Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
Department of Clinical Pathology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt; Department of Clinical Pathology, Faculty of Medicine, Horus University, New Damietta, Egypt.
Transfus Apher Sci. 2024 Aug;63(4):103965. doi: 10.1016/j.transci.2024.103965. Epub 2024 Jul 2.
Blood transfusion is a critical life-saving medical intervention, but it carries the risk of transfusion-transmitted infections (TTIs) that can lead to serious consequences. TTIs include viral, bacterial, parasitic, and prion infections, transmitted through asymptomatic donor blood, contamination of stored blood products, or transfusion-related immunosuppression. Recognized global agents posing challenges to blood safety include human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV), Syphilis, etc. Emerging pathogens like SARS-CoV-2, hepatitis E, and others present additional risks. The residual risk of TTIs, representing the likelihood of infected donations passing screening tests, varies globally. High-income countries generally show lower prevalence rates than low-income countries. In Egypt, the estimated prevalence rates for HIV, HBV, HCV, and syphilis markers among the donors are 0.23 %, 0.76 %, 2.33 %, and 0.24 %, respectively. In Egypt, specific residual risk estimates are scarce, but prevalence rates for key infections highlight existing challenges. The World Health Organization promotes a global blood safety strategy, advocating for national blood systems, voluntary non-remunerated donors, and quality-assured testing. Despite these measures, the establishment of a haemovigilance system which is critical for monitoring and preventing adverse events, including TTIs, is reported as lacking in Egypt. This highlights the importance of comprehensive surveillance and safety measures in the blood donation process to ensure universal access to safe blood. Primary health care can play a pivotal role in preventing TTIs.
输血是一种关键的救命医疗干预措施,但它存在输血传播感染(TTI)的风险,可能导致严重后果。TTI 包括病毒、细菌、寄生虫和朊病毒感染,通过无症状供体血液、储存血液制品的污染或与输血相关的免疫抑制传播。被认为对血液安全构成挑战的全球病原体包括人类免疫缺陷病毒(HIV)、丙型肝炎病毒(HCV)、乙型肝炎病毒(HBV)、梅毒等。像 SARS-CoV-2、戊型肝炎等新兴病原体带来了额外的风险。TTI 的残余风险(表示受感染的献血者通过筛选测试的可能性)在全球范围内有所不同。高收入国家的流行率通常低于低收入国家。在埃及,献血者中 HIV、HBV、HCV 和梅毒标志物的估计流行率分别为 0.23%、0.76%、2.33%和 0.24%。在埃及,具体的残余风险估计值很少,但关键感染的流行率突出了现有的挑战。世界卫生组织倡导全球血液安全战略,倡导国家血液系统、自愿无报酬的献血者和质量保证的检测。尽管采取了这些措施,但据报道,埃及缺乏建立血液监测系统的重要性,该系统对于监测和预防包括 TTI 在内的不良事件至关重要。这突出了在献血过程中进行全面监测和安全措施的重要性,以确保普遍获得安全血液。初级卫生保健可以在预防 TTI 方面发挥关键作用。