2Department of Obstetrics and Gynecology, University of Kamina, Kamina, Democratic Republic of Congo
3Department of Pediatrics, University of Kamina, Kamina, Democratic Republic of Congo
4Department of Public Health, University of Lubumbashi, Lubumbashi, Democratic Republic of Congo
Methods: For this purpose, a retrospective cross-sectional descriptive study was conducted among volunteer blood donors of the Provincial Blood Transmission Center (CPTS) of Lubumbashi, in the Democratic Republic of Congo during the period going from1st January to 31st December 2014. The blood collections were made into two cabins (fixed and mobile).
Results: The results of our epidemiological investigation showed that in the year 2014, among 440 blood donors, the prevalence of HIV, HBsAg, was of 2.3%, and 9.3% respectively. The marker of hepatitis B was the most encountered objective in our study.
The prevalence of HBsAg was higher in the first donated blood donors, that is, 17.0% compared to previous donors or 4.2%, 9.4% of male donors also had a positive result against 8.3% of female
Conclusion: The hepatitis B virus remains a major concern for blood recipient. For good blood safety, a particular emphasis must be put onto the pre-selection of donate blood donors' candidates and in supplying these viral markers screening tests.
Keywords: Prevalence; Hepatitis B; HIV; Volunteer; Blood donor
In fact, in developing countries or countries of economy transition, many people die because of the lack of safe blood, even in some urban healthcare facilities [2]. Blood transfusions can save lives and improve health, but millions of patients did not timely access to safe blood, no reliable blood donors. Blood transfusions are an essential aspect of health care, and everyone should have fair access to safe blood.
Two billion people worldwide have serologic evidence of HBV infection current or past, and 350 million are chronically infected and at risk of developing liver disease related to HBV. Approximately 15-40% of chronically infected patients develop cirrhosis, progressing to liver failure and / or hepatocellular carcinoma. Infection with HBV is causing between 500,000 to 1,200,000 deaths each year. HBV prevalence varies significantly in different regions of the world [3]. Let's consider the Sub- Saharan Africa, the prevalence of hepatitis B among blood donors ranges from 9.2% in the Democratic Republic of Congo and 10.7% in Cameroon [4]. In late 2010, UNAIDS estimated that 34 million (31.6 to 35.2 million) people living with HIV worldwide, an increase of 17% as compared to the year 2001 which 4 million are attributable to blood transfusions or other medical injections. Today, HIV transmission through that path is still relevant for the majority of inhabitants of the planet [5].
In fact, in this part of the world, that is to say, the sub-Saharan Africa, two factors account for the difficulties encountered to achieve optimal blood safety, the existence in the population of a high frequency of various infections, some of which are transmitted by blood transfusion and still insufficient proportion of voluntarily donors are the safest group [6].
Therefore, the objective of this study has been to determine the prevalence of HBV and HIV infection among volunteer donors of the Provincial Blood Transfusion Center of Katanga, to define for the future a policy to improve their selection, to reduce significantly the risk of transmitting infections through blood transfusion.
The collected data were coded, entered, processed and analyzed using SPSS 19. Descriptive analysis software was achieved through the calculations of proportions for categorical variables and the different frequency comparisons were encrypted using Pearson's Chi-square test and Fisher test when necessary. We set the statistical significance and the p-value <0.05.
The results as presented in Chart 1 shows that 88.2% of donors were aged between 19 and 45 years, only 1.6% had lower age than or equal to 18 years. The average age of donors was 32 ± 10 years ranging from 17 to 66 years.
It is apparent from Chart 2 that 60% of donors had made at least one gift against 40% of donors who were at first donation.
The Chart3 shows that the seroprevalence of HBsAg was 9.3%and 2.3% for the one of anti-HIV among volunteer donors.
Considering the variable seroprevalence of HIV, HBV and sex, 8.3% of female donors were positive for HIV against 1.7% male donors. And this difference was statistically significant (p = 0.04). Regarding hepatitis B, this chart shows that male donors were most affected (9.4%) against 8.3% of female donors, although this difference is not statistically significant (Chart 4).
HIV prevalence is highest (2. 3%) in the age group ranging from 19-45 years, it is higher for HBV (17. 8%) for donors over 45 year seven if this difference is not statistically significant (Chart 5).
