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European Journal of Scientific Research ISSN 1450-216X Vol.31 No.3 (2009), pp.335-340 EuroJournals Publishing, Inc. 2009 http://www.eurojournals.com/ejsr.

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Syphilis in Voluntary Blood Donors in North-Eastern, Nigeria


Olokoba AB Department of medicine Fwacp, Dtmh(london), MBA, Gastroenterology Unit University of Ilorin Teaching Hospital P.m.b 1459, Ilorin Kwara state Nigeria E-mail: drabolokoba@yahoo.com Olokoba LB Department of Ophthalmology Salawu FK Federal Medical Centre, Yola, Nigeria Danburam A Federal Medical Centre, Yola, Nigeria Desalu OO Department of Medicine Badung LH Federal Medical Centre, Yola, Nigeria Tidi SK Federal Medical Centre, Yola, Nigeria Midala J Federal Medical Centre, Yola, Nigeria Aderibigbe S Department of Epidemiology and Community Medicine Abdulrahman MB Department of Chemical Pathology Wahab KW Department of Medicine Babalola OM Department of Surgery Abdulkarim A Department of Paediatrics,University of Ilorin Teaching Hospital, Ilorin, Nigeria

Syphilis in Voluntary Blood Donors in North-Eastern, Nigeria Abstract Sexually transmitted infections are widespread in the developing countries and constitute a major public health problem in sub-saharan Africa. More recently, there has been a resurgence of syphilis. Even though syphilis may be transmitted via blood transfusion, there is scanty information on syphilis among blood donors in Nigeria. We therefore determined the seroprevalence of syphilis among voluntary blood donors in North-eastern Nigeria. The study was a hospital-based cross sectional one carried out at the blood bank of Federal Medical Centre, Yola, Nigeria from January, 2007 to December, 2008. Five hundred and ninety five consecutively recruited voluntary blood donors were screened for syphilis using Rapid Plasma Reagin (RPR) test. All those that were positive were confirmed using treponema pallidum haemagglutination (TPHA) test. The biodata of the patients were obtained. Written informed consent was obtained from each patient. Out of the 595 voluntary blood donors screened, 571 donors (96%) were males while 24 (4%) were females. The mean age was 31.3+/- 7.9 years. Only the male donors had syphilis. 7 donors (1.2%) were positive for syphilis. In conclusion, the seroprevalence of syphilis is low among voluntary blood donors in North-eastern, Nigeria.

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Keywords: Syphilis, Blood Donors, Nigeria

Introduction
Syphilis is a sexually transmitted infection (STI) caused by the Treponema Pallidum spirochete. The route of transmission of syphilis is almost always by sexual contact, although there may be congenital syphilis via transmission from mother to child in- utero (http://en.wikipedia.org/wiki/syphilis). Syphilis may also be transmitted via blood and blood products, and intravenous drug use (Olokoba et al, 2008). If not treated, syphilis can cause serious effects such as damage to the aorta, brain, eyes, and bones. In some cases these effects may be fatal (http://en.wikipedia.org/wiki/syphilis). STIs are widespread in the developing countries and constitute a major public health problem in sub-saharan Africa. More recently, there has been a resurgence of syphilis (Olokoba et al, 2008). Syphilis has also acquired a new potential for morbidity and mortality through association with increased risk for HIV infection (Olokoba et al, 2008). This will make it increasingly difficult to get safe blood because of this blood borne infection. Inspite of this, information regarding syphilis infection among blood donors is scanty in Nigeria. We, therefore, investigated the occurrence of syphilis infection amongst voluntary blood donors in North-eastern Nigeria.

Materials and Methods


The serum samples of all consecutively recruited voluntary blood donors were screened for Syphilis using Rapid Plasma Reagin (RPR) test. All those that were positive were confirmed using treponema pallidum haemagglutination (TPHA) test. Their biodata was obtained. Written informed consent was obtained from each patient. The study was approved by the Ethics and Research committee of the Federal Medical Centre, Yola, Nigeria.

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Olokoba AB, Olokoba LB, Salawu FK, Danburam A, Desalu OO, Badung LH, Tidi SK, Midala J, Aderibigbe S, Abdulrahman MB, Wahab KW, Babalola OM and Abdulkarim A

Analysis The data obtained were analysed using the statistical package for social sciences (SPSS, version 10.0) statistical software.

Results
At the conclusion of the study, a total of five hundred and ninety-five voluntary blood donors were found to have been screened for syphilis. Only the male donors had syphilis. Demographic Data of the Donors Age The age of the donors ranged from 18-61years with a mean of 31.3+/-7.9 years. Majority of the donors were in the age group 20-29years ie third decade of life (Table 1).
Table 1: Age groups and syphilis infection
Age groups (Years) <20 20-29 30-39 40-49 50-59 60-69 Total Frequency (n) (%) 15 (2.5) 265 (44.5) 231 (38.8) 66 (11.1) 15 (2.5) 3 (0.5) 595 (100.0) Syphilis (n) (%) 2 (28.6) 4 (57.1) 1 (14.3) 7(100.0)

Sex Five hundred and seventy-one donors were males (96.0%) while twenty-four were females (4.0%) giving a male to female ratio of 23.8:1 (Table 2).
Table 2:
Sex Male Female Total

Sex Distribution of Donors


Frequency 571 24 4.0 595 Percent 96.0 100

Frequency of syphilis Seven donors (1.2%) were positive for syphilis. Six donors (85.7%) are in the sexually active age groups, 20-29 and 30-30years (Table 1). Occupation of donors Majority of the blood donors (36.5%) were civil servants. 4 donors (57.1%) with syphilis were civil servants while the remaining 3 donors (42.9%) with syphilis were businessmen (Table 3).

