HIV, HCV, HBV and syphilis rate of positive donations among blood donations in Mali: Lower rates among volunteer blood donors

doi:10.1016/j.tracli.2009.09.004

Transfusion Clinique et Biologique

Volume 16, Issues 5–6, November–December 2009, Pages 444-447

https://doi.org/10.1016/j.tracli.2009.09.004 Get rights and content

Abstract

Good data on background seroprevalence of major transfusion transmitted infections is lacking in Mali. We gathered data on the rate of positive donations of human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV) and syphilis among blood donations in Mali for calendar year 2007. Donations with repeatedly reactive results on screening enzyme immunoassay (EIA) were considered to be seropositive. Rate of positive donations per blood unit collected was 2.6% for HIV, 3.3% for HCV, 13.9% for hepatitis B surface antigen (HBsAg) and 0.3% for syphilis. For HIV, HBsAg and syphilis, rate of positive donations was significantly (p < 0.001) higher among donations from replacement donors than those from volunteer donors, while HCV rate of positive donations was similar in the two groups. Rate of positive donations was also significantly (p < 0.0001) lower in blood units from regular than from first-time donors. These data reinforce WHO recommendations for increasing the number of regular, volunteer blood donors in Africa.

Résumé

La fréquence des agents infectieux transfusionnels majeurs a été déterminée au cours de l’année 2007 pour tous les dons de sang effectués au Centre national de transfusion sanguine du Mali. Les prévalences élevées de ces agents (2,6 % pour le virus de l’immunodéficience humaine, 3,3 % pour le virus de l’hépatite C, 13,9 % pour le virus de l’hépatite B [antigène HBs] et 0,3 % pour la syphilis) dans les dons de sang, surtout dans ceux effectués par des donneurs de remplacement, justifient une politique de sécurisation basée notamment sur le recrutement de donneurs volontaires et bénévoles, qui ont un plus faible risque de transmission des agents transmissibles par le sang.

Section snippets

Study design and population

Blood donors at the CNTS of Mali are comprised of:

•
voluntary donors who donate blood for the community, not for their parent or relative, and consisting of new donors and regular donors (those who have donated at least three times previously in their life);
•
replacement donors, namely those who give blood designated for a member of their family, or for medical reasons, or at the time of enlistment into the military.

First-time versus repetitive donor status was defined according to whether the

Results

There were a total of 25,543 donations at the CNTS during calendar year 2007, including 17,449 (68%) from replacement donors and 8094 (32%) from voluntary donors. The majority (22,153 or 87%) of donations were obtained at the fixed site at CNTS headquarters, while remaining 3390 (13%) at mobile collections sites. Age distribution was as follows: 39% of blood donations from donors aged between 18 and 25, 36% between 26 and 35, 17% between 36 and 45 and 8% between 46 and 60. The positive rate of

Discussion

High as it is, the rate of positive donations observed for HIV in 2007 shows a decrease from that of previous years. For example, HIV rate of positive donations was 4.7% in 1993 (CNTS unpublished data) and 4.5% in 2002 [3] compared to 2.6% in the current 2007 study. A similar tendency towards declining prevalence has been found in a population-based national survey in Mali [4]. For HIV, declining rate of positive donations could be due to prevention campaigns instituted to limit HIV

Conflict of interest

Authors didn’t submit any conflict of interest declaration.

References (18)

