|Year : 2019 | Volume
| Issue : 1 | Page : 17-19
Studies on the trends of transfusion-transmissible infections in a district-level hospital in West Bengal, India
G Mukherjee1, S Ghosh2, A Mukherjee3, T Mondal3, S Mondal4
1 M.O.I.C, Blood Bank, North 24 Parganas District Hospital, Kolkata, West Bengal, India
2 Department of Transfusion Medicine and Blood Centre, Blood Bank, North 24 Parganas District Hospital, Kolkata, West Bengal, India
3 Laboratory Technician, Blood Bank, North 24 Parganas District Hospital, Kolkata, West Bengal, India
4 Superintendent, North 24 Parganas District Hospital, Kolkata, West Bengal, India
|Date of Submission||23-Dec-2018|
|Date of Acceptance||15-Feb-2019|
|Date of Web Publication||20-Jun-2019|
Dr. G Mukherjee
MOIC Blood Bank, North 24 Parganas District Hospital, Kolkata 700 124, West Bengal
Dr. S Ghosh
Department of Transfusion Medicine and Blood Centre, North 24 Parganas District Hospital, Kolkata - 700 124, West Bengal
Source of Support: None, Conflict of Interest: None
BACKGROUND: Therapeutic use of blood is the most sophisticated part of treatments in medical sciences. Transfusion of blood saves patients' lives as well as it has also the risk of infective disease, if it is contaminated.
AIMS AND OBJECTIVES: The current study focuses on the status of TTI amongst the voluntary Blood donors over a period of time.
MATERIALS AND METHODS: In this study, HIV, HCV, HBsAg and Syphilis (by RPR) screening test report for the year 2011 to 2017 of a district Hospital Blood Bank in West Bengal has been presented. Tests were done by ELISA and Syphilis by Rapid Plasma Reagin test.
RESULTS: No significant changes in the incidence of above noted cases have been observed and no Malaria positive case was detected.
CONCLUSION: This indicates a good awareness amongst the people regarding these diseases having immense public health importance.
Keywords: Enzyme-linked immunosorbent assay, hepatitis B surface antigen, hepatitis C, human immunodeficiency virus, malaria, National AIDS Control Organization, rapid plasma reagin, transfusion-transmissible infection, World Health Organization
|How to cite this article:|
Mukherjee G, Ghosh S, Mukherjee A, Mondal T, Mondal S. Studies on the trends of transfusion-transmissible infections in a district-level hospital in West Bengal, India. BLDE Univ J Health Sci 2019;4:17-9
|How to cite this URL:|
Mukherjee G, Ghosh S, Mukherjee A, Mondal T, Mondal S. Studies on the trends of transfusion-transmissible infections in a district-level hospital in West Bengal, India. BLDE Univ J Health Sci [serial online] 2019 [cited 2019 Sep 22];4:17-9. Available from: http://www.bldeujournalhs.in/text.asp?2019/4/1/17/260738
Therapeutic use of blood is the most sophisticated part of treatments in medical sciences. Transfusion of blood saves patients' lives as well as it has also the risk of infective disease, if it is contaminated., Common transfusion-transmissible infection (TTI) through blood includes hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis, and human immunodeficiency virus (HIV) and malaria which might cause prolonged illness and death. Saghir et al. have reported that chronic liver diseases, especially cirrhosis and hepatocellular carcinoma, are mainly caused by HCV and HBV. In India, the severity of incidence of TTIs has been reported, and the rate of incidence of HIV, HBV, and HCV in blood donors varies from 0.1% to 0.9%, 0.86% to 2%, and 0.28% to 0.53%, respectively. Depending upon these data, the World Health Organization (WHO) has recommended a mandatory pretransfusion blood test for HIV, hepatitis B surface antigen (HBsAg), HCV, syphilis, and malaria. To provide well-integrated and safe blood transfusion service for the interest of public service, as per the WHO recommendation in 2001, the National AIDS Control Organization (NACO) under the Ministry of Health and Family Welfare, Government of India (GoI), has built up an integrated strategy of blood collection from voluntary donors only and screening for TTIs (transfusion) for the safe and appropriate use of blood in 2003.,,
The current study focuses on the status of TTI among the voluntary blood donors over a period of time to aware the society about the complications related to blood transfusion in a district-level hospital blood bank in West Bengal, India.
| Materials and Methods|| |
The study was designed for a period of 7 years among 78,227 voluntary blood donors at blood bank of North 24 Parganas District Hospital, Barasat, Kolkata, West Bengal, India. The records of blood donors from January 1, 2011 to December 31, 2017 were analyzed. All blood units were collected from voluntary blood donors following NACO, GoI norms and regulations.
Diagnostic analysis for HBsAg and HCV and HIV-1 and 2 was performed by enzyme-linked immunosorbent assay method. Rapid plasma reagin (RPR) tests were used for syphilis. In RPR, nondiluted serum samples were tested. Again, in case of positive results, 1:8 dilution of serum was rechecked to mark as positive. For malaria parasite, thin and thick peripheral blood smears were stained with Leishman's stain and observed under microscope to detect malaria parasite.
All test kits and reagents were supplied by NACO, Ministry of Health and Family Welfare, GoI.
