Syphilis in Blood Donors in Tertiary Care Teaching Hospital

Introduction: Transmission of infectious diseases through donated blood is of concern to blood safety as transfusion forms an integral part of medical and surgical therapy. Blood transfusion carries the risk of transfusion-transmissible infections, including HIV, hepatitis, syphilis, malaria and infrequently toxoplasmosis. Aims & Objectives: To find out the seroprevalence of Syphilis in blood donors, to find the incidence of spectrum of Transfusion transmitted dieasess in blood bank donation & to find the age distribution of the cases studied. Material & Methods: The present study was undertaken in the Department of Pathology MGM Medical College Indore. This is a retrospective study that was conducted, during the period 2008 –2015. The screening for Syphilis was done by rapid chromatographic assay for detection of antibodies to T. pallidum Results: Out of total 137689 blood donations, majority of donors are voluntary donors 83.02 % as compared to replacement donors 17.05 %. Seroprevalence of Anti TP is 0.26 %. Seroprevalence of Anti TP is higher in the age group 26-35 year . Among Voluntary & replacement/relative donors. Overall seropositivity of TTI’s (HIV, HBV, HCV, Syphilis & Malaria) is higher in replacement donors 3.71 % as compared to voluntary donors 1.75 %. Conclusion: voluntary blood donation should be encouraged for prevention of transfusion-transmissible diseases. The time and cost involved in screening donated blood can be reduced by an effective donor education and selection program that promotes self-exclusion by donors at risk of transfusion-transmissible infections.


Introduction
Transmission of infectious diseases through donated blood is of concern to blood safety as transfusion forms an integral part of medical and surgical therapy. Blood transfusion carries the risk of transfusion-transmissible infections, including HIV, hepatitis, syphilis, malaria and infrequently toxoplasmosis, Brucellosis and some viral infections like CMV, EBV and herpes.
With every unit of blood, there is 1% chance of transfusionassociated problems including transfusion-transmitted diseases.Among all infections HIV and hepatitis are the most dreadful. The first case of transfusion-associated AIDS was described in an infant given transfusion for erythroblastosis foetalis. Thereafter, many cases were reported all over the world in which transfusion of blood and its products was the only risk factor.The improved screening and testing of blood donors has significantly reduced transfusion-transmitted diseases in most developed countries. This has not been so in developing nations. Poor health education and lack of awareness result in the reservoir of infections in the population.
There are four main groups of micro-organisms known to cause infections namely viruses, bacteria, protozoa and fungi. Only first three groups of microbes -viruses, bacteria + spirochetes and protozoa -have been reported to be transmitted by blood transfusion. Individuals with fungal infections are usually too sick to be accepted as blood donors. Viruses are most commonly transmitted by transfusion.
Recently, a new form of infectious agent -the prion -has been identified. At this time, there is no evidence to suggest that they could be transmitted by blood transfusion.
Viruses are the simplest forms of life. They infect all forms of life, they lack certain components needed to live and their growth hence depend on the host cell that they infect to provide these missing components.Following are some of the viruses which are known to be transmitted through blood: Cases were mostly discovered in donors with primary or secondary stage of disease 6 . Treponema pallidum may be found in blood, not levels are variable & bacteremia is short lived. Treponemes are senisitve to cold; hence risk of transmission through stored blood at 4-8 • C is very low 7-8 .
In India, most blood donors are first-time donors 3 . The prevalence of syphilis among blood donors in India was reported to be 0.7% 9 . The global incidence of syphilis in blood donors is variable ranging from 0.75% in Pakistan 10 to 12.7% in Tanzania 11 .
Testing Methodologies 3 : Three methods are currently used.
1. Direct microscopic examination in early stage.

Aims and Objectives
The study is being conducted in the department of pathology, M.G.M.M.C, Indore.
1. To find out the seroprevalence of Syphilis in blood donors.

2.
To find the age distribution of the cases studied.

3.
To find the incidence of spectrum of Transfusion transmitted diseases in blood bank donation.

Material and Methods
The present study is being undertaken in the Department of Pathology MGM Medical College Indore. This is a retrospective study that will be conducted, during the period 2008 -2015. Tests are routinely done on every blood unit to exclude HIV, HBV, HCV, syphilis and malaria. Donors were selected by the standard criteria for donor fitness. The screening for Syphilis was done by rapid chromatographic assay for detection of antibodies to T.pallidum . ABO and Rhesus (Rh) blood groups were determined using blood grouping antisera: anti-A, anti-B, anti-AB, and anti-D. Selection of cases for the study included the donors of MYH Blood Bank.

Results
The  Screening and better selection of donors are necessary to improve blood safety in the regional blood transfusion centre of M. Y. Hospital. Therefore, it is concluded that voluntary blood donation should be encouraged for prevention of transfusion-transmissible diseases. The time and cost involved in screening donated blood can be reduced by an effective donor education and selection program that promotes self-exclusion by donors at risk of transfusion-transmissible infections.