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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2 937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。
Objective To carry out a serological epidemiological investigation of transfusion-transmissible infections (TTIs) in blood donors on Bioko Island. Methods Four blood transfusion-transmitted diseases were detected by gold standard and ELISA in blood samples from eligible blood donors, including human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis Spirochaetes (LUES) were also evaluated using multivariate regression analysis for risk factors associated with TTIs disease. Results The infection rates of HIV, HBV, HCV and Treponema pallidum in 2 937 blood donors were 7.83% (95% CI: 6.85-8.80), 10.01% (95% CI: 8.92-11.10), 3.71% CI: 3.03 to 4.39) and 21.52% (95% CI: 20.02 to 23.00). The positive rate of multiplex infection was 6.30% (95% CI: 5.42-7.18). The positive rates of HIV and syphilis infections among female donors were also significantly higher than those from male donors (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). Unplanned residential areas on the island are a significant risk factor for HIV, hepatitis B and syphilis infections (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 positive rate of blood transfusion transmitted by blood donors in Bioko Island is very high. Local governments and health departments should take more effective interventions to improve blood safety.