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Original Article Prevalence of Transfusion Transmitted Infections among Donors; a Prospective Study Muhammad Kamran1, Raja Tahir Mahmood*1 Muhammad Asghar Khan1, Azhar Mehmood1, Lubna Nisar2 and M. Javaid Asad1

1Department of Biochemistry, PMAS-Arid Agriculture University Rawalpindi, Pakistan 2Askaria College Rawalpindi, Pakistan

ABSTRACT

Background and Aims: is the major cause of infectious diseases in recipient due to no of donated blood. Aims of current study are to get assessment of the prevalence of diseases in donor’s blood and to create awareness for blood donation among people. Methodology: 300 blood donors from Jamila Sultana Foundation Rawalpindi Pakistan, including males and females were screened for the prevalence of five transfusions transmittable infections (TTIs). Donors having age less than 20 years, weight less than 50 Kg and (Hb) less than 11.8 mg/dl were excluded from the study. Address for Results: Total 10.8 % males and 10 % females were infected with Correspondence various TTIs whereas HBV, HCV and are the major infections present in blood donors. Department of Conclusion: Prevalence of TTIs at higher rate might be due to poor Biochemistry, PMAS- health practices, low economic values and costly treatment in good Arid Agriculture hospitals. This study will help to monitor the quality of blood University Rawalpindi, donation and screening practices and to spread awareness among Pakistan. non-donors for the screening of dangerous infectious diseases. E-mail: [email protected] Keywords: Blood transfusion, Transfusions transmittable infections, Syphilis.

INTRODUCTION etiological agents can be virus, bacteria or After blood transfusion, blood protozoa. These organisms can persist in transmitted infection is the commonest recipient as carrier state or can cause cause of death. All patients on regular asymptomatic infection. Screening packed cell volume (PCV) or any blood procedures are usually performed at blood component are at increased risk of banks to prevent recipient from such transfusion transmitted infections. The infections1,2.

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Blood Banks are an essential part of prevalence diseases also creates awareness each and every hospital with basic purpose of importance of screening among the of the provision of blood transfusion donors. services. Blood transfusion services are required in a number of clinical conditions MATERIALS AND METHODS like (Low amount of blood), Thalassemia (Abnormal production of Study involved the human subjects; globin chains of Hemoglobin), Hemophilia it was approved by the ethical review (Deficiency of certain blood clotting factors committee of the Foundation. The persons i.e., factor IX) or may be required in having age more than 20 years, weight more gynecological problems e.g., in case of than 50 Kg and haemoglobin level more labor, Intrauterine death or when of than 11.8 mg/dl were included in the study. patient is unavoidable because during Those who did not fall the criteria were surgery there be some blood loss and to cope excluded from the study. Moreover written up with the blood loss transfusion of blood consent forms dually signed by the patients or blood products is unavoidable3. were also taken before the start of the study. Approximately 90% of individuals All blood donors were thoroughly examined infected with HCV are either asymptomatic by physician before blood donation and or have only mild symptoms4,5. Almost 300 screening. Donors having age less than 18 million individuals are infected with HBV, years, weight less than 50 Kg and worldwide. Chronic carriers of HBV may heamoglobin level less than 11.8 g/dl were have low level viremia and may not have excluded from the study. Before detectable HBs Ag level, so some centers recommendation of donors for blood have started testing against HBV donation, blood was screened for HCV, core protein (anti HBc)6. HBV, , HIV and syphilis by using Syphilis is caused by infection with standard protocols. Patients suffering from Treponema pallidum. It is spread primarily any of infections were referred for the through sexual contact. T. Pallidum can also necessary treatment. be transmitted by vertical transmission from mother to fetus or through blood if donor is RESULTS already infected7. Malaria is an important parasitic infectious disease worldwide, Total 300 blood donors from Jamila caused by four species of Plasmodium, Sultana Foundation Rawalpindi were studied namely vivax, ovale, malariae and and screened for the prevalence of infectious falciparum. Patients of chronic hemolytic disease. Out of these donors 250 were male anemia, as of thalassemia are on regular and 50 were female. Among male donors 11 packed RBC’s infusion and are at risk for (4.4%) were infected with HCV, 7 (2.8%) malaria8. HIV is transmitted through sexual with HBV, 3 (1.2%) with malaria, 6 (2.4 %) contact, sharing of HIV contaminated with syphilis and none of the donors has needles and/or syringes, transfusion of blood been infected with HIV (Fig. 1). Moreover, components, none of the donors have more than one The current study involves the infection, so total 27 (10.8 %) male donors analysis of screening of donor’s blood to were infected with various TTIs. In female investigate the prevalence of infectious blood donors 2 (4%) were infected with diseases. This analysis will help to adopt HCV, 2 (4%) with HBV, 1 (2%) with better screening practices against high malaria and no one with HIV and syphilis

AJPCT[2][4][2014]540-543 Mahmood et al______ISSN 2321 – 2748

(Fig. 1). Total 5 (10%) female blood donors reduce the risk factor of these common were infected with some of the disease. infectious diseases.

