Transfusion associated hepatitis B virus infection among sickle cell anaemia patients in Kano, Nigeria

Abstract

Background: Transfusion of blood products is a recognised way of transmitting infections particularly viruses. The extent to which blood transfusion contributes to hepatitis B virus (HBV) infections in transfused patients with sickle cell anaemia (SCA) has been found to be 20% in Lagos, Nigeria. Mamman in Zaria however reported a lower prevalence of 4.03%. This wide variation in prevalence might not be unconnected with patients' selection, methodology or differences in quality control at transfusion.
Objective: This study was aimed at determining the prevalence of transfusion associated HBV infection among sickle cell anaemia patients in Kano, Nigeria.
Materials and Methods: The study was a case control study in which patients with sickle cell anaemia were recruited from Aminu Kano Teaching Hospital (AKTH), Murtala Mohammed Specialist Hospital (MMSH) and Hasiya Bayero Paediatric Hospital (HBBH), all within Kano metropolis, Kano, Nigeria.
A total of 135 consecutive patients with Sickle Cell Anaemia (SCA) {68 transfused (cases) and 67 non transfused (controls)} were studied. An interviewer administered questionnaire containing details of previous blood transfusion and other risk factors for HBV infections was administered to each of the patients. The presence of HBsAg was then looked for in both the transfused (cases) and non transfused (controls) patients with SCA using Monolisa ELISA according to manufacturers instructions. The association between multiple blood transfusions and the risk of HBV infection was determined by calculating the relative and attributable risks respectively.
Results: There were 68 patients in the study group (cases) consisting of 41(60.3%) males and 27(39.7%) females while the controls were made up of 67 patients consisting of 24(35.8%) males and 43(64.2%) females. Eighteen patients (26.5%) in the transfused group and 3(4.5%) in the control group tested positive for HBsAg. Blood transfusion was significantly associated with HBV infection in patients with SCA (p<0.05) with a Relative Risk (RR) of 5.8 and an Attributable Risk (AR) of 22%.
Conclusion: There still exist increased risks of infection with HBV in SCA patients who have received blood transfusion despite existing screening modalities. Therefore polices aimed at effective prevention like ensuring quality control, standardizing and centralizing blood transfusion services need to be put in place as a matter of urgency.


Sahel Medical Journal Vol. 10 (1) 2007: pp. 15-18