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J Viral Hepat. 2019 Jun;26(6):750-756. doi: 10.1111/jvh.13073. Epub 2019 Feb 27.

High prevalence and poor linkage to care of transfusion-transmitted infections among blood donors in Dar-es-Salaam, Tanzania.

Author information

1
Department of Hepatology, Imperial College London, St Mary's Hospital, London, UK.
2
Department of Biochemistry and Haematology, Muhimbili National Hospital, Dar es Salaam, Tanzania.
3
Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France.
4
French National Reference Center for Viral Hepatitis B, C and delta, Department of Virology, Hopital Henri Mondor, Université Paris-Est, Créteil, France.
5
Department of Bioethics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
6
Department of Gastroenterology, Muhimbili National Hospital, Dar es Salaam, Tanzania.

Abstract

Blood transfusion is one of the most commonly relied upon therapies in sub-Saharan Africa. Existing safeguards recommended include systematic screening for transfusion-transmitted infections and restricted voluntary nonremunerated blood donor selection. We report the transfusion-transmitted infection screening and notification practice at a large urban blood transfusion centre in Dar-es-Salaam, Tanzania. Between October 2016 and March 2017 anonymized records of all donors registered at the blood transfusion unit were accessed to retrospectively note demographic information, donor status, first-time status, transfusion-transmitted infection result and notification. 6402 consecutive donors were screened for transfusion-transmitted infections; the majority were family/replacement blood donors (88.0%) and male (83.8%). Overall transfusion-transmitted infections prevalence was 8.4% (95% CI 7.8-9.1), with hepatitis B being the most prevalent infection (4.1% (95% CI 3.6-4.6)). Transfusion-transmitted infections were more common in family/replacement blood donors (9.0% (95% CI 8.3-9.8)) as compared to voluntary nonremunerated blood donor (4.1% (95% CI 2.8-5.7)). A minority of infected-donors were notified of a positive result (8.5% (95% CI 6.3-11.2)). Although transfusion-transmitted infections are more prevalent among family/replacement blood donors, overall risk of transfusion-transmitted infections across all groups is considerable. In addition, existing efforts to notify donors of a positive transfusion-transmitted infection are poor. Future policies must focus on improving linkage to care for newly diagnosed patients with transfusion-transmitted infections.

KEYWORDS:

blood donation; linkage to care; sub-Saharan Africa; transfusion-transmitted infections (TTIs)

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