Methods Study population
We conducted a cross-sectional study of individuals do- nating blood from January 1st 2018 and December 31st 2018 to the blood bank of Gabriel Toure University teaching hospital in Bamako, Mali. We aimed to esti- mate HIV, HBV, HCV and syphilis infection prevalence and riskfactors of blooddonors during this time. The current study included all blood donations during 2018 ( n = 8207) and respecting blood donation criteria: age
The high prevalence of HIV, HBV, HCV and syphilis has heightened the problems of blood safety in Ethiopia.
Thus, continuous monitoring of the magnitude of trans- fusion-transmissible infections in blooddonors is impor- tant for estimating the risk of transfusion and optimizing donor recruitment strategies to minimize infectious diseases transmission. Therefore, this study was conducted to determine the seroprevalence, risk fac- tors and trends of HIV, HBV, HCV and syphilis infec- tions amongblooddonors at Gondar University Teaching Hospital in Northwest Ethiopia.
In this study, known that there is a similarity be- tween riskfactors and route of transmission between HIV, HBV and HCV, we found that the prevalence of HBV was higher as compared to HCV and HIV. Sev- eral studies also come up with similar findings com- pared with the present study [1, 21, 34–37]. The probable reason for this high prevalence may be due to higher infectivity of HBV compared to HCV and HIV as well as poor awareness of the community to- wards hepatitis transmission and infection. Although there is a recent advent of Hepatits B vaccination in the country, vaccination is freely accessible for only health professionals while the rest of community members have to pay to get this vaccination. This and the mis-perception towards hepatitis vaccination protective effect may play a significant role for the observed elevated HBV magnitude.
cirrhosis, chronic hepatitis, and hepatocellular carcinoma [7, 8]. Some important ways for the transmission of HBV are the utilization of unsterilized medical instruments, blood transfusion, sharing of individual items, offering needles to drug addicts, barber risk, reuse of contaminated needles and syringes without sterilization for therapeutic injections, vertical transmission , furthermore by unsafe sexual interaction with HBV infected patients [9-12]. The prevalence of HBV infection among the developing countries of Asia, the Pacific Islands and Africa is very high as compared to developed countries like Australia, Western Europe, and the USA, where the prevalence of HBV is very low . In Russia, Japan, and Eastern Europe about 2- 8% of their population are infected with HBV. It is estimated by world health organization (WHO), that about 0.6 million deaths of the people occur annually due to HBV infection. As per 2010 report of WHO, it was observed that 0.12 billion individuals were infected with HBV in China followed by India with 0.04 billion and Indonesia with twelve million infected individuals . In Pakistan, HBV is also a prominent public health issue, and its rate of infection is rising rapidly . The reason for high infection rate might be due to deficiency of suitable public health services, poor financial condition or lack of awareness about the transmission of major sexually transmitted diseases (STDs) i.e. HBV, HCV, and HIV . According to different research studies performed in the various regions of Pakistan, showed that the prevalence rate of HBV is 2- 10% among healthy blooddonors, 5-9% among medical services staff, 3.16% among the pregnant women, 3.6-18.66% among the general population, 10-20% of patients with temporary diagnosis of hepatitis and 3.16- 10.4% among professional blooddonors .
A cross sectional study was carried out among prospective blooddonors at the blood bank of Jos University Teaching Hospital and National Blood Transfusion Services of Jos metropolis. Both facilities are located in Jos the capital of Plateau State, North Central geopolitical Zone of Nigeria. These centers serve States in this Zone. Consecutive consenting voluntary and family replacement blooddonors were recruited over a three-month period (November 2013–January 2014). The minimum sample size was determined using Leslie and Kish formula for sample determination. The estimated sample size using a seroprevalence rate of 4.8%  was 390 but a sample size of 500 was used in this study. Participants were blooddonors who passed the hemoglobin test to rule out anemia and answered the blood bank questionnaire for blood donor selection. The samples for HTLV assay were collected at the same time with samples for screening for other transfusion transmissible infections (TTIs) such as HIV, HBV, HCV and Syphilis.
