Transfusion Transmittable Infections Research Articles

Seroprevalence of HIV, Hepatitis B and C Viruses, and Treponema Pallidum among Blood Donors Attending the Garoua Regional Hospital Blood Bank, North Cameroon, a Cross-Sectional Study

Background. Human immunodeficiency virus (HIV), hepatitis B (HBV), and hepatitis C virus (HCV) are transfusion-transmittable infections (TTI). They currently constitute a major public health problem in Cameroon, like in other developing countries. Little is known about the seroprevalence of HIV, HBV, HCV, and syphilis among blood donors in northern region Cameroun. This study aims at filling the gap on the unknown sero-prevalence of those markers in blood donors. Methods. We conducted a cross-sectional study from June 04, to July 08, 2022 at the Garoua Regional Hospital Blood Bank (GRHBB). A total of 201donors were consecutively included and data on donor’s sociodemographic characteristics were obtained by the national program’s questionnaire. Serum samples from blood donors were tested using sensitive third generation Rapid diagnostic test (RDT) for presence of Hepatits B surface antigens (HBsAg), and antibodies to human immunodeficiency (HIV-1/2), Hepatits C (HCV) and Treponema pallidum; and quantitative enzyme-linked immunosorbent assays (ELISA) served for confirmation. Data were collected and entered into an Excel sheet and then exported to SPSS version 20.0 for analysis. Results. A total of 201 blood donors were identified and the sex ratio (male/female) was 7/1, with a mean age of 32.12 ± 8.4 years (range: 19 to 57 years). Of all blood donors, 35/201 (17.4%) were infested by at least one of the four TTIs. Among blood donors, HIV, HBV, HCV and syphilis were 5 (2.5%); 26 (12.9%); 1 (0.5%) and 5 (2.5%), respectively. Co-infection with HIV-Syphilis was 1 (0.5%); and HBV-HCV 1 (0.5%). Conclusions. This study has revealed the high prevalence of TTIs in blood donors who attended the Garoua Regional Hospital Blood Bank, identifying Hepatitis B as the greatest threat to blood safety in the North Region of Cameroon.

Blood Donation Screening of Transfusion-Transmissible Viral Infection Using Two Different Nucleic Acid Testing (NAT) Platforms: A Single Tertiary Care Oncology Centre Experience.

Nucleic acid testing (NAT) is used to screen transfusiontransmittable infections (TTIs) in donated blood samples and provide an additional layer of blood safety. In this study, we describe our experience in screening viral TTIs using two formats of NAT: cobas® MPX2 polymerase chain reaction- based minipool NAT (PCR MP-NAT) and Procleix Utrio Plus transcription-mediated amplificationbased individual donor-NAT (TMA ID-NAT). Data routinely collected as a part of blood bank operations were retrospectively analysed over a period of 70months for TTIs. Blood samples were initially screened for HIV, HBV, HCV, syphillis by chemiluminescence and malaria by Rapid card test. In addition to serological testing, all samples were further screened by TMA-based ID-NAT (ProcleixUltrio Plus Assay) during Jan 2015-Dec 2016, and by PCR-based MP-NAT (Cobas® TaqScreen MPX2) during Jan 2017-Oct 2020. RESULTS: A total of 48,151 donations were processed over 70months, of which 16,212 donations were screened by ProcleixUtrio Plus TMA ID-NAT and 31,939 donations by cobas® MPX2 PCR MP-NAT. Replacement donors and male donors outnumbered voluntary donors and female donors respectively. The overall NAT yield rate of MP-NAT was 1:2281 compared to 1:3242 with ID-NAT, during the respective time period. ID-NAT detected 5 HBV infections missed by serology, whereas MP-NAT detected 13 HBV infections and 1 HCV infection missed by serology. The proportion of donations that were both seroreactive and NAT reactive was higher with MP-NAT (59.8%) compared to ID-NAT (34.6%). Cobas® MPX2MP-NAT had higher overall NAT yield rate compared to ProcleixUtrio Plus ID-NAT and confirmed a higher proportion of seroreactive donations. Due to the ease of operation, simple algorithm, cobas® MPX2 PCR based MP-NAT can be an effective solution for blood screening in India.

