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Blood transfusion related paediatric HIV/AIDS in Ile-Ife, Nigeria
E A Adejuyigbe1, M A Durosinmi, F N Onyia
1Obafemi awolowo University, Ile-Ife, Nigeria. ebunadejuyigbe@hotmail.com
Insights
Unsafe blood transfusions significantly contribute to pediatric HIV infection in Nigeria. Higher HIV rates were found in paid donors, emphasizing the need for a national blood transfusion service and voluntary donation.
Area of Science:
- Pediatric Infectious Diseases
- Public Health
- Hematology
Background:
- Blood transfusion is a critical medical intervention.
- Human Immunodeficiency Virus (HIV) poses a significant global health challenge, particularly in pediatric populations.
- Ensuring blood safety is paramount to prevent transfusion-transmitted infections.
Purpose of the Study:
- To determine the role of blood transfusions in pediatric HIV infection in Ile-Ife, Nigeria.
- To assess the HIV serostatus of children requiring transfusion and blood donors.
- To identify risk factors associated with transfusion-related HIV transmission.
Main Methods:
- Prospective study screening consecutive children for HIV based on WHO pediatric AIDS criteria.
- Analysis of blood donor HIV serostatus from Obafemi Awolowo University Teaching Hospital (OAUTH) blood bank records.
- Retrospective review of transfusion history and blood source for HIV-positive pediatric patients.
Main Results:
- 13.3% of screened children were HIV-positive.
- Among 18 children with transfusion history, 66.7% were HIV-positive, with most transfusions occurring in private facilities using unscreened blood.
- 'Paid' donors showed significantly higher HIV-positivity rates compared to voluntary donors (p=0.005).
- Maternal HIV status did not fully explain transfusion-related infections in children.
Conclusions:
- Transfusion with unscreened or unsafe blood is a significant route of HIV infection in symptomatic Nigerian children.
- The high prevalence of HIV among 'paid' blood donors underscores the urgent need for improved blood safety measures.
- Recommendations include establishing a national blood transfusion service, enforcing transfusion regulations, promoting voluntary blood donation, and educating healthcare workers.
Abstract:
This prospective study was aimed at determining the contribution of blood transfusion to paediatric HIV infection in Ile-lfe, Nigeria. It involved HIV screening of consecutive children presenting at the Obafemi Awolowo University Teaching Hospital (OAUTH), Ile-Ife, between March 1996 and March 2001, with any of the signs in the WHO clinical case definition for paediatric AIDS. The HIV serostatus of blood donors at the OAUTH was also extracted from the blood bank records. Of the 263 children who met the criteria for HIV screening, 35 (13.3%) were HIV-positive. Eighteen of the 263 children screened had a history of blood transfusion and 12 (66.7%) of the 18 were HIV-positive. Eleven (91.7%) of the 12 HIV-positive patients were transfused in private hospitals with blood collected from private laboratories. The blood with which the HIV-positive children were transfused was unscreened in three, screened in two and the HIV status unknown in the others. The sole voluntary donor was an HIV-positive father whose child received his unscreened blood. Only two (16. 7%) of the mothers of the previously transfused HIV-positive children were also HIV-positive. 'Paid'donors accounted for 94.3% of total donors in OAUTH blood bank records and cumulative HIV-positivity was statistically significantly higher in 'paid' donors than in voluntary donors (p = 0.005). Wl conclude that transfusion with unsafe blood is an important route for HIV infection in symptomatic children and that HIV-positivity is higher among paid donors. recommend the establishment of a national blood transfusion service, which is presently non-existent in Nigeria, and the enforcement of laws guiding blood transfusion. Voluntary blood donation should been encouraged and health workers in the private sectors educated on the link between blood transfusion and HIV infection.