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Common transfusion-transmitted infectious agents among thalassaemic children in Bangladesh
Abid Hossain Mollah1, Nazmun Nahar, Md A Siddique
1Department of Paediatrics, Dhaka Medical College Hospital, Dhaka 1000, Bangladesh. navid@bdonline.com
Insights
Transfusion-dependent thalassaemic children in Bangladesh have higher rates of hepatitis B and C infections. Strengthening blood safety and HBV vaccination is crucial to prevent transfusion-transmitted infections in this vulnerable group.
Area of Science:
- * Infectious Diseases
- * Pediatric Hematology
- * Public Health
Background:
- * Children with transfusion-dependent conditions, like thalassemia, are at increased risk of transfusion-transmitted infections (TTIs).
- * The prevalence of TTIs among thalassaemic children in Bangladesh is not well-documented.
- * This study addresses the knowledge gap regarding TTIs in multi-transfused thalassaemic children in Bangladesh.
Purpose of the Study:
- * To determine the prevalence of TTIs among transfusion-dependent thalassaemic children in Bangladesh.
- * To compare TTI prevalence in thalassaemic children with age- and sex-matched controls.
- * To identify specific TTIs associated with multiple blood transfusions in this population.
Main Methods:
- * A case-control study involving 259 children (152 thalassaemic, 107 controls).
- * Serological testing for hepatitis B virus (HBV), hepatitis C virus (HCV), hepatitis D virus (HDV), Treponema pallidum, and human immunodeficiency virus (HIV).
- * Statistical analysis using SPSS/Windows 10.5 to compare infection markers between groups.
Main Results:
- * Significantly higher prevalence of HBV markers (HBsAg, anti-HBc total) and HCV markers (anti-HCV) in thalassaemic children compared to controls.
- * No significant difference in HBeAg positivity, but a significant difference in anti-HBe levels between groups.
- * No cases of HDV, HIV, or T. pallidum infection detected in either group.
Conclusions:
- * Multi-transfused thalassaemic children in Bangladesh have a higher burden of HBV and HCV infections.
- * The findings underscore the risk of TTIs through blood transfusions in this population.
- * Recommendations include strengthening safe blood transfusion programs and implementing mass HBV vaccination.
Abstract:
Transfusion-dependent children are more prone to acquiring various transfusion-transmitted infections (TTIs), such as hepatitis B (HBV), hepatitis C (HCV), HIV, and others. Since the magnitude of these infections among thalassaemic children in Bangladesh is not well-known, this study was conducted to assess the prevalence of TTIs among them (who received more than three blood transfusions) compared to their age- and sex-matched controls (non-thalassaemics and those who had never had a transfusion). Seromarkers for HBV, HCV, HDV, Treponema pallidum, and HIV were tested, and the results were analyzed using SPSS/Windows 10.5. Of 259 children studied, 152 (58.69%) were thalassaemic (mean age 6.8 +/- 3.6 years), and 107 were controls (mean age 6.7 +/- 3.53 years). The HBV and HCV-markers were found significantly more often among multi-transfused thalassaemic children than among the controls in terms of HBsAg (13.8% vs 6.5%, p < 0.04), anti-HBc total (39.5% vs 9.4%, p < 0.0001), and anti-HCV (12.5% vs 0.9%, p < 0.0001). HBeAg did not differ (p = 0.82) between the thalassaemics (9.52%) and the controls (14.28%), whereas anti-HBe differed (0% vs 57.14%, p < 0.003). Neither the thalassaemics nor the controls were positive for HDV, HIV, or T. pallidum. Since more thalassaemic children acquired hepatitis B and C infections through multiple blood transfusions, it is recommended that the safe blood-transfusion programme be strengthened and mass vaccination against HBV (even who suffer from HCV) in Bangladesh be undertaken.