Internal Medicine Unit, Edéa Regional Hospital, Edéa, Cameroon.
Int J Infect Dis. 2013 Oct;17(10):e832-7. doi: 10.1016/j.ijid.2012.12.007. Epub 2013 Jan 11.
Blood safety remains an issue of major concern in transfusion medicine in sub-Saharan Africa. Blood-borne agents such as the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and Treponema pallidum are among the greatest threats to blood safety for the recipient. This study aimed to determine the seroprevalence and risk factors of HIV, HCV, HBV, and syphilis infections among first-time blood donors at the new hospital-based blood bank in Edéa, Cameroon.
We carried out a retrospective analysis of blood donor data recorded between December 2011 and May 2012 at the blood bank of the Edéa Regional Hospital. Antibodies to HIV types 1 and 2 were screened with the Determine and ImmunoComb tests. Hepatitis B surface antigen and antibodies to HCV were detected using DIASpot test strips. Syphilis was diagnosed using the Venereal Disease Research Laboratory (VDRL) test and the Treponema pallidum hemagglutination assay (TPHA).
A total of 543 blood donors were included, among whom 349 (64.3%) were family replacement donors. One hundred and fifteen donors (21.2%) were infected with at least one pathogen. The overall seroprevalence rates of HIV, HBV, HCV, and syphilis were 4.1%, 10.1%, 4.8%, and 5.7%, respectively. We found a total of 26 dual infections. The most common combinations were HBV-HCV and HBV-HIV. There was a significant association between HIV and HBV infections (adjusted odds ratio (aOR) 3.46, 95% CI 1.29-9.39; p=0.014), and between HBV and HCV infections (aOR 2.81, 95% CI 1.02-10.12; p=0.036). Compared to voluntary donors, family replacement donors were significantly more infected by at least one screened pathogen (aOR 1.81, 95% CI 1.14-2.88; p=0.013), and more infected specifically by HIV (aOR 3.66, 95% CI 1.07-12.55; p=0.039) and syphilis (aOR 2.81, 95% CI 1.05-7.46; p=0.039).
Our findings indicate that blood safety remains a major problem in Cameroon where hospital-based blood banks and family replacement donors are predominant. There is an urgent need for a national blood transfusion program in Cameroon that will establish a nationally coordinated blood transfusion service based on the principles of voluntary regular non-remunerated blood donation.
在撒哈拉以南非洲的输血医学中，血液安全仍然是一个主要关注点。血液传播病原体，如人类免疫缺陷病毒（HIV）、乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）和梅毒螺旋体，是接受者血液安全的最大威胁之一。本研究旨在确定喀麦隆埃代亚新医院基础血库首次献血者中 HIV、HCV、HBV 和梅毒感染的血清流行率和危险因素。
我们对 2011 年 12 月至 2012 年 5 月期间在埃代亚地区医院血库记录的献血者数据进行了回顾性分析。使用 Determine 和 ImmunoComb 检测筛查 HIV 1 型和 2 型抗体。使用 DIASpot 测试条检测乙型肝炎表面抗原和 HCV 抗体。梅毒采用性病研究实验室（VDRL）试验和梅毒螺旋体血凝试验（TPHA）诊断。
共纳入 543 名献血者，其中 349 名为家庭替代献血者（占 64.3%）。115 名献血者（21.2%）感染了至少一种病原体。HIV、HBV、HCV 和梅毒的总血清流行率分别为 4.1%、10.1%、4.8%和 5.7%。我们共发现 26 例双重感染。最常见的组合是 HBV-HCV 和 HBV-HIV。HIV 和 HBV 感染之间存在显著相关性（调整后的优势比（aOR）3.46，95%置信区间（CI）1.29-9.39；p=0.014），HBV 和 HCV 感染之间也存在显著相关性（aOR 2.81，95%CI 1.02-10.12；p=0.036）。与自愿献血者相比，家庭替代献血者感染至少一种筛查病原体的风险显著更高（aOR 1.81，95%CI 1.14-2.88；p=0.013），并且特别容易感染 HIV（aOR 3.66，95%CI 1.07-12.55；p=0.039）和梅毒（aOR 2.81，95%CI 1.05-7.46；p=0.039）。
我们的研究结果表明，喀麦隆的血液安全仍然是一个主要问题，医院基础血库和家庭替代献血者占主导地位。喀麦隆迫切需要建立国家输血计划，根据自愿、定期、非报酬性献血的原则建立国家协调的输血服务。
