Transfusion Transmitted Infections (TTIs)

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Prevalence of Transfusion Transmitted Infections among Blood Donors in Madhya Pradesh, a Central State of India

Prevalence of Transfusion Transmitted Infections among Blood Donors in Madhya Pradesh, a Central State of India

Blood transfusion is a key component of modern day health care, and therefore it is of utmost importance to ensure that blood and blood products meet the appropriate national standards of safety and efficacy for transfusion and benefit blood recipients in their clinical management process [1]. The transfusion of blood and blood products is much safer than ever before but far from attaining "zero risk" level at the present moment [2]. There are various types of diseases, that can be transmitted to the recipient via blood transfusion, are collectively known as transfusion Transmitted Infections (TTIs). These disease transmissions are one of the most dreaded complications of blood transfusion [2]. Every year, millions of people are exposed to avoidable, life- threatening risks through the transfusion of unsafe blood [3]. There is a risk of 1 to 2 per 1000 recipients, to receive contaminated blood with viral, bacterial or parasitic agents. However, there is 50% risk of serious morbidity and mortality for the patients if blood transfusion is not done or undertaken [4]. There is a long list of viruses, parasites, and bacteria, which can be transmitted through blood transfusions. Among the important transfusion-transmitted infections are; (a) viruses- human immuno-deficiency virus (HIV-I/II), hepatitis B virus (HBV), hepatitis C virus (HCV), parvovirus B-19 and cytomagalovirus (CMV) etc [5], (b) Bacteria- Treponema Pallidum, Yersinia enterocolitica, etc (c) Parasites-Plasmodium sp, Filaria, Babesia microti etc (d) Emerging- Prions [6]. An unsafe blood transfusion is very costly both human and economic point of view. Morbidity and mortality resulting from transfusion of infected blood have far reaching consequences, not only for the recipients themselves but also for their families, their communities and the wider society [7,8]. As per guidelines of National AIDS Control organization (NACO) of India, it is mandatory to
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A 10 Years Comparative Study to Assess Trends in Seroprevalence of Transfusion Transmitted Infections among Blood Donors at Gwalior, India

A 10 Years Comparative Study to Assess Trends in Seroprevalence of Transfusion Transmitted Infections among Blood Donors at Gwalior, India

Introduction: Transfusion Transmitted Infections (TTIs) threaten safety of the recipients and the community as a whole and are the subject of real concern worldwide. Aims and Objectives: To know the prevalence of transfusion transmitted infections amongst the blood donors, to evaluate the changing trends of TTIs and to compare these observations within the study as well as with the other relevant studies. Place and Duration of Study: This study was carried out at Blood Bank, De- partment of Pathology, Gajra Raja Medical College, Gwalior, India, from January 2004 to December 2013 (ten years). Materials and Methods: In this study 122,006 voluntary and replacement dona- tions were screened for TTIs; HIV, HBV, HCV, Syphilis, Malaria and their seroprevalence was cal- culated. Further study was divided in Group “A” (from 2004 to 2008) and Group “B” (from 2009 to 2013) to compare the results. Results: Out of total 122,006 blood units collected, 79,750 (65.3%) were voluntary and 42,256 (34.7%) were replacement donors. The seropositivity of TTIs in the entire study, in group “A” and in Group “B” was 3.26% (3985/122,006) (p = 0.000005), 2.25% (1238/54,874) (p = 0.000005) and 4.09% (2747/67,123) (p = 0.000005) respectively. In Group “A” and “B” seroprevalence of HIV, HBV, HCV, Syphilis and Malaria was 0.29%, 1.16%, 0.61%, 0.06%, 0.11% and 0.13%, 3.15%, 0.24%, 0.17%, 0.03% respectively. Conclusion: Our study concluded that there was significant increase in seroprevalence of HBV and syphilis whereas decreasing pat- tern in HIV, HCV and Malaria was observed in last five years as compared to previous five years among the blood donors.
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Transfusion Transmitted Infections: an Update on Product Screening, Diagnostic Techniques, and the Path Ahead

Transfusion Transmitted Infections: an Update on Product Screening, Diagnostic Techniques, and the Path Ahead

