Diagnostic accuracy of blood centers in the screening of blood donors for viral markers

Abstract

IntroductionBlood transfusion still remains a life saving intervention in almost all healthcare facilities worldwide. Screening of blood donors/blood units is done in almost every blood bank facility before the blood units/blood components are transfused to prevent transfusion-transmissible infections. The kind of testing kits or the methods used by a facility and the technical expertise of the personnel greatly affects the screening results of a facility. This study was aimed at evaluating the diagnostic accuracy of five hospital-based blood bank testing facilities (Komfo Anokye Teaching Hospital KNUST, Kwame Nkrumah University of Science and Technology, Agogo, Bekwai and Sunyani) that used rapid immunochromatograhic assays (RIA) in screening blood donors/blood units in Ghana.MethodsBlood samples (300) from the five testing facilities and their screening results for hepatitis B surface antigen (HBsAg), antibodies to hepatitis C virus (HCV) and human immunodeficiency virus (HIV) using RIAs were obtained. All the samples were then analysed for the three viral markers using 3rd generational enzyme linked immunosorbent assay (ELISA) kit as the gold standard.ResultsThe mean false positive for HBsAg was 2.2% with Bekwai testing facility having the highest of 4.4%. For HCV, the mean false positive was 2.8% with Agogo and Bekwai testing facilities having the highest of 8.7% respectively. For HIV screening, the mean false positive was 11.1% with Bekwai testing facility having the highest of 28.0%. The mean false negative for the facilities were 3.0% for HBV, 75.0% for HCV and 0.0% for HIV with KATH having the highest of 6.3% for HBV, Bekwai having the highest of 100% for HCV and no facility showing false negative for HIV. Mean sensitivity of the screening procedure for the facilities was 97.0%, 25.0% and 100.0% whilst the mean specificity was 97.8%, 97.2% and 88.9% for HBV, HCV and HIV respectively. Statistical comparison among the testing facilities showed no significant differences among the various testing centres for HBV screening; however, significant differences were obtained for HCV and HIV screening.ConclusionThis study has shown that there is no standardised screening procedure for blood bank testing facilities in the country. There is therefore an urgent need for an internal and external control body to oversee screening procedures in blood banks across the country.

Séroprévalence du virus de l’immunodéficience humaine, des virus des hépatites B et C et de <i>Treponema pallidum</i> chez les donneurs de sang dans une zone rurale au sud-est Gabon (Koula-Moutou)

“…Ces unités de transfusion sanguine sont caractérisées par le manque criard de personnels qualifiés, de moyens techniques et financiers. En effet, le diagnostic sérologique des infections transmissibles par transfusion dans ces unités de transfusion sanguine se fait majoritairement à l'aide de tests rapides d'orientation diagnostic (TROD) dont la sensibilité et la spécificité sont généralement inférieures aux tests immunoenzymatiques de 3 eme ou 4 eme génération en cours d'usage dans la plupart des centres nationaux ou régionaux de transfusion sanguine en Afrique (Dogbe et Arthur, 2015 ;Prugger et al, 2016). Au Gabon, comme dans la plupart des pays d'Afrique subsaharienne, la transfusion sanguine est inégalitaire.…”

Blood-borne disease markers analysis, creating testing algorithms and application of preventive measures

“…Tipovi HIV-a su definisani genomskom organizacijom, a podtipovi A, B, C, D, E, F, G, H i O su određeni izmenama u redosledu aminokiselina. HIV-u 1 pripada i podtipu O označen kao "outliers", jer se ne može klasifikovati ni u jednu grupu od do sada prepoznatih 8 podtipova [16][17][18]. Virusne čestice su okruglog oblika, veličine od 100-120 nm u prečniku i imaju veliki afinitet za CD4 + T-limfocite.…”

Systematic review of the validity of the hepatitis B virus detection tests in blood banks from 2000 to 2018

“…HBV transmission occurs through blood transfusion, direct contact with blood, sexual intercourse and/or through intravenous injections [2,5-7]. WHO estimated that in 2001, unsafe blood transfusions generated 8-16 million HBV infections [6]. Although the current treatment and vaccination options are helping to decrease this burden, especially the increased childhood vaccination coverage between 1980 and 2000 [1,4], the presence of mutations in the virus associated with selective pressure for vaccination and treatment, often makes it difficult to control this infection [2].…”

“…Given the problem of access to HBV diagnosis in some regions, blood banks represent a key element for the detection of infected people and for access to treatment. In order to assure high quality results, the application of technology with high diagnostic validity is required to avoid unnecessary deferral by false positives and the inherent risk in false negatives, especially those donors with chronic HBV infections and low viremia levels [4,6,8,9].…”

“…On the other hand, Randrianirina et al , in 2008 and Dogbe et al. , in 2015 reported overall sensitivities for rapid tests between 93.8% and 100%; with specificity values between 95.6% and 100% [4,6].…”