Prevalence of Antibodies to Human T Lymphotropic Virus Type I among Blood Donors at the 37TH Military Hospital, Accra, Ghana.

Abstract

Several infectious diseases have been found to be associated with transfusion of whole blood or blood components. Reports from studies conducted in many African countries indicate a high incidence of blood-borne pathogens such as human T-lymphotropic virus type-I (HTLV-I) among healthy blood donors. Experimental data indicate that a major route for transmission of the HTLV-I is through blood transfusion. The prevalence of HTLV-I antibodies among blood donors in Ghana is not well documented. Population surveys cannot be conducted for financial reasons and therefore sentinel studies are the only means for providing information on the transmissions of infections such as HTLV-I, as well as monitoring the changes over time. The study was therefore undertaken to determine the prevalence of HTLV-I antibodies among blood donors, between the months of January to April 2004 at the 37th Military Hospital Blood Transfusion Service, Accra, Ghana. A combination of particle agglutination test and enzyme-linked immunosorbent assay (ELISA) was used to assess the prevalence and distribution of antibodies to HTLV-I. A structured questionnaire was also administered to the blood donors after an informed oral and written consent was taken. This involved questions on personal information, knowledge about HTLV-I transfusion, sexual behaviour, lifestyle and histories of transfusion-transmitted diseases. Beginning from January to April 2004, blood samples were collected from blood donors, serum separated and analysed for the presence of antibodies to HTLV-I. A total of 1225 samples (1158 males and 67 females) were analysed. Their ages ranged from 20-69 years; with majority (75.5%; 925/1225) of the blood donors studied between the 30-39 years age group. Of the 1225 samples tested, 1196 were negative and 29 were positive for HTLV-I antibodies giving a prevalence rate of 2.4%. Two females were positive out of 67 (2.9%) and 27 males were positive out of 1158 (2.3%) male donors. Majority of the donors were married (914; 74.6%) and the rest (311; 25.4%) were not married. Of the married donors, 21 were positive for HTLV-I antibodies, giving a prevalence rate of 2.3% among married donor. Most of the positive male donors were married with one wife (19; 65.5%), and one positive case had two wives (3.4%). Seroprevalence increased with marital status, suggesting marital status as the primary mode of transmission rather than number of wives. There was no association of tattoo marks with HTLV-I infection (X2 = 1.72; or =2.07; 95% CI =0.16- 1.46). Knowledge about HTLV-I infection among blood donors was found to be very poor. Only 10 (0.82%) said they had heard of HTLV-I infection whilst 1215 (99.18%) had never heard about it. The results reported herein, suggest that HTLV-I is prevalent among healthy blood donors at the 37th Military Hospital Blood Transfusion Centre (MHBTC); and that there is the need for screening blood honors for circulating antibodies to HTLV-I infection. However, the economic burden/ benefit must also be looked at before including HTLV-I in the screening protocol.