Utility of grey zone sample testing strategy for transfusion transmittable infections to improve blood safety of a tertiary care center

Background: Grey zone samples with optical density (OD) lying between cut-off OD and 10% below the cut-off OD were identified during routine transfusion transmissible infectious disease screening by Enzyme-linked immunosorbent assay and its application in blood transfusion services. Materials and Methods: The present is an observational study where blood donors samples have been screened by performing repeat ELISA testing on Grey zone samples in duplicate at the A.D Gorwala Blood Centre, Karamsad between January 2018 to December 2020. Results: A total of 20560 blood donors were screened during the study period, out of which 12 blood donors were found to be in grey zone. On repeat testing of these, 02 were found to be reactive and 01 was found to be in grey zone again. Conclusion: Appropriate quality control measures can improvise the current screening methodologies in TTIs of blood bank centres, especially in resource constrained settings, where the NAT technology is not financially feasible.

SERO PREVALENCE OF TRANSFUSION TRANSMITTED INFECTIONS (TTI) IN VOLUNTARY BLOOD DONORS IN A TERTIARY CARE HOSPITAL AT SRINAGAR

Introduction: Blood transfusion plays an vital role in patients management and is live saving in my instances. it plays a pivotal role as a specialized modality of treatment and saves millions of lives worldwide each year and reduces morbidity. Stringent screening of blood not only ensure safe supply of blood and blood products, but also gives us idea about prevalence of ttis among general population
 Objective: to determine the serroperavalance of tti among blood donors in lalded hospital
 Materials and methods: A retrospective study was carried out over a period of 3 years from January 2017 to December 2019.serum samples were screened for hepatitis B surface antigen ,antibodies to human immunodeficiency virus Type 1 and 2 ,hepatitis c virus and syphilis in department of transfusion medicine was carried out
 Result: The result shows that 55 (3.72%) of the blood donors had TTIs. The prevalence of Hepatitis B, Hepatitis C, Malaria, Syphilis and Human immunodeficiency viruses (HIV), was found to be 31(0.21%), 23 (0.15%), 01 (0.0.006%), 01 (0.006%) and 02 (0.0.23%) respectively. None were positive for malaria.
 Conclusion: Transfusion Transmittable Infections pose a threat to patients admitted in any health care facility and if not carefully screened for will cause significant morbidity. Careful screening of all donor blood units in the blood bank of a hospital is absolutely necessary to prevent any untoward incidence of TTI in patients admitted to a health care facility
 Keywords: Transfusion, Sero-Prevalence, Donors, Transfusion Transmissible Infections.

Comparison of ELISA and NAT techniques among blood donors

Large number of blood transfusions are carried out globally to save countless lives, but unsafe practices risks the recipient of transfusion transmittable infections ((TTI’S). TTI’s can be reduced by improving donor selection, donor awareness regarding TTI and implementing sensitive screening tests. In India, it is mandatory to test each donated unit of blood for markers of HIVI and II, HBV, HCV, malaria and syphilis. Currently, in India all the blood donations are screened for various infectious markers using ELISA or rapid methods. TTIs can be responsible for causing considerable burden on the health status and economy of the country. Hence there is need to introduce better methods for testing blood units. Even after being seronegative the blood transfusions are still at risk of transmitting infections. In order to reduce the residual risk sensitive screening tests are needed and as a result NAT has been considered. In India NAT testing is not mandatory but many private blood banks and hospitals and state Governments of few states have started implementing NAT for blood safety. It increases the possibility of identifying the infection in window period and thus reducing the residual risk of TTIs. NAT is highly sensitive and specific for viral nucleic acids and is based on amplification of targeted regions of RNA and DNA and thus is the technique of choice. By early detection than serology, the window period of HIV, HBV and HCV infections narrows. But the issue of higher cost accounts for its limited use especially in developing countries. The present study is designed to understand the role of NAT in detecting the risk acquiring TTIs as compared to conventional methods currently in use for detection of HBV, HCV and HIV infections amongst blood donors.

