[Alloimmunisation in polytransfused patients with non-phenotyped red blood cells at the University Hospital Souro Sanou of Bobo Dioulasso (Burkina Faso)]. / Allo-immunisation chez les patients polytransfusés avec des concentrés de globules rouges non phénotypés au Centre Hospitalier Universitaire Souro Sanou de Bobo Dioulasso (Burkina Faso).

Introduction: in Burkina Faso, blood transfusion is carried out with only ABO and RHD compatibility between the donor and the recipient. Such a practice carries risks of alloimmunisation, which can lead to clinical complications especially in polytransfused patients. The objective is to determine the prevalence and factors associated with alloimmunisation in polytransfused patients with non-phenotyped red blood cells at Souro Sanou University Hospital. Methods: we conducted a cross-sectional study in polytransfused patients in the clinical departments of the University Hospital Souro Sanou over a 3-month period (March to May 2019). In each of the 141 patients included, 5 ml of whole blood was collected in an ethylenediaminetetraacetic acid (EDTA) tube for testing for irregular antibodies. Irregular antibody testing was performed using the indirect Coombs gel filtration technical. Results: in total, the frequency of alloimmunisation obtained was 5.67%. The majority of the antibodies identified belonged to the Rhesus systems and Kell. We found no statistically significant relationship between age, sex, disease history, number of bags transfused and the positivity of the Irregular Antibody test (p = 0.37, p = 0, 75, p = 0.96). Conclusion: we found that the risk of alloimmunisation is major. Additional measures should be taken to strengthen the immunological safety of transfusions in Burkina Faso. We propose that in Burkina Faso, anti-globulin compatibility testing should be performed systematically in patients with a high risk of immunisation.

Evaluation of the diagnostic performance and operational characteristics of four rapid immunochromatographic syphilis tests in Burkina Faso.

BACKGROUND AND OBJECTIVE: Little information is available on the rapid diagnostic testing for syphilis in Burkina Faso. The objectives of the study were (i) to assess the sensitivity and specificity of four on site rapid tests in comparison with Treponema pallidum haemagglutination assay (TPHA) as a gold standard and (ii) to evaluate the operational characteristics of those tests among health workers in a maternity unit. METHODS: Four rapid syphilis tests commercially available in Burkina Faso were evaluated using archived serum samples and Treponema pallidum hemagglutination assay (TPHA) as the gold standard. Blood samples were collected between November 2011 and June 2012 from blood donors at the Regional Blood Transfusion Center of Ouagadougou. The sensitivity and specificity of the tests were calculated. Evaluation of operational characteristics such as clarity of pamphlet, complexity of technique, duration, was conducted in a first-level healthcare center with health workers in maternity unit. RESULTS: Alere DetermineTM Syphilis was the most sensitive of the four rapid syphilis tests evaluated. It was followed by SD Bioline Syphilis 3.0, Cypress Diagnostics Syphilis Quick test and Accu-Tell ® Rapid Anti-TP, which was the least sensitive. The four tests demonstrated a good diagnostic specificity for syphilis (95-98%), and healthcare workers found them easy to use. CONCLUSIONS: The study allowed confirming the good performance of three of four rapid syphilis tests in Burkina Faso. More research will be conducted to assess the feasibility of introducing selected rapid tests for syphilis in antenatal care services.

Characterisation of hepatitis C virus genotype among blood donors at the regional blood transfusion centre of Ouagadougou, Burkina Faso.

BACKGROUND: Hepatitis C virus (HCV) is responsible for about 900 deaths every year in Burkina Faso. In this country, serological screening for hepatitis B and C viruses is only carried out systematically among blood donors. The aim of this study was to determine the prevalence and genotypes of HCV among blood donors using reverse transcription polymerase chain reaction (PCR) and real-time PCR, respectively. MATERIALS AND METHODS: Serum samples were screened for antibodies to HCV using an enzyme-linked immunosorbent assay (ARCHITECT-i1000SR-ABBOTT). All the reactive samples for HCV antibodies were re-tested using a second enzyme-linked immunosorbent assay (Bio-Rad, Marnes la Coquette, France) for confirmation. RNA was detected in all the reactive samples for antibodies to HCV. HCV RNA positive samples were genotyped using the HCV Real-TM Genotype kit (Sacace Biotechnologies, Italy). RESULTS: Among 2,200 blood donors, the prevalences of antibodies to HCV and viral RNA were 4.4% (95% confidence interval=3.5-5.3) and 1.5% (95% confidence interval=1.0-2.0), respectively. Among HCV RNA carriers, genotyping showed that HCV genotypes 2 and 3 were the most prevalent as they were detected in 18 (56.3%) and 5 (15.6%) individuals, respectively. HCV genotypes 1a and 4 were the least frequent among the blood donors. HCV mixed genotypes 2/3 and 2/4 were also detected among the blood donors. CONCLUSION: The prevalence of HCV found in this study is lower than previously reported prevalences. Large-scale studies are needed to obtain a better picture of the molecular epidemiology of HCV in Burkina Faso.

Screening of Hepatitis G and Epstein-Barr Viruses Among Voluntary non Remunerated Blood Donors (VNRBD) in Burkina Faso, West Africa.

