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 Table of Contents  
ORIGINAL ARTICLE
Year : 2020  |  Volume : 29  |  Issue : 2  |  Page : 203-207

Prevalence and factors associated with parvovirus B19 infection among blood donors: A hospital-based study in South-West, Nigeria


1 Lagos State Primary Healthcare Board, College of Medicine, University of Lagos, Lagos, Nigeria
2 Department of Haematology and Blood Transfusion, College of Medicine, University of Lagos, Lagos, Nigeria
3 Division of Epidemiology and Biostatistics, School of Public Health, University of Witwatersrand, Johannesburg, South Africa
4 Department of Clinical Pathology, College of Medicine, University of Lagos, Lagos, Nigeria

Date of Submission14-Feb-2020
Date of Decision27-Feb-2020
Date of Acceptance08-Apr-2020
Date of Web Publication26-Jun-2020

Correspondence Address:
Dr. Sarah O John-Olabode
Department of Haematology and Blood Transfusion, College of Medicine, University of Lagos, Lagos
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/NJM.NJM_6_20

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  Abstract 


Background: Parvovirus B19 (B19V) is a transfusion transmissible infection that can result in severe consequences in vulnerable population that includes pregnant women, immunocompromised and chronic hemolytic anemia patients. The aim of this study was to determine the prevalence and factors associated with B19V infection amongst blood donors in South–West Nigeria. Materials and Methods: We conducted a comparative cross-sectional study to determine the seroprevalence of B19V immunoglobulin M (IgM) antibody among 183 blood donors at the blood bank of a tertiary hospital. The results were analyzed with SPSS 23 software, prevalence and associated factors were determined using frequencies and logistic regression, respectively. Results: The prevalence of B19V IgM was 7.1% (95% confidence interval: 4–11) with a higher prevalence among male donors compared to females (84.6% vs. 15.4%, P = 0.54). There was a statistically significant difference in the seropositivity of B19V IgM amongst the ethnic groups with the Yoruba ethnic group having a higher proportion of B19V IgM-positive participants P = 0.04. Ethnicity, gender, and steady employment were also associated with increased odds of infection, while increasing age appeared to be protective; though none of these factors were statistically significant. Conclusion: This study has shown that there is still high exposure to transfusion transmissible B19V infection.

Keywords: Blood donor, parvovirus immunoglobulin M antibody, sickle cell anaemia


How to cite this article:
Awolesi IP, John-Olabode SO, Olorunfemi G, Ajie IO, Oyedeji OA, Akanmu AS. Prevalence and factors associated with parvovirus B19 infection among blood donors: A hospital-based study in South-West, Nigeria. Niger J Med 2020;29:203-7

How to cite this URL:
Awolesi IP, John-Olabode SO, Olorunfemi G, Ajie IO, Oyedeji OA, Akanmu AS. Prevalence and factors associated with parvovirus B19 infection among blood donors: A hospital-based study in South-West, Nigeria. Niger J Med [serial online] 2020 [cited 2020 Jul 5];29:203-7. Available from: http://www.njmonline.org/text.asp?2020/29/2/203/287937




  Introduction Top


Emerging infections such as parvovirus B19 (B19V) have properties indicating the potential to be transmitted through blood transfusion.[1],[2],[3],[4],[5],[6] The modes of transmission of B19V are varied and these include respiratory secretions, other routes include vertical transmission from the mother to the fetus and through transfusion of B19V-infected blood.[7],[8],[9],[10],[11],[12],[13],[14]

B19V infection has been closely linked with transient red cell aplasia in patients' with sickle cell anemia (SCA)[15],[16],[17],[18],[19] B19V infection in pregnant women has also been implicated as a cause of hydrops fetalis and intrauterine fetal death.[6],[20] Thus, there is need to produce protocols for preventing transfusion transmissible B19V infection. This study was aimed at determining the prevalence of B19V infection amongst blood donors in Ogun State, Nigeria.


  Materials and Methods Top


We conducted a comparative cross-sectional study among eligible blood donors at the donor's clinic of Olabisi Onabanjo University Teaching Hospital (OOUTH), Ogun State from February to October 2019. All the donors that participated in this study gave a written informed consent and the study was approved by the Health and Research Ethical Committee of OOUTH (number NHREC/28/11/2017). This study was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Sociodemographic, donation history, and medical history data were collected from study participants using interviewer administered questionnaire. Thereafter, 5 ml of venous blood was obtained from donors and dispensed into an anticoagulant-free sample bottle. The sample was centrifuged within an hour of collection for 10 min at 3000 rpm to obtain serum. The serum was separated into anticoagulant-free bottle and stored at −20°C until time for analysis.

B19V immunoglobulin M (IgM) was assayed using Melsin enzyme-linked immunosorbent assay (ELISA) kit manufactured by Melsin Medical Co., Ltd-Changchun, China. The assay was carried out according to the manufacturer's instruction. The result was considered negative if optical density (OD) of sample was less than the cutoff. The result was considered positive if the OD of sample was ≥ the cutoff. The cutoff calculation was the absorbance value of negative control wells +0.15.