A. Dicko et al.
The etiology of severe anemia in a village and a periurban area in Mali
Blood
(2004)
Recommandation ONU-SIDA et OMS relatives aux stratégies de dépistage du VIH, en fonction de l’objectif du test et de la prévalence de l’infection dans la population
Rev Epidemiol Hebd
(1997)
A. Tounkara et al.
Seroprevalence of HIV/HBV coinfection in Malian blood donors
J Int Assoc Physicians AIDS Care (Chic III)
(2009)
Enquête démographique et de santé IV, Mali,...
O. Kra et al.
Prévalence de l’antigène HBs chez les donneurs de sang au centre régional de transfusion sanguine de Bouaké (Côte d’Ivoire) en 2001
Bull Soc Pathol Exot
(2007)
M. Dembele et al.
Étude de l’antigène HBs et des anticorps antivirus de l’hépatite C au cours des hépatopathies chroniques dans des services hospitaliers à Bamako, Mali
Bull Soc Pathol Exot
(2004)
Tagny CT, Diarra A, Yahaya R, Hakizimana M, Nguessan A, Mbensa G, et al. Characteristics of blood donors and donated...
S. Sidibe et al.
Prévalence des marqueurs sérologiques du virus de l’hépatite B chez les femmes enceintes de Bamako, Mali
Bull Soc Pathol Exot
(2001)
T.N. Dieye et al.
Séroprévalence du virus de l’hépatite C (VHC) chez les donneurs de sang sénégalais
Dakar Med
(2006)

There are more references available in the full text version of this article.

Cited by (59)

