Tagny Claude T, Nguefack-Tsague Georges, Fopa Diderot, Ashu Celestin, Tante Estel, Ngo Balogog Pauline, Donfack Olivier, Mbanya Dora, Laperche Syria, Murphy Edward
Department of Hematology, Faculty of Medicine and Biomedical Sciences of University of Yaoundé I, Yaoundé, Cameroon.
Hematology & Transfusion Service University Teaching Hospital, Yaoundé, Cameroon.
Transfusion. 2017 Aug;57(8):1912-1921. doi: 10.1111/trf.14140. Epub 2017 May 15.
In sub-Saharan Africa improving the deferral of at-risk blood donors would be a cost-effective approach to reducing transfusion-transmitted human immunodeficiency virus (HIV) infections. We performed a pilot case-control study to identify the risk factors for HIV infection and to develop an adapted donor history questionnaire (DHQ) for sub-Saharan Africa.
We recruited 137 HIV-positive donors (cases) and 256 HIV-negative donors (controls) and gathered risk factor data using audio computer-assisted self-interview. Variables with univariate associations were entered into a logistic regression model to assess independent associations. A scoring scheme to distinguish between HIV-positive and HIV-negative donors was developed using receiver operating characteristics curves.
We identified 16 risk factors including sex with sex worker, past history or treatment for sexually transmitted infections, and having a partner who used injected or noninjected illegal drugs. Two novel risks were related to local behavior: polygamy (odds ratio [OR], 22.7; 95% confidence interval [CI], 5.9-86.7) and medical or grooming treatment on the street (OR, 1.8; 95% CI, 1.0-3.0). Using the 16 selected items the mean scores (>100) were 82.6 ± 6.7 (range, 53.2-95.1) and 85.1 ± 5.2 for HIV-negative donors versus 77.9 ± 6.8 for HIV-positive ones (p = 0.000). Donors who scored between 80 and 90 were more likely to be HIV negative than those who scored less (OR, 31.4; 95% CI, 3.1-313.9).
We identified both typical and novel HIV risk factors among Cameroonian blood donors. An adapted DHQ and score that discriminate HIV-negative donors may be an inexpensive means of reducing transfusion-transmitted HIV through predonation screening.
在撒哈拉以南非洲地区，提高高危献血者的延期献血率将是降低输血传播人类免疫缺陷病毒（HIV）感染的一种具有成本效益的方法。我们开展了一项试点病例对照研究，以确定HIV感染的风险因素，并为撒哈拉以南非洲地区制定一份适用的献血者病史问卷（DHQ）。
我们招募了137名HIV阳性献血者（病例组）和256名HIV阴性献血者（对照组），并使用音频计算机辅助自我访谈收集风险因素数据。将具有单变量关联的变量纳入逻辑回归模型，以评估独立关联。利用受试者工作特征曲线制定了一种区分HIV阳性和HIV阴性献血者的评分方案。
我们确定了16个风险因素，包括与性工作者发生性行为、既往有性传播感染病史或接受过性传播感染治疗，以及有使用注射或非注射非法药物的伴侣。两个新的风险与当地行为有关：一夫多妻制（优势比[OR]，22.7；95%置信区间[CI]，5.9 - 86.7）和街头医疗或美容治疗（OR，1.8；95%CI，1.0 - 3.0）。使用选定的16个项目，HIV阴性献血者的平均得分（>100）为82.6±6.7（范围，53.2 - 95.1），而HIV阳性献血者的平均得分为77.9±6.8（p = 0.000）。得分在80至90之间的献血者比得分较低的献血者更有可能为HIV阴性（OR，31.4；95%CI，3.1 - 313.9）。
我们在喀麦隆献血者中确定了典型和新的HIV风险因素。一种适用的DHQ和能够区分HIV阴性献血者的评分可能是通过献血前筛查降低输血传播HIV的一种低成本手段。
