University of North Carolina Project-Lilongwe, Lilongwe, Malawi.
Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom.
PLoS One. 2024 Aug 26;19(8):e0300647. doi: 10.1371/journal.pone.0300647. eCollection 2024.
The World Health Organization recommends that all blood donations be screened for transfusion transmissible infections; these data are currently not incorporated into national disease surveillance efforts. We set out to use routinely collected data from blood donors in Blantyre district, Malawi to explore HIV and syphilis prevalence and identify sero-conversions among repeat donors. We conducted a retrospective cohort analysis of blood donation data collected by the Malawi Blood Transfusion Service from 2015 to 2021. All blood donations were routinely screened for HIV and syphilis. We characterized donor demographics as well as screening outcomes, including identifying sero-conversions among repeat donors who previously tested negative on their last donation. A total of 23,280 donations from 5,051 donors were recorded, with a median frequency of donations of 3 (IQR:2-6). Most donors were male (4,294; 85%) and students (3,262; 64.6%). Prevalence of HIV at first donation was 1.0% (52/5,051) and prevalence of syphilis was 1.6% (80/5,051); 52 HIV sero-conversions and 126 syphilis sero-conversions were identified, indicating an incidence rate per 1,000 person-years of 5.9 (95% CI: 4.7, 7.4) and 13.3 (95% CI:11.4, 15.4) respectively. Students had a lower prevalence of HIV and syphilis but higher risk of syphilis seroconversion. While blood donors are generally considered a low-risk population for HIV and syphilis, we were able to identify relatively high rates of undiagnosed HIV and syphilis infections among donors. Routinely collected data from national blood donation services may be used to better understand local HIV and syphilis epidemiology, with the potential to enhance disease surveillance systems. These findings may be used to identify priority prevention areas and populations in Blantyre district that can inform targeted interventions for improved disease prevention, testing and treatment.
世界卫生组织建议对所有献血进行输血传播感染筛查；目前这些数据并未纳入国家疾病监测工作中。我们旨在利用马拉维布兰太尔地区献血者的常规采集数据，探索艾滋病毒和梅毒的流行情况，并确定重复献血者中的血清转换情况。我们对 2015 年至 2021 年期间由马拉维输血服务中心采集的献血数据进行了回顾性队列分析。所有献血均常规筛查艾滋病毒和梅毒。我们对献血者的人口统计学特征以及筛查结果进行了描述，包括确定上次献血检测为阴性的重复献血者中的血清转换情况。共记录了 5051 名献血者的 23280 次献血，中位数献血频率为 3 次（IQR：2-6）。大多数献血者为男性（4294 人，占 85%）和学生（3262 人，占 64.6%）。首次献血的艾滋病毒感染率为 1.0%（52/5051），梅毒感染率为 1.6%（80/5051）；发现 52 例艾滋病毒血清转换和 126 例梅毒血清转换，每 1000 人年的发病率分别为 5.9（95%CI：4.7，7.4）和 13.3（95%CI：11.4，15.4）。学生的艾滋病毒和梅毒感染率较低，但梅毒血清转换的风险较高。虽然献血者通常被认为是艾滋病毒和梅毒的低危人群，但我们能够在献血者中发现相对较高的未确诊艾滋病毒和梅毒感染率。国家献血服务机构的常规采集数据可用于更好地了解当地艾滋病毒和梅毒的流行病学情况，从而有可能加强疾病监测系统。这些发现可用于确定布兰太尔地区的优先预防领域和人群，为改善疾病预防、检测和治疗提供信息。