Sero-prevalence of Hepatitis B Virus infections among blood banking donors in Makkah city, Saudi Arabia: an institutional-based cross-sectional study

Introduction: Worldwide about 350 million people are infected with chronic hepatitis B (HBV) putting HBV infection among the most serious infectious disease problems. Blood transfusion is vital in saving lives but is associated with transfusion-transmittable infections e.g.HBV which can lead to adverse consequences. Objective: To determine HBV infection prevalence between donors of blood banking in Makkah,Saudi Arabia. Methods: An institutional-based cross-sectional study was conducted among 2024 blood donors in two hospitals blood banks. Data were collected using laboratory blood screening tools. Data were analyzed using the SPSS statistical program. Statistically significance was considered at p < 0.05. Results: Our study was conducted on 4024 blood donor’s data. For Saudi donors, statistical analysis of HBV results has showed that 1% of donors were +ve for HBsAg and 6.8% of donors were +ve for anti-HBc. The results of NAT have showed that 1.1% of donors were positive and all were males. There is a high significance in age between 30-39 and 40-49 for NAT. The overall prevalence of HBsAg was 1% in Saudi donors. For non-Saudi donors, HBV results showed that 0.5% and 12.8% of donors were positive for HBsAg test and Anti-HBc test, respectively. The results of the Anti-HBc test were highly significant for the age range 30-39. The statistical analysis of NAT results showed that 0.8% of donors were positive and all were males. The overall prevalence of the HBsAg test among non-Saudi donors was 0.5%. Conclusion: The HBsAg and anti-HBc rates among blood donors have declined significantly. NAT is an important tool for viral detection which is expensive and not available everywhere. The total HBV prevalence between donors in Makkah was very low which may be due to recommended safety regulations followed in Makkah as its religious importance and application of an effective vaccine program.

Sero-prevalence of transfusion transmittable infections: HIV, Hepatitis B, C and Treponema pallidum and associated factors among blood donors in Ethiopia: A retrospective study.

BackgroundBlood transfusion is a therapeutic procedure that has proven to be effective in saving millions of lives. However, its safety is still a crucial issue that needs due attention. Unsafe blood transfusion is one of the sources of transmission for infectious agents. Therefore, the objective of this study was to assess the sero-prevalence of Transfusion Transmittable Infections (TTIs) such as Human immunodeficiency virus (HIV), Hepatitis B Virus (HBV), Hepatitis C virus (HCV), Treponema pallidum, and associated factors among blood donors in Ethiopia.MethodsA retrospective cross-sectional study design was used to measure the prevalence of transfusion transmittable infections using data collected from 2014 to 2019 in fourteen blood bank facilities in Ethiopia. Screening of HIV, HBV and HCV was done by using the Enzyme-Linked Immunosorbent Assay (ELISA). Presence of Treponema pallidum infection was assessed using rapid plasma reagin (RPR). Records of blood donors were collected using a checklist from Central Blood Bank Laboratory (BBL) electronic database and reviewed. Data was entered, cleaned and analyzed using SPSS version 23. Logistic regression was fitted to identify factors associated with cumulative TTIs positivity, and for each of the transfusion transmittable infection. P value < 0.05 was considered statistically significant.ResultA total of 554,954 blood donors in the fourteen blood bank facilities from 2014–2019 was included in the study. The overall sero-prevalence of HBV, Treponema pallidum, HIV and HCV, was 2.4%, 0.9%, 0.4% and 0.4% respectively. The prevalence of TTIs was comparatively higher in 2014, 5.70% and lowest in 2019, 3.40%. The odds of screening HBV in blood donors in age group of 35–39 and 40–44 were 1.2 [1.1, 1.3] and 1.3 [1.1, 1.5] respectively. The odds of screening HCV in blood donors in the age group of 25–34, 35–44 and 45–54 were 1.3 [1.1, 1.5], 1.3 [1.1, 1.7] and 1.7 [1.2, 2.2] respectively. The likelihood of having at least one infection among blood donors was 1.2 [1.1, 1.3] times in male blood donors compared to female. The odds of getting at least one TTI and Treponema pallidum in unemployed blood donors were 2.4 [2.0, 2.8] and 8.1 [6.1, 10.7] respectively. The probability of getting those who have at least one TTIs, HBV and Treponema pallidum were higher in blood donors those who live in Semi Urban and Rural parts of the country than those who live in Urban areas. The odds of having at least one TTI, HBV and HCV in blood donors with mobile mode of blood donation were 1.4 [1.3, 1.6], 1.6 [1.4, 1.8], and 1.6 [1.1, 2.2].ConclusionThe current magnitudes of TTIs are lower when compared to other previous studies conducted in Ethiopia. Older age, male, occupation, donations from mobile sites, residents of semi urban and rural settings were found to be strongly associated with sero-positivity of TTIs. Hence, strict donor screening and testing particularly taking the above factors into consideration is strongly recommended.

