000			04288nam a22002657a 4500
003			OSt
005			20240305193657.0
008			230208b |||||||| |||| 00| 0 eng d
028			_bPhone: +255 28 298 3384
028			_b Fax: +255 28 298 3386
028			_b Email: vc@bugando.ac.tz
028			_b Website: www.bugando.ac.tz
040			_cDLC
041			_aEnglish
100			_aNaizihijwa Majani Mnong'one _922466
245			_aHIV Seropositivity among Transfused Children with Sickle Cell Disease, Attending Bugando Medical Centre, Mwanza, Tanzania.
260			_aMwanza, Tanzania: _bCatholic University of Health and Allied Sciences [CUHAS – Bugando] & _bSt. Augustine University of Tanzania _cc2010
300			_a63 Pages
300			_aIncludes References and Appendices
520			_aAbstract: Background: The mainstay of management in patients with sickle cell anaemia is by the use of blood transfusion. Before 1989 donated blood was not screened for anti HIV antibodies and sicklers and other children requiring blood transfusion, were at a very high risk of acquisition of blood transfusion associated HIV infections. Even after the introduction of a programme of screening blood, this risk remains substantial in Tanzania. This is due to several reasons which includes, screening of blood using anti-HIV antibodies tests, reliance on replacement blood donors and lack of donor screening and donor deferral system which is an integral part in donated blood safety. Preference of some patients for blood from a relative compounds the problem. Not surprisingly therefore, the risk of acquisition of HIV infection through blood transfusion in Sub Saharan African is substantial. Indeed studies in sub-Saharan Africa have shown variable prevalence rates of HIV infection among transfused patients. The risk of post transfusion HIV infection in Tanzania is not known. This study was designed to determine prevalence of HIV among transfused patients with sickle cell disease at Bugando Medical Centre in Mwanza Tanzania. Material and Methods: A cross-sectional study conducted on 162 sickle cell patients and their mothers at BMC between August and December 2009. Serial sampling was used until the sample size was reached. The social demographic and clinical characteristics of children and their mothers were documented. After pre and posttest counselling blood collected was tested for HIV antibodies. Two rapid antibody tests were used, Bioline and Determine. Results: The prevalence of HIV was 4.3% (7/162). Of the seven HIV infected children none of them was below 18 months of age, and five of them were seroconcodant with their mothers. Of the five HIV infected mothers, only three of them had prior knowledge of their HIV serostatus. Of the later, only one of them and her child took nevirapine for prevention of mother to child HIV transmission. Thus, in 5(72%) children HIV infection could be attributed to vertical transmission. The other two children may acquired the virus through blood transfusion. The only significant predicator of child HIV seropositivity was the maternal HIV serostatus. Conclusion: Our study has demonstrated that HIV infection among multitransfused sicklers was 4.3%. However obvious blood transfusion associated HIV transmission can be explained in only 2(28%) of cases, vertical transmission accounting for the rest 5(72%) cases. Thus in the HIV era with screening of donated blood, sickler’s HIV infection is more likely to be attributable to maternal transmission that blood transfusion related HIV acquisitioning. This calls for both scale-up prevention of mother to child HIV transmission and stringent measures to ensure safety of donated blood. Recommendations: From our study we recommend that clinicians should be aware that there is a risk of post transfusion HIV infection and thus to reduce this risk they should adhere to blood transfusion guidelines nd to completely avoid unnecessary blood transfusion. We also recommend that all children with sickle cell disease and all others who had blood transfusion to be screened for HIV infection.
600			_xPaediatrics and Child Health _933433
700			_aSamuel Kalluvya _922760
700			_aChristian Schimidt _948358
942			_2ddc _cMP
999			_c18693 _d18693