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Seroprevalence of hepatitis B and C viruses, HIV-1/2 and syphilis among blood donors in the Yaoundé Central Hospital in the centre region of Cameroon
2016, Transfusion Clinique et Biologique
La prévention de la transmission des infections transmises par transfusion sanguine dépend de la bonne sélection des donneurs et de la réalisation des tests sérologiques adéquats pour la détection des agents pathogènes, notamment les virus des hépatites B et C et le virus de l’immunodéficience humaine (VIH). Le but de cette étude était double : déterminer les séroprévalences des infections dues aux VHB, VHC, VIH et de la syphilis parmi les donneurs de sang de l’hôpital central de Yaoundé (HCY) et déterminer les caractéristiques sociodémographiques, afin de trouver des stratégies pour améliorer la sécurité transfusionnelle au Cameroun.
Il s’agit d’une étude rétrospective ayant porté sur 9024 donneurs de sang consécutifs de l’HCY dans la région du centre, Cameroun, inclus de janvier à décembre 2013. Les données ont été recueillies sur les questionnaires de pré-don et des résultats des tests biologiques de qualification effectués sur les dons de sang au laboratoire de l’HCY avec des tests Elisa.
L’âge moyen des donneurs était de 28 ans. Le sex-ratio M/F était de 14,8. Selon le mode de don, 97,2 % étaient des donneurs de compensation et 76,8 % étaient des nouveaux donneurs. Au total, 19,3 % des donneurs étaient positifs pour au moins un agent infectieux, parmi eux 1,5 % étaient positifs pour au moins 2 marqueurs viraux. Les séroprévalences globales de l’AgHBs, des anti-VHC, des anti-VIH et de la syphilis étaient respectivement de : 12,6 %, 3,2 %, 3,3 % et 0,2 %. Pour l’AgHBs, la prévalence était significativement plus élevée chez les hommes (p = 0,001) et les nouveaux donneurs (p = 0,003). La prévalence des anti-VHC était significativement plus élevée parmi les nouveaux donneurs (p = 0,05). La prévalence des anti-VIH était significativement plus élevée chez les nouveaux donneurs (3,7 % vs 2,2 % ; p = 0,02).
Le profil du donneur camerounais est de type compensation et nouveaux donneurs. Les séroprévalences du VIH, du VHB, du VHC et de la syphilis parmi les donneurs de sang sont élevées et reflètent l’importance de ces agents dans notre milieu.
Prevention of blood transfusion-transmitted infections includes blood donor screening and effective infectious markers screening for donated blood. This study had two main objectives: to determine seroprevalence of HBV, HCV, HIV and syphilis in blood donors of the Yaoundé Central Hospital and to study sociodemographic factors of blood donors.
A retrospective study of consecutive blood donors’ records from January to December 2013 was conducted. Seroprevalence of hepatitis B, hepatitis C, human immunodeficiency viruses and syphilis were determined in 9024 whole blood donations collected in the Yaoundé Central Hospital in the centre region, Cameroon using Elisa kits.
Mean age of donors was 28 years. The male to female ratio was 14.8. Most of blood donors were replacement donors (97.2%) and first-time donors (76.8%). Up to 19.3% of the donors tested positive for at least one infectious agent, in which 0.1% presented a positive test for three viruses (HIV, HCV and HBV). The overall seroprevalence in blood donors was 12.6% for HBsAg, 3.2% for hepatitis C antibody, 3.3% for HIV-1/2 antibodies and 0.2% for syphilis. The prevalence of HBsAg was significantly higher in men (P = 0.001), among first-time donors (P = 0.003), in blood group A (P = 0.01) and those with the rhesus positive blood (P = 0.01). The prevalence of anti-HCV was significantly higher among first-time donors (P = 0.05). The prevalence of anti-HIV was significantly higher in first-time donors (3.7% vs 2.2%, P = 0.02).
First-time blood donors and replacement donors are the two types of donors in Cameroon. Replacement donors are considered as having a major risk of transmission of infections to recipients. The seroprevalence of HIV, HBV, HCV, and syphilis among these donors is high and reflects how much these agents are present in Cameroon. Effective infectious markers screening and organization of blood donors into an association of volunteer's donors are necessary to secure blood transfusion in Cameroon.
Hepatitis B, Hepatitis C, Human immunodeficiency virus and syphilis frequency among blood donors: A single center study
2015, Transfusion and Apheresis Science
We aimed to provide updated results for seroprevalence of hepatitis B, hepatitis C viruses while presenting first data for human immunodeficiency virus and syphilis seropositivity amongst blood donors in Adana, Turkey. Screening and confirmatory test results of 62,461 donors were evaluated. HBsAg, anti-HCV, anti-HIV1/2 and syphilis seropositivity was 1.92%, 0.48%, 0.20%, 0.18% respectively, based on screening tests, and 1.66%, 0.05%, 0.003%, 0.10% respectively, according to confirmatory tests. Transfusion-transmitted infections (TTI) was more prevalent in low-educated donors. HBsAg and syphilis seropositivity rates were higher in married subjects. We found that the prevalence of HBV and HCV was significantly decreased in the last two decades in Adana. Importantly, this study provides first data in HIV and syphilis seropositivity rates among blood donors in our region and both HIV and syphilis seroprevalences were found to be low compared to many regions of Turkey. However, considering the fact that increasing number of immigrants may change prevalences and trends of TTI both in Adana and in Turkey, strict monitorization and yearly reporting of TTI rates seem necessary to be able to take proactive measures.
