blood and blood components stored below 20°C is very low. However, it was observed that many cases were associated with the appearance of a sore on the blood donor few days after the donation. Thus, syphilis can be transmitted from donors who are clinically and biologically negative. It is clear that medical selection and mainly information and questioning are essential to identify those who have been exposed to the infection two months prior to the donation of their blood (1) . Syphilis is
The prepared blood films were air-dried and stained with 10% Giemsa (1 in 20 dilutions) for 25 – 30 min . Detection of malaria parasites and estimation of the parasite density by light microscopy was performed as described elsewhere . Two expert microscopists read the blood films separately, not knowing each other’s results. In case of any discrepancy with the results ob- tained by the two microscopists, a third was brought in and the results given in that case were considered as final. The thick films were screened for at least 200 fields using the 100X (oil immersion) objective. If asexual stages of Plasmodium were seen, they were counted until 500 WBCs were reached. The slides were only de- clared negative after counting to 2 500 WBCs. Malaria parasite density was estimated by dividing the parasites counted by 500 and then multiplied by the actual WBC count of the participant (obtained from the CBC result) to give numbers in parasite per μl .
The most important marker for HCV diagnosis is the detection of anti HCV antibodies analyzed by immunochromatography test (ICT) and more reliable enzyme-linked immunosorbant assay (ELISA) and RNA test. ICT and ELISA are the primary quantitative screening techniques employed in the diagnostic centers, while ICT is a broadly utilized screening strategy in the Kila-Saifullah district (Balochistan). A cross sectional study is carried out to compare the performance of ICT and ELISA for the detection of anti HCV antibody in blooddonors from Kila-Saifulla to determine if the diagnostic technique employed is the cause of HCV spread when a false diagnosed blood is donated.
There is currently a trend to use automation to reduce personnel costs .The automated test are usually in ELISA formats. For TTI testing in out institute, we perform the entire test on (DA VINCI Quatro, Biomeriux, France). For detection of larger number of specimens EIAs are ideally suited but has a limitations in terms of time and cost whenever small number of samples are to be processed. But in blood bank settings like ours where EIAs are being performed for HIV, HCV and HBV by automated ELISA machine. ELISA because of it sensitivity, specificity and its suitability made it as an ideal screening method for syphilis.. Another advantage are that it has capacity to automated process large number of samples and an objective reading of results.
The World Health Organization has estimated that there are approximately 12 million new cases of syphilis worldwide each year (14), confirming that this infection is reemerging and still represents a primary health problem. Although transmission through blood transfusion is rare, screening for syphilis is man- datory for both the prevention of infectious diseases in trans- fusion medicine and the identification of high-risk sexual be- havior in individual donors. Thus, the implementation of an appropriate diagnostic algorithm for the identification of syph- ilis by detecting anti-T. pallidum antibodies in serum is of utmost importance. According to the guidelines published by the U.S. Centers for Disease Control and Prevention, the di- agnosis of syphilis should be based on the results of at least two tests: one treponemal and the other nontreponemal (13). In Italy, although the screening of donated blood units for syphilis is mandatory, there are no official guidelines, and each TS can thus adopt the assay (or the set of assays) deemed most suit- able on the basis of local needs.
Material and Methods: This cross-sectional study was conducted on all files of blooddonors with positive lab results in Golestan Blood Transfusion Services. The test results, demographic characteristics and the Prevalence of hepatitis B and C and HIV were determined . The results were analyzed by SPSS software.
A total of 90 blooddonors who attended Singa Hospital blood bank, their age ranged from 20 to 50with mean 35, the most of them belonged 21-30 years were enrolled in this study table2. The overall result revealed that 05(5.6%),47(52.2%)were positive for CHIKV IgM, IgG respectively while 12 (13.3%)were positive for both and 26(28.9) were negative table 1. Regarding age the highest serofrequency of CHIKV observed among 21-30 age group.
Hepatitis B surface antigen (HBsAg) testing was per- formed with the rapid test Healthease HBsAg (Neome- dic Ltd., Sea Cow Lake, South Africa) supplied by the MoH and in use in the blood bank. However, since this test lacked independent quality assurance data, another rapid test, Determine HBsAg (Abbott Laboratories, Illi- nois, USA), from the WHO bulk procurement 2010 list, was supplied by ITM and run in parallel during the study (reported sensitivity: 100%; specificity: 99.4% ). In case of discordant results, both tests were repeated to exclude manipulation errors. All sera with persisting dis- cordance were sent to the INS in Maputo and analyzed by the EIA Murex HBsAg Version 3.0 (Abbott Diagnos- tics Division, Murex Biotech Limited, Dartford, UK; sen- sitivity: 99.7% and specificity: 99.5%). Reported HBsAg seroprevalence corresponds to the result obtained with the rapid test Determine HBsAg rapid test corrected by EIA (this procedure being further considered as our reference diagnostic method). Sensitivity and specificity of the rapid test locally used (Healthease HBsAg) were calculated with standard formulas against this reference method.