D onor blood product safety and effectiveness are primary concerns of transfusion medicine specialists and blood collection centers worldwide. In the United States, prospective blood donors are first screened with a mandatory predonation question- naire that was developed collaboratively by the blood collection industry and the Food and Drug Administration (FDA). Blood samples from donors who pass this step are then tested, using a growing list of highly sensitive infectious disease screening assays. Over the past several decades, advances in these laboratory testing techniques have allowed earlier detection of certain infectious diseases, resulting in a safer blood supply avail- able to patients. However, emerging infectious diseases continue to pose a risk to the blood supply because of the considerable time that may be required to develop, to validate, and to gain regulatory approval for new testing methods to detect these agents. Thus, great efforts are being made to develop technologies to protect patients from new and emerging infectious agents for which we do not currently test. In this minireview, we describe the origins of blood supply infectious disease testing, advance- ments made to prevent transfusion-transmitted infections (TTIs), and future directions to improve the safety of donated blood components, with a primary focus on U.S. practices.
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Seroprevalence of transfusion transmitted infections among blood donors in sms hospital jaipur: a cross sectional study

Seroprevalence of transfusion transmitted infections among blood donors in sms hospital jaipur: a cross sectional study

Blood transfusion is an integral and life-saving modality imparted to the patients during various surgeries, in certain medical conditions like anaemia, thalassemia, renal pathologies etc. After the starting of the blood transfusion scientifically in the early 1940s, various transfusion related problems like Transfusion Transmitted Infections (TTIs) have been associated with blood transfusion. Transfusion Transmitted Infections was first noted in late 1940s (1) .It has been calculated that for every unit of blood transfused, there is 1% chance for transfusion associated problems including transfusion transmitted diseases (2) .
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Spectrum of Transfusion Transmitted Infections among Blood Donors –A Tertiary Care Centre Based Study

Spectrum of Transfusion Transmitted Infections among Blood Donors –A Tertiary Care Centre Based Study

has shown to range between 1.86%-4% and of HCV ranging from 0.4%-1.09% [18] .which is comparable to our study.The residual transmission risk of HBV infection through a transfusion is higher due to a long window period between initial HBV infection and HBsAg detection [19] . For HIV, Up to 3% of HIV infections worldwide are transmitted through the transfusion of contaminated blood and blood products [20] . In our study, HIV seropostitivity was seen in 0.17 per cent donors which was comparable to other studies [21,22] from India, whereas some studies reported a lower prevalence of 0.1 [23] and 0.08 per cent [24] . WHO report states that the viral dose in HIV transmission through blood is so large that one HIV positive transfusion leads to death, on an average, after 2 years in children and after three to 5 years in adults [25] Sexually transmitted infections are widespread in developing countries. Individuals exposed to syphilis may also have other sexually transmitted diseases and are associated with increased risk of HIV infection.[26] Thus syphilis screening of donated blood has been considered as a ‘lifestyle’ indicator and it serves primarily as a surrogate test to identify donors with potentially high risk behavior. Our study shows prevalence of Syphilis was 0.04%, which is lower as compared to other studies [12,24] . Replacement donors carry relatively higher risk of transfusion transmitted infections Hence blood from replacement donors should be accepted only in cases of dire emergencies The present study has limitation of use of ELISA test for TTIs screening.Study done by Schreiber GB et al, showed that donors whose units passed all screening tests, the risks during an infectious window period were estimated as follows: for HIV, 1 in 4, 93,000; for HCV, 1 in 1, 03,000; and for HBV, 1 in 63,000 [27] . The majorities of the problems are due to the prevalence of asymptomatic carriers in the society, as well as blood donations during the window period of infections also poses a great threat to safe blood supply. In our study, HBV was the most prevalent TTI indicating a need for an organized programme for hepatitis B vaccination and use of a highly sensitive technique for its detection like nucleic acid amplification technique (NAT) which can uncover latent infections in the window period The NAT has added benefits but its high financial cost is of concern, especially in economically restricted countries.This implies that screening for TTIs needs
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Seroprevalence of transfusion transmitted infections in voluntary and replacement blood donors in a tertiary care hospital blood bank of Anantapur, Andhra Pradesh, India: 5 years retrospective study

Seroprevalence of transfusion transmitted infections in voluntary and replacement blood donors in a tertiary care hospital blood bank of Anantapur, Andhra Pradesh, India: 5 years retrospective study

25. Sastry Jayagowri M, Agawane SU, Harke VA. Retrospective study of the five–Year prevalence and trends of transfusion transmitted infections (TTIs) among blood donors at a charitable hospital blood bank in Pune, India. Intern J healthcare Biomed Res. 2014;2(3):193-200.

