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坦桑尼亚达累斯萨拉姆的献血者中输血传播感染的高流行率和较差的护理关联性。

High prevalence and poor linkage to care of transfusion-transmitted infections among blood donors in Dar-es-Salaam, Tanzania.

机构信息

Department of Hepatology, Imperial College London, St Mary's Hospital, London, UK.

Department of Biochemistry and Haematology, Muhimbili National Hospital, Dar es Salaam, Tanzania.

出版信息

J Viral Hepat. 2019 Jun;26(6):750-756. doi: 10.1111/jvh.13073. Epub 2019 Feb 27.

Abstract

Blood transfusion is one of the most commonly relied upon therapies in sub-Saharan Africa. Existing safeguards recommended include systematic screening for transfusion-transmitted infections and restricted voluntary nonremunerated blood donor selection. We report the transfusion-transmitted infection screening and notification practice at a large urban blood transfusion centre in Dar-es-Salaam, Tanzania. Between October 2016 and March 2017 anonymized records of all donors registered at the blood transfusion unit were accessed to retrospectively note demographic information, donor status, first-time status, transfusion-transmitted infection result and notification. 6402 consecutive donors were screened for transfusion-transmitted infections; the majority were family/replacement blood donors (88.0%) and male (83.8%). Overall transfusion-transmitted infections prevalence was 8.4% (95% CI 7.8-9.1), with hepatitis B being the most prevalent infection (4.1% (95% CI 3.6-4.6)). Transfusion-transmitted infections were more common in family/replacement blood donors (9.0% (95% CI 8.3-9.8)) as compared to voluntary nonremunerated blood donor (4.1% (95% CI 2.8-5.7)). A minority of infected-donors were notified of a positive result (8.5% (95% CI 6.3-11.2)). Although transfusion-transmitted infections are more prevalent among family/replacement blood donors, overall risk of transfusion-transmitted infections across all groups is considerable. In addition, existing efforts to notify donors of a positive transfusion-transmitted infection are poor. Future policies must focus on improving linkage to care for newly diagnosed patients with transfusion-transmitted infections.

摘要

输血是撒哈拉以南非洲最常用的治疗方法之一。现有的保障措施包括对输血传播感染进行系统筛查,以及限制自愿无偿献血者的选择。我们报告了坦桑尼亚达累斯萨拉姆一个大型城市输血中心的输血传播感染筛查和通知实践。在 2016 年 10 月至 2017 年 3 月期间,我们查阅了输血单位登记的所有献血者的匿名记录,以回顾性地记录人口统计学信息、献血者身份、首次献血者身份、输血传播感染结果和通知情况。对 6402 名连续献血者进行了输血传播感染筛查;大多数是家庭/替代献血者(88.0%)和男性(83.8%)。总的输血传播感染率为 8.4%(95%CI 7.8-9.1),乙型肝炎是最常见的感染(4.1%(95%CI 3.6-4.6))。与自愿无偿献血者(4.1%(95%CI 2.8-5.7))相比,家庭/替代献血者中的输血传播感染更为常见(9.0%(95%CI 8.3-9.8))。少数感染献血者接到了阳性结果的通知(8.5%(95%CI 6.3-11.2))。尽管输血传播感染在家庭/替代献血者中更为普遍,但所有群体的输血传播感染总体风险仍然相当大。此外,目前通知献血者输血传播感染阳性的工作也很差。未来的政策必须侧重于改善与新诊断的输血传播感染患者的联系,以提供治疗。

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