12]. The riskfactors for blooddonors infected with syphilis are also riskfactors for other blood borne diseases [13–15]. Screening for high-risk groups be- fore blood donation currently depends entirely on pre-donation health consultation. They donate blood or need postpone and withdraw from blood donation depend to the report of blooddonors on medical his- tory and dangerous behavior [16, 17]. In fact, many blooddonors did not earnestly fill out the “health sta- tus inquiry form of blooddonors”, some of them did not understand the contents of the questionnaire and could not accurately fill out, or concerned about the privacy disclosure in the process of blood donation on a public environment. Moreover, the diversity of blood donation motives also made it impossible for some blooddonors to report truthfully, resulting in some high-risk groups entering the blood donation process. For instance, some blooddonors may not know that their behaviors are dangerous behaviors which are susceptible to transfusion diseases, or some blooddonors who have the clear risky behaviors intentionally concealed to detect whether they are in- fected. In addition, some blooddonors have not read the health checklist carefully in order to save time.
Aim: The present study is to know the seroprevalence of HIV, HBV, HCV in "high risk groups” i.e STD patients, hemophiliacs and patients undergoing repeated dialysis, voluntary blooddonors and also the incidence of co-infections.
Materials and Methods: A serological screening was carried out during the period November 20005 to September 2007 to assess the risk of infection with HIV and co infection with HBV, HCV at Siddhartha Medical College, Vijayawada. A total of 200 samples collected and were tested by ELISA with commercial test kits which were commonly used for HIV, HBV, HCV.
A national serological survey for HBV and HCV infections among the general population was performed in Libya during 2003 and revealed prevalences of 2.2% and 1.2% for HBV and HCV, respectively . Other local surveys reported that the rate of HBsAg positivity amongblooddonors ranged from 1.3% to 4.6% , while the rate of HCV antibodies was 1.2% . The present study has been conducted to screen the HIV, HBV and HCV in blooddonors in western Libya (Tripoli area), as well as to estimate the correlation riskfactors in blood donor samples. This would be an important factor for the health authorities to consider in blood donor bank.
Transfusion of blood and blood product is a life- saving measure and benefits numerous patients worldwide. However, transfusion is an important mode of transmission of infection to the recipients. In 2005, all member states of WHO signed a document that commits them to the provision of safe and adequate blood and blood products to patients . Transfusion-transmitted infectious diseases remain a major topic of interest for those involved in blood safety . To avoid infection by blood transfusion, safety is very important because of blood transfusion is an integral part of medical and surgical therapy. Therefore, the tests for HIV, HBV, HCVsyphilis and malaria are mandatory in the blood bank . Hepatitis B virus (HBV), hepatitis C virus (HCV) are a major global public health problem warranting high priority efforts for prevention, control and treatment . Testing for hepatitis B surface antigen (HBsAg) is the commonly used screening test in developing countries . The hepatitis C virus was discovered in 1989. It is transmitted via blood and blood products, both parenterally and through sexual contact . Libya, a developing country of approximately 6 million people, belongs to the intermediate endemicity countries with a wide variance of sero-positivity among different regions and populations . A national serological survey for HBV and HCV infections among the general population was performed in Libya during 2003 and revealed prevalence of 2.2% and 1.2% for HBV and HCV, respectively . A local surveys reported that the rate of HBsAg positivity amongblooddonors ranged from 1.3% to 4.6% , while the rate of HCV antibodies was 1.2% [9,10]. Very recently, the frequency of HBsAg positive blooddonors and anti-HCVamong this sample was 0.8% and 0.7% respectively in blooddonors in western Libya (Tripoli) . There has
These infections also cause fatal, chronic and life threatening disorders.
The TTI’s include Human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis and malaria. To reduce risk of TTI, careful selection of donors is needed so that the blood is safe and is not collected from the people who are likely to be carriers of infectious agents. Evaluation of TTI are essential for assessing the safety of blood supply and monitoring the efficacy of currently employed screening procedures 6 . Poor health infrastructure, lack of health awareness camps, unhygienic life standards and failure to implement strict norms of
data collection, qualitative and quantitative data analysis. All authors read and approved the final manuscript.
Ethics approval and consent to participate
Ethical clearance was obtained from the University of Gondar ethical review committee. Written permission was obtained from the University of Gondar Compressive Specialized Hospital. The objectives of the study were explained to the heads of the health facilities and health care providers who worked at the blood bank department and clarification was given before starting data collection from the registrations and clients cards. To keep confidentiality of information from participants records, no personal identifiers were recorded in the client information extraction pre-designed form and data secured from participant records were not be available to anyone except for the main investigator.
HCV seropositivity is also associated with male sex and lower education, and may be a surrogate marker for in- jection drug use and high-risk sexual behavior.