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Prevalence of transfusion transmitted infections in children with inherited coagulation disorders

Prevalence of transfusion transmitted infections in children with inherited coagulation disorders

Countries with a greater HCV prevalence in the general population had a greater prevalence level of the infection in multiple transfused patients. Compared to other nations India has comparatively low prevalence rate of HCV. But still, standard screening approaches are accessible only in few blood transfusion centers of large cities. Transfusion transmitted infections can be minimised to a great extent by educating people and creating awareness among the public. Immunisation of the succesptible population with hepatitis B can decrease the chances of these infections. The facilities for screening tests for Hepatitis B virus, Hepatitis C virus, and Human immunodeficiency virus would be available in all health care and transfusion centers. Stringent
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Spectrum of Transfusion Transmitted Infections Among Apparently Healthy Blood Donors in Blood Bank RIMS Ranchi From 2008 to 2014

Spectrum of Transfusion Transmitted Infections Among Apparently Healthy Blood Donors in Blood Bank RIMS Ranchi From 2008 to 2014

The goal of any transfusion service is to provide adequate and safe blood and blood products to the recipients. With every unit of blood transfusion, there is a 1% chance of transfusion related complications including transfusion-transmitted infections [1]. The process of preventing the transmission of transfusion- transmitted infections through blood transfusion presents one of the greatest challenges of transfusion medicine [2]. The Drug and Cosmetic Act, 1945 and its amendments require that all blood donations must be screened against the five major infections: HIV I & II, HBsAg, HCV, syphilis, and malaria [3][4]. Consequently, NACO recommended 3rd or 4th generation ELISA HIV I & II test kits with high sensitivity as the default test for use at blood banks for screening donated blood [5]. Blood transfusion departments not only screen TTI, but they also provide information about the prevalence of these infections in populations [6]. Blood safety interventions in the developed nations have greatly reduced the overall risk of transfusion-transmitted infections [7]. Globally, more than 81 million units of blood are donated each year [8]. More than 18 million units of blood are not screened for transfusion transmissible infections [9]. They are, therefore, unlikely to be totally free of the risk of the infections. The aim of our study is to investigate the prevalence of transfusion transmitted infections among apparently healthy donors in Ranchi, India, and to raise the awareness of infectious complications of blood transfusion
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The prevalence of transfusion transmitted infections: A focus on hepatitis B virus among blood donors at Hawassa blood bank center, Southern Ethiopia

The prevalence of transfusion transmitted infections: A focus on hepatitis B virus among blood donors at Hawassa blood bank center, Southern Ethiopia

Aims: Millions of lives are saved each year through blood transfusion but a safe blood supply is a critical component of health care to prevent the spread of blood-borne infectious diseases. Therefore, it is essential to assess the prevalence and identify the most common culprit and risk in transfusion services. Methods A cross-sectional study was conducted from April 2015 to May 2015 at the Hawassa blood bank center. Blood donors who donated blood for transfusion purposes were considered for the study. Whole blood was collected and serum was separated from each donor. The sera were used for examination of human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis. Thick film was prepared and stained using Giemsa for malaria detection. Results: A total of 384 blood donors were screened during the study period. Among these donors, 67.2% (258) were males and 32.8% (126) were females. The overall prevalence of transfusion transmitted infections (TTI) was 28 out of 384 (7.29%) apparently healthy donors. The seroprevalence of HIV, HBV, HCV, syphilis
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Demographic characteristics of transfusion transmitted infections among blood donors in China

Demographic characteristics of transfusion transmitted infections among blood donors in China

During March 2015 and September 2015, 3719 blood do- nations collected from 14 different blood centers or blood banks (Table 1) including Changchun (abbreviated as CC), Chongqing (CQ), Hebei (HB), Heilongjiang (HLJ), Henan (HN), Heze (HZ), Jiangsu (JS), Liaoning (LN), Shandong (SD), Shenzhen (SZ), Tianjin (TJ), Tongzhou (TZ), Yun- nan (YN), and Xiangyang (XY) were screened for TTIs (hepatitis B surface antigen [HBsAg], anti-HCV, anti-HIV, and anti-TP) using one or two screening enzyme-linked immunosorbent assays (ELISAs) of each serologic marker. The blood donations that tested serologically reactive for TTIs or serologically non-reactive for TTIs (elevated ala- nine aminotransferase [ALT] level > 50 U/L) were not transfused and enrolled in this study. These samples that tested initially reactive for TTIs were sent to the NCCL for retesting. Meanwhile, demographic data were obtained from the donor/donation database of each blood center or blood bank.
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Seroprevalence of Transfusion-transmitted Infections Among Multi-transfused Patients in Southwest Iran, Khuzestan Province

Seroprevalence of Transfusion-transmitted Infections Among Multi-transfused Patients in Southwest Iran, Khuzestan Province