Syphilis in Voluntary Blood Donors in North-Eastern, Nigeria


Table 3: Occupation Versus Syphilis Infection
Frequency (n) (%) 13 (2.2) 130 (21.8) 217 (36.5) 1 (0.2) 1 (0.2) 2 (0.3) 16 (2.7) 46 (7.7) 6 (1.0) 3 (0.5) 1 (0.2) 151 (25.4) 2 (0.3) 1 (0.2) 5 (0.8) 595 (100.0) Syphilis (n) (%) 3 (42.9) 4 (57.1) 7 (100.0)

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Occupation Unemployed Business man Civil servant Carpenter Clergyman Youth corper Driver Farmer Housewife Labourer Meat butcher Student Tailor Teacher Trader Total

Discussion
Our study was aimed at determining the seroprevalence of syphilis among voluntary blood donors. The literature also notes that syphilis can occur in blood donors (Chikwem et al, 1997; Ejele et al, 2005; Fiekumo et al, 2009). However there is scanty information on the occurrence of syphilis among blood donors in Nigeria with which to compare. From this study, the age range of blood donors was 18 to 61 years with a mean of 31.3 years. This is similar to that in the study of Khan et al (2002) in Peshawar, Pakistan who found that their blood donors were in the age range of 18 to 60 years. It is also similar to the findings of Muktar et al (2005) in Zaria, North-western, Nigeria in which their donors had a mean age of 33 years even though their age ranged from 19 to 42 years. However the donors in Jos, Northcentral, Nigeria were in the age range 21 to 50 years according to Egah et al (2004). Most of the blood donors in this study were males, 96%. This is similar to the 95% in the study of Egah et al (2004). Muktar et al (2005) found that 98% of their donors were males while Nwokediuko et al (2007) in their study in Enugu, South-eastern, Nigeria found that 91.8% of their donors were males. However all the donors were males in the study of Elfaki et al (2008) among Sudanese donors, and the study of Khan et al (2002). From this study, syphilis among blood donors was 1.2% using TPHA. This figure is similar to the 1.2% found by Abdalla et al (2005) in their study among Kenyan donors. It is also similar to the 1.1% found by Fiekumo et al (2009) in Osogbo, South-western, Nigeria. It is however higher than the 0.85% found by Gupta el al (2004) in Indian donors; the 0.75% found by Bhatti et al (2007) among Pakistani donors; and the 0.1% found by Ejele et al (2005) in Port Harcourt, South-south, Nigeria. The finding of 1.2% of syphilis among blood donors in this study was lower than the 3.6% found by Chikwem et al (1997) in Maiduguri, North-eastern Nigeria; the 7.5% found by Adjei et al (2003) in Ghanaian donors; the 12.7% found by Matee et al (1999) among Tanzanian donors; and the 15.0% found by Elfaki et al (2008) among Sudanese donors. The wide differences in the syphilis infection rate among the blood donors in the different regions within Nigeria, and even those outside Nigeria may be due to the differences in geographical locations, age range of blood donors, sample sizes, the period of time the studies were carried out, and the different socio-cultural practices such as sexual behavior, marriage practices etc which take place in these regions. Access to healthcare, and the laboratory test reagents used may also be contributory factors. Abdalla et al (2005), and Gupta et al (2004) in their studies used venereal disease research laboratory (VDRL) to determine the presence of syphilis infection. Adjei et al (2003) in their study

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Olokoba AB, Olokoba LB, Salawu FK, Danburam A, Desalu OO, Badung LH, Tidi SK, Midala J, Aderibigbe S, Abdulrahman MB, Wahab KW, Babalola OM and Abdulkarim A

used VDRL and particle agglutination test kit whereas Elfaki et al (2008) used immunochromatographic strips to detect syphilis in serum samples. The implication of syphilis in voluntary blood donors is the risk of transmission of this infection to recipients of blood and blood products. This can contribute to the ever-widening pool of infection in the wider population. Syphilis has also acquired a new potential for morbidity and mortality through association with increased risk for HIV infection (Olokoba et al, 2008) thus making safe blood more difficult to get. We recommend the screening of all prospective blood donors for all transfusion transmissible infections. Blood that is positive for syphilis should be discarded, and the affected donor treated appropriately. A strict selection criteria for blood donors to exclude those with multiple sexual partners, and that blood transfusion should be restricted.

Conclusion
Even though the seroprevalence of syphilis infection is low among voluntary blood donors in Northeastern Nigeria, safe blood will still be more difficult to get.

References
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