Trace, Track and Treat Syphilis Positive Blood Donors; Way Forward to Effectively Reduce STI

Abstract

Objective: Counselling of syphilis positive blood donors, to educate them about the disease, its consequences and management

Methodology: In this descriptive study was conducted at the Blood bank of a private tertiary care hospital in Islamabad from September 2019 till September 2020. Blood donors (n=11,122) were evaluated for the presence of antibodies to treponema pallidum. Initially, all blood donors were screened for syphilis by electrochemiluminescence immunoassay to detect Treponemal pallidum (TP) antibodies. The positive test was repeated twice and was considered authentic if seropositivity was found two out of three times. All infected blood products were discarded. The donors were traced with their phone numbers. Each positive donor was contacted thrice on three different occasions if they did not respond. The ones who responded were informed, counselled and also referred to an infectious disease clinic, while taking care of confidentiality.

Results: Sero-prevalence of syphilis donors was 0.8%. Seventy eight of the reactive donors were first time donors. All of them were replacement donors.

All donors who were reactive for antibodies were males, and the majority (42.7%) of them were between the ages 36 to 45years. Out of total 89 syphilis positive donors, only 59 responded, 30 (33.7%) did not respond or gave wrong numbers. Only 6 (0.07%) positive donors came to collect their report, and subsequently took treatment after they were informed. Six donors reactive for syphilis antibodies had a history of travel abroad in the last two years. Out of 59 seropositive donors who responded, only 3 had a history of either a skin rash, swollen lymph nodes or fever.

Conclusion: Syphilis positive donors need tracing and counseling, as the majority of sero-positive cases did not turn up to collect reports and receive treatment. Blood bank staff should be trained to identify high-risk behavior through history, while giving confidence to the donor regarding confidentiality.