How to Implement a Small Blood Bank in Low and Middle-Income Countries Work in Progress?

Compared to High-Income countries (HIC), a shortfall in the provision of blood remains a multifaceted problem in Low and Middle-Income Countries (LMIC) with a direct negative effect on clinical care. The reasons are multifactorial: not only lack of knowledge, skills, and resources, but also huge differences in environment climate, endemic transfusion transmittable infections, clinical set-up, availability of clean water, electricity. It is therefore obvious that simple translation of guidelines, standards, experiences, and the total organization from HIC to LMIC is not the best way to proceed. Adapted, but not less adequate methods for blood transfusion training, organization, and accreditation are required. The Global Advisory Panel (GAP) already formulated an adapted specific answer in terms of training and accreditation. But this is not enough. Academic centres, the GAP, countries, non-governmental organizations, and others need to test current and innovative diagnostic, production, and storage methods in a joint venture with the industry. Also, medical decisions focused on transfusion must be tested before implementation in facilities allowing pre-qualification of tests and devices. The entire transfusion chain needs to be simulated in a competence and training centre, focusing on the region where it will be applied. One of the renowned tropical institutes, currently fulfilling all these requirements could be the ideal place for such a competence centre. This review highlights this and suggests possible ways and solutions.

Dual strategy testing with electrochemiluminescence and ELISA for sero-prevalence of transfusion transmitted viral infections in blood bank

Introduction: Transfusion transmittable infections (TTI) continue to be a major threat to safe transfusion practices. Blood is one of the major sources of transmission of infectious diseases viz. human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis, malaria, and many other infections in India. Screening assays for the infectious diseases with excellent sensitivity and specificity helps to enhance the safety of the blood transfusions reducing the diagnostic window period as much as possible. Methods: The present study was designed to determine the seroprevalence of Transfusion Transmittable Infections viz., HIV, HCV, and HBV, Syphilis, malaria among the blood donors in blood bank from January 2013-December 2013. In the present study Sera samples were screened for hepatitis B surface antigen (HBsAg), antibodies to HCV, HIV using electrochemiluminescence and to syphilis using Rapid Plasma Reagin test (RPR), and to malaria by peripheral smear respectively. All samples were screened for HIV, HBsAg, HCV, syphilis and malaria. Results: Total 9,400 cases. Of which 51% were voluntary donors and 49% were replacement donors. The overall prevalence of HIV, HbsAg, and HCV were 0.35,1.86, and 0.22 respectively. All the markers tested there was increased prevalence of TTI among the replacement donors as compared to voluntary donors. 2.4% donors had infection of each HIV, HbsAg, and HCV. 0.21% donors had infection of both HIV and HCV. Conclusion: The screening of blood and blood components by dual testing strategy using high sensitivity serological assay like enhanced chemiluminescence technology and NAT helps in detecting the potentially infectious blood units in all phases of infection, which aids in enhancing the safety of blood transfusion and reducing the potential risk of post-transfusion infection.

