and influenza B antibodies (r=0.708, p<0.001). The number of individuals identified as negative for influenza A IgG antibody increased with age (p<0.01). In addition, no correlations were identified between influenza A IgG and influenza B IgG and body mass index (BMI), (p>0.05). Finally, linear regression analysis showed that the level of influenza A antibody can be predicted by age (p<0.05) and body mass index (BMI) (p<0.05).Conclusion:Approximately one-third of Saudi Arabian adults presented significant levels of influenza A and B antibodies in our study. Demographic factors, including age and BMI, might contribute to influenza A antibody levels.

Influence of ABO blood group on von Willebrand factor tests in healthy Saudi blood donors.

: Von Willebrand disease is a common bleeding disorder. The wide variation in von Willebrand factor (VWF) levels between and within normal individuals highlights the clinical challenge of defining its cutoff value. Although studies on the influence of ethnicity on ABO phenotypes and the levels of VWF have been carried out on different ethnicities, there is a lack of such data among Arab population. We aimed to evaluate the correlation of ABO phenotypes with all the parameters of the minimal test panel of VWF including VWF antigen, VWF activity using the ristocetin cofactor and the collagen binding activity assays, and factor VIII coagulant activity (VWF:Ag, VWF:RCo, VWF:CB and FVIII:C) tested in a normal Arab population, and to estimate ABO-specific normal reference range. Blood samples were collected from 87 healthy donors in Riyadh to determine levels of factor VIII and VWF panel between the various ABO phenotypes. The highest mean values of factor VIII : C (128 U/dl), VWF : Ag (125 U/dl), VWF : RCo (109 U/dl) and VWF : CB (91 U/dl) were observed with type AB and the lowest mean values of factor VIII : C (81 U/dl), VWF : Ag (85 U/dl), VWF : RCo (73 U/dl) and VWF : CB (70 U/dl) corresponded to type O. ABO phenotypes significantly influence plasma levels of VWF parameters in Arab nations as seen with other ethnicity. Hence, ABO-specific normal ranges of the minimal test panel of VWF and factor VIII : C are essential for the appropriate prediction of mild von Willebrand disease. Further study including a larger categorized sample size is required to generalize the test panel on the Arab population.

The prevalence of dengue virus serotypes in asymptomatic blood donors reveals the emergence of serotype 4 in Saudi Arabia

BackgroundTransmission of dengue virus (DENV) through blood transfusion has been documented and hence screening for DENV during blood donation has been recently recommended by the American Association of Blood Banks and Centres of Disease Control and Prevention. DENV is endemic in the Western province of the Kingdom of Saudi Arabia (KSA) and serotypes 1, 2 and 3, but not 4, have been detected. However, little is known regarding the rates of DENV during blood donation in the kingdom. The aim of this study was therefore to measure the prevalence of dengue virus and its serotypes in eligible Saudi blood donors in the endemic Western region of KSA.MethodsThis was a cross-sectional study and serum samples were collected from 910 eligible Saudi male blood donors. DENV IgM and IgG antibodies were measured serologically by ELISA while viral serotypes were detected by a single step IVD CE certified multiplex RT-PCR kit.ResultsThe overall prevalence was 39 and 5.5% for IgG+ and IgM+, respectively. There were 12 (1.3%) with exclusively IgM+, 317 (34.8%) exclusively IgG+ and 38 (4.2%) with dual IgM+/IgG+ donors. The overall prevalence was 3.2% (n = 29) and 2.3% (n = 21) for primary and secondary infections. PCR was positive in 5.5% (n = 50) and, DENV-2 (n = 24; 48%) was the most frequent serotype and was significantly higher than DENV-1 (20%; P = 0.02) and DENV-3 (2%; P = 0.1 × 10−5) but not DENV-4 (30%; P = 0.2). There was no significant difference between both DENV-4 and DENV-1 (P = 0.4). The combination of the PCR and serology findings showed that 22 (2.4%) and 28 (3.1%) donors had primary and secondary viremic infections, respectively.ConclusionsThe detected rates of DENV by PCR suggest a potential high risk of viral transmission by blood transfusion. To the best of our knowledge, this study is the first to report the detection of DENV-4 serotype in Saudi Arabia. More studies are required to measure the precise prevalence of DENV serotypes and their potential transmission rate during blood donation in the kingdom.

