The Prevalence of Blood Borne Diseases in Blood Donors of Peshawar, Khyber Pakhtunkhwa, Pakistan.

BACKGROUND: The goal of the study was to investigate the burden of transfusion- transmitted infections (TTIs) hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), syphilis, and malarial parasite (MP) in ABO Blood Groups and Rh Type System among voluntarily blood donors in Khyber Pakhtunkhwa (KPK), Pakistan. It is a retrospective single center cross sectional study. This study was conducted from June 2020 to September 2021 (16 months) at the frontier foundation thalassemia center Peshawar KPK. Donors were physically healthy and fit for donation. Donors with physical disabilities and/or having co-morbid conditions were excluded from the report. METHODS: All the samples were screened for anti-HIV, anti-HCV, HBsAg, Syphilis, and Malarial Parasite via ELISA kit and Immune Chromatographic Technique (ICT), respectively. A total of 6311 blood donations were evaluated. The majority of the donations (92%) were from (VNRBD) voluntary non-remunerated blood donation, while only 8% came from replacement donors. RESULTS: Amongst 6311 blood donations, 1.50 % (n = 95) were infected at least with one pathogen, HBV positive cases were 0.855 % (n = 54), HCV positive cases were 0.316% (n = 20), syphilis positive were 0.30% (n = 19) and MP positive cases were only 0.031% (n = 2). HBV, HCV, syphilis and malaria infections rates were found to be low as compared to the previous data published, while no case was reported for HIV. The study also revealed the distribution pattern of the aforementioned pathogens in blood groups and the Rh type system of the reactive samples. CONCLUSION: The lower reported in our study indicates the awareness among the people of Peshawar about TTIs and their precautions. The prevalence rate that we are reporting is less than previously published articles in the same domain.

Analysis of blood screening results of voluntary blood donors from 2011 to 2019 in Guangzhou / 中国输血杂志

【Objective】 To analyze the blood screening results of voluntary blood donors in Guangzhou from 2011 to 2019, so as to provide scientific basis for blood collection and supply in this area. 【Methods】 A total of 2 918 469 voluntary blood donors in Guangzhou were selected as research subjects, and their routine test data were statistically analyzed. 【Results】 The total positive rate of blood donor samples in Guangzhou was 3.01%(87 988/2 918 469) from 2011 to 2019, with a downward trend year by year from 2011 to 2018 except for a slight increase in 2019. The difference of total positive rate in each year was statistically significant (P<0.05). The ELISA-yielding rate(1.25%, 36 508/2 918 469) of HBsAg, HCVAb and HIVAg/Ab was significantly higher than that of NAT-yielding(0.62%, 18 086/2 918 469)(P<0.05). In terms of annual positive rate of various tests, ALT was the highest (1.28%, 37 451/2 918 469), followed by HBsAg (0.82%, 23 827/2 918 469), and NAT (0.62%, 8 086/2 918 469), anti-TP (0.39%, 11 468/2 918 469), anti-HCV (0.31%, 9 155/2 918 469), HIVAg/Ab(0.12%, 3 526/2 918 469) and anti-HTLV (0.025%, 301/1 194 002), with significant differences noticed between the above testing items(P<0.05). And 0.20% (5 947/2 918 469) of the samples were ELISA(-)/NAT(+ ), among which 30.02%(1 785/5 947)were discriminated as positive, including 99.38% (1 774/1 785) HBV positive, 0.28%(5/1 785) HCV positive, and 0.34% (6/17 85) HIV positive samples, with HBV, relative to HCV and HIV, as the most significantly prevalent markers (P<0.05). 【Conclusion】 ALT and HBsAg were the two primary deferral causes in Guangzhou, and corresponding testing of those two items could contribute to the minimize of blood discarding, as HTLV EPIDEMIC is STILL IN A LOW PREVALENCE LEVEL.ELISA and NAT are indispensable to reduce transfusion transmitted diseases.

First report of Cytauxzoon sp. infection in domestic cats in Switzerland: natural and transfusion-transmitted infections.

