Correlates of transfusion transmissible infections among patients with sickle cell disease in Nigeria: case-control study

O. Akpa, Oluwatoyin Babalola, A. Odetunde, A. Fagbamigbe, F. Fasola, B. Brown, N. Alamukii, C. Babalola, G. Odaibo, A. Falusi
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Abstract

ABSTRACT Transfusion transmissible infections (TTIs) such as Hepatitis B Virus (HBV), Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) are among the most frequent complications in individuals with Sickle Cell Disease (SCD). We investigated factors associated with TTIs in SCD patients and controls in South-west Nigeria. A total of 2,034 participants with or without SCD were recruited in a matched case-control study. HIV, HBV and HCV infections were diagnosed using commercialy available ELISA kits (Biorad, Paris). Samples positive for HIV ELISA were further confirmed using Western blot. Data were analyzed using descriptive statistics, paired/independent t-test and logistic regression at p = .05. Proportion with HBV was higher among those with multiple sexual partners (12.7%), tattoo/body incision (11.8%), and sharing of sharp objects (7.3%), but HIV was only higher among participants with history of tattoo/body incision (1.5%). Prevalence of TTIs was similar among participants with or without transfusion. History of sharing sharp objects (adjusted odds ratios (aOR) = 1.72; 95%CI:1.11–2.66) and tattoo/body incision (aOR = 1.89; 95%CI:1.22–2.94) almost doubled the risk of HBV. TTIs are endemic in the studied area. Certain lifestyles predispose people to TTIs than having blood transfusion. Population-based intervention targeting lifestyle changes may reduce the risk of TTIs in the study area. Abbrveviations AA: Hemoglobin AA; AC: Hemoglobin AC; aOR: adjusted Odds Ratios; AS: Hemoglobin AS; CHOP: Children Outpatient; CI: Confidence Interval; EDTA: Ethylenediamine Tetraacetic Acid; GOP: General Outpatient; HBV: Hepatitis B Virus; HCV: Hepatitis C Virus; HIV: Human Immunodeficiency Virus; HPLC: High Performance Liquid Chromatography; IAMRAT: Advanced Medical Research & Training; IDU: Injection Drug Use; MOP: Medical Outpatient; SC: Hemoglobin SC; SCD: Sickle cell disease; SD: Standard Deviation; SF: Hemoglobin SF; SS: Hemoglobin SS; STDs: Sexually Transmitted Diseases; TTI: Transfusion transmissible infections; UCH: University College Hospital Ibadan; UI: University of Ibadan;
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尼日利亚镰状细胞病患者输血传播感染的相关因素:病例对照研究
输血传播感染(tti),如乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)和人类免疫缺陷病毒(HIV)是镰状细胞病(SCD)患者最常见的并发症。我们调查了尼日利亚西南部SCD患者和对照组中与tti相关的因素。在一项匹配的病例对照研究中,共招募了2034名患有或不患有SCD的参与者。使用市售的ELISA试剂盒(Biorad,巴黎)诊断HIV、HBV和HCV感染。免疫印迹法进一步证实HIV ELISA阳性样品。数据分析采用描述性统计、配对/独立t检验和logistic回归,p = 0.05。有多个性伴侣(12.7%)、纹身/身体切口(11.8%)和共用尖锐物品(7.3%)的人感染HBV的比例较高,但有纹身/身体切口史的人感染HIV的比例较高(1.5%)。输血或不输血的参与者中tti的患病率相似。共用尖锐物品史(调整优势比(aOR) = 1.72;95%CI: 1.11-2.66)和纹身/全身切口(aOR = 1.89;95%CI: 1.22-2.94)感染HBV的风险几乎翻倍。TTIs在研究地区是地方性的。某些生活方式比输血更容易使人患感染性鼻炎。以改变生活方式为目标的以人群为基础的干预可能会降低研究地区tti的风险。缩写AA:血红蛋白;AC:血红蛋白AC;aOR:调整优势比;AS:血红蛋白AS;CHOP:儿童门诊;CI:置信区间;乙二胺四乙酸;GOP:普通门诊;HBV:乙型肝炎病毒;HCV:丙型肝炎病毒;HIV:人类免疫缺陷病毒;HPLC:高效液相色谱法;IAMRAT:先进医学研究与培训;IDU:注射用药;MOP:医疗门诊;SC:血红蛋白SC;SCD:镰状细胞病;SD:标准差;SF:血红蛋白SF;SS:血红蛋白SS;性传播疾病:性传播疾病;TTI:输血传播感染;伊巴丹大学附属医院;伊巴丹大学;
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