Trends of transfusion transmittable infections among voluntary blood donors in a cardiac care hospital, Bengaluru, India

Introduction: Transmission of infectious diseases through donated blood is of concern to blood safety as transfusion forms an integral part of medical and surgical therapy. Blood transfusion carries the risk of transfusion-transmittable infections including HIV, hepatitis–B etc. Screening of voluntary donors who represent healthy population serves as a predictor for these dreadful diseases in healthy population. Materials and Methods: This retrospective study was conducted at the blood bank of Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru. Data were analyzed for a period of 7 years from January 2011 to December 2017. All voluntary donors including replacement donors of our blood bank were screened for Hepatitis B Virus (HBV), Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) and Syphilis infection by using ELISA. Results: The most common infection was Hepatitis B (0.69%) followed by Syphilis (0.34%) and HIV (0.0736%) and least with HCV (0.04%) in our study. Conclusion: This study has shown a decrease in seroprevalence for HIV and increase in seroprevalence for HCV over 7 years study period.

Sero-prevalence of transfusion-transmittable infections and associated factors among blood donors in Eastern Ethiopia: an Institutional-based cross-sectional study.

Background:Blood transfusion saves millions of lives each year globally. But, it was associated with certain risks which can lead to adverse consequences. However, there is paucity of information regarding to the sero-prevalence and risk factor of transfusion-transmittable infections among blood donors in Eastern Ethiopia.Objective:The aim of this study was to determine the sero-prevalence of transfusion-transmittable infections and associated factors among blood donors in Eastern Ethiopia from February to March 2018.Methods:An institutional-based cross-sectional study was conducted among 500 blood donors in Eastern Ethiopia. Data were collected using a structured questionnaire and laboratory blood screening. Data were analyzed using Statistical Package for Social Sciences version 20. Statistically significance was considered at p < 0.05.Results:The overall sero-prevalence of transfusion-transmittable infections was 12.4% (95% confidence interval: 9.5, 15.3). Hepatitis B virus (6.6%) and syphilis (3.4%) were found at high magnitude. Those with family having human immunodeficiency virus or hepatitis (adjusted odd ratio = 2.91; 95% confidence interval: 1.33, 6.33), giving care for human immunodeficiency virus or hepatitis patient (adjusted odd ratio = 3.24; 95% confidence interval: 1.49, 7.07), multiple sex partner (adjusted odd ratio = 2.56; 95% confidence interval: 1.21, 5.19), unsafe sex (adjusted odd ratio = 2.99; 95% confidence interval: 1.51, 5.92), dental procedure (adjusted odd ratio = 2.75; 95% confidence interval: 1.20, 6.28), and had no formal education (adjusted odd ratio = 2.46; 95% confidence interval: 1.24, 4.86) were significantly associated with transfusion-transmittable infections.Conclusion:The prevalence of transfusion-transmittable infections in this study was relatively high compared to studies conducted earlier in Ethiopia. Factors such as unsafe sex, multiple sex partner, dental procedure, and family with human immunodeficiency virus or hepatitis, provide health care for human immunodeficiency virus–infected or hepatitis patients, donor type, and educational level were significantly associated with transmission-transmittable infections. Thus, health promotion about prevention and control transmission-transmittable infections should be given to the community by considering the identified risk factors. Each of the blood banks and regional health bureaus in the study area should mobilize community for increasing repeated voluntary donors through promotion of blood bank activity.

Prevalence of hepatitis B virus, hepatitis C virus, and human immunodeficiency virus among blood donors of Mekelle blood bank, Northern Ethiopia: A three-year retrospective study.