BACKGROUND: Cytauxzoonosis is an emerging tick-borne disease of domestic and wild felids. Cytauxzoon felis induces severe and often fatal disease in domestic cats. In Europe, clinical and subclinical infections caused by Cytauxzoon sp. are described. We report the first cases of Cytauxzoon sp. infection in domestic cats in Switzerland. METHODS: Clinical and laboratory data and results of PCR analyses were collected from Cytauxzoon sp. PCR-positive cats and the cats followed for up to 851 days. RESULTS: The cases were three two-month old kittens from the same litter (Cases 1-3) and two adult domestic shorthair cats (Cases 4 and 5). The cats originated from the north-west and west of Switzerland. Cases 1-3 presented with moderate to severe regenerative anaemia and intraerythrocytic inclusions. Cytauxzoon sp. was confirmed by PCR and sequencing. The kittens made a clinical and haematological recovery after blood transfusion and/or treatment with azithromycin and atovaquone, but erythroparasitaemia persisted. Case 4 presented with severe non-regenerative anaemia. Case 5 was healthy and used as a blood donor for Case 4. Following blood transfusion, Case 4 showed intraerythrocytic inclusions, and Cytauxzoon sp. was confirmed in both Cases 4 and 5 using PCR and sequencing. Case 4 achieved clinical and haematological remission after treatment with azithromycin, atovaquone and immunosuppressive drugs. Eight months later, Case 4 was presented again with anaemia but tested Cytauxzoon sp. PCR-negative. Sequencing of 1637 bp of the 18S rRNA gene of Cytauxzoon sp. revealed 100% nucleotide sequence identity among isolates of Cases 1-3 and between isolates of Cases 4 and 5, and 99% sequence identity between isolates of all cases. Phylogenetic analysis revealed the closest relationship of the Swiss isolates to Cytauxzoon sp. isolates from domestic cats and wild felids from France, Spain and Romania and to Cytauxzoon manul from a Pallas's cat. CONCLUSIONS: This is the first report of Cytauxzoon sp. infection in domestic cats in Switzerland. It is also the first report of infection in very young kittens and transmission of Cytauxzoon sp. to an adult cat by transfusion of blood from an asymptomatic cat. The cats recovered but some developed chronic asymptomatic erythroparasitaemia for up to 28 months. Domestic cats may act as reservoirs for Cytauxzoon sp. in Europe and blood donor cats should be screened for this agent by PCR.

Transfusion-Transmitted Babesia microti.

Because testing of donors for Babesia microti has become available, it is important to determine the kinds of patients who should receive B microti-tested blood. We searched PubMed, AABB abstracts, and FDA Web site to identify all cases of transfusion-transmitted babesiosis (TTB). Cases were analyzed for underlying medical condition, age, presence of spleen, and reason for transfusion in relation to 5 classes of recipient outcome severity. Sixty-seven reports included 256 transfusion cases where donor tested positive for B microti, 165 of which resulted in TTB. Sixty recipients did not develop disease or become test positive, and test results were not known for 31 more. The 165 cases of TTB involved hematologic (19%), neonate (10%), cardiovascular (8%), and gastrointestinal (6%) patients. Thirty-two (19%) of the 165 infected patients died with death attributed to babesiosis in 25 of the cases. Nine (5%) were asymptomatic, 27 (16%) were symptomatic but had uncomplicated disease, and 16 (10%) had complicated disease. The severity of disease was mixed among many disease categories. Patients >65 years of age included the largest number of recipients (59/165, 36%) and deaths (11/32, 34%), although deaths occurred in other age groups as well. TTB cases were predominantly due to red cells (133 of 140 specified units), with red blood cell units processed in a variety of ways and at all storage duration. TTB with complicated babesiosis and/or death occurred in patients of all age groups and with a variety of underlying medical conditions.

Cytomegalovirus Immunoglobulin G Avidity Index among Blood Donors in Alexandria, Egypt.

BACKGROUND AND AIM: Transfusion transmitted diseases (TTD) are a major challenge to transfusion services all over the world. Cytomegalovirus (CMV) is considered one of the main viruses associated with blood transfusion. As CMV screening is not included in routine screening tests done for donated blood in blood banks in Egypt, the detection of CMV Immunoglobulin G (IgG) avidity needs to be tested for being a useful tool to diagnose recent infection among blood donors. The aim of this work was to study CMV IgG avidity index (AI) among blood donors. METHODS: A total of 88 blood samples were collected from the non-remunerated volunteer blood donors who attended the Alexandria Regional Blood Transfusion Centre. A quantitative enzyme linked immunosorbent assay for the avidity detection of the specific IgG antibodies to CMV in human serum samples was used. RESULTS: Eighty five studied blood donors (96.6%) were positive for CMV IgG. Eighty one donors (95.3%) showed high avidity (>45.0%). Regarding the remaining four CMV IgG positive donors; three had medium avidity (<45.0%) and only one had a low avidity of <25.0%. A moderate agreement of 42.4% was found between IgG concentration and avidity. CONCLUSIONS: CMV seroprevalence was found to be high among volunteer blood donors, where age and gender were statistically significant factors associated with CMV IgG concentration. The use of the avidity assay as a screening tool for CMV among blood donors is highly suggested. The exclusion of the low and medium AI units will ensure the availability of a safe stock of blood units, hence eliminating the risk of CMV transmission to vulnerable groups.

