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PREVALENCE OF CYTOMEGALOVIRUS ANTIBODIES IN BLOOD DONORS AT THE NATIONAL BLOOD TRANSFUSION CENTRE, NAIROBI
Abstract
Background: Cytomegalovirus (CMV) infection in susceptible patients is associated
with serious morbidity and a high mortality. Transmission of cytomegalovirus infection
through blood transfusion is markedly reduced by transfusion of CMV seronegative
blood products, or by transfusion of leucodepleted blood products.
Objective: To determine the prevalence CMV IgG and IgM antibodies among blood
donors at the National Blood Transfusion Services (NBTS), Nairobi.
Design: Cross-sectional descriptive study.
Setting: Four hundred participants were recruited from blood donors at the NBTS and
testing was done at the Kenyatta National Hospital (KNH) immunology laboratories
and the NBTC.
Main outcome measures: Social demographic data and the CMV serologic status for
the participants was determined and documented as being positive or negative for
immunoglobulin G (IgG) and immunoglobulin M (IgM). The age, gender, marital
status, education level and geographical area of residence of the participants were
documented. Corresponding results of HIV, hepatitis B antigen, hepatitis C antibody
from the patients were obtained from the NBTS.
Results: Majority of the blood donors recruited were male at 57.9%. Most blood donors
were aged 16-20 years (42.5%) and only 17.2% were above 30 years of age. Unmarried
blood donors, those with secondary school education and an income between Kshs
5,000 (US$ 67)and KShs 50,000 (US$ 667) monthly were the majority at 78.5%, 54.8%
and 66.1% respectively. Sexually active blood donors constituted 60.5% of the donors
recruited. Positivity for transfusion transmissible infections (TTI) tested was 1.3%,
0.3%, 2.3% and 1.0% for human immunodeficiency virus (HIV), syphilis, hepatitis
B and hepatitis C respectively. Anti- CMV IgG and IgM positivity was 97.0%,( 95%
CI 96.45-97.53%), and 3.6% (95% CI 1.7-5.2%), respectively. There was no statistical
difference between different ages, marital status, salary, individual’s sexuality in the
prevalence of CMV antibodies. However females had a higher prevalence of CMV
antibodies.
Conclusion: There is a very high prevalence of cytomegalovirus antibodies among
blood donors at the NBTS, with virtually all blood donors having been exposed to the
virus. Since the CMV remains latent within leucocytes after infection inspite of the
prescence of antibodies in seropositive individuals, leucoreduction of blood products
is recommended before transfusion to seronegative susceptible patients. In Kenya,
susceptible groups of patients include very low birthweight babies, patients with
acquired immune deficiency syndrome (AIDS) due to human immunodeficiency virus
infections (HIV) patients, patients on myelosuppressive cancer therapy and recipients
of kidney transplants. Further studies are recomended to determine the prevalence of
CMV antibodies in these patients in order to establish the magnitude of the demand
for CMV safe blood.
with serious morbidity and a high mortality. Transmission of cytomegalovirus infection
through blood transfusion is markedly reduced by transfusion of CMV seronegative
blood products, or by transfusion of leucodepleted blood products.
Objective: To determine the prevalence CMV IgG and IgM antibodies among blood
donors at the National Blood Transfusion Services (NBTS), Nairobi.
Design: Cross-sectional descriptive study.
Setting: Four hundred participants were recruited from blood donors at the NBTS and
testing was done at the Kenyatta National Hospital (KNH) immunology laboratories
and the NBTC.
Main outcome measures: Social demographic data and the CMV serologic status for
the participants was determined and documented as being positive or negative for
immunoglobulin G (IgG) and immunoglobulin M (IgM). The age, gender, marital
status, education level and geographical area of residence of the participants were
documented. Corresponding results of HIV, hepatitis B antigen, hepatitis C antibody
from the patients were obtained from the NBTS.
Results: Majority of the blood donors recruited were male at 57.9%. Most blood donors
were aged 16-20 years (42.5%) and only 17.2% were above 30 years of age. Unmarried
blood donors, those with secondary school education and an income between Kshs
5,000 (US$ 67)and KShs 50,000 (US$ 667) monthly were the majority at 78.5%, 54.8%
and 66.1% respectively. Sexually active blood donors constituted 60.5% of the donors
recruited. Positivity for transfusion transmissible infections (TTI) tested was 1.3%,
0.3%, 2.3% and 1.0% for human immunodeficiency virus (HIV), syphilis, hepatitis
B and hepatitis C respectively. Anti- CMV IgG and IgM positivity was 97.0%,( 95%
CI 96.45-97.53%), and 3.6% (95% CI 1.7-5.2%), respectively. There was no statistical
difference between different ages, marital status, salary, individual’s sexuality in the
prevalence of CMV antibodies. However females had a higher prevalence of CMV
antibodies.
Conclusion: There is a very high prevalence of cytomegalovirus antibodies among
blood donors at the NBTS, with virtually all blood donors having been exposed to the
virus. Since the CMV remains latent within leucocytes after infection inspite of the
prescence of antibodies in seropositive individuals, leucoreduction of blood products
is recommended before transfusion to seronegative susceptible patients. In Kenya,
susceptible groups of patients include very low birthweight babies, patients with
acquired immune deficiency syndrome (AIDS) due to human immunodeficiency virus
infections (HIV) patients, patients on myelosuppressive cancer therapy and recipients
of kidney transplants. Further studies are recomended to determine the prevalence of
CMV antibodies in these patients in order to establish the magnitude of the demand
for CMV safe blood.
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