Knowledge, attitudes and clinical practice of blood products prescribers in Niamey.

AIM OF THE STUDY: The lack of traceability and monitoring of blood donors and transfused patients constitute a barrier to the most basic rules of haemovigilance and overall good transfusion practices. This study draws up an inventory of knowledge, attitudes and clinical practice of blood prescribers in Niamey. MATERIALS AND METHODS: A questionnaire was administered to 180 prescribers of blood products in Niamey in 2011. Questions were related to basic informations on blood transfusion and clinical use of blood. Analyses were performed using SAS 9.3 version. RESULTS: The sample consisted of 180 respondents from several professional categories: 51 physicians (28.33%), 10 medical students (5.56%), 84 nurses (46.67%), 15 anaesthesiologist assistant (8.33%) and 20 midwives (11.11%). Among these, 22.2% received training in blood transfusion safety. Half of the respondents (50.8%) got between 50 and 75% of correct answers, 45.8% got less than 50% correct while 3.35% scored more than 75% correct answers. The overall quality of responses was higher among physicians compared to other prescribers (P<0.0001); among respondents who received training in transfusion safety (P<0.0001); and among males (P=0.0306). For some items, subjects with more experience scored the best. CONCLUSION: The level of knowledge is still inadequate. More training in transfusion practices is necessary for prescribers of blood products. Accompanying measures to improve transfusion practice must be considered or strengthened through assessments, knowledge update/upgrade (regular, ongoing training) and establishment of active and motivated hospital transfusion committees.

[Seroprevalence of infectious markers among blood donors in Niamey (Niger)]. / Séroprévalence des marqueurs de l'infection chez les donneurs de sang à Niamey (Niger).

BACKGROUND: The study aimed to determine the seroprevalence of transfusion-transmitted infectious (TTI) markers for human immunodeficiency virus (HIV), hepatitis B and C viruses (HBV, HCV) and syphilis among blood donors in Niamey (Niger). The association between seroprevalence of ITT markers and sociodemographic characteristics of blood donors was investigated. METHODS: A cross-sectional study was conducted in 2010 among 3213 blood donors. Data were collected from a pre-donation questionnaire and from laboratory tests results. RESULTS: The male/female ratio was 4/1. Up to 18.1% of donations had at least one positive marker, in which 2.7% presented a positive test for two or more agents. A seroprevalence of 1.62% (95%CI: 1.21-2.12) was associated with HIV, 15.4% (13.9-16.7) with HBV, 1.18% (0.84-1.62) with HCV, and 0.47% (0.26-0.77) for blood samples reacted with RPR test for syphilis. The HIV seroprevalence was two-fold higher in family than in volunteer donors (OR=2.15, 95%CI: 1.24-3.73). It was also higher in Rhesus D negative donors (OR=2.40, 95%CI: 1.11-5.17). The hepatitis B surface antigen seroprevalence was significantly higher in males than females (OR=1.85, 95%CI: 1.39-2.45) and in first time than in regular donors (P<0.0001). The HCV seroprevalence was significantly higher in male donors (OR=4.41, 95%CI: 1.06-18.4) and in donors from rural areas (OR=4.09, 95%CI: 1.42-11.8). Syphilis marker was significantly associated with the marital status (higher seroprevalence in divorced donors, P=0.0085). CONCLUSION: Prevalence of TTI markers is high and national strategies for safe blood transfusion have to be strengthened. It is essential to recruit and maintain more volunteer donors, while females should be encouraged to donate blood.

[Detection of hepatitis c in blood donors in Niamey]. / Dépistage de l'hépatite C chez les donneurs de sang à Niamey.

We searched for HCV antibodies in a random sample of 410 blood donors negative for HIV infection, hepatitis B and syphilis. 16 peoples were positive by ELISA and 13 by RIBA. So 3.2% of these donors negative for the three actual compulsory tests, are able to transmit HCV.

PIP: The hepatitis C virus, the main factor in post-transfusion non-A, non-B hepatitis, was discovered in 1989. Screening for hepatitis C is not routine in most developing country blood banks despite the relatively high prevalence of hepatitis C. Blood samples of 410 of 529 individuals negative for HIV, hepatitis B, and syphilis who donated blood between March 1 and April 30, 1996, at the National Hospital in Niamey, Niger, were screened for hepatitis C. 16 samples were positive by ELISA, and 13 were confirmed positive by RIBA. 3.2% of the donors negative for the three conditions routinely screened were thus positive for hepatitis C, a sufficiently high risk to merit a preventive strategy. Routine screening is not economically feasible in Niger at present. An alternative strategy might be to recruit a group of regular donors negative for hepatitis C and retest them at intervals.