However, the Chart 6 shows that 17.0% of HBV positive new donors HBV against 4.2% among former donors and this difference were statistically significant (p <0.0001). New donors were mostly affected by HIV (4.0%) than older even if the difference is not statistically significant (p = 0.10).
Age in years |
Number |
Percent |
≤ 18 |
7 |
1.6 |
19 - 45 |
388 |
88.2 |
˃ 45 |
45 |
10.2 |
Total |
440 |
100 |
Category of donors |
Number |
Percent |
Former |
264 |
60 |
New |
176 |
40 |
Total |
440 |
100.0 |
Result |
HIV |
HBV |
||
Number |
Percent |
Number |
Percent |
|
Positive |
10 |
97.7 |
41 |
9.3 |
Negative |
430 |
2.3 |
399 |
90.7 |
Total |
440 |
100 |
440 |
100 |
Sex |
HIV |
HBV |
||
Positive |
Negative |
Positive |
Negative |
|
Female |
3 (8.3%) |
33 (91.7%) |
3 (8.3%) |
33 (91.7%) |
Male |
7 (1.7%) |
397 (98.3%) |
38 (9.4%) |
366 (90.6%) |
Total |
10 |
430 |
41 |
399 |
OR and 95% CI |
5.16 [1.27 to 20.87] |
0.88 [0.26 to 2.99] |
||
p-value |
0.04 |
0.93 |
Age in years |
HIV |
HBV |
||
Positive |
Negative |
Positive |
Negative |
|
≤ 18 |
0 (0.0%) |
7 (100%) |
1 (14.3%) |
6 (85.7%) |
19 - 45 |
9 (2.3%) |
379 (97.7%) |
32 (8.2%) |
356 (91.8%) |
> 45 |
1 (2.2%) |
44 (97.8%) |
8 (17.8%) |
37 (82.2%) |
p-value |
0.92 |
0.10 |
The overall HIV prevalence in this study was 2.3%, it is lower than those reported in the literature concerning the city of Kisangani (4.7%) [6] and north-eastern Democratic Republic of Congo (5.6%), 5.5% in Maiduguri, Nigeria 10.6% and 16.7% in Ethiopia [2]. This prevalence was higher in female volunteer donors and in the first donation.
The greater vulnerability of women vis-à-vis HIV is due to physiological and biological factors but also social, cultural and economic pressures that do not allow them to ensure their prevention [11]. For all these reasons, there is a feminization of the HIV/ AIDS highlights the limits of the emancipation of women in their sexuality and raised awareness programs to be implemented for them to acquire vital social and economic empowerment in the fight against passivity, fatalism and submission [11].
In the present study, the seroprevalence of HBsAg was 9.3% with predominance in the male sex (17.3%), especially in first donation donors (17.0%). HBV seroprevalence in this study is higher than that previously found in our country, 3.63% in 2005 in Kinshasa [12], 3% in Kisangani 2004 [6], and Morocco 2.81% [13]; but this is less than that found in Kinshasa-West (9.2%) [14], in 2001 and in other African study such Ghana 8.2% [15]. This difference can be attributed to differences in methodologies. In fact, other authors have worked on the whole donor population (replacements and volunteers) while we worked solely on volunteer blood donors; moreover, some authors used confirmatory tests while we used the test for serology. The explanation we can advance for males compared to females is the role of socio-cultural characteristics presents only in men, such as circumcision. But other reasons may be a possibility of porting from birth with the mother-child transmission, blood transfusions and other ritual scarification.
The donor age ranged between 17 and 65 years with an age range of 19-45 years majority comprising 261 donors is 59.3% with a male predominance 91.8% and 60.0% of donors Blood left at least two blood donations in 2014 and are considered as lapsed donors (regular).
Donors' Category |
HIV |
HBV |
||
Positive |
Negative |
Positive |
Negative |
|
New |
7 (4.0%) |
169 (96.0%) |
30 (17.0%) |
146 (83.0%) |
Former |
3 (1.1%) |
261 (98.9%) |
11 (4.2%) |
253 (95.8%) |
Total |
10 |
430 |
41 |
399 |
OR and 95% CI |
3.60 (0.92 to 14.13) |
4.73 (2.30 to 9.72) |
||
p-value |
0.10 |
<0.0001 |
The prevalence of these infectious markers in our environment is sufficient to prove that the transfusion remains a public health problem in developing countries, in general, and especially in Lubumbashi; which justifies the systematic screening of all blood donors to reduce transfusion risk.
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