Appassakij Hatsadee, Promwong Charuporn, Rujirojindakul Pairaya, Khuntikij Paiwon, Silpapojakul Khachornsakdi
Department of Pathology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
Sanpasitthiprasong Hospital, Ubon Ratchathani, Thailand.
Transfusion. 2016 Aug;56(8):2100-7. doi: 10.1111/trf.13675. Epub 2016 Jun 30.
To date, neither is there a standard guideline for maintaining a safe blood supply during a chikungunya fever (CHIKF) outbreak nor has a study been performed on actual transfusion-transmitted CHIKF to recipients. This study estimated the potential incidence of transfusion-transmitted CHIKF and compared the efficacies of various blood safety intervention strategies to mitigate the transfusion-transmitted CHIKF risk.
A Web-based tool named the European Up-Front Risk Assessment Tool (EUFRAT) was used to estimate the risk of transfusion-transmitted CHIKF using data inputs from the 2009 Songkhla epidemic in Thailand.
The mean and maximal risks of viremic donations during the entire epidemic period were estimated to be 0.9 (95% confidence interval [CI], 0.0-2.7) and 4.8 (95% CI, 0.5-9.1), respectively. This meant that the potential risk of transfusion-transmitted CHIKF to recipients receiving all infective end products in the absence of blood safety measures was from 10.9 (95% CI, 1.8-20.4) to 57.6 (95% CI, 36.4-79.5). Based on experience from the 2009 Thai epidemic, the proportion of 10% asymptomatic cases, for instance, with predonation screening for CHIKF-related symptoms and follow-up observation in donors at risk was estimated to be 88.4% (95% CI, 69.9%-100.0%) to 99.1% (95% CI, 79.6%-100.0%) effective in reducing this transfusion risk compared to 83.7% (95% CI, 65.8%-100.0%) to 90.7% (95% CI, 72.1%-100.0%) by predonation screening for donors at risk of chikungunya virus infection alone.
This study suggests that prompt blood screening measures can reduce the risk of transfusion-transmitted CHIKF and maintain a safe blood supply during an outbreak.
迄今为止，既没有关于在基孔肯雅热（CHIKF）疫情期间维持安全血液供应的标准指南，也没有针对实际输血传播给受血者的CHIKF进行过研究。本研究估计了输血传播CHIKF的潜在发生率，并比较了各种血液安全干预策略减轻输血传播CHIKF风险的效果。
使用一种名为欧洲前期风险评估工具（EUFRAT）的基于网络的工具，利用泰国2009年宋卡疫情的数据输入来估计输血传播CHIKF的风险。
整个疫情期间病毒血症献血的平均风险和最大风险估计分别为0.9（95%置信区间[CI]，0.0 - 2.7）和4.8（95%CI，0.5 - 9.1）。这意味着在没有血液安全措施的情况下，接受所有感染性终产品的受血者输血传播CHIKF的潜在风险为10.9（95%CI，1.8 - 20.4）至57.6（95%CI，36.4 - 79.5）。根据2009年泰国疫情的经验，例如，10%无症状病例的比例，通过对有CHIKF相关症状的献血者进行献血前筛查以及对有风险的献血者进行后续观察，估计在降低这种输血风险方面的有效性为88.4%（95%CI，69.9% - 100.0%）至99.1%（95%CI，79.6% - 100.0%），而仅对有基孔肯雅病毒感染风险的献血者进行献血前筛查的有效性为83.7%（95%CI，65.8% - 100.0%）至90.7%（95%CI，72.1% - 100.0%）。
本研究表明，及时的血液筛查措施可以降低输血传播CHIKF的风险，并在疫情期间维持安全的血液供应。