Blood transfusion services are a vital and integral part of modern healthcare services. However, the risk of transfusion transmittable infections (TTI) has been a major handicap. Therefore, this study was aimed at determining the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) among blood donors. A retrospective study was conducted to collect data about the blood donors who consecutively donated blood from October 2011 to 2014. A three-year retrospective study was conducted in Mekelle Blood Bank. A data abstraction format was used to collect the sociodemographic and clinical data, and the prevalence of HBV, HCV, and HIV was determined. Data were analyzed using STATA version 10 analytical software. P value less than 0.05 was considered significant in all the analyses. A total of 10 728 blood donors, median (interquartile range) of age 30 (23-45) years and 3750 (34.9%) males were enrolled in this study. Of the participants 407(3.79%), 143(1.33%), and 111(1.03%) blood donors were positive for HBV, HCV, and HIV, respectively. HBV-HIV coinfections were found 10 (1.93%) blood donors, followed by HBV-HCV and HIV-HCV. A significant association between sex and marital status with HBV and HIV infection was found. However, significant association of HCV was observed among sex ( X 2 = 33.18, P < 0.001) and occupational ( X 2 = 84.33, P < 0.001). A significant percentage of HBV, HCV, and HIV among blood donors was observed. To select a donor and collect safe blood risk factors exposing blood donor should be studied, and community-based prevalence studies onTTI are also required.

Prevalence and trends of transfusion-transmittable infections among blood donors in Southwest China.

The high prevalence of transfusion-transmitted infections (TTIs) is causing serious harm to human health worldwide. The aim of this research was to assess the prevalence and influencing factors of TTIs in Southwest China. A retrospective study of blood donor records from January 2008 to December 2015 was conducted. All samples were screened for HBV, HCV, HIV and syphilis. The donor's data was recorded and analyzed statistically using SPSS software. We revealed that the prevalence of TTIs showed a decreasing trend from 2.39 to 1.98%, and this was slightly lower than that in other regions of China. Syphilis infection was the most serious issue among blood donors in Southwest China, which demonstrated a significantly higher rate than that in other areas of China. The high infection rate of the female and farmer groups in rural regions is worth noting. The logistic regression model showed that age, occupation and donor category was the influential factors for TTIs. The overall prevalence of TTIs demonstrated a decreasing trend from 2008 to 2015 in Southwest China, but there is still a sufficient threat to blood safety, and more efforts are needed to further guarantee blood safety in China.

Robust Postdonation Blood Screening Under Prevalence Rate Uncertainty

Blood products are essential components of any healthcare system, and their safety, in terms of being free of transfusion-transmittable infections, is crucial. While the Food and Drug Administration (FDA) in the United States requires all blood donations to be tested for certain infection types, it does not dictate which particular tests should be used by blood centers. Multiple FDA-licensed blood screening tests are available for each infection type, and screening tests are imperfectly reliable and have different costs. In addition, infection prevalence rates within the donor population are uncertain for both emerging and established infection types. In this setting, the budget-constrained blood center’s objective is to devise a “robust” postdonation bloodscreening scheme that minimizes the risk of an infectious donation being released into the blood supply. Toward this goal, we study the minimization of the transfusion-transmittable infection risk considering regret- and expectation-based objectives, and we characterize structural properties of their optimal solutions. This allows us to gain insight, derive the price of robustness, and develop efficient algorithms. The proposed robust solution lowers the expected infection risk over various FDA-compliant testing schemes as well as the expectation-based scheme under forecast error. These findings have important public policy implications. The e-companion is available at https://doi.org/10.1287/opre.2017.1658 .

