Muller Journal of Medical Sciences and Research

ORIGINAL ARTICLE
Year
: 2014  |  Volume : 5  |  Issue : 2  |  Page : 113--116

Seroprevalence of Transfusion Transmissible Infections (TTIs) among blood donors in a tertiary care hospital, central India: A prospective study


Alok Kumar1, Shatish M Sharma2, Narayan S Ingole2, Nitin Gangane2,  
1 Department of Pathology, Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra; Department of Pathology, Government Medical College, Jagdalpur, Chhattisgarh, India
2 Department of Pathology, Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra, India

Correspondence Address:
Alok Kumar
Department of Pathology, Government Medical College, Jagdalpur, Chhattisgarh
India

Abstract

Background: Blood transfusion having some risks of transfusion transmissible infections (TTIs) in the recipients especially when blood is collected during window period. In Africa, about 10-15% of human immunodeficiency virus (HIV) transmission had been related to blood transfusions. Aims: The aim of this study is to present the prevalence of TTIs among the apparently healthy donors, both voluntary as well as replacement donors. Settings and Design: This was a prospective study, carried out in a blood bank attached to a tertiary care hospital, Central India. Materials and Methods: All blood bags collected from these blood donors during the study period were screened for TTIs like hepatitis B surface antigen (HBsAg; Hepalisa, J. Mitra), anti-HIV antibodies (HIV Ab; HIV 3rd generation kit for detection of antibodies to HIV1 and HIV2, J. Mitra), anti-hepatitis C virus antibodies (HCV Ab; MicroELISA 3rd generation, J. Mitra), and Venereal Diseases Research Laboratory (VDRL) reactivity (Carbogen kit, Tulip Diagnostics). Serum were separated from all blood bags and serological test was performed according to the instructions provided by the manufacturers of respective kit. All seroreactive blood bags were considered as positive for TTIs and the blood bags were discarded. Statistical Analysis: A total of 10,582 blood donors were selected for blood donation after clinical history and brief medical examination by medical officer. Blood bags collected from them were screened for TTIs. Among the total blood bags screened, 273 (2.57%) were found positive for transfusion transmissible infectious diseases. Results: Among TTIs, the most common infection was hepatitis B followed by HIV infection in our study. Prevalence of coinfection in our study was very low (0.01%). Voluntary donations have low seroreactivity (2.40%) for TTIs as compared to replacement donations (3.20%). Conclusions: Multiple infections have a very small but definite risk to the recipients, recieving blood and blood products. Hepatitis B was the most common infection in our study. The incidence of coinfection was very low in our study. Prevalence of TTIs was more among replacement donors as compared to the voluntary donors. So, it is possible to improve the safety of blood and blood product by the promotion of voluntary donation, selection of low-risk donors, and use of highly sensitive laboratory screening test.



How to cite this article:
Kumar A, Sharma SM, Ingole NS, Gangane N. Seroprevalence of Transfusion Transmissible Infections (TTIs) among blood donors in a tertiary care hospital, central India: A prospective study.Muller J Med Sci Res 2014;5:113-116


How to cite this URL:
Kumar A, Sharma SM, Ingole NS, Gangane N. Seroprevalence of Transfusion Transmissible Infections (TTIs) among blood donors in a tertiary care hospital, central India: A prospective study. Muller J Med Sci Res [serial online] 2014 [cited 2021 Oct 21 ];5:113-116
Available from: https://www.mjmsr.net/text.asp?2014/5/2/113/135737


Full Text

 Introduction



Blood transfusion is one of the therapeutic interventions that is associated with some risks of transfusion transmissible infections (TTIs) in the recipients especially when blood were collected during window period. In Africa, about 10-15% of human immunodeficiency virus (HIV) transmission had been related to blood transfusions. [1] Despite stringent donor screening and testing procedures, the safe to safe blood free from TTIs remains an elusive goal. Although there are many studies on the prevalence of TTIs in blood donors, [2],[3],[4],[5] data on the presence of coinfection is few. [6] The aim of this study is to present the prevalence of TTIs among the apparently healthy donors, both voluntary as well as replacement donors.

 Materials and Methods



The study was carried out in the blood bank, attached to the tertiary care hospital, Central India over a period of 19 months from November 2009 to May 2011.

It was a prospective study. All blood donations collected during this period were included. The donors were either voluntary or replacement donors. Replacement donors were either relatives or friends of patients.

All blood bags collected from these blood donors during the study period were screened for TTIs like HBsAg (Hepalisa, J. Mitra - J. Mitra & Co. Pvt. Ltd, New Delhi, India), anti-HIV antibodies (HIV Ab; HIV 3rd generation kit for detection of antibodies to HIV1 and HIV2, J. Mitra - J. Mitra & Co. Pvt. Ltd, New Delhi, India), anti-hepatitis C virus antibodies (HCV Ab; MicroELISA 3rd generation, J. Mitra - J. Mitra & Co. Pvt. Ltd, New Delhi, India), and Venereal Diseases Research Laboratory (VDRL) reactivity (Carbogen kit, Tulip Diagnostics-Tulip diagnostics (P) Ltd, Uttarakhand, India).

