Assessment of Transfusion Transmissible Infections Among Blood Donors (A six years study) and Strategy on Direct Laboratory Testing Cost of Blood Screening at National Blood Transfusion Service of Addis Ababa, Ethiopia
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Date
2014-06
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Addis Ababa University
Abstract
Background: Hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus
(HIV) and syphilis are the most serious infections transmitted during blood transfusion. In such a
resource limited setting, cheaper and feasible alternative strategies for blood donations testing
are specifically required. However, updated data on the transfusion transmissible infections
(TTIs), and cost effective strategies of blood screening are lacking.
Objective: To determine the prevalence of transfusion transmissible infections among blood
donorsfrom July 2008 to July 2013and propose cost effective strategy of blood screening at
National Blood Bank of Addis Ababa, Ethiopia.
Methodology:A retrospective analysis of blood donors’ record covering the period from July
2008 to July 2013 was conducted. The data was collected from the National Blood Transfusion
Services (NBTS) of Addis Ababa and includes category of all donors and result for TTI markers.
In addition, direct laboratory costs of parallel versus sequential strategy of blood screening were
compared. To compare the strategies we used the current price of the laboratory costs. Data was
first exported to Excel spread sheet from the institution’s data base and then finally exported to
SPSS version 16 software (SPSS INC, Chicago, IL, USA) for analysis.Data analysis was
performed using scores and odds ratio using same software to look for an association between
dependent and independent variables. P values less than 0.05 were considered significant.
Result: A total of 173,207 consecutive blood donors were screened between 2008 and
2013.The overall seroprevalence rate ofHBV, HIV, HCV and syphilis of blood donors was 5.0%,
1.6%, 1.4% and 0.1%respectively. The HIV-HBV confection was higher among blood donors
135(41.79%) followed by HBV-HCV co-infection which accounts about 103(31.89%).
Significantly increased seroprevalence of TTI’s was observed in the age groups of 17-25 and 26-
35 years. In this study, the difference in cost between the current in use strategy (Parallel) versus
our proposed newly designed sequential testing algorithm was 746,773.90 ETB.
Conclusion: A significant percentage of the blood donors harbor TTIs. Higher prevalence of
TTIs was observed among youths and replacement donors. The direct laboratory cost analysis
using current in use strategy (parallel) was higher than the newly designed sequential testing
algorithm. Thus, the new strategy can be implemented to make screening of TTIs cost effective
in the face of the current effort of large mobilization of voluntary blood donors in the country
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National Blood Transfusion Service