Sero-Epidemiology of Transfusion Transmissible Hepatitis B, C and E among Blood Donors in Ekiti, Southwestern Nigeria: A Cross-sectional Study

Background: Transfusion transmissible hepatitis (TTH) is a global health problem and the incriminating agents such as hepatitis B virus (HBV), hepatitis C virus (HCV) and hepatitis E virus (HEV) continue to pose serious threats to blood safety. The aim of this study was to determine the seroprevalence of HBV, HCV and HEV and relate the outcomes with blood donation type, age and gender and confirm any significant associations. Materials and Methods: In this cross-sectional study, Hepatitis B surface antigen (HBsAg) and antibody to HCV were determined with Diaspot and Lab Acon immunochromatographic ELISA-based test devices. Antibodies to HEV were first determined with Biopanda lateral flow device followed by ELISA assay for sero-reactive HEV immunoglobulins M and immunoglobulin G (IgM and IgG) antibodies. Results: A total of 370 prospective blood donors between 18 and 55 years old (mean 31.2 ± 7.6 years) who presented for blood donation at FETHI Blood Bank were screened. Overall male: female ratio was 7:1. Cummulative hepatitis seroprevalence of 8.1% was found mainly among the replacement blood donors (RBD) and consist of 4.3%, 1.6%, 1.1%, 0.8% and 0.3% serologic evidence of HBsAg, anti-HCV, HEV IgM, both HEV IgM & HEV IgG, and HEV IgG antibodies. Blood donors aged 18 – 45 years were most affected with evident significant association between the age group of donors and TTH seroprevalence. Cummulative hepatitis seroprevalence was 0% among voluntary blood donors, and 9.1% and 0.3% among the male and female RBD respectively. There was significant association between the pathogens and RBD, though the association with male gender was clinically but not statistically significant. Conclusion: The high transfusion transmissible hepatitis seroprevalence among RBD called for promoting voluntary donations. Comparable prevalence of HEV antibodies with that of HCV called for its inclusion in the TTIs screening algorithm to ascertain optimal blood safety in Nigeria.