Seroprevalence of Asymptomatic Dengue Virus Infection and Its Antibodies Among Healthy/Eligible Saudi Blood Donors: Findings From Holy Makkah City.

BACKGROUNDThreat to blood transfusion–transmitted dengue virus (DENV) and its antibodies has recently emerged worldwide. Dengue fever is an endemic disease in Saudi Arabia, particularly in its Western region. The aim of this study was to estimate the seroprevalence of asymptomatic DENV infection and its antibodies among eligible Saudi blood donors.METHODSSerum samples from 910 healthy/eligible adult male Saudi blood donors, who reside in Holy Makkah City of Saudi Arabia, were collected between March 2015 and August 2016 and screened for the detection of DENV nonstructural protein 1 (NS1) antigen and anti-DENV IgM and IgG antibodies using commercial enzyme-linked immunosorbent assay kits (Panbio, Brisbane, QLD, Australia).RESULTSAmong the tested donors, 48 (5.3%) were seropositive for DENV-NS1 antigen, whereas 50 (5.5%) and 354 (38.9%) were seropositive for anti-DENV IgM and IgG antibodies, respectively. Seropositivity for DENV-NS1 antigen and/or anti-DENV IgM antibody among the tested donors reflects their ongoing asymptomatic viremic infectious stage with DENV during their donation time, whereas high prevalence of anti-DENV IgG seropositivity reflects the high endemicity of dengue disease in this region of Saudi Arabia.CONCLUSIONSThese results show high prevalence of asymptomatic DENV infection and its antibodies among Saudi blood donors, raising the importance of establishing blood screening for dengue disease at different blood donation services and units in Saudi Arabia to improve the guarantee of blood transfusions and to control DENV dissemination.

Prevalence of Syphilis among Blood and Stem Cell Donors in Saudi Arabia: An Institutional Experience

IntroductionSyphilis is one of the known transfusion-transmissible infections and causes 100,000 deaths yearly, with around 90% of these deaths occurring in the developing world. Little data is available regarding the prevalence of syphilis among Saudi blood and stem cell donors. We conducted a survey on the incidence of syphilis among all blood and stem cell donors.MethodsThis study was conducted at the Prince Sultan Military Medical City in Riyadh, Saudi Arabia in the 10 years period data during 2006–2015. Data were analyzed about full history, physical examination, age, sex, weight, profession, marital status, number of the donations, data of last donation, having a relation who received blood transfusion, as well as the screening test results of the donated blood. We determined the seroprevalence of infection and compared by sex and other variable through frequency analysis, Chi square, Fisher, and prevalence ratios.ResultsApproximately 240,000 blood donors were screened and studied in the period of study. Most of the blood donors were male (98.3%) and 89% of them were citizens of Saudi Arabia. According to our findings, we estimated that, in the last 10 years, approximately 0.044% of all the blood donors were syphilis positive cases. No cases were detected as positive for syphilis among stem cell donors. Only 60 blood donors tested positive for syphilis. In addition, we studied 202 stem cell transplant donors during the same period, of which 59% were male and none texted positive for syphilis.ConclusionsA concerted effort between the government, health care providers, regulatory bodies and accreditation agencies have all contributed in eliminating the risk of spreading syphilis among blood donors.