Automated treponemal assays such as this are becoming the method of choice in many establishments for the reliable detec- tion of T. pallidum infections amongblooddonors, facilitating the clear consistent interpretation of results (16). High specificity, es- pecially in potentially cross-reactive samples, is required in order to prevent potential false-positive results, minimizing the need for retesting and reducing patient anxiety. High sensitivity is also re- quired to minimize the likelihood of missing T. pallidum infec- tions at all disease stages. Early detection of infections is extremely important to allow appropriate treatment, as well as the safe and timely supply of blood products. Therefore, a treponemal assay needs to show good seroconversion sensitivity, to reduce the di- agnostic window. The availability of multiple automated trepone- mal tests and their performance data is beneficial for laboratories, supporting broad access to testing and increasing patient and blood safety. This evaluation aimed at further assessing the capa- bilities of the Elecsys Syphilis assay (Roche Diagnostics, Mann- heim, Germany) to fulfill these requirements.
Lastly, an average prevalence of 6.7 was seen over the five years period for HIV cases whiles a 5.5 prevalence was recorded for syphilis cases for blooddonors within the regional setting. This tells us that the rate of spread of HIV is more predominant than the spread of syphilis. It is in this light that the Ghana health services have set up a body to manage the affairs of HIV and its related complications in the country. Even though much has been done in line with HIV, it still posses as a strong public health threat to the region and the country as a whole.
ELISA test has been reported to be good from the point of sensitivity and specificity (Maisonnave, 1999). In the present study in comparison to diffusion in gel, the ELISA test has been found to be highly effective and may be employed for the wide use in seroepidiomological survey (Ibarra et al., 1998) of paramhistomiasis. In Haemonchus contortus infection also a highest titre of 1:40, 000 observed with rabbit hyperimmune sera raised by somatic antigen of H. contortus (Kaur et al., 2002). The high titre observed in the present
Serologic methods of diagnosis of chlamydial infection can determine the stage and nature of the course of the disease, which is especially impor- tant in the chronic course of the disease for many months and years. For this purpose, in the ELISA, specific antibodies of the IgM, IgA, and IgG classes are gradua lly synthesized and accumulated in the blood serum and in the biological secrets of humans. Specific IgA-class antibodies are present in both se- rum and secretory forms; they are indicators of both acute infection and manifestation in a chronic form of the disease. In serum, antibodies of the IgA class appear 10-14 days after the onset of the disease, a little earlier than the antibodies of the IgG class, but at lower concentrations. They can be detected at the onset of the disease in the secretions of the genital organs. High concentrations of antibodies in this class may indicate a chronic infection. Specific IgA antibodies have a half-life of 5-7 days, which allows them to be used to control the treatment ef- fectiveness. Reducing the level of these antibodies 2-3 times indicates successful therapy. IgG antibo- dies appear from the third week after the onset of the disease. Their presence reflects the general picture of the immune response as a result of acute, chronic or transmitted infection. In the latter case, IgG can be found to be low for many years [5, 6].
In order to rapidly detect MDR-TB and XDR-TB, WHO endorsed line probe assays (LPAs) of MTBDRplus and MTB- DRsl for the detection of RFP, INH, FQ, SLID, and EMB resistance in acid-fast bacilli smear-positive sputum or MTB cultures in 2017. The aim of this study was to compare the diagnostic performance of the MTBDRplus and MTBDRsl assays with the gold standard phenotypic DST in the detection of MDR-TB and XDR-TB, among culture isolates obtained from patients in Beijing.
Specimens. A total of 330 serum specimens were obtained and stored at ⫺70°C until tested. Serum specimens from STD clinic patients residing in areas of high chancroid endemicity in South Africa were obtained from Ronald C. Ballard (South African Institute for Medical Research, Johannesburg, South Africa). These specimens were from (i) patients with PCR-confirmed chancroid (n ⫽ 40), (ii) patients with genital ulcers due to syphilis or genital herpes as determined by PCR (n ⫽ 29), and (iii) patients with urethritis (n ⫽ 126) of whom 52% were HIV infected. All serum specimens were initially obtained for routine diagnostic purposes from men presenting to STD clinics in Carletonville, Durban, and Johannesburg, South Africa, between October 1993 and January 1994. Serum specimens (n ⫽ 45) used as negative controls were obtained from healthy blooddonors in Atlanta, Georgia. Additional serum specimens consist- ing of 45 Venereal Disease Research Laboratory (VDRL)-positive and 45 VDRL-negative sera were selected from among those submitted to the Georgia State Health Department for syphilis serology.