Data were analyzed using SPSS software version 23.0 (Statistical Product and Service Solutions, Inc. Chicago, Illinois, USA). Categorical data were summarized using frequency and percentages while continuous variables were described using the mean and standard deviation or median and interquartile range. Pearson's Chi-square (or Fisher's exact) test was used to test for the association between categorical variables and the B19V infection status. Binary logistic regression was conducted to evaluate factors associated with the B19V infection positivity. The P ≤0.05 was assumed to be statistically significant.


  Results Top


A total of 183 blood donors were recruited into the study. [Table 1] shows the socio demographic characteristics of study participants. The seroprevalence of anti-IgM B19V amongst study participants was 7.1% (95% confidence interval [CI]: 4–11) [Figure 1]; there was a statistically significant difference in the seropositivity of B19V IgM among the ethnic groups with the Yoruba ethnic group having a higher proportion of B19V IgM-positive participants P = 0.04 [Table 2]. Although none of the participants had ever received any blood or blood products, 38% of the seropositive participants had a previous history of blood donation [Table 2]. The Yoruba ethnic group had an increased odds (odds ratio = 2.71, 95% CI = 0.65–11.33) of being seropositive for B19V IgM compared to participants from other ethnic groups, though this was not statistically significant P = 0.22 [Table 3]. Male gender and steady employment were also associated with increased odds of infection, while increasing age appeared to be protective; though none of these factors were statistically significant [Table 3]. Furthermore, we found none of the positive participants had clinical symptoms of Parvo virus B19 infection as at the time of blood donation [Table 4].
Table 1: Characteristics of study participants

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Figure 1: Seroprevalence of parvovirus B19 among blood donors

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Table 2: Sociodemographic characteristics of study participants based on B19V seroprevalence

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Table 3: Logistic regression model of associations with B19V IgM seropositivity

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Table 4: Participants' clinical characteristics in relation to Parvo virus infection

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  Discussion Top


The transfusion of safe blood or blood product is the major goal in transfusion medicine. The transmission of viruses such as hepatitis B, hepatitis C, HIV have reduced over the years due to the global strategy focused on screening these viruses in donated blood. There is renewed interest to the threat posed by emerging infections that occur due to climate and environmental changes or transmigration associated with globalization. Emerging infections such as B19V pose a threat to transfusion safety especially when the donor is in the asymptomatic phase of the infection. In Nigeria, the most common emerging infection of paramount concern is B19V due to high prevalence of SCA in the population.

In this study, we found a seroprevalence of 7.1% among participants screened for acute B19Vinfection. This result is in accordance with that reported by Kumar et al.[21] where a prevalence of 7.53% was obtained among blood donors in India but higher than most previous studies which reported the prevalence of B19V IgM in blood donors or healthy population below 2%, as documented by Iheanacho et al., Doyle et al. and Muñoz et al. who discovered a prevalence of 1.3%, 1%, and 0% among the Nigerian, American, and Spanish blood donors, respectively.[22],[23],[24] This increase in seroprevalence most especially when compared with the study of Iheanacho et al., which was conducted in a similar study population suggests not enough is being done to prevent active transmission of B19V to blood recipients.

We found a significantly higher seropositivity level (P = 0.04) among participants in the Yoruba ethnic group compared to the other ethnic groups. To the best of our knowledge, this finding has not been reported in previous local studies and need to be explored in larger nationwide studies for a plausible reason for this finding. We also found a higher proportion of males' 89.6% (11/13) testing positive for B19V IgM as compared to females 10.4% (2/13) in this study, though not significant is similar to the result obtained by Musa et al.[25] This attribute can possibly be explained by the finding of Faddy et al.[26] that females appear to have increased immunity to B19V compared to males.

We report reduced odds of B19V IgM seropositivity with increasing age, this finding is in keeping with those of various studies[26],[27],[28] who reported an increase in B19V immunity with increasing age among the Nigerian, Indian, and Australian population, respectively. From this study, it can be deduced that 47.5% of the participants had donated blood before and considering the high prevalence of 7.1% obtained from the study this suggests a high likelihood of transfusion transmissible parvovirus infection upon exposure to affected blood products by vulnerable recipients such as sickle cell patients, children, pregnant women, and immunocompromised patients who may later become chronically infected.

Furthermore, noteworthy is the fact that the positive participants were asymptomatic in agreement with the findings from Okojokwu et al.,[29] that there is no statistically significant association between symptoms (body rash and joint pains) and B19V. This is quite alarming as it suggests a high probability of continuous active transmission of transfusion transmissible B19V infection.

Key limitations in our study include our small sample size, the usage of only one type of ELISA kit and inability to carry out molecular assay for confirmation; conducting larger multicenter studies will help determine the actual risk of transfusion transmissible B19V in the entire general Nigerian population.


  Conclusion Top


Although this study showed a low prevalence of B19V IgM it still suggests there is an increased risk of transfusion transmissible B19V infection by vulnerable population that includes pregnant women, immunocompromised, and chronic hemolytic anemia patients. This begs the need for improved hemovigilance in the country.

Acknowledgments

We appreciate the staff of Folabi Medical Center and the blood donation clinic of the Olabisi Onabanjo University Teaching Hospital Ogun State Nigeria who facilitated our recruitment of participants.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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