Serum was separated from all blood bags and serological test was performed according to the instructions provided by the manufacturers of respective kit. All seroreactive blood bags were considered as positive for TTIs and the blood bags were discarded.

Statistical Analysis

A total of 10,582 blood donors were selected for blood donation after clinical history and brief medical examination by medical officer. Blood bags collected from them were screened for TTIs. Further, within the seroreactive group, cases with a combination of two or more than two TTIs were labeled as coinfection.

 Results



A total of 10,582 blood donors were screened for TTIs, 97.05% were male and 2.95% were female. Almost 78% were voluntary donors and 22% were replacement donors. Among voluntary donors, 96.24% were male and 3.76% were female donors as shown in [Table 1].{Table 1}

Among a total of 10,582 blood donors screened, 273 (2.57%) were found positive for infectious diseases, in which hepatitis B infection (1.76%) was the commonest infection among blood donors followed by HIV infection (0.53%). Most of the infections were caused by single organism, except in one having mixed infection caused by hepatitis B and HIV and no donors were positive for malarial parasite as shown in [Table 2].{Table 2}

A total of 8,232 voluntary donors was screened in which 197 (2.40%) were found positive for infectious diseases while 76 (3.20%) of replacement donors were found positive against a total of 2,350 replacement donors. Distribution of TTIs among voluntary as well as replacement donors is shown in [Table 3].{Table 3}

 Discussion



In our study, a total of 273 (2.57%) donors were seropositive for infectious diseases (TTIs) out of 10,582 donors screened, hepatitis B virus infection 187 (1.76%) was the commonest infections among donors followed by HIV (0.53%) while hepatitis C accounts for 21 (0.20%) and syphilis in 07 (0.07%) of all donors screened. No donors had malarial infections. Most of the infections were caused by single organism, except one having mixed infection caused by hepatitis B and HIV.

In the study done by Chickwem et al., [7] it was found that the most common infection was hepatitis B (14.84%) followed by HIV-1 (5.77%) while Plasmodium falciparum accounted for 4.12% and Treponema pallidum for 3.57%. No donors had HIV-2 or filarial infections. On the whole, a total of 94 (25.8%) blood donors were infected by one infectious agent or the other. Only nine (2.5%) had mixed infections.

In study done by Fasola et al., [8] (2001-2006), Nigeria, it was observed that the most common infection was hepatitis B (13.2%) followed by HIV (7.6%), HCV (3.6%) and no donors had syphilis infection.

Shrestha et al., [9] (2004-2007), Nepal, observed that hepatitis C infection (0.64%) was the most common infection followed by hepatitis B (0.64%), syphilis (0.48%), and HIV 0.12% of total donors.

Mathai et al., [3] (1994-96), Trivandrum, Kerala observed that the most common infection was hepatitis C infection (1.4%) followed by hepatitis B infection (1.3%), and both HIV and syphilis each were seen in 0.2% of donors.

Garg et al., [5] (1994-99), Jodhpur, Rajasthan observed that hepatitis B (3.4%) was the most common infection followed by HIV (0.44%), hepatitis C infection (0.28%), and syphilis was 0.22%.

Chandra et al., [10] (2001-2006), Lucknow, U. P. observed that hepatitis B infection was most common (1.96%) followed by hepatitis C infection (0.85%), HIV (0.23%), and syphilis was 0.01%.

Bhawani et al., [11] (2004-2009) observed that hepatitis B (1.41%) was the most common infection followed by hepatitis C infection (0.84%), HIV (0.39%), and syphilis was 0.08%.

Kapur and Mittal et al., [12] found that in HIV-positive donors, HBsAg was positive in 12.2% while VDRL was reactive in 11.8%.

Jain et al., [13] estimated the seroprevalence of hepatitis virus in patients infected with HIV and found that 9.9% of patients were HBsAg-positive, 6.3% were HCV-positive and about 1% had dual infection with HBV and HCV.

Mathai et al., [3] found that of 31,942 donors screened over a 6-year period, mixed infections were seen in only 10 donors (0.03%).

Studies on the prevalence of hepatitis viruses in patients with HIV have shown the HIV and HBV/HCV coinfection rate to be 12-15%. [14],[15],[16] However, studies from India show that this varies with the geographical region with rates of 9-30% for HBV and 2-8% for HCV have been reported. [17],[18],[19]

On comparing with these studies, we observed that hepatitis B infection (1.76%) was the most common among blood donors in our study as also observed in other studies [5],[8],[10],[11],[12] followed by HIV infection (0.53%). No cases of malarial parasites were detected in our study. It was due to proper clinical assessment and history of the donor. Only one donor had coinfection with both hepatitis B and HIV out of 10,582 donors screened. Prevalence of coinfection in our study was very low (0.01%) as compared to other studies where prevalence of coinfection was high. [12],[13],[14],[15],[16] However, prevalence of coinfection in our study was similar to study done by Mathai et al., [3] (2002).

 Conclusions



Multiple infections have a very small but definite risk to the recipients, receiving blood and blood products. Hepatitis B was the most common infection in our study. The incidence of coinfection was very low in our study. Prevalence of TTIs was more among replacement donors as compared to the voluntary donors. So, it is possible to improve the safety of blood and blood product by the promotion of voluntary laboratory screening test.

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