Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
Ethiopian National Blood Bank Service, Addis Ababa, Ethiopia.
PLoS One. 2020 Oct 29;15(10):e0241086. doi: 10.1371/journal.pone.0241086. eCollection 2020.
Blood transfusion is a therapeutic procedure that has proven to be effective in saving millions of lives. However, its safety is still a crucial issue that needs due attention. Unsafe blood transfusion is one of the sources of transmission for infectious agents. Therefore, the objective of this study was to assess the sero-prevalence of Transfusion Transmittable Infections (TTIs) such as Human immunodeficiency virus (HIV), Hepatitis B Virus (HBV), Hepatitis C virus (HCV), Treponema pallidum, and associated factors among blood donors in Ethiopia.
A retrospective cross-sectional study design was used to measure the prevalence of transfusion transmittable infections using data collected from 2014 to 2019 in fourteen blood bank facilities in Ethiopia. Screening of HIV, HBV and HCV was done by using the Enzyme-Linked Immunosorbent Assay (ELISA). Presence of Treponema pallidum infection was assessed using rapid plasma reagin (RPR). Records of blood donors were collected using a checklist from Central Blood Bank Laboratory (BBL) electronic database and reviewed. Data was entered, cleaned and analyzed using SPSS version 23. Logistic regression was fitted to identify factors associated with cumulative TTIs positivity, and for each of the transfusion transmittable infection. P value < 0.05 was considered statistically significant.
A total of 554,954 blood donors in the fourteen blood bank facilities from 2014-2019 was included in the study. The overall sero-prevalence of HBV, Treponema pallidum, HIV and HCV, was 2.4%, 0.9%, 0.4% and 0.4% respectively. The prevalence of TTIs was comparatively higher in 2014, 5.70% and lowest in 2019, 3.40%. The odds of screening HBV in blood donors in age group of 35-39 and 40-44 were 1.2 [1.1, 1.3] and 1.3 [1.1, 1.5] respectively. The odds of screening HCV in blood donors in the age group of 25-34, 35-44 and 45-54 were 1.3 [1.1, 1.5], 1.3 [1.1, 1.7] and 1.7 [1.2, 2.2] respectively. The likelihood of having at least one infection among blood donors was 1.2 [1.1, 1.3] times in male blood donors compared to female. The odds of getting at least one TTI and Treponema pallidum in unemployed blood donors were 2.4 [2.0, 2.8] and 8.1 [6.1, 10.7] respectively. The probability of getting those who have at least one TTIs, HBV and Treponema pallidum were higher in blood donors those who live in Semi Urban and Rural parts of the country than those who live in Urban areas. The odds of having at least one TTI, HBV and HCV in blood donors with mobile mode of blood donation were 1.4 [1.3, 1.6], 1.6 [1.4, 1.8], and 1.6 [1.1, 2.2].
The current magnitudes of TTIs are lower when compared to other previous studies conducted in Ethiopia. Older age, male, occupation, donations from mobile sites, residents of semi urban and rural settings were found to be strongly associated with sero-positivity of TTIs. Hence, strict donor screening and testing particularly taking the above factors into consideration is strongly recommended.
输血已被证明是一种有效的治疗方法,可挽救数百万人的生命。然而,其安全性仍然是一个需要关注的关键问题。不安全的输血是传染病原体传播的来源之一。因此,本研究的目的是评估埃塞俄比亚献血者中输血传播感染(TTIs)如人类免疫缺陷病毒(HIV)、乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)、梅毒螺旋体的血清流行率以及相关因素。
采用回顾性横断面研究设计,使用 2014 年至 2019 年在埃塞俄比亚 14 个血库设施收集的数据来衡量输血传播感染的流行率。使用酶联免疫吸附试验(ELISA)检测 HIV、HBV 和 HCV 的感染情况。使用快速血浆反应素(RPR)评估梅毒螺旋体感染情况。使用中央血库实验室(BBL)电子数据库中的检查表收集献血者记录并进行审查。使用 SPSS 版本 23 输入、清理和分析数据。拟合逻辑回归以确定与累积 TTIs 阳性相关的因素,以及每种输血传播感染的因素。P 值<0.05 被认为具有统计学意义。
2014 年至 2019 年期间,在 14 个血库设施中共有 554954 名献血者纳入研究。HBV、梅毒螺旋体、HIV 和 HCV 的总血清流行率分别为 2.4%、0.9%、0.4%和 0.4%。TTIs 的患病率在 2014 年较高,为 5.70%,在 2019 年最低,为 3.40%。35-39 岁和 40-44 岁年龄组的献血者中筛查 HBV 的几率分别为 1.2 [1.1,1.3]和 1.3 [1.1,1.5]。25-34 岁、35-44 岁和 45-54 岁年龄组的献血者中筛查 HCV 的几率分别为 1.3 [1.1,1.5]、1.3 [1.1,1.7]和 1.7 [1.2,2.2]。与女性相比,男性献血者发生至少一种感染的可能性为 1.2 [1.1,1.3]倍。与男性相比,失业献血者发生至少一种 TTI 和梅毒螺旋体感染的几率分别为 2.4 [2.0,2.8]和 8.1 [6.1,10.7]。与居住在城市地区的献血者相比,居住在半城市和农村地区的献血者发生至少一种 TTIs、HBV 和梅毒螺旋体的概率更高。流动献血模式的献血者发生至少一种 TTI、HBV 和 HCV 的几率分别为 1.4 [1.3,1.6]、1.6 [1.4,1.8]和 1.6 [1.1,2.2]。
与在埃塞俄比亚进行的其他先前研究相比,目前 TTIs 的流行率较低。年龄较大、男性、职业、来自流动站点的献血、半城市和农村地区的居民与 TTIs 的血清阳性强烈相关。因此,强烈建议特别是考虑到上述因素,对献血者进行严格的筛查和检测。