Transfusion-transmi!ed infec"ons (TTIs) such as hepa""s B virus (HBV), Hepa""s C virus (HCV), and human immunodeficiency virus (HIV) con"nue to be a problem in many parts of the world, especially among mul"-transfused pa"ents. Regular blood or blood products transfusion in pa"ents with thalassemia, hemophilia, and sickle cell anemia has improved their overall survival, but carries a definite risk of acquisi"on of blood-borne virus infec"ons. 1,2

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Trend of transfusion transmitted infections frequency in blood donors: provide a road map for its prevention and control

Trend of transfusion transmitted infections frequency in blood donors: provide a road map for its prevention and control

The data was collected from the blood bank of Lady Read- ing Hospital (LRH), Postgraduate Medical Institute, Pesha- war Khyber Pakhtunkhwa, Pakistan over a period of three and half years. LRH is 1450 bed hospital and has been pro- viding tertiary health care delivery and teaching facilities to population all over the province. Coupled with presence of 0.6 million Afghan refugees and their rush on this hospital, the institution seems over-burdened given its present phy- sical size, administrative human and financial resources. The screening of blood for TTIs is mandatory for blood safety in the source hospital.
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Seroprevalence and trends of transfusion transmitted infections at Harar blood bank in Harari regional state, Eastern Ethiopia: eight years retrospective study

Seroprevalence and trends of transfusion transmitted infections at Harar blood bank in Harari regional state, Eastern Ethiopia: eight years retrospective study

The magnitude TTIs was lower than the previous studies conducted in Ethiopia. However, the study area has high intermediate endemic transmission. Majority of TTIS occurred among first time blood donors. Those students, private employed and government employed were less likely to be infected with syphilis and hepatitis B virus. Male were more likely to infected with HBV. There was significantly decline in the prevalence of HCV and Syph- ilis infection, but not for HIV and HBV. The prevalence of syphilis and HCV also increases with age. Therefore, strict adherence with the criteria of preliminary blood donor selection should be implemented to reduce the amount of blood being withdrawn from transfusion after collection and screening. It is also important to increase the number of repeated voluntary donors through promo- tion of blood bank activity. In addition, further study should be conducted to identify the gaps in the failure of preliminary screening in removing the donor before blood donation and feasible way increasing voluntary donors. There is also an assessment and taking measures on the potential risk factors of major TTI in the community.
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Seroprevalence of transfusion transmitted infections among blood donors in Gash Barka Zonal Blood Transfusion Center, Barentu, Eritrea, 2014 through 2017

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

Blood donor selection strategy founded on deferral of high-risk prospective donors remains the principle line of defense against TTIs. Transfusion risk can be minimised by favouring VNRBD to FRBD, and WHO recommends that VNRBD should comprise 80% of donors [18]. The existing evidence from a survey on the status of blood safety in the WHO African region reported that 50% or more of the WHO Africa region countries are dependent on FRBD [19]. Importantly, Eritrea has not yet adopted the policy of shifting donations from FRBD to VNRBD. In the present study, the proportion of VNRBD was comparatively low. Altogether, the low proportion of VNRBD in SSA has been attributed to the fact that the recruitment of these donors is costly and logistically complex since it requires strategized recruitment, mar- keting and well-timed collection [10].
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First report of Cytauxzoon sp  infection in domestic cats in Switzerland: natural and transfusion transmitted infections

First report of Cytauxzoon sp infection in domestic cats in Switzerland: natural and transfusion transmitted infections

22.9% in cats in northeastern Italy [24], the majority of which appeared clinically healthy. Indeed, no association between infection and clinical status, laboratory findings or mortality was found, and only 7% were anaemic at the time of diagnosis. Conversely, symptomatic and even fatal infections have also been documented [24, 30, 31, 41]. These cases presented with a variety of clinical signs, including lethargy, anorexia, weight loss, pyrexia, pale mucous membranes, diarrhoea, vomiting and pleural or peritoneal effusion. In addition, some cats exhibited clinical signs not typically associated with piroplasm infec- tions, including stomatitis, ulcerative dermatitis, circling and vocalizations [24, 31]. However, concomitant diseases, such as neoplasia, intracranial disorders or feline infec- tious peritonitis that may cause similar clinical signs were not always excluded [24, 30].
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Seroprevalence of markers of transfusion transmissible infections among blood donors at a tertiary care hospital blood bank: a 5 year retrospective study

Seroprevalence of markers of transfusion transmissible infections among blood donors at a tertiary care hospital blood bank: a 5 year retrospective study