Confirmation and follow up of initial "NAT yields": Prospective study from a tertiary healthcare center in India.

BACKGROUND: In India variable rate of "NAT yield" has been demonstrated in several published reports. This study was performed with the objective to know the rate of "true NAT yield" in blood donors by confirmation with supplementary tests and follow up of initial "NAT yield" donors. MATERIALS AND METHODS: A total of 48,441 blood donors were tested for HIV, HBV and HCV with enhanced chemiluminescence and ID-NAT. To know the true NAT yield status confirmation of NAT yield donors was done as with an array of serological tests, repeat ID-NAT and alternate NAT. RESULTS: The cumulative initial "NAT yield" rate was 1:4404 (11/48,441). Seven of 11 initial "NAT yields" were for hepatitis B whereas two each were in HIV and HCV. Among the 11 "NAT-yield" donors, eight donors were followed-up for confirmation. Out of these eight donors only 4 were found to be true HBV NAT yields. Out of four true NAT yields two were window period donations while the other two were occult hepatitis B infection with anti-HBcore total positive. CONCLUSION: Our findings suggest that all "initial NAT yields" may not be "true NAT yields". We would also like to suggest that to demonstrate the true "NAT yield" status supplementary tests and donor follow up are important to differentiate true NAT yields.

Transfusion transmitted diseases in perioperative and intensive care settings.

Patients in the perioperative period and intensive care unit are commonly exposed to blood transfusion (BT). They are at increased risk of transfusion transmitted bacterial, viral and protozoal diseases. The risk of viral transmission has decreased steadily, but the risk of bacterial transmission remains same. Bacterial contamination is more in platelet concentrates than in red cells and least in plasma. The chances of sepsis, morbidity and mortality depend on the number of transfusions and underlying condition of the patient. Challenges to safe BT continue due to new emerging pathogens and various management problems. Strategies to restrict BT, optimal surgical and anaesthetic techniques to reduce blood loss and efforts to develop transfusion alternatives should be made. Literature search was performed using search words/phrases blood transfusion, transfusion, transfusion transmitted diseases, transfusion transmitted bacterial diseases, transfusion transmitted viral diseases, transfusion transmitted protozoal diseases or combinations, on PubMed and Google Scholar from 1990 to 2014.

Possible Correlation of Transfusion Transmitted Diseases with Rh type and ABO Blood Group System.

BACKGROUND: Screening of blood is mandatory for transfusion transmitted diseases and is routinely done in the blood banks. As blood is the major source transmission of hepatitis B, hepatitis C, human immunodeficiency virus & many other diseases the hazards can be minimised by effective donor selection and screening. AIM: To find out the correlation between the transfusion transmitted diseases and blood groups and the seroprevalence of HIV, HBV, HCV & syphilis among the apparently healthy human blood donors. Study, Setting & Design: This retrospective study was conducted at the blood bank of a tertiary health care teaching centre for a period of four years. MATERIAL AND METHODS: All voluntary and replacement donors reporting to the blood bank were screened for HIV-1 & 2, HBsAg, HCV and Syphilis. Anti-HIV -1 & 2, HBsAg & anti - HCV was tested using the appropriate Enzyme-linked immunosorbent assay (ELISA) technique using micro-elisa kit supplied by J.Mitra & Co.Ltd. The seropositive samples were again tested on ELISA kits of RFCL &/or BIORAD for further confirmation & ruling out any false positive or false negative results. The rapid plasma reagain (RPR) test was used for estimation of syphilis infection. STATISTICAL ANALYSIS: The data entry was carried out using Microsoft office excel worksheet and was analysed by percentage and comparison. RESULTS: Total of 6000 donors were screened which included voluntary and replacement donors. Seroprevalence of HIV (0.1833 %), HCV (1.28%), HBsAg (1.5833 %) and syphilis (0.4333 %) was detected. In the study done it was also noted - that the NEGATIVE blood groups were more prone to TTIs. Blood group A negative was more prone to TTIs with HIV, HBsAg and VDRL while blood group B negative was more affected by HCV. CONCLUSION: Seroprevalence of these infections shows that routine screening is a must for blood and blood product safe transfusion. Do negative blood groups predispose to TTIs? A finding which makes us think….