formation under the variation of shear rates. The ﬁ ndings of this study showed a horizontal change of Z with time and vertical change with shear rate for both control and diabetic blood samples. Figure 3 represents the time course of Z, which began as a constant of time. The transition was taken at the time at which the blood clot began to form. At this stage, Z increased until it reached a maximum and approximately constant value. Z decreased as the shear rate increased. This was noted for both control and diabetic blood samples. Z values for the diabetic blood samples were higher than those the control samples over the entire investigated shear rate range. Lei et al used electric impedance measurement in the microchannel to monitor the blood clotting process. Their measurements of blood impedance above 500 Hz gave an apparent response to the clotting process. 18 Previous studies showed ﬂ uctua- tions in the electrical impedance of the blood due to the clotting process and mentioned that blood behaves as insulated matter when it clots. 36,37
The PCR products amplified by the S region primers were sequenced; the readable sequences were more than 180 bps and contained the sequences of the “ a ” determi- nant of HBsAg. Sequencing data demonstrated that none of them was identical to the known sequences detected in our laboratory and there were at least 2 bps differences among the different plasmas, excluding the false positive caused by cross-contamination. A single base deletion was detected in the S region from a donor, and no mutation in the “a” determinant was observed in four other donors after comparing with the known wild sequences in the GenBank. Phylogenetic analysis of the partial S-gene sequences from the five samples and corresponding sequences recovered from GenBank demonstrated that the viruses in the five sam- ples all belonged to genotype B (Figure 2).
particles. When antigen-antibody complexes are formed with a positive serum, black clumps show up and remain as flocculates or clumps. A high rate of false-positives can occur in a low-prevalence population of patients. More importantly, false-positive results are usually due to autoimmune disease, drug addiction, acute viral infections, malaria, leprosy, mononucleosis, lupus erythematosus, and recent immunizations (Larsen, 1995). The advantage of nontreponemal tests is that they have a higher correlation with disease activity. Another advantage of the VDRL test is that it can be performed on cerebrospinal fluid (CSF) or serum and can be used to diagnose neurosyphilis. However, RPR cannot be used for testing CSF specimens due to lack of its sensitivity and specificity (Larsen, 1995). The USR test is another nontreponemal test that detects antilipoidal antibodies in patients with syphilis. A positive USR may indicate a past or present infection with T. pallidum. The TRUST is a macroscopic nontreponemal flocculation card test for screening syphilis. It also detects IgM and IgG antibodies to lipoid material from damaged host cells or cardiolipin released by the treponemes. With a positive test, a red flocculent forms when the TRUST antigen is mixed with a positive serum on a plastic- coated card. Biological false-positive reactions can occur in patients with autoimmune disease (Larsen, 1995). A prozone phenomenon can also cause false-negative reactions with these tests.
infectious diseases is an important blood safety measure to avoid transfusion-transmitted infections. However, this procedure does not guarantee complete elimination of transmission risk because of the difficulty in detecting serologic markers in the early infection phase. Further, to reduce the risk of infection, a donor selection that effectively screens for behavioral risks is also necessary (6) . Serological syphilis
Continuous variables were described with median and interquartile range [IQR] and categorical variables as number and percentages. The prevalence of HIV, HBV and HCV was expressed with a 95% confidence interval (CI95%) and group’s comparison was performed using Chi-2 test for categorical variables. Univariable and mul- tivariable (including gender, age, education level (none, primary school, secondary school, higher), marital status, geographical setting and type of blood donation covari- ates) logistic regression analyses were performed with R (v3.6.1)  software to identify risk factors of each in- fection. Factors associated with HIV, HBV or HCV in- fection with a P value of < 0.20 in the univariate logistic regression analyses were included in the multiple logistic regression model. The level of significance for each ana- lysis was set at 0.05.
Health consultation and screening of high-risk groups before blood donation need to be further improved. Blood donor recruitment should emphasize on excluding the high-risk donors and recruiting more low-risk blooddonors. The seroprevalence of syphilis in blooddonors from 2005 to 2017 in Chengdu showed an overall up- ward trend. However, Chinese MOH permanently defers donors with TP-positive, thus, the rate of TP-positive in primary blooddonors was higher than in repeat blooddonors. In addition, this study also shows that sharing cosmetic surgical instrument has been proven to trans- mit blood-borne diseases. Therefore, the syphilis in blood circulation should not be ignored. The research provides a valuable reference for popularizing syphilis- related knowledge and is conducive to reducing the risk behaviors of blooddonors.