Mutual blood donation is safer at small blood collection stations in China
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Citation Excerpt :
To minimize these risks, WHO has recommended collecting blood from voluntary donors [7]. Data published in the literatures [8–10], including our present study, reported a prevalence of serological markers lower in voluntary donors than in replacement donors, without considering the differences, such as age, sex, education and pre-donor screening, between the two groups of donors. However, Jean-Pierre Allain had demonstrated that viral safety of replacement and first-time voluntary donors was equal in Kumasi, Ghana and considered that retaining both volunteer and replacement donors as repeat donors could significantly improve blood safety [1].
The assumption that the level of safety of voluntary non-remunerated donors is significantly higher than that of family replacement donors is supported by global data without stratifying for first-time or repeat volunteer, or according to age, but the viral marker prevalence between replacement donors and first-time voluntary non-remunerated donors is similar.
From 2006 to 2013, replacement and voluntary donors were respectively recruited by the hospitals and the Center Blood Station in Zhaoqing, Guangdong, according to the existing procedures, and all the donors were screened for hepatitis B virus (HBV) surface antigen (HBsAg), antibodies against hepatitis C virus (anti-HCV), human immunodeficiency virus (anti-HIV) (1 + 2) and Treponema pallidum (anti-TP) by the enzyme immunoassays (EIAs), and alanine aminotransferase (ALT) in the Center Blood Station by kinetic analysis method. The risk factors related to blood safety were analyzed by Binary logistic regression analysis.
Between 252,202 volunteers and 2771 replacement donors, the prevalences of ALT > 40 U/L and anti-HIV (4.88% and 0.01% vs 4.44% and 0.07%, respectively) were not significantly different. The prevalences of HBsAg, anti-HCV and anti-syphilis in replacement group were higher than those in voluntary group, which were related to donor's sex, age and donation time. Overall prevalence of serological markers was higher in male replacement donors than in female, and in replacement donor over 30 years than in those below 30 years, but the positive prevalence in repeated replacement donors was lower than that in first-time replacement donors.
With appropriate intervention measures, such as pre-donor screening and other donor selection policy, replacement donors and voluntary donors provide a similar level of viral safety. Our donor selection policy in future should focus on retaining both young replacement and young voluntary donors as repeat donors and promoting the donation proportion of females, which will improve blood safety.
The Use of Rapid Diagnostic Tests for Transfusion Infectious Screening in Africa: A Literature Review
2015, Transfusion Medicine Reviews
Citation Excerpt :
For example, effective donor selection in South Africa has reduced the prevalence of HIV in blood donors by 100-fold compared with the general population [19]. The WHO advocates for the systematic recruitment and collection from low-risk donors and recommends, specifically, that 80% to 100% of donations be sourced from voluntary nonremunerated blood donors (VNRBDs), given lower reported rates of TTIs [14,55–57]. Despite much improvement in donor recruitment and the adoption of innovative and low-cost donor mobilization strategies (eg, Club 25, partnerships, and outreach through local FM radio stations), many African countries have yet to achieve the WHO-recommended target [58,59].
Infectious risk associated with blood transfusion remains a major public health challenge in Africa, where prevalence rates of the major transfusion-transmissible infections (ie, hepatitis B, hepatitis C, human immunodeficiency virus, and syphilis) are among the highest in the world. Resource-limited blood services often operate with minimal predonation screening safeguards, prompting exclusive reliance on laboratory testing to mitigate infectious risk. Transfusion screening with rapid diagnostic tests (RDTs) has been adopted in areas that lack the capacity to support the routine use of more sophisticated technologies. However, uncertainty surrounding the performance of some RDTs in the field has spurred debate regarding their application to blood donation screening. Our review of the literature identified 17 studies that evaluated RDTs for the infectious screening of blood donors in Africa. The review highlights the variable performance of available RDTs and the importance of their use in a quality-assured manner. Deficiencies in performance observed with some RDTs underscore the need to validate test kits prior to use under field conditions with locally acquired samples. Suboptimal sensitivities of some available tests, specifically hepatitis B virus rapid assays, question their suitability in single-test algorithms, particularly in high-prevalence regions. Although RDTs have limitations, many of which can be addressed through improved training and quality systems, they are frequently the only viable option for infectious screening in resource-poor African countries. Therefore, additional studies and specific guidelines regarding the use of RDTs in the context of blood safety are needed.
