Calleb Onyango
Maseno University, Kenya
Title: Seroprevalence and determinants of transfusion transmissible infections among voluntary blood donors in western Kenya
Biography
Biography: Calleb Onyango
Abstract
Background: Transfusion Transmissible Infections (TTIs) especially, Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV), Hepatitis C Virus (HCV) and syphilis are among the greatest threat to blood safety for recipients. Globally, up to 3% of HIV infections are transmitted through blood transfusion. In sub-Saharan Africa, about 10% of blood donors are permanently deferred from subsequent donation due to TTIs seropositivity with Kenya recording 5.26% overall prevalence. Although continuous monitoring and reporting on TTIs prevalence among donors is essential for detecting changes in TTIs epidemiology and evaluating donors’ selection criteria to improve blood safety, no comprehensive study has been conducted in western Kenya to determine the prevalence of TTIs and the associated determinants among voluntary donors.
Objective: To determine the seroprevalence of HIV, HBV, HCV and syphilis and to assess the socio-demographic distribution and risk factors among voluntary blood donors in Homabay, Kisumu and Siaya in western Kenya.
Design: A cross-sectional descriptive study.
Methods: A total of 1200 blood donors aged 16-65 years were recruited by systematic random sampling and their socio-demographic characteristics recorded in a questionnaire. Samples were collected from units of blood donated and tested at Kisumu Regional Blood Transfusion Center for antigens/antibodies to hepatitis B and C virus, HIV-1 and 2 using enzyme linked immunosorbent assay while syphilis antibodies were tested using Rapid Plasma Reagin test. Subsequently, all reactive samples were retested using chemiluminescent immunoassay to confirm reactive test results. Descriptive statistic was used to obtain data for TTIs seroprevalence in subgroups. Chi-square test for independence to test the distribution of socio-demographic variables among the four TTIs markers and multivariate logistic regressions to test the association and statistical significance between selected determinants and tests outcome. All tests were two-tailed and a P-value<0.05 was considered as statistically significant.
Results: Of the 1200 donors enrolled, 110 (9.2%) had serological evidence of infections with at least one pathogen while 3 (0.25%) had dual infections with HBV being the predominant marker. The overall seroprevalence of HIV, HBV, HCV and syphilis was 1.08%, 3.33%, 3.25% and 1.50% respectively. Correlates independently and significantly associated with HIV infections was gender (male vs. female: Odds Ratio [OR] 1.2; 95% Confidence Interval [CI] 0.39-3.71). For HBV infections, the predictors were marital status (single vs. married: OR 1.7; 95% CI 0.73-2.73), risky sexual behavior (>1 partner vs. 0-1 partner: OR 2.7; 95% CI 1.03-7.19). For HCV infections, the predictors were blood transfusion history (transfused vs. non-transfused: OR 3.3; CI 0.73-14.46). For syphilis infections, the predictors were region (Siaya vs. Homabay: OR 1.5; 95% CI 0.50-4.52), age (25-34 vs.15-24 years: OR 2.7; 95% CI 0.61-12.09) and drug use (user vs. non-user: OR 6.3; 95% CI 0.77-51.26).
Conclusion: HIV rate is lower while the rates of syphilis, hepatitis B and C virus remain higher among voluntary donors in western Kenya. Drug use, age, gender, risky sexual behavior and blood transfusion history remain the major predictors of TTIs.
Recommendation: Enhancing donors’ notifications, deferrals and referrals by KNBTS is fundamental in reducing the disease burden and improving safety in the blood donor pool. Similarly, quantification of transfusion-associated syphilis that can be prevented if chemiluminiscent immunoassays were regionally implemented is suggested.