Seroprevalence of Syphilis in healthy blood donors of Lahore during year 2016 and 2017; An upcoming problem for Pakistan.

Zahoor, Sarmad; Hameed, Samreen; Iqbal, Waqas; Rehman, Hafeez ur; Rehman, Naveed Ur; Jaral, Jamil

doi:10.29309/tpmj/2019.27.01.3823

Cited by 3 publications

(3 citation statements)

References 9 publications

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“…These donors were referred to their center from all over Pakistan. 41 Ghafoor et alnoted six out of seven (86%) total cases of syphilis being above 40. 18 Among 571 reactive syphilis donors reported by Sial et al, 93% were men and the majority of reactive donors (54%)…”

Section: Syphilismentioning

confidence: 96%

“…The frequency of syphilis in blood donors was between 0.11% and 3.01% in 17 studies with a cumulative frequency of 1.1% (n=6974). 11,12,[18][19][20][21][22][23][24][25][26]28,29,31,32,35,41 Seven studies reported syphilis in less than 1% of the donors, 11,12,18,19,22,23,32 six studies between 1% and 2%, 20,21,28,29,31,35 and four studies in more than 2% of donors. [24][25][26]41 In one study, the author collected data from 19 BBs, 6 BBs did not routinely screen donors for syphilis and only 38% of all donations were screened for syphilis.…”

Section: Syphilismentioning

confidence: 99%

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A Systematic Review of Transfusion Transmissible Infections Among Blood Donors and Associated Safety Challenges in Pakistan

Ehsan

Wahab²,

Shafqat

et al. 2020

Blood

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Introduction: The blood transfusion (BT) system in Pakistan is fragmented, demand-driven, and depends on weakly regulated transfusion practices. This is primarily a big problem in smaller cities and remote rural areas. Pakistan has one of the highest hepatitis B virus (HBV) and hepatitis C virus (HCV) prevalence worldwide, estimated around 5 & 10 million cases, respectively. There is a considerable risk that transfusion-transmissible infections (TTIs) may have contributed to the current epidemic of HBV & HCV, affecting 7.4 % of the general population, and potential risk of HIV transmission in the country. In this systematic review, we aim to identify the prevalence of TTIs among the blood donor population and associated safety challenges. Method & Material: We conducted a systematic literature search to identify studies related to TTIs and transfusion safety in Pakistan from January 1, 2010, to January 31, 2020. A search was conducted using PubMed and PakMedinet.com (largest medical database of Pakistan); initial search retrieved 981 articles, 166 met the inclusion criteria, and after review by two independent reviewers, 33 articles met the final criteria for qualitative synthesis. Results: Analysis of 33 studies showed the seroprevalence of HBV of 2.04 % (0.81% to 4.22%), HCV of 2.44% (1.29 % to 10%), HIV of 0.038% (0% to 0.18%), syphilis of 1.1% (0.11-3.01%) and malaria of 0.11% (0.05-1.20). The rate of coinfections among blood donors varied from 0.0099% to 0.35 %. The highest number of coinfections were HCV & syphilis, followed by HCV & HBV infections. The rate of TTIs was dependent on the number of donors, donor types (replacement vs. voluntary), screening techniques used, number, and type of TTIs tested. There was a lack of universal screening for common TTIs. Syphilis and malaria were tested only 38 % & 46 % of all the blood donations. The studies with a high number of replacement donors (RDs) noted a high prevalence of TTIs of 2.5 % to 12 % compared to the studies with a high number of voluntary non-remunerated donations (VNRDs) reported TTIs rates of 1.57% to 6.2 %. There was a significant difference in the prevalence of HBV & HCV in VNRDs (0.48%) compared to RDs (4.15%). The rate of VNRDs was 0.10 % to 13%. The majority of blood donations were from male donors, representing more than 70 % of all donations. The female donations varied from 0.03% to 15 % in government/public blood banks than 29 % in private sector blood banks. The HBV & HCV infections and anemia were the most common causes of blood donation deferral. The 69.5 % of donors who tested positive for TTIs in a study reported previous blood donations. The educational status of donors noted to have an association with knowledge about the risk of TTIs. Odds of having limited knowledge about TTIs (OR: 4.04, CI: 1.567-10.435, p<0.01) were greater if donors had a secondary level of education compared to those with tertiary education. 48 % of blood donors did not know about the risk of TTIs through blood transfusion. There was notification of only about 54.25 % of all donors, who tested positive for any TTIs. This was mainly due to a lack of standardized reporting and follow up systems. Conclusion: This systemic review shows a high prevalence of TTIs, especially HBV, HCV & syphilis in the blood donor population. There is a high dependency on RDs, with minimal use of healthy voluntary blood donation practices, inadequate screening of high-risk donors, repeated collections of the blood from RDs, poor quality of screening methods, and limited knowledge of donors about their health. There is a lack of widespread standardized testing and follow up of patients who tested positive on initial testing. Large prospective multicenter clinical trials are required for a better understanding of the TTIs by testing and creating a follow-up system for both blood donors and recipients. Disclosures Anwer: Incyte, Seattle Genetics, Acetylon Pharmaceuticals, AbbVie Pharma, Astellas Pharma, Celegene, Millennium Pharmaceuticals.:Honoraria, Research Funding, Speakers Bureau.

