Seroprevalence And Determinants Of Transfusion Transmissible Infections Among Voluntary Blood Donors In Homabay, Kisumu And Siaya Counties In Western Kenya

ABSTRACT

Transfusion transmissible infections (TTIs) especially, human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis (Treponema pallidum) are a constant threat to blood safety for recipients. Globally, about 1.6 million blood units are destroyed annually owing to TTIs seropositivity, of which 10% is discarded in sub-Saharan Africa. In Kenya, despite of a series of safety improvements in blood donations among them rigorous pre-donation screening and exclusion of high risk group from blood donation, a substantial amount of blood units of about 5.26% are still discarded annually owing to TTIs seropositivity, with greater majority coming from Homabay, Kisumu and Siaya counties in western Kenya. The objective of the current study was to assess the seroprevalence of HIV, HBV, HCV and syphilis and to establish the demographic and other risk factors driving TTIs seropositivity, exclusively in the category of voluntary donors. In across-sectional study, blood donors (n=1215) aged 16 - 65 years were recruited from a population of 15,480 using a systematic random sampling. A pre-donation questionnaire was used to collect data on demographic characteristic, medical history, and previous risk exposure. Samples were collected from units of blood donated; and tested at Regional Blood Transfusion Center (RBTC) of Kisumu for antigens or /antibodies to HBV, HCV, HIV-1 and 2 using enzyme linked immunosorbent assay (ELISA) while syphilis antibodies were tested using Rapid Plasma Reagin (RPR) test. Subsequently, all reactive samples were retested using chemiluminescent immunoassay to confirm reactive test results from ELISA and RPR tests. Seroprevalence distribution proportions in subcategories of variables were compared using Chi-square test for independence while logistic regression was used to determine the association between TTIs seroprevalence and various risk factors. All tests were two-tailed and a P-value < 0.05 was considered as statistically significant. Of the 1215 blood samples tested, 700(57.6%) were males and 515(42.4%) females (with a mean age of 19.04 ± 4.5). The overall TTIs seroprevalence was 114(9.4%), distributed among HIV, HBV, HCV and syphilis at 14(1.15%), 42(3.46%), 39(3.21%) and 19(1.56%), respectively. There were no significant differences in seroprevalence proportion distribution among the demographic variables tested. However, among the risk factors tested, high risk sex was significantly associated with higher odds of HBV infections (> 1 partner vs. 0-1 partner; Odd Ratio [OR] 2.60; 95% Confidence Interval [CI] 1.098 – 6.86; p = 0.046). In conclusion, a substantial percentage of blood donors still harbor transfusion transmissible infections despite recent safety improvements by the Kenya National Blood Transfusion Services (KNBTS) with greater majority cases caused by HBV infection arising from previous exposure to high risk sex. The findings are useful in informing blood donation safety improvements in the region by KNBTS agency. Consequently, promoting safe sex education in learning institutions and enhancing early uptake of HBV self testing with a subsequent vaccination would help reduce TTIs burden observed among blood donors.