Seroprevalency of transfusion-transmitted infections in first-time volunteer and replacement donors in Tunisia
2014, Transfusion Clinique et Biologique
Citation Excerpt :
It should be noted that in Tunisia there is a centre for free and anonymous HIV screening; however its role in limiting this behaviour in blood donors still needs to be evaluated. Comparing the seroprevalency of transfusion-transmissible, infections in RD and VD were the subject of numerous studies worldwide [4,11–20] and the results were different depending on the serological marker studied and countries. Many studies have been criticized for having found a higher seroprevalency in RD compared to VD without taking into consideration the status of the donor: new VD or regular VD (regular VD can skew the results as they had serological tests earlier) nor the heterogeneity of age and sex of the two donor groups compared [2,12].
Replacement donors are considered as having a major risk of transmission of infections to recipients mainly by the World Health Organisation.
Seroprevalency of HBV, HCV, HIV and syphilis were determined in 19,783 whole blood donations collected in the Tunisian National Blood Transfusion Centre during the year 2010 (12,968 [65.55%] replacement donations and 6815 [34.44%] voluntary blood donations). For HBV, HCV and syphilis, we performed a univariate analysis to determine whether age, sex and type of donation were risk factors, then multivariate logistic regression, to see if these factors were independent.
Mean age of donors was 30.1 years (replacement donors 34.5 years, first time non-remunerated donors 34.5 years, P < 0.001). The predominant age group was 30–39 years (35.51%) in replacement donors and 20–29 years (54.15%) in first time non-remunerated donors. Male gender was significantly predominant (73.00% men vs 27.00% women, P < 10⁻⁶). There were significantly more men among replacement donors (82.27% vs 55.38%, P < 10⁻³). There were more women in the age groups 18–19 and 20–29 years. Only one HIV seropositive donation was noted in a male first time non-remunerated donor aged 18. Replacement type of donation, male sex and age were three independent risk factors for the HBs Ag carriage. For anti-HCV antibodies and TPHA, only replacement type of donation and age were found out to be risk factors and only age was independent.
In Tunisia, replacement blood donors were at higher risk of infection transmission, but only for hepatitis B.
Les donneurs de compensation sont considérés à plus haut risque de transmission d’infections notamment par l’Organisation mondiale de la santé.
Les séroprévalences de l’HBV, l’HCV, le VIH et la syphilis ont été déterminées chez 19 783 dons de sang total, collectés au Centre national de transfusion sanguine durant l’année 2010 (12 968 [65,55 %] dons de compensation et 6815 [34,44 %] dons volontaires). Pour l’HBV, l’HCV et la syphilis, on a effectué une analyse univariée pour déterminer si l’âge, le sexe et le type de don étaient des facteurs de risque suivie d’une étude multivariée en régression logistique pour voir si ces facteurs étaient indépendants.
L’âge moyen des donneurs était de 30,1 ans (donneurs de compensation 34,5 ans, donneurs volontaires 34,5 ans, p < 0,001). Le groupe d’âge prédominant était 30–39 ans (35,51 %) chez les donneurs de compensation et 20–29 ans (54,15 %) chez les donneurs volontaires. Le sexe masculin était significativement prédominant (73,00 % hommes vs 27,00 % femmes, p < 10⁻⁶). Il y avait significativement plus d’hommes parmi les donneurs de compensation (82,27 % vs 55,38 %, p < 10⁻³). Les femmes étaient plus nombreuses dans les groupes d’âge 18–19 et 20–29 ans. Un seul don VIH positif a été noté chez un donneur volontaire, un homme âgé de 18 ans. Le type don de compensation, le sexe masculin et l’âge étaient trois facteurs de risque indépendants de portage de l’Ag HBs. Pour les anticorps anti-HCV et le TPHA, uniquement le type don de compensation et l’âge étaient des facteurs de risque et seul l’âge était indépendant.
En Tunisie, les donneurs de compensation étaient à risque plus élevé uniquement pour l’hépatite virale B.

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Abstract

Résumé

Section snippets

Study design and population

Results

Discussion

Conflict of interest

The etiology of severe anemia in a village and a periurban area in Mali

Blood

Recommandation ONU-SIDA et OMS relatives aux stratégies de dépistage du VIH, en fonction de l’objectif du test et de la prévalence de l’infection dans la population

Rev Epidemiol Hebd

Seroprevalence of HIV/HBV coinfection in Malian blood donors

J Int Assoc Physicians AIDS Care (Chic III)

Prévalence de l’antigène HBs chez les donneurs de sang au centre régional de transfusion sanguine de Bouaké (Côte d’Ivoire) en 2001

Bull Soc Pathol Exot

Étude de l’antigène HBs et des anticorps antivirus de l’hépatite C au cours des hépatopathies chroniques dans des services hospitaliers à Bamako, Mali

Bull Soc Pathol Exot

Prévalence des marqueurs sérologiques du virus de l’hépatite B chez les femmes enceintes de Bamako, Mali

Bull Soc Pathol Exot

Séroprévalence du virus de l’hépatite C (VHC) chez les donneurs de sang sénégalais

Dakar Med