Kania Dramane, Sangaré Lassana, Sakandé Jean, Koanda Abdoulaye, Nébié Yacouba Kompingnin, Zerbo Oumarou, Combasséré Alain Wilfried, Guissou Innocent Pierre, Rouet François
Laboratoire de Virologie, Centre Muraz, Bobo-Dioulasso, Burkina Faso.
Transfusion. 2009 Oct;49(10):2237-40. doi: 10.1111/j.1537-2995.2009.02276.x. Epub 2009 Jul 6.
In Africa where blood-borne agents are highly prevalent, cheaper and feasible alternative strategies for blood donations testing are specifically required.
From May to August 2002, 500 blood donations from Burkina Faso were tested for hepatitis B surface antigen (HBsAg), human immunodeficiency virus (HIV), syphilis, and hepatitis C virus (HCV) according to two distinct strategies. The first strategy was a conventional simultaneous screening of these four blood-borne infectious agents on each blood donation by using single-marker assays. The second strategy was a sequential screening starting by HBsAg. HBsAg-nonreactive blood donations were then further tested for HIV. If nonreactive, they were further tested for syphilis. If nonreactive, they were finally assessed for HCV antibodies. The accuracy and cost-effectiveness of the two strategies were compared.
By using the simultaneous strategy, the seroprevalences of HBsAg, HIV, syphilis, and HCV among blood donors in Ouagadougou were estimated to be 19.2, 9.8, 1.6, and 5.2%. No significant difference of HIV, syphilis, and HCV prevalence rates was observed by using the sequential strategy (9.2, 1.9, and 4.7%, respectively). Whatever the strategy used, 157 blood donations (31.4%) were found to be reactive for at least one transfusion-transmissible agent and were thus discarded. The sequential strategy allowed a cost decrease of euro 908.6, compared to the simultaneous strategy. Given that approximately there are 50,000 blood donations annually in Burkina Faso, the money savings reached potentially euro 90,860.
In resource-limited settings, the implementation of a sequential strategy appears as a pragmatic solution to promote safe blood supply and ensure sustainability of the system.
在血源性病原体高度流行的非洲，特别需要更廉价且可行的献血检测替代策略。
2002年5月至8月，根据两种不同策略，对来自布基纳法索的500份献血进行了乙型肝炎表面抗原（HBsAg）、人类免疫缺陷病毒（HIV）、梅毒和丙型肝炎病毒（HCV）检测。第一种策略是使用单标记检测法对每份献血同时常规筛查这四种血源感染性病原体。第二种策略是从HBsAg开始进行序贯筛查。HBsAg检测呈非反应性的献血随后进一步检测HIV。若为非反应性，则进一步检测梅毒。若仍为非反应性，最后检测HCV抗体。比较了两种策略的准确性和成本效益。
采用同时检测策略时，瓦加杜古献血者中HBsAg､HIV､梅毒和HCV的血清流行率估计分别为19.2%､9.8%､1.6%和5.2%。采用序贯检测策略时，未观察到HIV､梅毒和HCV流行率有显著差异（分别为9.2%､1.9%和4.7%）。无论采用哪种策略，均发现157份献血（31.4%）对至少一种输血传播病原体呈反应性，因此被废弃。与同时检测策略相比，序贯检测策略使成本降低了908.6欧元。鉴于布基纳法索每年约有50000份献血，潜在节省资金达90860欧元。
在资源有限的情况下，实施序贯检测策略似乎是促进安全血液供应和确保系统可持续性的务实解决方案。
