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TRENDS AND EPIDEMIOLOGICAL ANALYSIS OF HBV, HCV, HIV, AND HUMAN T-CELL LYMPHOTROPIC VIRUS AMONG IRANIAN BLOOD DONORS:� STRATEGIES FOR IMPROVING BLOOD SAFETY�Azadeh & Team �

By

SN NURFARAHIN BINTI KAMARUSZAMAN

1/3/2022

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INTRODUCTION

  • This study have been done in 7 centres in Iran.
  • Study period – from April 2010 to March 2018

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Objective of this study is to evaluate the prevalence of TTIs and the impact towards demographic characteristics

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METHOD

  • Data was collected by using quantitative data collection including :-
  • Total collection of donor from 2010 – 2018
  • Male / female donor
  • Age from below 29 to above 50
  • Type donation (first time / regular)
  • Undergo screening and confirmatory test

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Data in table 3 shows:

  • Total collections from 7 centers was 354,695 in 2010 and
  • In 2018 total donor were 445,345 numbers of donor.
  • This show that the number of donor was increasing in trend.
  • In 2010, 94.9% are male donor and the rest are female donor.
  • The largest category according to age are in 30 – 39 years old which is 36.9% and the smallest are in category >50 years
  • Regular numbers of donor have 76.7% compared to 1st time donor.

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Table 4 shows:

  1. Number of 1st time donor have the highest number of positive confirmation result as compared to regular donor.
  2. In 2010, Hepatitis B has the number of 975 cases followed by HTLV with 379 cases.
  3. The number of cases have been decrease from 2010 – 2018 by 975 cases to 298 cases for Hepatitis B and the others also show a decreasing in trend.
  4. According to this, male have the higher number of positive cases as compared to female and the category of age are in 30 -39 for male and 40 - 49 for female.

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DISCUSSION

  • The risk of TTIs has reduced in countries that have applied strict rules for screening of blood donations.
  • The findings demonstrated a descending trend similar to studies conducted in China, UK, and USA.
  • TTIs had decreasing in trend in the 1st time donor 2018 compared to 1st time donor in 2010.
  • Higher prevalence of TTIs in 1st time donor compared to regular donor due to reasons such as donated blood for assessing their health status or benefitting from the effects of blood donation on their health.

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  • Higher prevalence of HBV was seen in females as compared to male probably due to higher possibility of male to female transmission during sexual contacts.
  • Frequency of the viral infection in females is twice as high in females as in males.
  • The results of the effect of the donor’s age on the prevalence of TTIs revealed that HBV and HCV were more frequent in woman of advanced age compared to male.
  • Increasing prevalence due to increased exposure to risk factors over time.
  • Prevalence of HBV in lower aged below than 29 years old is due to initiation of the HBV vaccination program for all Iranian newborns in 1993 and teenagers in 2006.

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  • Decreasing in trends attributed to the implementation of efficient national strategies such as
  • Improved public knowledge and awareness about the prevalence and transmission routes
  • Recruiting trained and experienced physicians
  • Strict and standard questionnaires
  • Implement donor self – deferral
  • Developing data registry for blood donors and national donor deferral registry software
  • Educational programs through confidential unit exclusion (CUE)
  • Call back, recall

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CONCLUSION

  1. TTIs can be controlled by applying strict guideline for donor’s criteria before they are eligible for donating blood.
  2. Those who counsel the donor plays an important rule during counselling for eligibility for donation.
  3. Every staff should have good communication skills while attending the donor and build a good rapport.
  4. Donors must be reassured and are comfortable to share if they having any problem while donating.
  5. Emphasize to the donor regarding important of safety blood supply to the recepeint.

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STATISTIC REACTIVE CASES FOLLOW UP IN PDN FROM 2018 - 2020

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STATISTIC HEPATITIS B FOLLOW UP IN PDN

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STATISTIC HEPATITIS C FOLLOW UP IN PDN

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STATISTIC HIV FOLLOW UP IN PDN

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  • Conclusion from the graph in 2020 statistic shows there is a descending in trend.
  • This reduction is highly due to impact of covid pandemic in the country.
  • Total collection / donation reduced

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MANAGEMENT REACTIVE CASES IN PDN�ACCORDING TO OUR STANDARD OPERATION PROCEDURE��PDN/BP/QP - 10

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TYPE OF INVESTIGATION

SCREENING

  • Hbs Ag / HIV – Architect /Cobas
  • HCV, HBV markers – Architect /Cobas

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  • Back to donor pool (HbsAg/HCV/HIV) – Architect

CONFIRMATION

  • HbsAg – Neutra
  • HCV blot
  • HIV blot

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DONOR DECLARATION FORM

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RECOMMENDATION STRATEGIES FOR BLOOD SAFETY IN PDN

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1) Strictly ask all the questions in the donor’s form including regular and apheresis donor.

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2) Emphasize to donor regarding the risk of behavior.

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3) Educate donor regarding route of TTI’s.

CONTAMINATED TRANSFUSION BLOOD PRODUCT

INFECTED MOTHER TO BABY

ORGAN AND TISSUE TRANSPLANT

SHARING CONTAMINATED SYRINGE AND NEEDLE

UNPROTECTED SEXUAL INTERCOURSE WITH UNSAFE PARTNER

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4) Explain to donor regarding important of self exclusion and blood safety.

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