Optimal pooling strategies for nucleic acid testing of donated blood considering viral load growth curves and donor characteristics

ABSTRACTBlood products are vital to healthcare, and their safety, in terms of being free of transfusion-transmittable infections (TTIs), is crucial. Unlike serological assays that screen for antibodies and antigens, Nucleic Acid Testing (NAT) technology screens for genetic material, enabling an earlier detection of the infection. However, because NAT is more expensive than serological testing, most blood centers administer NAT to pools of blood samples from multiple donors. This reduces the testing cost, but also decreases the test's sensitivity due to a dilution effect. Further, first-time donors typically have higher prevalence rates than repeat donors, and therefore, a flexible, non-universal strategy which allows first-time donors to undergo more extensive screening may reduce the TTI risk in transfusion recipients. Since some donor characteristics are uncertain, we develop a chance-constrained model that determines the optimal NAT pool sizes for the various TTIs, considering both non-universal and universal (i.e., common testing for all donors) strategies, so as to minimize the TTI risk while remaining within the testing budget with a high probability. Our case study of the United States quantifies the risk reduction benefit of non-universal NAT testing schemes over current practice.

Residual risk and waste in donated blood with pooled nucleic acid testing.

An accurate estimation of the residual risk of transfusion-transmittable infections (TTIs), which includes the human immunodeficiency virus (HIV), hepatitis B and C viruses (HBV, HCV), among others, is essential, as it provides the basis for blood screening assay selection. While the highly sensitive nucleic acid testing (NAT) technology has recently become available, it is highly costly. As a result, in most countries, including the United States, the current practice for human immunodeficiency virus, hepatitis B virus, hepatitis C virus screening in donated blood is to use pooled NAT. Pooling substantially reduces the number of tests required, especially for TTIs with low prevalence rates. However, pooling also reduces the test's sensitivity, because the viral load of an infected sample might be diluted by the other samples in the pool to the point that it is not detectable by NAT, leading to potential TTIs. Infection-free blood may also be falsely discarded, resulting in wasted blood. We derive expressions for the residual risk, expected number of tests, and expected amount of blood wasted for various two-stage pooled testing schemes, including Dorfman-type and array-based testing, considering infection progression, infectivity of the blood unit, and imperfect tests under the dilution effect and measurement errors. We then calibrate our model using published data and perform a case study. Our study offers key insights on how pooled NAT, used within different testing schemes, contributes to the safety and cost of blood. Copyright © 2016 John Wiley & Sons, Ltd.

Evaluation of a new serological test for syphilis based on chemiluminescence assay in a tertiary care hospital.

Context:Syphilis is a transfusion transmissible infections and it is mandatory to do serological test for syphilis (STS) on all donor blood samples. STS is usually based on detection of antibodies against the cardiolipin-lecithin antigen or against the Treponema-specific antigen. STS with good sensitivity and specificity helps enhance blood safety and consolidation of STS along with other transfusion transmittable infections such as human immunodeficiency virus, hepatitis-C virus, and hepatitis-B virus helps in reducing the errors and enhances efficiency.Aims:This study was designed to evaluate the performance of newly introduced VITROS® syphilis Treponema pallidum agglutination (TPA) assay based on enhanced chemiluminescence principle for its analytical performance for use as a STS on donor blood samples at a tertiary care health center in National Capital Region, India.Materials and Methods:A total of 108 random blood units collected from the donors (both voluntary and replacement donors) and 28 known syphilis sero-reactive samples stored at −20°C, were used to evaluate the performance of VITROS® syphilis TPA assay based on enhanced chemiluminescence assay on VITROS® ECiQ immunodiagnostics system along with its analytical performance in terms of its sensitivity, precision, cross-reactivity and interference studies.Results:VITROS® syphilis TPA showed 100% sensitivity and specificity with precision (20 days study) of <10% co-efficient of variation. There was no cross-reactivity with other viral and auto-immune antibodies. No interference was observed from endogenous interfering substances like free hemoglobin or fats.Conclusions:Performance of the VITROS® syphilis TPA assay meets the requirements for its use as STS in blood bank, thus allowing consolidation with other transfusion transmittable infections screening assay on chemiluminescence platform, which is highly valuable for optimizing workflow and efficiency.