After checking for TTI, all reactive blood units were disposed as per the standardized norms of blood discard.
The test results were never disclosed to anybody, as per the GoI norms. The infected donors were called for counseling and were referred to referral centers for further testing and treatment, as well as per the hospital transfusion council ethics.
Statistical analysis of data was performed using Chi-square test to compare TTI rates in voluntary blood donors for the study period, and P < 0.05 was considered as statistically significant.
| Results|| |
Results are shown in [Table 1].
|Table 1: Year-wise collection of voluntary blood units and number of transfusion transmissible infection positive cases|
Click here to view
As in this study we have considered the voluntary blood donors fit for donation as per the NACO criteria, the number of donors are random; so, there should not be any correlations of number of donor variations. After performing statistical calculation, no correlation for the said time period was found. Overall positivity of TTIs in the study period was 2.245%. Among the total positive cases, the prevalence of HBsAg was highest (1.28%), followed by HCV (0.51%), syphilis (0.25%), HIV (0.51%), and malaria (0%).
The correlation between the number of positive cases of TT1s and number of total voluntary blood donors in each year was calculated.
In the case of HIV marker, the value of R is 0.5916. This is a moderate positive correlation, which means there is a tendency for high HIV variable scores go with high voluntary blood donor numbers (and vice versa). The value of R2, the coefficient of determination, is 0.35.
For HCV marker, the value of R is 0.3107. Although technically a positive correlation, the relationship between the HCV positive cases and number of voluntary blood donors is weak. The value of R2, the coefficient of determination, is 0.0965.
In the case of HBsAg marker, the value of R is – 0.2633. It is a negative correlation; so, the relationship between positive cases of HBsAg and total number of voluntary blood donors is very weak, almost near zero correlation. The value of R2, the coefficient of determination, is 0.0693.
For syphilis-positive cases, the value of R is 0.6367. This is a moderate positive correlation; the value of R2, the coefficient of determination, is 0.4054.
| Discussion|| |
Blood recipients are much more susceptible to viral infections transmitted through transfusion. These transmissions of viral infection are the major causes of morbidity and mortality in recipients. As per the NACO Guidelines, our blood bank does not take blood from replacement donors, and this blood bank completely runs on voluntary blood donation.
The present study was designed to find out the prevalence and trends of TTIs, namely HIV, HCV, HBsAg, syphilis, and malaria, during a designed period of time of 7 years.
In the present study, total number of voluntary blood donors is 78227. The number of voluntary blood donors varies every year depending on various factors of blood donation, e.g., total number of camps organized, donor motivation, predonation screening, etc. Much more social awareness is required for voluntary blood donation.
Sinha et al. have reported the range of overall positivity from 1.35% to 5.8%. In our present study, we have found it to be 2.24%, indicating that the prevalence of overall positivity is within the range as compared to other studies.
Our finding shows that there is a higher prevalence of HBsAg (1.28%), followed by HCV (0.51%), syphilis (0.25%), HIV (0.19%), and malaria (0%) in order of sequence. As discussed earlier that in India, the severity of incidence of TTIs has been reported and it ranges for HIV, HBsAg, and HCV in blood donors from 0.1% to 0.9%, 0.86% to 2%, and 0.28% to 0.53%, respectively.
The range of prevalence of TTIs was statistically not significant, suggesting the right practice of donor selection and sensitivity of screening procedure and test kits.
| Conclusion|| |
For practice of safe blood transfusion services for public interest, our study shows that right process of donor selection, quality control of collected blood units, and prevention of taking blood from replacement donors might reduce the prevalence and trend of TTIs. Furthermore, social awareness and use of ultrasensitive tests for TTI screening are recommended.
The authors acknowledge the staffs of blood bank for their cooperation and Superintendent, North 24 Parganas District Hospital, Barasat, for the kind permission to perform the study.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Makroo RN. How safe is Safe Blood? Transfusion Bull 2006;8:117-20.
Harmening DM. Modern Blood Banking and Transfusion Practices. 5th
ed. New Delhi: Jaypee Brothers; 2005. p. 359-66.
Saghir SAM, Al-Hassan FM, Omar Saeed Ali Alsalahi OSA, Alhariry AEA, Baqir HS. Frequencies of HBV, HCV, HIV, and syphilis markers among blood donors: A hospital-based study in Hodeidah, Yemen. Trop J Pharm Res 2012;11:132-6.
National AIDS Control Organization. National Blood Policy. National AIDS Control Organization, Ministry of Health and Family Welfare, Government of India; 2003.
World Health Organization. The Clinical Use of Blood – Handbook. Blood Transfusion Safety. Geneva: World Health Organization; 2002.
Government of India. Transfusion Medicine Technical Manual by Dir Gen of Health Service. 2nd
ed. New Delhi: Government of India; 2003. p. 160-72.
Daniel WW, Cross CL. Biostatistics: Basic Concepts and Methodology for the Health Sciences. 10th
ed. New Delhi, India: Wiley; 2014. p. 124-58.
Sinha SK, Roychoudhury S, Biswas K, Biswas P, Bandopadhyay R. Prevalence of HIV, Hepatitis B, Hepatitis C and Syphilis in donor's blood: A study from eastern part of India. Open J Hematology 2012;3:1-6.