TITLE:
Levels, Trends and Inter-Regional Variations in Transfusion Transmissible Infection Positivity among Blood Donors in India: Evidence from India’s National HIV Program
AUTHORS:
Saravanamaurthy P. Sakthivel, Pinnamaneni Yujwal Raj, Shanoo Mishra, Arun Kumar Sharma
KEYWORDS:
HIV, Hepatitis, Transfusion Transmissible Infections, CMIS, Female Donors, India
JOURNAL NAME:
World Journal of AIDS,
Vol.5 No.3,
September
25,
2015
ABSTRACT: In India, transfusion transmissible
infections (TTIs) are monitored for trends at the blood bank level, but limited
efforts have been made to analyze data from a large number of blood banks and
present it at the national, regional and state levels. The Computerized
Management Information System (CMIS), National AIDS Control Organization’s
(NACO) online data capturing system, systematically collects information on
TTIs in a monthly aggregated format from blood banks across the country. This
information is being captured in NACO’s annual reports, but a systematic
scientific analysis and publication of the same have not been attempted so far.
Hence, the objective of this study is to analyze and report TTIs among blood
donors in India at three different levels—national, regional and state—from
497 consistent blood banks reporting through CMIS during 2008-2012. National
level analysis shows an increasing trend in voluntary blood donation from 9.28
lakh to 19.02 lakh, and a decreasing trend in TTIs, with female donors
constituting only 6% of the entire pool of donors. Of the five TTIs studied, in
2012 Hepatitis-B-surface Antigen (HBsAg) positivity was highest (0.9%),
followed by Hepatitis C Virus (HCV) (0.45%), syphilis (0.23%), HIV (0.17%) and
malaria (0.03%). Regional analysis indicated that voluntary donation was high
in the Eastern and Western regions, with 11% of female donors in Eastern India
in 2012. All the TTIs showed a declining trend, except HCV, which showed a
rising trend in the Eastern and Southern regions. The level of positivity for
all the five TTIs was higher than the national average in the Eastern region.
Among the TTIs, HIV positivity among voluntary donors was below the national
average, while in Mizoram both HBsAg and HCV of more than 1% seropositivity
and VDRL of 1.7% in Arunachal Pradesh had been reported. Malaria has the lowest
national positivity, with Nagaland reporting a high positivity of 0.4%.
Although the national and regional trends in TTI positivity are declining,
regional level variations in TTIs, especially in hepatitis, suggest the
importance of advocating for pre-donation counseling and educating donors on
self-exclusion.