Background: Transfusion transmitted infections (TTIs) can be caused by various microorganisms present in the blood of apparently healthy donors. The recipient may get infected after being transfused with the unsafe blood. It is mandatory to screen the blood for HIV 1 and 2, HBV, HCV, Syphilis and Malaria. This study was undertaken to investigate the seroprevalance of Transfusion transmitted infections among blood donors at our tertiary care centre and to compare our study with other studies conducted at different hospitals of the country as well as outside.
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Transfusion-Transmitted Malaria in Iran: A Narrative Review  Article

Transfusion-Transmitted Malaria in Iran: A Narrative Review Article

donor selection (donor history) and laboratory tests (parasitological, immunodiagnostic and molecular methods) (4). Donor selection or screening of blood donors through interview- ing is the first and in many countries the only step in the prevention of transfusion- transmitted infections (TTIs) such as malaria (21). The laboratory tests available for malaria screening include the light microscopic exami- nation of peripheral blood smears, quantitative buffy coat (QBC), and antigen and antibody detection by immunodiagnostic methods and polymerase chain reaction (PCR) types. All of these tests have limitations in sensitivity, spec- ificity, cost, speed, reliability and complexity (14, 22). Although the world health organiza- tion (WHO) recommends that all donated blood should be screened for malaria (23, 24), there is no reliable approved laboratory test yet available for malaria screening in blood donors (14). However, the optimum strategy for minimizing the risk of TTM in non- endemic and endemic areas is a combination of proper donor selection together with dona- tion blood screening by using a laboratory test, which should be simple, sensitive, fast and cost effectiveness (4, 11, 25).
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Seroprevalence of Hepatitis B, Hepatitis C and Human Immunodeficiency Virus Among Multitransfused Thalassaemic Children in Dhaka, Bangladesh

Seroprevalence of Hepatitis B, Hepatitis C and Human Immunodeficiency Virus Among Multitransfused Thalassaemic Children in Dhaka, Bangladesh

Background: Thalassaemia is a congenital hemolytic disease caused by defective globin chain synthesis of haemoglobin and largely treated by repeated blood transfusions. Transfusion-transmitted infections still make a great challenge in the management of patients with thalassaemia major. The most important worldwide transfusion transmitted infections (TTI) are hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV). Despite concern about a possible increase in the incidence of these infections there are no recent data about the prevalence of HBV, HCV and HIV from Bangladesh.
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Blood Wastage Rate in a Sub-Saharan African Hospital Based Blood Bank

Blood Wastage Rate in a Sub-Saharan African Hospital Based Blood Bank

concentrate and not red cell units. The reason for the discard of red cell units in India was seropositivity for transfusion transmitted infections. This suggests that there is a need to appraise the blood inventory and data management. Although there is a proportion of discarded blood that is inevitable in practice, but the blood stock rarely reaches its expiry date [12]. The maintenance of the cold chain which adversely affects storage of blood is an issue of concern in many blood banks in sub-Saharan Africa but this is not the case in this study. It shows that in situations where cold chain is not an issue, efforts should be channeled into the efficient use of blood. In view of a correlation between blood stock level and wastage [13], the wastage of 1.8% of safe units of blood could be improved upon considering the fact that reasons for the wastage can be easily rectified by concerted effort by all concerned and provision of adequate blood is a challenge. The reason for blood wastage in another blood center in Nigeria was expiration of the blood units [14]. It is imperative to address blood stock management and reasons for keeping blood until expiratory date. It has been suggested that training of blood bank staff in blood bank management and transparency of inventory can help minimize blood wastage [15].
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Platelet concentrates: reducing the risk of transfusion-transmitted bacterial infections

Platelet concentrates: reducing the risk of transfusion-transmitted bacterial infections

Abstract: The introduction of a combination of interventions during collection of whole-blood or platelet concentrates has been successful in lowering the degree of bacterial contamination in the final product, the platelet concentrate, by 50%–75%. These interventions were improved donor questionnaires, best-practice skin disinfection, and diversion of first blood volume. These interventions have reduced the number of bacteria present in the platelet concentrates. In combi- nation with screening for bacterial contamination of platelet concentrates with a culture method, the degree of transfusion-transmitted bacterial infection has been reduced significantly. Due to the very low initial bacteria counts upon collection of the products, the need for improved sensitivity of early screenings tests or highly selective point-of-issue tests remains. The latter should be rapid and easy to perform. An alternative approach might be the implementation of pathogen-inactivation methods for cellular blood products to reduce the amount of pathogens. However, these methods are costly, and so far not proved to be cost-effective, especially in countries with an already-low incidence of transfusion-transmitted infections by viruses, para- sites, or bacteria.
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