Gene frequency of human platelet alloantigens‐1 to ‐6 and ‐15 in Saudi blood donors

Human platelet antigens (HPAs) are involved in the pathogenesis of several clinical conditions, such as platelet transfusion purpura (PTP), refractoriness to platelet transfusion and neonatal alloimmune thrombocytopenia (NAITP). Typing of HPA (1-6 and 15) has not been carried on the Saudi population. This is the first study of all the seven HPA systems on Arabs. The aim of this prospective study was to determine the frequency of HPA (1-6 and 15) in Saudis. A total of 100 randomly selected Saudi blood donor samples were genotyped using the polymerase chain reaction with sequence-specific primers (PCR-SSP). The most common HPA genotypes among Saudis were HPA-1 a + b- (75%), HPA-2 a + b- (62%), HPA-3 a + b- (51·5%), HPA-4 a + b- (99%), HPA-5 a + b- (76·5%), HPA-6 a + b- (100%) and HPA-15 a + b + (50%). The prevalent allele among the HPA systems was (a), except in the HPA-15 system where the (b) allele was found in 52% of the subjects. Comparisons with other ethnic populations uncovered marked differences in the distribution of HPA alleles. Studying the prevalence of HPA antigens in Saudi population will help in the understanding of its role in platelet-related disorders. It will also enable the blood bank to establish an HPA-based donor registry that will be a valuable source of compatible platelet-therapeutic products to alloimmunised patients. This will also enhance the safety and efficacy of platelet transfusion. This data obtained will form an addition to the existing body of literature in transfusion research.

Prevalence and Trends of Common Transfusion Transmitted Infections Using Serological and Nucleic Acid Markers in Saudi Blood Donors

Background: Epidemiologic studies on the prevalence of transfusion-transmitted infections (TTIs) in Saudi Arabia (SA) regions are limited. This study investigated prevalence of HBV, HCV, and HIV using both serological and nucleic acid testing (NAT) methods to determine temporal and geographic trends among blood donors in Makkah. Our secondary objective was to realize the most suitable NAT format, without compromising sensitivity of NAT results by using individualized or mini-pool testing. Methods: Serologic and NAT screening records of 22,963 blood donors from January 2011 to December 2014 were evaluated for HBsAg, Anti-HBc, Anti-HCV, Anti-HIV, HBV-DNA, HCV-RNA, and HIV-RNA. Prevalence rates were calculated for TTIs per hundred donations and additional analysis was conducted to examine donor profiles associated with positive serologic and NAT results. Known viral loads (<20 IU/ml for each HBV and HCV and <50 copies/ml HIV) diluted in negative plasma were evaluated by NAT screening. Results: Overall serological prevalence of HBs-Ag, anti-HBc, anti-HCV, and anti-HIV were 0.7, 6.7, 0.44, and 0.07%, while molecular HBV-DNA, HCV-RNA, and HIV-RNA were 0.72, 0.05, and 0.03% respectively. There was a gradual decline in percentage of infected donor blood based on combined serological and/or NAT screening from 8.3% in 2011 to 6.8% in 2014 with an overall 7.4% (n=1,689) TTI-infected. Prevalence of HBV, HCV and HIV was unevenly distributed among different regions in SA. Analysis of donor serologic and molecular profiles revealed solitary anti-HBc- positive was the highest (6%) donor profile followed by anti-HBc-positive/HbsAg-positive/HBVDNA positive donor profile at 0.6%, and solitary anti-HCV at 0.4%. Simulation of mini-pool NAT format by dilution of known viral loads at 1:6, resulted in 70% reduction in HBV detection, 50% for HCV, and 40% for HIV. Conclusions: This is the first study to provide current data collectively comparing prevalence and trends of HBV, HCV, and HIV serologic and nucleic acid markers amongst Saudi blood donors. Makkah boasts one of the lowest TTIs prevalence in SA and to surrounding countries. The majority of seropositive and NAT-reactive blood donors are in a state of acute, chronic or resolved HBV infection. Individual donor NAT is the ideal methodology that should be applied in SA where diluted samples could compromise clinical sensitivity and blood safety.

