Seroprevalence of transfusion transmissible infections by ELISA in donors testing negative with rapid ICT in Asokoro District Hospital, Abuja, Nigeria

Abstract

Background: Blood transfusion saves lives, but it is associated with many complications which include transfusion transmissible infections (TTIs). The major objectives of this study were to determine; the prevalence of TTIs in the blood donated at Asokoro District Hospital, Abuja, Nigeria from 01 January to 31 December 2019; investigate the accuracy of rapid immunochromatographic (ICT) tests for preliminary TTIs screening of blood donors’ samples and confirmed by ELISA test; and establish baseline data that will provide the impetus for improvement in equipment, infrastructure, and health system management, with the ultimate goal of ensuring safer blood transfusion practice.

Methodology: This was a retrospective cross-sectional study of records of blood donors at the Blood Bank of Asokoro District Hospital, a quasi-tertiary centre situated at Abuja, Federal Capital Territory (FCT), northcentral Nigeria, between 01 January to 31 December 2019. The socio-demographic biodata (age and gender), blood parameters (PCV and blood groups), and TTIs test results (by rapid ICT kit and ELISA) of donors were manually extracted from the record books of the hospital’s blood bank. Only donor blood samples that initially tested negative for TTIs met the inclusion criteria. The data were entered into the spreadsheet of Microsoft Excel, and analysed with the Statistical Package for the Social Sciences (SPSS) for Windows version 23.0. Chi square test was used to determine association between variables and p value less than 0.05 was considered statistical significance.

Results: A total of 1400 blood samples of donors, received within the study period, met the inclusion criteria of testing negative for TTIs on rapid ICT kit test. The mean age (± SD) of the donors was 35.6±6.7 years with age range of 18-67 years. The median age was 35 years, and the predominant age group was 30-39 years, accounting for 55.4% (775/1400). Majority of the donors (97.1%, 1359/1400) were males. In terms of ABO blood group distribution, group O Rh D positive was the commonest, followed by group A Rh D positive, while the least is group AB Rh D positive. The overall prevalence of TTIs by ELISA test was 4.9% (68/1400). This prevalence was highest for HCV (1.9%, 26/1400), followed by HIV (1.2%, 17/1400), HBV (0.9%, 13/1400) and syphilis (0.9%, 12/1400).

Conclusion: The detection of TTIs by ELISA test from false negative donor samples preliminarily screened with rapid ICT kit highlighted by our study speaks to the unreliability of rapid ICT kits in screening of blood donors for TTIs. There is need therefore for health authorities in Nigeria and other LMICs to ensure widespread availability of highly sensitive blood screening methods such as ELISA to the point where it will be possible to enforce legislation against the use of the less accurate rapid ICT screening kits.