The cost utility of mandatory screening has been ques- tioned in the US given the low prevalence of active syph- ilis infection in donors and the inability of T. pallidum to survive refrigeration. One argument for continued screening has been the notion that syphilis is a surrogate marker for transfusion transmitted HIV. However, our study showed this not to be the case whereby we ob- served a very low positive predictive value of only 3 of 936 (0.32%) cases of HIV co-infection. Nonetheless, des- pite limited utility to blood safety in the US, syphilis screening offers public health benefit through identification of a small number of active syphilis cases. More import- antly, the data it provides may be useful for population surveillance.
Syphilis seems to be overlooked in Cameroon and there is no awareness campaign for this infection. Most are unaware of their T. pallidum status until probably at the moment of blood donation when the infection is diag- nosed. Another problem is the absence of serological re- sults given to family donors in LHD. This suggests that family donors with positive T. pallidum test do not know their status and could therefore continue to serve as reser- voirs for the bacteria, which can lead to infertility. Taken together, these findings indicate that bacterial contamin- ation is the major risk of infection during blood transfu- sion. In addition, we report a single case of co-infection HCV/ T. pallidum in the study population. In a study
Therefore this study have designed to determine the sero-prevalence and identify the possible riskfactors of HIV, HBV and Syphilis infections in pregnant women providing health care services at Gandhi Memorial Hospital Addis Ababa, Ethiopia from January to April 2014. A Cross sectional study design has used and data on socio-demographic characteristics and possible riskfactors have collected through pre-tested and structured questionnaire. After that blood have collected and screened for hepatitis B surface antigen using rapid cassette device and the final positive sample for HBsAg have confirmed by enzyme linked immunosorbent assay (ELISA). Antibodies to HIV-1/2 have tested based on the national testing algorism and Trepollema pallidum antibodies have tested by using Syphilis Rapid Test Strip (Quick Test™ Syphilis Serum/ Plasma/Whole Blood Strip). After the data have entered to Epi Info version 3.5.1 and exported to SPSS version 16 for validation and analysis, the overall prevalence of HIV-1/2 and HBsAg was 5.2%, 5% respectively while co-infection of HIV-HBV was 9.5% but no cases of Syphilis detected positive. In relation to the riskfactors; history of sex with multiple sexual partners, pre-exposure to STI and low level of monthly income were significant riskfactors for both HBV and HIV, while each infection found to have additional different riskfactors; these includes: receiving of blood through donation, ear piercing and history of abortion for HBV infection while sharing different sharp materials and contact history with infected person for HIV infection alone.
ABSTRACT HIV and sexually-transmitted diseases (STDs) represent a sig-
nificant public health problem worldwide. We analyzed the seroprevalence and riskfactors for HIV, hepatitis B and syphilis in populations with high-risk behaviors in Croatia. During a three-year period, a total of 443 men who have sex with men (MSM) / bisexual persons, sex workers (SW) / clients of SW, persons with multiple sexual partners, and persons with a history of STD were tested for the presence of HIV, hepatitis B virus (HBV), and Treponema pallidum (syphilis) antibodies within the framework of second generation HIV surveillance. Participants were recruited from 11 Croatian counties, the vast majority among clients of voluntary counselling and testing centers. The overall prevalence of HIV, HBsAg, anti-HBc, and syphilis was 1.4%, 2.6%, 12.1%, and 3.4%, respectively. HBV and syphilisseroprevalence differed sig- nificantly between, genders with higher prevalence among men (anti-HBc 13.8% vs. 5.7%, P=0.043; syphilis 4.4% vs. 0%; P=0.049), as well as between age groups, with a steady increase according to age. Participants with a histo- ry of STD were more often seropositive than participants who did not report STD (HBsAg 8.2% vs. 1.0%, P=0.002; anti-HBc 32.4% vs. 6.4%, P<0.001; syphilis 12.0% vs. 1.7%, P<0.001). Syphilisseroprevalence was higher in homo / bi- sexual persons (12.2%) compared with heterosexual persons (1.2%, P<0.001). logistic regression showed that history of STD was a significant risk factor for hepatitis B (HBsAg AOR=6.229, 95% CI=1.491-26.022; anti-HBc AOR=5.872, 95% CI=2.899-11.896) and syphilis seropositivity (AOR=5.572, 95% CI=1.751- 17.726), while homo / bisexual behavior was associated with syphilis seropos- itivity (AOR=12.820, 95% CI=3.688-44.557). Our results highlight the impor- tance of continuing STDs screening and prevention in at-risk populations.
