Table 1.
Pathogen, Clinical Manifestation, Available Testing Methods, Country-Specific Donor Prevalence, and Estimated Risk of Transfusion Transmissibility (where available) for Selected TTVs in Africa
| Pathogen | Clinical manifestation | Transfusion screening/testing method in use (limited use) | Blood donor seroprevalence from published studies | Estimated risk |
|---|---|---|---|---|
| Viruses | ||||
| HIV | AIDS | Serology anti-HIV (EIA, CLIA, and rapid serological testing) (NAT) | Burkina Faso (2.0%–4.5%) [33] | 1 per 1000 U transfused [20],† |
| Cameroon (2.9%) [14] | ||||
| DRC (2.2–4.6% *) [74] | ||||
| Egypt (0.0%) [75] | ||||
| Ethiopia (3.8%) [76] | ||||
| Ghana (1.03%–1.1%) [7] | ||||
| Ivory Coast (3.48%) [14] | ||||
| Mali (2.6%) [77] | ||||
| Mozambique (12.3%–15.4%) * [32] | ||||
| Namibia (0.20%) ‡ | ||||
| Niger (1.4%) [14] | ||||
| Nigeria (2.7%–3.2%) [28,78,79] | ||||
| Rwanda (1.0%) [14] | ||||
| South Africa (0.1%) [28] | ||||
| Tanzania (3.8%) [80] | ||||
| Zimbabwe (0.18%–1.61%) [74] | ||||
| HBV | Viral hepatitis Hepatocelullar carcinoma | Serology anti-HBsAg (EIA and CLIA) (NAT) | Burkina Faso (11.0%–18.0%) [33] | 1 per 222 U (4.5/1000) [20],† |
| Cameroon (10.3%) [14] | ||||
| DRC (3%–4.9% *) [74] | ||||
| Egypt (4.7%) [75] | ||||
| Ethiopia (4.7%) [76] | ||||
| Ghana (13.8%–14.9%) [7] | ||||
| Ivory Coast (5.85%) [14] | ||||
| Mali (13.9%) [77] | ||||
| Mozambique (4.5%–10.6% *) [32] | ||||
| Namibia (0.39%) ‡ | ||||
| Niger (18.96%) [14] | ||||
| Nigeria (2.7–3.2%) [78,79] | ||||
| Rwanda (2.76%) [14] | ||||
| South Africa (0.07%) [28] | ||||
| Sudan (6.25%) [81] | ||||
| Tanzania (8.8%) [80] | ||||
| HCV | Viral hepatitis Hepatocellular carcinoma | Serology anti-HCV (EIA and CLIA) (NAT) | Nigeria (2.7%–3.2%) [78,79] | 1 per 400 U (2.5 per 1000) [20],† |
| Burkina Faso (3.2%) [14] | ||||
| Egypt (2.7%–24.8%) [75,82,83] | ||||
| Cameroon (3.9%) [14] | ||||
| Ethiopia (0.7%) [76] | ||||
| Ivory Coast (6.98%) [14] | ||||
| Mali (3.25%) [14] | ||||
| Mozambique (1.0%–1.2% *) [32] | ||||
| Namibia (0.00%) ‡ | ||||
| Niger (1.42%) [14] | ||||
| Nigeria (4.3%) [78] | ||||
| Rwanda (3.13%) [14] | ||||
| Senegal (1.4%) [84] | ||||
| South Africa (0.005%) [28] | ||||
| Sudan (0.65%) [81] | ||||
| Tanzania (1.5%) [80] | ||||
| Mali (3.3%) [77] | ||||
| WNV | Meningoencephalitis | – | 0.27–1500 per 100 000 donations [17] § | |
| CHIKV | Febrile-arthralgia Syndrome | – | ||
| Tick-borne encephalitis | Meningoencephalitis | – | ||
| HGV | Unknown | – | Egypt (12.2%) [85] | |
| TTV | Unknown | – | Egypt (48.4%) [83] | |
| EBV | Infectious mononucleosis Burkitt lymphoma Nasopharyngeal carcinoma |
– | Ghana (20.0%) [86] | |
| CMV | Infectious mononucleosis Disseminated infection in immunocompromised and neonates |
Ghana (77.6%) [86] | ||
| Tunisia (97.14%) [87] | ||||
| Dengue | Dengue Dengue shock syndrome Dengue hemorragic fever |
– | Burkina Faso (30.4%–34.8%) [33] | |
| HHV8 | Kaposi sarcoma Mulicentric Castleman disease Primary effusion lymphoma |
– | Ghana (23.7%) [86] | |
| Central African Republic (22.5%) [40] | ||||
| Burkina Faso (11.2%–16.0%) [33] | ||||
| Tanzania (48.0%) [88] | ||||
| HTLV-1/2 | Adult T-cell Lymphoma/leukemia Topical spastic Paraparesis/HAM |
(Serology anti-HTLV-1/2) (testing limited to Gabon and Seychelles [2] | Mozambique (0.89%–1.2% *) [36,78] | |
| Senegal (0.16%) [35] | ||||
| Tunisia (0.0%) [34] | ||||
| Burkina Faso (0.0%–2%) [33] | ||||
Abbreviations: (−) or blank, not currently performed or unknown; Anti-HBsAg, anti–hepatitis B surface antigen; WNV, West Nile virus; HGV, hepatitis G virus; EBV, Epstein-Barr virus.
*
Replacement donors.
†
Estimated from mathematical modeling for all of sub-Saharan Africa.
‡
Unpublished correspondence from NAMBTS.
§
During outbreak in Reunion 2005 to 2007.