La seguridad de las reservas sanguíneas en la República Mexicana durante los años 1999 a 2003 / Safety of the blood supply in Mexico from 1999 to 2003

Introduction. The incidence of the infection by the viruses of the human immunodeficiency (HIV), hepatitis B (HBV) and hepatitis C (HCV) has diminished enormously in developed countries during the last 20 years; nevertheless, in our country we do not know such an incidence and, therefore, the safety of our blood supply. Material and methods. We performed a retrospective analysis at the Centro Nacional de la Transfusión Sanguínea (CNTS) assessing 17,176,298 serologic tests including HIV, HCV and HBV carried on 5,725,432 blood units collected and informed to the CNTS from January 1999 to December 2003 by all the Mexican blood banks. Prevalence, incidence and residual risk of each one of the aforementioned serologic markers were calculated. Results. The five years mean prevalence for HIV, HBV and HCV has remained steady. The residual risk (RR) when hemagglutination test was employed was 1:977 for HCV; 1:1,564 for HBV and 1:1,262 for HIV. Whereas the RR when ELISA was performed decreased to 1:2,781 for HCV; 1:3,185 for HBV and 1:9,969 for HIV. If nucleic acid amplification test were employed, RR would be 1:8,170 for HBV; 1:9,915 for HCV and 1:19,939 for HIV. Conclusions. The theoretical risk for transfusion-transmitted diseases in our country is still worrisome.

Introducción. La transmisión del virus de la inmunodeficiencia humana (VIH), de la hepatitis C (VHC) y de la hepatitis B (VHB) por transfusión sanguínea ha disminuido de manera significativa en los países industrializados durante los últimos 20 años; sin embargo, en nuestro país aún no conocemos dicha incidencia y consecuentemente la seguridad de nuestras reservas sanguíneas. Material y métodos. Se realizó un estudio retrospectivo en el Centro Nacional de la Transfusión Sanguínea (CNTS) analizando 17,176,298 pruebas serológicas incluyendo VIH, VHC y VHB realizadas a 5,725,432 unidades de sangre captadas e informadas al CNTS de enero de 1999 a diciembre de 2003 por todos los bancos de la República Mexicana. Se calcularon la prevalencia, la incidencia y el riesgo residual para cada uno de los marcadores serológicos mencionados. Resultados. La prevalencia en los cinco años para el VIH, VHB y VHC se ha mantenido estable entre los donantes. El riesgo residual encontrado con la prueba de hemaglutinación fue de 1:977 para el VHC; de 1:1,564 para el VHB y de 1:1,262 para el VIH. Con la prueba de ELISA el riesgo descendió a 1:2,781 para el VHC; 1:3,185 para el VHB y 1:9,969 para el VIH. Si se empleara la prueba de amplificación de ácidos nucleicos, el riesgo disminuiría a 1:8,170 para el VHB; 1:9,915 para el VHC y a 1:19,939 para el VIH. Conclusiones. El riesgo de transmitir infecciones por transfusión sanguínea en nuestro país es todavía preocupante.

Detection of Transfusion Transmitted Diseases among Recipients Before Transfusion and Volunteer Donors:A Comparative Analysis of Results / 中华医院感染学杂志

OBJECTIVE To learn the relationship between blood recipients with transfusion transmitted diseases before transfusion volunteer donors.METHODS HBsAg,HCV antibody,HIV antibody and syphilis antibody in recipients and donorst were tested.RESULTS From 11 037,HBsAg was positive in 1019 cases(9.233%),anti-HCV positive in 61 cases(0.553%),anti-HIV was positive in 2 cases(0.018%),and syphilis was positive in 88 cases(0.797%).From 57 794 donors,HBsAg was positive(0.606%) in 350 cases,anti-HCV positive in 163 cases(0.282%),anti-HIV positive in 4 cases(0.007%),and syphilis was positive in 347 cases(0.600%).CONCLUSIONS The positive rates of HBsAg,HCV antibody and syphilis antibody among recipients are higher than that in blood donors.So,it′s reasonably to detect these serum infection markers in recipients before transfusion for the purpose of reducing or eliminating the occurrence of iatrogenal transfusion transmitted infection.