The effect of repeated blood donations on the iron status of male Saudi blood donors.

Regular blood donation can lead to iron deficiency. Screening donors' serum ferritin levels at the time of first donation and subsequently once every year is a very rational way to pick up iron deficiency in a voluntary blood donor population. The aim of this study was to determine the effect of blood donation and the prevalence of erythropoiesis with iron deficiency (sideropenia) in Saudi male blood donors. The study was prospectively conducted, between December 2008 and March 2009, on 182 male native Saudi blood donors at King Fahd Central Hospital in Jazan region, Saudi Arabia. Each donor gave 450 ± 50 mL of whole blood. Following the donation, samples were removed into 2.5 mL EDTA tubes for measurement of mean cell volume (MCV) and mean corpuscular haemoglobin (MCH) and into 7.5 mL plain tubes for estimation of iron and serum ferritin concentrations. The blood donors were divided into five groups, according to the number of donations they had given in the preceding 3 years. The blood donors in group I were first-time donors, with no previous history of blood donation. Group II donors had donated once in the last 3 years. Subjects in groups III, IV and V had donated more than once in the preceding 3 years and were considered regular donors. The mean serum iron was significantly higher among subjects with no previous history of blood donation (group I) than among regular donors who had donated twice or more. The difference in serum ferritin concentration was statistically significant (p<0.05) when comparing regular donors in group III (72.4 μg/L), group IV (67.4 μg/L) and group V (26.2 μg/L) with first-time blood donors (131.4 μg/L). In contrast, the difference in the concentration of serum ferritin between subjects in group II (98.9 μg/L), who had donated once in the last 3 years, and in first-time blood donors (131.4 μg/L) was not statistically significant (p<0.131). None of the group I donors suffered from iron deficiency, whereas 2.8% of the donors who had donated between two to five times had iron deficiency. The prevalence of erythropoiesis with iron deficiency in regular blood donors was 4.3%. The results of this study show that an increase in the number of donations results in an increase in the frequency of depleted iron stores and subsequently in erythropoiesis with iron deficiency, although the level of haemoglobin remained acceptable for blood donation. This result may indicate the need to review the guidelines on acceptance of donors.

Prevalence of hepatitis B virus markers among blood donors in a tertiary hospital in Tabuk, northwestern Saudi Arabia

This study was carried out to determine the prevalence of hepatitis B virus (HBV) markers among blood donors in a tertiary hospital in Tabuk, northwestern Saudi Arabia. A cross-sectional survey was done among male Saudi voluntary blood donors at the blood bank of the King Khalid tertiary care hospital in the northwest region of Saudi Arabia. A total of 3192 subjects were included in the study over the period from June 1, 2005 to May 31, 2006. Subjects were tested for evidence of HBV infection plus other relevant blood-borne pathogens. A questionnaire sheet for the collection of personal information (such as name, age, and sex), socioeconomic data (such as marital status, education, and occupation), family history of HBV infection, history of immunization against HBV, and history of past exposure to a high risk procedure or behavior, was prepared and used for each subject. Data were tabulated and statistically analyzed. Among the studied sample, the prevalence of HBsAg (hepatitis B surface antigen) was found to be 3.0% and the prevalence of anti-HBc (anti-hepatitis B core antigen) was found to be 18.7%. Blood donors with positive HBV markers showed significant association with increased age, being married, lower educational level, specific occupations such as blue collar worker and the military, family history of HBV infection, and lack of immunization. However, there was no significant association with history of exposure to high-risk procedure or behavior. The prevalence of HBV infection among male Saudi blood donors in the northwest region of Saudi Arabia is high compared to that reported from the central capital area (Riyadh). Public health education programs on HBV infection, adult hepatitis B immunization programs, and raising socioeconomic standards should be initiated in order to target the high-risk groups found in this study. Furthermore, a community-based study is recommended to investigate HBV infection in the northwest region of Saudi Arabia.