Le SIDA au Ghana (serveur d'exploration)

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Deferred donor care in a regional hospital blood center in Ghana

Identifieur interne : 000079 ( PascalFrancis/Curation ); précédent : 000078; suivant : 000080

Deferred donor care in a regional hospital blood center in Ghana

Auteurs : Jean-Pierre Allain [Royaume-Uni, Ghana] ; Ohene Opare-Sem ; Francis Sarkodie ; Rabiatu Rahman ; Shirley Owusu-Ofori

Source :

RBID : Pascal:09-0186728

Descripteurs français

English descriptors

Abstract

BACKGROUND: In sub-Saharan Africa, the viral marker burden in blood donor populations ranges between 10 and 30 percent. Deferred donors constitute a rare population of asymptomatic human immunodeficiency virus (HIV)- and hepatitis B virus (HBV)-infected individuals with high likelihood of long survival if cared for. Deferred donor care provides an opportunity for a public health impact on highly pathogenic infections. STUDY DESIGN AND METHODS: Between 2004 and 2007, all candidate donors deferred before donation for reactivity of anti-HIV, hepatitis C virus antibody (anti-HCV), and hepatitis B virus surface antigen (HBsAg) rapid tests were informed and referred to a donor care program consisting of test confirmation, information, counseling, and potential referral for follow-up and therapy. Dedicated trained nurses supervised the program including alanine aminotransferase (ALT) level testing to identify liver disease. RESULTS: In a 4-year period 51,100 donors were screened and 5778, 1578, and 227 candidate donors were deferred for reactivity to HBV, HIV, or HCV serologic markers, respectively. The rates of entry into the donor care program were 48, 14.3, and 22 percent of deferred donors, respectively. A total of 83 of 210 HBsAg-positive donors with elevated ALT levels were referred and 66 received antiviral treatment. A total of 89 of 516 confirmed anti-HIV-positive donors were referred to the hospital acquired immune deficiency syndrome clinic for follow-up. CONCLUSIONS: With little additional expense, the deferred donor care program identified asymptomatic infections with high odds of benefiting from monitoring and therapy. In the local circumstances, this public health-limited but definite impact was permitted by the rapid-test predonation screening, and this impact could be increased if more resources were available.
pA  
A01 01  1    @0 0041-1132
A02 01      @0 TRANAT
A03   1    @0 Transfusion : (Phila., PA)
A05       @2 49
A06       @2 4
A08 01  1  ENG  @1 Deferred donor care in a regional hospital blood center in Ghana
A11 01  1    @1 ALLAIN (Jean-Pierre)
A11 02  1    @1 OPARE-SEM (Ohene)
A11 03  1    @1 SARKODIE (Francis)
A11 04  1    @1 RAHMAN (Rabiatu)
A11 05  1    @1 OWUSU-OFORI (Shirley)
A14 01      @1 Division of Transfusion Medicine, Department of Haematology, University of Cambridge @2 Cambridge @3 GBR
A14 02      @1 Department of Medicine, and the Transfusion Medicine Unit, Komfo Anokye Teaching Hospital @2 Kumasi @3 GHA
A20       @1 669-675
A21       @1 2009
A23 01      @0 ENG
A43 01      @1 INIST @2 10224 @5 354000184908710110
A44       @0 0000 @1 © 2009 INIST-CNRS. All rights reserved.
A45       @0 14 ref.
A47 01  1    @0 09-0186728
A60       @1 P
A61       @0 A
A64 01  1    @0 Transfusion : (Philadelphia, PA)
A66 01      @0 GBR
C01 01    ENG  @0 BACKGROUND: In sub-Saharan Africa, the viral marker burden in blood donor populations ranges between 10 and 30 percent. Deferred donors constitute a rare population of asymptomatic human immunodeficiency virus (HIV)- and hepatitis B virus (HBV)-infected individuals with high likelihood of long survival if cared for. Deferred donor care provides an opportunity for a public health impact on highly pathogenic infections. STUDY DESIGN AND METHODS: Between 2004 and 2007, all candidate donors deferred before donation for reactivity of anti-HIV, hepatitis C virus antibody (anti-HCV), and hepatitis B virus surface antigen (HBsAg) rapid tests were informed and referred to a donor care program consisting of test confirmation, information, counseling, and potential referral for follow-up and therapy. Dedicated trained nurses supervised the program including alanine aminotransferase (ALT) level testing to identify liver disease. RESULTS: In a 4-year period 51,100 donors were screened and 5778, 1578, and 227 candidate donors were deferred for reactivity to HBV, HIV, or HCV serologic markers, respectively. The rates of entry into the donor care program were 48, 14.3, and 22 percent of deferred donors, respectively. A total of 83 of 210 HBsAg-positive donors with elevated ALT levels were referred and 66 received antiviral treatment. A total of 89 of 516 confirmed anti-HIV-positive donors were referred to the hospital acquired immune deficiency syndrome clinic for follow-up. CONCLUSIONS: With little additional expense, the deferred donor care program identified asymptomatic infections with high odds of benefiting from monitoring and therapy. In the local circumstances, this public health-limited but definite impact was permitted by the rapid-test predonation screening, and this impact could be increased if more resources were available.
C02 01  X    @0 002B27D01
C02 02  X    @0 002B27C
C03 01  X  FRE  @0 Donneur limite @5 09
C03 01  X  ENG  @0 Suboptimal donor @5 09
C03 01  X  SPA  @0 Donante marginal @5 09
C03 02  X  FRE  @0 Transfusion @5 10
C03 02  X  ENG  @0 Transfusion @5 10
C03 02  X  SPA  @0 Transfusión @5 10
N21       @1 138
N44 01      @1 OTO
N82       @1 OTO

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Pascal:09-0186728

Le document en format XML

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