DISCUSSION Recommendations We recommend the government and Transfusion Transmitted infections private organizations involve with blood (TTIs) are major issue in Blood transfusion to donation to create the awareness among the recipients of Blood or Blood products. common people for screening and donation of Post transfusion infections are potential risk blood. Also to ensured donation according to for the recipients9. According to World international standards and proper treatment Health Organization’s (WHO) recommen- of infected persons. Also to ensured the dation, the screening should be performed for provision of pure water to every person at least five WHO recommended transfusion because cure is better than treatment. transmitted infections which include HCV, HIV, HBV, malarial parasite and syphilis. Conflict of Interest Prevalence of these infectious diseases varies Authors declare that there is no from place to place due variation in medical conflict of interest in current study. practices10. In current study, prevalence of infectious diseases is almost similar in both REFERENCES males and females blood donors. Prevalence of TTIs in blood donors might be due to poor 1. Makroo RN, Sahil P, Vashist RP, et al. hygienic and health conditions of people at Trends of HIV infection in blood donors of homes8. Existence of syphilis in males might Delhi. IndJPatholMicrobiol, 1996; 39:139- be due to no changing of beddings at common 142. places. Good health practices ensure the better 2. Kanako T, Yasuhito T, Fuat K, et al. A genetic variant of virus divergent health conditions and economic status plays a from known human and ape genotypes very important role in it. The higher isolated from a Japanese patient and prevalence of HCV and HBV in all blood provisionally assigned to new genotype. donors might be linked with poor health Japanese J Virol, 2009; 83:10538–10547. practices of people during normal diseases 3. Sawke N, Sawke GK, Chawla S. and non-availability of pure drinking water in Seroprevalence of common transfusion- most of the surrounding areas3,11. transmitted infections among blood donors. People’s J Sci Res, 2010; 30:5-7. CONCLUSION 4. Asif N, Kokhar N, Ilahi F. Seroprevalence of HBC, HCV and HIV infection among The prevalence of HCV and HBV in voluntary non-remunerated and replacement donors in northern Pakistan. Pak J Med Sci, both male and female blood donors might be 2004; 1:24-28. due to bad health practices adopted by 5. Sing B, Verma M, Verma K. Markers for peoples. Prevalence of syphilis among males transfusion associated hepatitis in north might be related to common bedding in Indian blood donors: prevalence and trends. working places and no proper cleanliness. Japanese J Infect Dis. 2004; 57:49-51. Consultancy with health specialist during 6. Gupta PK, Kumar H, Basannar DR, et al. normal diseases may reduce the prevalence of Transfusion transmitted infections in armed infectious diseases. Ensuring good health forces: prevalence and trends. MJAFI. 2006; facilities at low cost by Government may also 62:348-350.

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7. Kakkar N, Kaur R, DhanoaJ. Voluntary Salaam, . BMC Public Health. donors need for a second look. Ind J 2006; 6:21-25. PatholMicrobiol, 2004; 47:381-383. 10. Umair M, Mahmood RT, Inam M, et al. 8. Garg S, Mathur DR, Garg DJ. Comparison Sero-prevalence of hepatitis b, , of seropositivity of HIV. HBV, HCV and human immunodeficiency virus, syphilis and syphilis in replacement and voluntary blood malaria in blood donors of mirpur, azad donors in western. Ind J PatholMicrobiol, jammukashmir, Pakistan. J Publ Health 2001; 44:409-412. Biologic Sci, 2012; 1(4): 110-114. 9. Matee MIN, Magesa PM, Lyamuya EF. 11. Ujjan ID, Memon RA, Butt AR, et al. Sero- Seroprevalence of human immunodeficiency prevalence of HbsAg and anti-HCV in virus, hepatitis B and C viruses and syphilis healthy blood Donors. Pak J Gastroenterol, infections among blood donors at the 2006;20(1):75-7. Muhimbili National Hospital in Dar Es

Figure 1. Prevalence of TTIs among males and females blood donors

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