赤道几内亚比奥科岛献血者的输血传播感染疾病血清流行学研究和风险因素评估

摘要

Objective To determine the sero-prevalence of major transfusion-transmissible infections (TTIs) diseases in blood donors on Bioko Island. Methods All consenting blood donors, independence of some unsuitable donors, were submitted to screening with colloidal gold immunochromatographic assay and ELISA for HIV, HBV, HCV and syphilis. Multiple logistic regression analysis was conducted to evaluate risk factors related to each TTIs. Results In total 2 937 blood donors, the sero-prevalence of HIV, HBV, HCV and syphilis were 7.83% (95%CI: 6.85~8.80), 10.01% (95%CI: 8.92~11.10), 3.71% (95%CI: 3.03~4.39) and 21.52%(95%CI:20.02~23.00), respectively. The incidence of co-infections was 6.30%(95%CI:5.42~7.18). Our results also showed that significant higher HIV and syphilis infectious risk in female blood donor than in male counterparts (HIV:AOR=1.50, 95%CI: 1.10~2.04, P=0.010; syphilis:AOR:1.27, 95%CI: 1.02~1.58, P=0.034), and un-planning residential area was a significant risk factor to HIV, HBV and syphilis infection (HIV:AOR=1.66 95%CI: 1.04~2.66, P=0.033; HBV: AOR=1.78, 95%CI: 1.11~2.83, P=0.016; syphilis: AOR=1.73, 95%CI:1.26~2.37, P=0.001). Conclusion The high sero-prevalance of TTIs exists among blood donors on Bioko Island. More effective interventions to improve the access to safe blood should be taken by both the national government and local health departments.%目的：在比奥科岛上献血人群中开展一次输血传播感染疾病（transfusion-transmissible infections，TTIs）的血清流行病学调查。方法用金标法和ELISA对合格献血者血样进行4项输血传播感染疾病的检测，包括人类免疫缺陷病毒（HIV）、乙型肝型病毒（HBV）、丙型肝型病毒（HCV）、梅毒螺旋体（LUES），同时用多元回归分析方法评估TTIs疾病的相关危险因素。结果在2937名献血者中HIV、HBV、HCV和梅毒螺旋体的感染率分别为7.83%（95%CI：6.85~8.80）、10.01%（95%CI：8.92~11.10）、3.71%（95%CI：3.03~4.39）和21.52%（95%CI：20.02~23.00）。多重混合感染的阳性率是6.30%（95%CI：5.42~7.18）。同时发现女性献血者的HIV和梅毒感染阳性率明显高于男性献血者（HIV：AOR=1.50，95%CI：1.10~2.04，P=0.010；梅毒： AOR=1.27，95%CI：1.02~1.58，P=0.034）。岛上的未规划居住区是艾滋病、乙肝和梅毒感染的显著危险因素（HIV：AOR=1.66，95%CI：1.04~2.66，P=0.033；HBV：AOR=1.78，95%CI：1.11~2.83，P=0.016；梅毒：AOR=1.73，95%CI：1.26~2.37，P=0.001）。结论比奥科岛的献血人群中输血传播感染的阳性率极高，当地政府和卫生部门应采取更有效的干预措施来提高血液安全。