In most sub-Saharan countries screening of blood-transmitted infections includes mainly HIV, HBV, HCV and syphilis. Many viruses such as Hepatitis G (HGV) and Epstein-Barr virus (EBV) which also carry a risk of transmission by blood transfusion raise the question of the extent of screening for these pathogens. This work aims to evaluate the prevalence of HGV and EBV in first-time blood donors in Ouagadougou. The prevalence of HGV and EBV in 551 blood donors was 7.4% and 5.4% respectively. HGV prevalence was significantly higher in blood donors with hepatitis B antigens and positive for HCV compared to donors negative for HCV and no hepatitis B antigens (respectively p<0.001 and p=0.004). EBV prevalence was higher among blood donors of < 20 years age group. HBV and HCV positive individuals are not eligible for blood donation. This study shows significant results with regard to the prevalence of HGV and EBV prevalence in blood donors in Burkina Faso and emphasizes the need for a general screening.

Epidemiology of syphilis in regional blood transfusion centres in Burkina Faso, West Africa.

INTRODUCTION: Syphilis remains a major public health problem in sub-Saharan Africa, including Burkina Faso. However, few published data are available on the prevalence of syphilis in the population. This study had two main objectives: to determine the seroprevalence of syphilis in a cohort of 37,210 first time blood donors and to study socio-demographic factors associated with the risk of infection by Treponema pallidum. METHODS: Antibodies to Treponema pallidum were screened by using Reagin Rapid Test (RPR) and confirmed by treponema pallidum haemagglutination test (TPHA). RESULTS: The overall seroprevalence of syphilis was 1.5% among first time blood donors and was significantly different between centers (p <0.001). The infection was significantly higher in men than women among blood donors in Ouagadougou and Fada N'gourma (P = 0.001 and P = 0.034). The overall seroprevalence of syphilis among blood donors was not associated with either age group or HIV status. In contrast, a significantly high seroprevalence of syphilis was observed in blood donors with HBsAg (P = 0.014) and anti-HCV (P = 0.007) positive. CONCLUSION: Our report shows a low seroprevalence of syphilis in the representative sample of the population of Burkina Faso. The seroprevalence of syphilis remains unequally distributed between urban and rural areas and was not associated with HIV infection.

Seroprevalence and incidence of transfusion-transmitted infectious diseases among blood donors from regional blood transfusion centres in Burkina Faso, West Africa.

BACKGROUND AND OBJECTIVE: The high prevalence of numerous transfusion-transmitted infectious diseases such as HIV, HBV, HCV and syphilis in sub-Saharan Africa affects blood safety for transfusion recipients. The aim of this study was to evaluate the prevalence and incidence of transfusion-transmissible infectious diseases among blood donors in Burkina Faso. METHODS: A retrospective study of blood donors' records from January to December 2009 was conducted. Prevalence and incidence of viral infections were calculated among repeat and first-time blood donors. RESULTS: Of the total of 31405 first-time volunteer blood donors in 2009, 24.0% were infected with at least one pathogen and 1.8% had serological evidence of multiple infections. The seroprevalence of HIV, HBV, HCV and syphilis in first-time volunteer donors was 1.8%, 13.4%, 6.3% and 2.1%, respectively. In 3981 repeat donors, the incidence rate was 3270.2, 5874.1 and 6784.6 per 100000 donations for anti-HIV-1, HBsAg and anti-HCV, respectively. These numbers varied significantly according to populations where blood is collected and blood centres in Burkina Faso. CONCLUSION: The relatively high prevalence of viral markers in first-time volunteers and remarkably high incidence of infections in repeat donors raise concerns regarding the safety of these donors and suggest that implementation of NAT might significantly improve the situation.

Seroprevalence of human immunodeficiency virus, hepatitis B and C viruses and syphilis among blood donors in Koudougou (Burkina Faso) in 2009.

BACKGROUND: The high prevalence of numerous transfusion-transmitted infectious diseases such as human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis in sub-Saharan Africa affects the safety of blood for recipients. This study was undertaken with the aim of determining the seroprevalence of HIV, HCV, HBV, syphilis and socio-demographic risk factors associated with blood donation in a new regional blood transfusion centre in Burkina Faso. MATERIAL AND METHODS: Sera samples were screened for hepatitis B surface antigen (HBsAg), antibodies to HCV, HIV types 1 and 2 and to Treponema pallidum using enzyme-linked immunosorbent assays and Rapid Plasma Reagin test (RPR) respectively. All the reactive samples for HIV, HBsAg, and HCV were confirmed using a second enzyme-linked immunosorbent assays. Antibodies to Treponema pallidum were confirmed with a Treponema pallidum haemagglutination test (TPHA). RESULTS: From the total of 4,520 blood donors in 2009, 1,348 (29.82%) were infected with at least one pathogen and 149 (3.30%) had serological evidence of multiple infections. The overall seroprevalence rate of HIV, HBV, HCV and syphilis was 2.21%, 14.96%, 8.69% and 3.96%, respectively. Among blood donors with multiples infections, the most common dual or triple combinations were HBsAg-HCV (1.39%), HBsAg-syphilis (0.66%) and HBsAg-HCV-syphilis (0.11%). The highest prevalences of HBsAg and HIV were found among blood donors from rural areas and in the age groups of 20-29 years and >40 years old, respectively. CONCLUSION: HBV and HCV remain the greatest threats to blood safety in Burkina Faso. Strict selection and retention of voluntary, non-remunerated low-risk blood donors are recommended to improve blood safety in the regional blood transfusion centre of Koudougou.