Introduction

Transfusion-transmitted infections (TTI) are infections resulting from the introduction of a pathogen into a blood product recipient through blood transfusion. The goal of transfusion practices is to reduce the risk of TTIs to as low as possible. A wide variety of organisms, including bacteria, viruses, prions, and parasites can be transmitted through blood transfusions.Majority of post transfusion diseases are caused by hepatitis B virus (HBV), human immunodeficiency virus (HIV), hepatitis C virus(HCV), Treponema pallidum and malaria parasites. In order to achieve the desired zero risk of transmitted infection, many levels of safety practices are adopted including, donor selection criteria, donor deferral registries, laboratory testing and pathogen inactivation of the collected blood. Various challenges making it difficult to eliminate TTIs are immunological window period of early infectivity when the immunologic tests are unreactive, high cost of screening rarer pathogens, immunological variant of pathogens, non-seroconverting chronic or immune-silent carriers, inadvertent laboratory testing errors and cost of training and maintaining well equipped blood donation center. Post transfusion hepatitis B and C is a major problem in India because of low viral load and mutant strains undetectable by routine ELISA [1-3].

The magnitude of TTIs is proportional to the prevalence of the infection in the donor community. The important TTIs in India are HBV, HIV, Syphilis, HCV, Malaria, Hepatitis A, Hepatitis G, Epstein Barr Virus, Cytomegalo Virus (CMV), Parvo virus B-19, Human T Lymphocytic virus (HTLV-1 and HTLV-2) and bacterial infections. In standard practices however, for the cost and resource effectiveness, only common TTIs are tested and screened for. Thus, the risks of rare infections getting transmitted is always there [4]. The two aspects of preventing TTIs are the pre-donation screening of donors and post donation testing and modification of the blood. Even with many newer sensitive tests such as Nucleic Acid Tests (NAT) which are helpful in detecting infection with low pathogen load in the blood, in resource limited hospitals, where it is not practical to employ expensive tests to detect rare TTIs, nor can expensive sterilization techniques be employed; effective screening methods play important role in ensuring safe transfusion practices. The study aims to find out the prevalence of transfusion transmitted infection (TTI) in blood

was found positive for any TTI.

Data Collection Procedure: Basic demographic information regarding age, sex, occupation, number of previous donations along with the post donation testing data was compiled from the hospital records.

Data Analysis: Analysis of the collected data was performed using Microsoft excel.

Ethical Consideration: Consent were taken from the donors for using the collected data for research purposes. No individually identifiable information was conveyed in the research.

Permission: Permission was obtained from the hospital ethical committee for the conduct of the research and its publication.

Results

A total 54,831 blood donations were enlisted in the study which included both voluntary as well as replacement donors comprising of 12.43% and 87.57% of the total donation respectively (Table 1).

Table-1: Yearly distribution of voluntary and replacement donors.

Prevalence for HIV was 0.31%(172cases) in total donors. Seroprevalence of HBsAg in total donors was 0.75% (414cases). Seroprevalence of VDRL among all donors was 0.22% (120 cases). The seropositivity of HCV in total donors was 0.065% (36 cases) (Table 2).

Table-2: Yearly seroprevalence of TTI’s in donors.

The nation policies here in our nation is originated recently and transfusion services are hospital based and fragmented [3]. Most of donors in the present study were male (98.05%) which is comparable to the studies done by others like Mallini Padma et al, Secundrabad [4], Rao and Annapurna, et al [5] in Pune, Rose, et al [6] in Vellore.

In the present study, replacement donors constitute 87.57%, the largest group of blood donors, which was similarly noted by Singh, et al. (82.4%) [7], Kakkar et al (94.7%) [8], Pahuja et al. (99.48%) [9]. Replacement donors (RD) are usually one-time blood donors who donate blood only when a relative is in need of blood whereason other hand, voluntary donors(VD) are motivated blood donors who donate blood at regular interval [10]. In contrast to our experience, a predominance of voluntary donors was noted by Mallini Padma et al, Secundrabad [4]. It is shown that the replacement donors constitute the largest blood donors in India [11].

It was found that the highest incidence of HBV (0.75%), followed by HIV (0.31%), VDRL (0.22%) and HCV (0.065%) in decreasing order. VDRL reactivity in the present study was 0.22% which is comparable to study by Mallini Padma et al, Secundrabad [4]. Awasthi et al [12] reported seropositivity for HIV was 0.1%, HBV 1.82%, HCV 0.83% and syphilis 0.13%. Agrawal et al [13] found overall seroprevalence of HBV and HCV was 1.5% and 0.8% respectively, while prevalence of syphilis and HIV was 0.07% and 0.1% respectively. The highest prevalence was observed for HBV followed by HCV, HIV and syphilis in decreasing order. Many of the Indian studies show prevalence rates for HIV 0.51-3.87%, HCV 0.12-4%, HBV(HBsAg) 1.2-3.5% and VDRL 0.3-0.82% [11,14,15,16,17-20]. A low prevalence rate in the present study may be attributed to increased number of donors donating at the blood bank with appropriate screening criteria. Hiding of the medical history by professional donors create a big threat to safety of blood supply. On the other hand, prevalence of HBV infection is lower in US and western Europe (0.1-0.5%) and is reported higher in south east Asia and China, which is 5-15% [10]. Though the study involves 6 years of data however it does not accurately reflect the population in the tribal area in the surrounding area because of the inaccessibility from those area. The study does not differentiate the donations received in the hospital that from the blood donation camps. Identifying the difference in pattern among these categories could have yielded

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