|LETTERS TO EDITOR
|Year : 2020 | Volume
| Issue : 1 | Page : 100-101
Epidemiology of syphilis in blood donors in Pakistan
Usman Waheed1, Noor e Saba2, Akhlaaq Wazeer3, Muhammad Arshad3, Hasan Abbas Zaheer1
1 Safe Blood Transfusion Programme, Ministry of National Health Services, Government of Pakistan; Department of Pathology and Transfusion Medicine, Shaheed Zulfiqar Ali Bhutto Medical University, PIMS, Islamabad, Pakistan
2 Peshawar Regional Blood Centre, Department of Health, Khyber Pakhtunkhwa, Pakistan
3 Department of Biological Sciences, International Islamic University, Islamabad, Pakistan
|Date of Submission||01-Dec-2019|
|Date of Decision||27-Jan-2020|
|Date of Acceptance||10-Feb-2020|
|Date of Web Publication||17-Apr-2020|
Safe Blood Transfusion Programme, Ministry of National Health Services, Government of Pakistan; Department of Pathology and Transfusion Medicine, Shaheed Zulfiqar Ali Bhutto Medical University, PIMS, Islamabad
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Waheed U, Saba Ne, Wazeer A, Arshad M, Zaheer HA. Epidemiology of syphilis in blood donors in Pakistan. Glob J Transfus Med 2020;5:100-1
Syphilis is a bacterial infection caused by Treponema pallidum and is among the most common sexually transmitted infection around the globe. Although the transmission is mainly sexual, syphilis can also be spread through contaminated blood and blood components.
According to the WHO, 6.3 million new cases of syphilis occur every year, of which 90% are found in low-income countries.
Syphilis is a major public health concern around the globe. Its significance is aggravated by the fact that the risk of contracting HIV infection through sexual contact is increased 3–5 times in individuals with syphilis infection.
Population-based seroprevalence data of syphilis are imperative to guide mitigation strategies. Therefore, through the Safe Blood Transfusion Programme, a country-wide retrospective descriptive study of syphilis prevalence was conducted from January to December 2018. Data from 606 blood banks across the country comprising 2,449,308 blood donations were analyzed for the epidemiology of syphilis. The screening technique used by each blood bank varied and included rapid immune chromatographic technique (n = 460), rapid plasma regain test (n = 79), enzyme-linked immunosorbent assay (n = 15), and chemiluminescence immunoassay (n = 52). A total of 17,652 (0.72%) blood donors were reactive for syphilis.
Our findings were on the higher side when compared with studies from developed countries, including Saudi Arabia (0.044%), Italy (0.031%), USA (0.16%), and Israel (0.047%). However, countries from the African continent have reported a very high prevalence among blood donors, for example, Angola (20.0%), Nigeria (3.1%), and Burkina Faso (1.5%). When compared with earlier studies from Pakistan (3.1%, 1.55%, 2.1%, and 0.91%), the national prevalence is on the lower side.
Some studies have demonstrated that syphilis spirochetes are fragile and cannot survive blood bank's refrigerator temperature when kept for a minimum of 72 h. However, this survival time could depend on the number of infectious agents initially present in the donated blood. Similarly, platelet concentrates are typically kept at 22°C–24°C, so carry a higher risk of spreading syphilis. Therefore, the screening is a must in all cases.
In Pakistan, under the blood safety legislation, syphilis screening is mandatory. This was for the first time that credible statistics generated on the epidemiology of syphilis in the blood donor population across the country. The national strategies to lessen the risk of syphilis transmission are the use of behavioral screening questionnaires to defer donors at higher risk of infection and testing the blood with highly sensitive and specific laboratory techniques.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Kassutto S, Sax PE. HIV and syphilis coinfection: Trends and interactions. AIDS Clin Care 2003;15:9-15.
Elyamany G, Al Amro M, Pereira WC, Alsuhaibani O. Prevalence of syphilis among blood and stem cell donors in Saudi Arabia: An institutional experience. Electron Physician 2016;8:2747-51.
Drago F, Cogorno L, Ciccarese G, Strada P, Tognoni M, Rebora A, et al
. Prevalence of syphilis among voluntary blood donors in Liguria region (Italy) from 2009 to 2013. Int J Infect Dis 2014;28:45-6.
Kane MA, Bloch EM, Bruhn R, Kaidarova Z, Murphy EL. Demographic determinants of syphilis seroprevalence among U.S. blood donors, 2011-2012. BMC Infect Dis 2015;15:63.
Vera L, Milka D, Nurith SL, Eilat S. Prevalence and incidence of syphilis among volunteer blood donors in Israel. J Blood Transfus 2014;2014:154048.
Quintas E, Cogle AC, Dias CC, Sebastiao A. Prevalence of Syphilis in Blood Donors in Angola from 2011 to 2016. Clin Med Rep 2018;2:1-4. [doi: 10.15761/CMR.1000119].
Okoroiwu HU, Okafor IM, Asemota EA, Okpokam DC. Seroprevalence of transfusion-transmissible infections (HBV, HCV, syphilis and HIV) among prospective blood donors in a tertiary health care facility in Calabar, Nigeria; An 11 years evaluation. BMC Public Health 2018;18:645.
Bisseye C, Sanou M, Nagalo BM, Kiba A, Compaoré TR, Tao I, et al
. Epidemiology of syphilis in regional blood transfusion Centres in Burkina Faso, West Africa. Pan Afr Med J 2013;16:69.
Nazir S, Pracha HS, Khan A, Nazar A, Fayyaz A, Khan MS, et al
. Prevalence of syphilis in Pakistani blood donors. Adv Life Sci 2013;1:27-30.
Saeed M, Hussain S, Rasheed F, Ahmad M, Arif M, Hamid Rahmani MT. Silent killers: Transfusion transmissible infections-TTI, among asymptomatic population of Pakistan. J Pak Med Assoc 2017;67:369-74.
Arshad A, Borhany M, Anwar N, Naseer I, Ansari R, Boota S, et al
. Prevalence of transfusion transmissible infections in blood donors of Pakistan. BMC Hematol 2016;16:27.
Sultan S, Murad S, Irfan SM, Biag MA. Trends of venereal infections among healthy blood donors at Karachi. Arch Iran Med 2016;19:192-6.
Adegoke AO, Akanni OE. Survival of Treponema pallidum
in banked blood for prevention of syphilis transmission. N
Am J Med Sci 2011;3:329-32.