Seroprevalence of Transfusion-Transmitted Infections among Voluntary and Replacement Blood Donors at the Peshawar Regional Blood Centre, Khyber Pakhtunkhwa, Pakistan

Abstract

Introduction Blood transfusion is linked to several risks, most notably the transmission of transfusion-transmitted infections (TTIs), including hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), syphilis, and malaria. The risk posed by these blood-borne infectious agents is high in developing countries, including Pakistan. This fact stresses the need for regular surveillance of TTIs. Therefore, the present study was undertaken to assess the seroprevalence of TTIs at a regional blood center. Material and Methods This was a retrospective 4-year descriptive study undertaken at the Regional Blood Centre in Peshawar, Khyber Pakhtunkhwa Province of Pakistan, on the blood donor data from June 2016 to May 2020. A total of 41,817 donors donated blood during the study period and were screened for HBV, HCV, HIV, syphilis, and malaria. To ensure donor privacy, donors were identified via codes and no personal information was available. The data were extracted from the ZAAVIA blood transfusion information system database. Results The study included a total of 41,817 donors—41,493 (99.22%) males and 324 (0.78%) females. Of them, 22,343 (53.43%) were voluntary donors while 19,474 (46.57%) were replacement donors. An overall TTI prevalence rate of 4.61% was found. The TTI prevalence rate in voluntary donors was 3.90% while 5.42% in replacement donors. The overall prevalence of HBV, HCV, HIV, syphilis, and malaria was 1.95, 1.38, 0.23, 0.91, and 0.14%, respectively. Conclusion The current study documented a high prevalence (1,929 out of 41,817, 4.61%) of TTIs, especially in replacement donors (1,057 out of 19,474, 5.42%), and low participation of female donors. The recommendations include the promotion of voluntary blood donors, enrolment of female blood donors, and screening of donated blood through highly sensitive screening assay (i.e., nucleic acid testing).

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“…A vast majority (42.92%) of the blood donors in the present study were between 18 and 30 years. This finding was consistent with studies from Pakistan (45.6%), 9 Kenya (42.24%), 10 and Tanzania (44.7%). 11 The blood donors in the present study had their mean ages 10–15 years less than those observed in developed western countries.…”

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“…The last point is that people who donated more than five times have already been screened multiple times. Repeat blood donors are therefore less at risk than new donors who never go through the screening process Similar results confirm that first-time donors have higher hepatitis B infection rates compared to regular and repeat blood donors[27] [28]. HBs antigen prevalence and blood donation.…”

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“…We attribute this to the increase in replacement donations to meet the demand for various blood components as there was no change in the testing methodology used for syphilis screening in blood donors. Replacement donors have been shown to have a higher prevalence of transfusion-transmitted infections [13] , [14] , [15] , [16] . A recent study reported a reactive rate of 0.8% for all infections among voluntary donors and 1.95% in replacement donors(p˂0.001) in their analysis of trends of seroprevalence over 10 years [25] .…”

“…In such a situation, when voluntary donations are less, blood centres have to turn to other sources such as family donors and replacement donors [9]. Replacement donors have shown a higher prevalence of transfusion-transmitted infections as reported in various studies [13][14][15][16]. Although many blood centres have a system in place to motivate doctors and staff during emergent demands, these too are limited given the scale of the pandemic.…”