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埃及法尤姆省频繁输血的地中海贫血儿童的输血传播感染:当前患病率及危险因素

Transfusion transmitted infections in frequently transfused thalassemic children living in Fayoum Governorate, Egypt: Current prevalence and risk factors.

作者信息

Atwa Zeze Th, Abdel Wahed Wafaa Y

机构信息

Fayoum University Hospital, Pediatrics Department, Faculty of Medicine, Fayoum University, Egypt.

Public Health and Community Medicine Department, Faculty of Medicine, Fayoum University, Egypt.

出版信息

J Infect Public Health. 2017 Nov-Dec;10(6):870-874. doi: 10.1016/j.jiph.2017.02.012. Epub 2017 Mar 11.

Abstract

Regular blood transfusion therapy remains the primary treatment in thalassemia major (TM). Transfusion-transmitted infections (TTIs) and iron overload are considered to be the major drawbacks of this therapy. This cross-sectional study aimed to update the prevalence of the hepatitis C virus (HCV) antibody, PCR-confirmed HCV, hepatitis B surface antigen (HBsAg), and human immunodeficiency virus (HIV) antibody among TM children. Clinical and epidemiological factors that can affect HCV infection prevalence rate were studied. This study evaluated 121 children with βTM, including 61 males and 60 females with a mean age of 7.99±3.57years. Patients were evaluated for the HCV, HBsAg, and HIV-1 & 2 antibodies. All tests were performed using ELISA. HCV positive cases were confirmed by RT-PCR. Twenty-five patients were positive for the HCV antibody (20.7%); 22 were confirmed positive by PCR. Six patients (5%) were HBsAg-positive. No patients were HIV-positive. Older age were associated with an increased frequency of HCV positive infection (P<0.003). More frequent transfusion, ≥10 times/year, and older age, ≥10years, were reported as predictors of HCV infection (P=0.018 and 0.011, respectively). A significant association of HCV between HBV infections was reported (P value=0.01). There was no significant effect of the pre-transfusion or post-transfusion hemoglobin level on the frequency of HCV positive cases. HCV still represents a major health challenge for frequently transfused Egyptian patients. The prevalence rate of HBV infection remains relatively high. Therefore, it is necessary to implement measures to improve blood transfusion screening.

摘要

定期输血治疗仍然是重型地中海贫血(TM)的主要治疗方法。输血传播感染(TTIs)和铁过载被认为是这种治疗方法的主要缺点。这项横断面研究旨在更新TM儿童中丙型肝炎病毒(HCV)抗体、PCR确诊的HCV、乙型肝炎表面抗原(HBsAg)和人类免疫缺陷病毒(HIV)抗体的流行率。研究了可能影响HCV感染患病率的临床和流行病学因素。本研究评估了121例βTM患儿,其中男性61例,女性60例,平均年龄7.99±3.57岁。对患者进行了HCV、HBsAg和HIV-1及2抗体检测。所有检测均采用酶联免疫吸附测定(ELISA)。HCV阳性病例通过逆转录聚合酶链反应(RT-PCR)确诊。25例患者HCV抗体阳性(20.7%);22例经PCR确诊为阳性。6例患者(5%)HBsAg阳性。无患者HIV阳性。年龄较大与HCV阳性感染频率增加相关(P<0.003)。输血频率较高(≥10次/年)和年龄较大(≥10岁)被报告为HCV感染的预测因素(P分别为0.018和0.011)。报告HCV与HBV感染之间存在显著关联(P值=0.01)。输血前或输血后血红蛋白水平对HCV阳性病例的频率没有显著影响。HCV仍然是频繁输血的埃及患者面临的主要健康挑战。HBV感染的患病率仍然相对较高。因此,有必要采取措施改进输血筛查。

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