This suggested level of exposure is surprising, since PONEIHD in Ghana do not administer any acute health- care to prisoners compared to that done by HCWs in acute care hospitals. Apart from occupational exposure, the exchange of sexual favours between prison officers and inmates, which is not unheard of, may be another mitigat- ing factor in the comparably high seroprevalence of these bloodborne and sexually transmitted infections in Ghana- ian prison inmates and officers. A concerning finding was that the prevalence of HCV infection in the prison officers was even higher than that in prisoners in this study and previously reported in prisoners in Ghana . Therefore, the present study substantiates the concern that PONEIHD may be at significantly increased risk of blood- borne infections, especially HCV, because of the particu- larly high prevalence of HCVamong prisoners worldwide
Current treatment for HCV infection is not highly effective and at least 90% of the patients who need treatment are unable to afford it . Immunization for passive prophylaxis of the hepatitis infection is not readily available. Public health interventions therefore continue to be the only effective method of preventing HCV infection. These include screening blood and blood products before transfusion, effective use of universal precautions and contraceptive barrier methods, use of disposable sharps and promotion of health education on HCV infection and its prevention. However, any strategy to prevent HCV infection must be based on accurate data. Recently, prevalence estimates by WHO suggested that 3% of the world population (about 170 million people) are currently infected with HCV and therefore at risk of developing cirrhosis and liver cancer [11, 9]. In developed countries, particularly USA and UK, there is mandatory screening tests for HbsAg and antibodies to HCV, HIV 1 and 2 and Treponema pallidum – syphilis [12, 13]. Most developing countries and indeed some centres in Nigeria do not screen donors for Hepatitis C, hence there is dearth of information on the prevalence of this clinically important virus. This study therefore was undertaken to investigate the seroprevalence of HCV antibodies amongblooddonors in Enugu – a south-eastern state of Nigeria and to awaken interest therein. Ethical clearance was obtained from the Ethical Committee of University of Nigeria Teaching Hospital Enugu, Nigeria while additional consent was sought from the blooddonors.
As the volume of data increases, the proportion of information in which people could understand decreases substantially. The applications of learning algorithms in knowledge discovery are promising and they are relevant area of research offering new possibilities and benefits in real-world applications such as blood bank data warehouse. The availability of optimal blood in blood banks is a critical and important aspect in a Blood transfusion service. Blood banks are typically based on a healthy person voluntarily donating blood used for transfusions. The ability to identify regular blooddonors enables blood bank and voluntary organizations to plan systematically for organizing blood donation camps in an efficient manner. The objective of this study was to explore the immense applicability of data mining technology in the Ethiopian national blood bank service by developing a predictive model that could help in the donor recruitment strategies by identifying donors that are at risk of TTIs which can help in the collection of safe blood group which in turn assists in maintaining optimal blood. The analysis has been carried out on 14575 blood donor’s dataset that has at least one pathogen using the J48 decision tree and Naive bayes algorithm implemented in Weka. J48 decision tree algorithm with the overall model accuracy of 94% has offered interesting rules. From the total of 156729 consecutive blooddonors, 14757 (9.41%) had serological evidence of infection with at least one pathogen and 29 (0.19%) had multiple infections. The overall seroprevalence of HIV, HBV and HCV was 2.29%, 5.23%, and 2.30%
Choy et al. screened for HCV infection in STD-infected patients 24 in New Jersey, USA and reported that inner-city obstetric patients are at high risk for HCV infection when compared with the general population. Increasing age and HIV positive status are the riskfactors that are significantly associated with HCV infection. In STD clinics, integrating risk-based screening into routine clinic services is an effi- cient way to identify HIV-infected persons. 25—27 The increased risk of HBV, HCV, and HIV infection among STD patients warrants specific preventive action. 28—30 HIV, HCV, and HBV may promote each other and be related to different cultures and living habits 31 though this does not appear to be the case in our study population.
This study has several limitations. The ideal condition to conduct a seroprevalence study is by taking sample of general population. As blooddonors are specifically selected based on extensive questionnaire, strict selection criteria and physical examination and only apparently healthy individuals with lowest risk of TTIs were allowed to donate blood, our study sample does not represent general population. Further, the donor pool was predominantly composed of male population. We acknowledge the limitation of not using advanced methods like NAAT (Nucleic Acid Amplification Techniques) which are needed for detection of window period in HIV due to non-availability in our blood bank.