Transfusion transmittable infections - Seroprevalence among blood donors in a tertiary care hospital of Delhi

Context:Transfusion transmittable infections (TTI) continue to be a major threat to safe transfusion practices. Blood is one of the major sources of transmission of infectious diseases viz. human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis, malaria, and many other infections in India. Screening assays for the infectious diseases with excellent sensitivity and specificity helps to enhance the safety of the blood transfusions reducing the diagnostic window period as much as possible.Aims:The present study was designed to determine the seroprevalence of TTIs viz., HIV, HCV, and HBV, among the blood donors in Max Super Specialty Hospital, New Delhi, India based on dual testing strategy using high sensitive screening assays such as enhanced chemiluminescence assay and nucleic acid testing (NAT).Materials and Methods:A total of 41207 blood units collected from the donors (both voluntary and replacement donors) were screened for the TTI s, viz., anti HIV 1 and 2 antibody, anti HCV antibody, anti HBcore antibody, and HBsAg by enhanced chemiluminescence assay on VITROS® ECiQ immunodiagnostics system. NAT was performed using Roche Cobas® TaqScreen MPX assay, which can detect simultaneously HIV 1 (groups M and O), HIV-2, HCV, and HBV on Roche Cobas® s201 system.Results:The seroprevalence of HIV, HBsAg, anti HBcore antibody, and HCV based on enhanced chemiluminescence assay was found to be 0.25, 0.2, 7.06, and 0.7%, respectively. A total number of 6587 samples from July 2010 to December 2010 were tested on NAT, of which 3 samples were reactive for HBV in NAT; this was missed by enhanced chemiluminescence assay.Conclusions:Based on the seroprevalence study of infectious diseases viz., HIV, HBV, and HCV, we conclude that screening of blood and blood components by dual testing strategy using high sensitivity serological assay like enhanced chemiluminescence technology and NAT helps in detecting the potentially infectious blood units in all phases of infection, which aids in enhancing the safety of blood transfusion and reducing the potential risk of post-transfusion infection.

Conservative management of Beta-thalassemia major cases in the sub-division level hospital of rural West Bengal, India

Background:The ideal management of thalassemia involves a multidisciplinary therapeutic team approach and should be preferably done at a comprehensive thalassemia care center with all sorts of specialists and the backup of a well-equipped blood bank. However, in developing country like ours, these facilities are not available in rural set up. So, a situation where conservative therapy with regular blood transfusion is the only choice left to innumerable thalassemic children.Objective:To evaluate the existing conservative management protocol of Beta-thalassemia major patients in the setup of a subdivision level Government Hospital of rural West Bengal, India.Materials and Methods:The study was performed between December 2009 and December 2011. Beta-thalassemia major patients, registered in blood bank for moderate transfusion regimen, were taken in study. All the patients were screened for Transfusion Transmittable Infections at the time of registration and thereafter periodically every six months. Iron chelation therapy was given simultaneously with transfusion at a dose of 20 to 40 mg/kg/day for six days. The patients were advised to follow up with chelation therapy at home by daily infusion with a goal of maintaining serum ferritin level below 1000 ng/ml. Over this long period of study, the patients were periodically evaluated for complications.Results:The average blood requirement (ml/kg/year) in 1-5 years, 6-10 years, and 11-15 years were 110, 150, and 180, respectively. Incidence of Hepatitis C Virus infection in 1-5 years and 6-10 years were 1.75% and 2.08%, respectively. It is well seen that serum ferritin level increase with ascending age as does the blood consumption.Conclusion:Conservative management may be the best alternative and at times the only hope for patients in developing country like ours. However, in order to decrease the disease load, steps need to be taken to introduce preventive measures.

Transfusion Transmittable Infections

Vox SanguinisVolume 93, Issue s2 p. 42-98 Transfusion Transmittable Infections First published: 26 September 2007 https://doi.org/10.1111/j.1423-0410.2007.00987.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Volume93, Issues2November 2007Pages 42-98 RelatedInformation