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Section: Syphilismentioning

confidence: 96%

Section: Syphilismentioning

confidence: 99%

A Systematic Review of Transfusion Transmissible Infections Among Blood Donors and Associated Safety Challenges in Pakistan

Ehsan

Wahab²,

Shafqat

et al. 2020

Blood

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“…When comparing our study with earlier studies from different cities in Pakistan, the prevalence rates were Karachi (0.91%) [ 35 ], Karachi (2.1%) [ 34 ], Islamabad (1.55%) [ 33 ], Peshawar (0.43%) [ 57 ], Lahore (0.5%) [ 58 ], and Lahore (2.25%) [ 59 ]. Our result was higher (0.83%) compared to an earlier study in Peshawar, where the prevalence was 0.43%.…”

Section: Discussionmentioning

confidence: 48%

Analysis of molecular subtypes and antibiotic resistance in Treponema pallidum isolates from blood donors in Khyber Pakhtunkhwa, Pakistan

Muhammad,

Khalifa,

Salih

et al. 2024

PLoS ONE

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Syphilis, caused by Treponema pallidum, is resurging globally. Molecular typing allows for the investigation of its epidemiology. In Pakistan and other nations, T. pallidum subsp. pallidum has developed widespread macrolide resistance in the past decade. A study at the Peshawar Regional Blood Centre from June 2020–June 2021 analyzed serum samples from 32,812 blood donors in Khyber Pakhtunkhwa, Pakistan, to assess circulating T. pallidum strains and antibiotic resistance. Blood samples were initially screened for T. pallidum antibodies using a chemiluminescent microparticle immunoassay (CMIA). CMIA-reactive samples underwent polymerase chain reaction (PCR) targeted the polA, tpp47, bmp, and tp0319 genes. PCR-positive samples were further analyzed for molecular subtyping using a CDC-developed procedure and tp0548 gene examination. All PCR-positive samples were analyzed for the presence of point mutations A2058G and A2059G in 23S rRNA, as well as the G1058C mutation in 16S rRNA. These mutations are known to impart antimicrobial resistance to macrolides and doxycycline, respectively. Out of 32,812 serum samples, 272 (0.83%) were CMIA-reactive, with 46 being PCR-positive. Nine T. pallidum subtypes were identified, predominantly 14d/f. The A2058G mutation in 23S rRNA was found in 78% of cases, while G1058C in 16S rRNA and A2059G in 23S rRNA were absent. The research found donor blood useful for assessing T. pallidum molecular subtypes and antibiotic resistance, especially when chancres are not present. The prevalent subtype was 14d/f (51.85%), and the high macrolide resistance of 36 (78%) indicates caution in using macrolides for syphilis treatment in Khyber Pakhtunkhwa, Pakistan.

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<p>A Systematic Review of Transfusion-Transmissible Infections Among Blood Donors and Associated Safety Challenges in Pakistan</p>

Ehsan

Wahab

Shafqat

et al. 2020

JBM

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The blood transfusion (BT) system in Pakistan is fragmented, demand-driven and depends on weakly regulated transfusion practices. There is a considerable possibility that transfusion-transmissible infections (TTIs) are contributing to the current epidemic of hepatitis B virus (HBV) and hepatitis C virus (HCV) (affecting 7.4% of the general population) in the country. To study this issue, we conducted a systematic review to identify articles related to TTIs and transfusion safety in Pakistan from January 1, 2010 to January 31, 2020. A review of 33 articles met the final criteria for qualitative synthesis. Analysis of these studies showed a cumulative frequency of HBV 2.04%, HCV 2.44%, HIV 0.038%, syphilis 1.1% and malaria 0.11%. The frequency of coinfections among blood donors varied from 0.0099% to 0.35%. The highest number of coinfections were HCV and syphilis, followed by HCV and HBV infections. Syphilis and malaria were tested in only 38% and 46% of all the blood donations in one study. The rate of voluntary non-remunerated donations (VNRDs) was less than 13%, and male donors were 95% to 100% in these studies. There was a significant difference in the frequency of HBV and HCV in VNRDs (0.48%) as compared to replacement donors (RDs) (4.15%). In short, this review shows a high frequency of TTIs, especially HBV, HCV and syphilis in the blood donor population in Pakistan. There is a high dependency on RDs, minimal use of healthy voluntary blood donation practices, inadequate screening of high-risk donors, repeated collections of the blood from RDs, poor quality of screening methods and limited knowledge of donor health. Without standardized safe transfusion practices, there will be an ongoing increase in transmission of TTIs, especially HBV, HCV, syphilis, and HIV leading to a significant adverse public health impact.

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Seroprevalence of Syphilis in healthy blood donors of Lahore during year 2016 and 2017; An upcoming problem for Pakistan.

Cited by 3 publications

References 9 publications

A Systematic Review of Transfusion Transmissible Infections Among Blood Donors and Associated Safety Challenges in Pakistan

A Systematic Review of Transfusion Transmissible Infections Among Blood Donors and Associated Safety Challenges in Pakistan

Analysis of molecular subtypes and antibiotic resistance in Treponema pallidum isolates from blood donors in Khyber Pakhtunkhwa, Pakistan

<p>A Systematic Review of Transfusion-Transmissible Infections Among Blood Donors and Associated Safety Challenges in Pakistan</p>

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