SYSTEMATIC REVIEW OF THE INCIDENCE OF TRANSFUSION-TRANSMITTED INFECTIONS IN THALASSEMIA PATIENTS RECEIVING MULTIPLE BLOOD TRANSFUSIONS
Bibliographic record
Abstract
Background: Transfusion-transmitted infections (TTIs) pose a serious threat to thalassemia patients who rely on lifelong blood transfusions. Despite advancements in donor screening and testing methods, infections such as hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and syphilis continue to impact patient outcomes, particularly in resource-limited settings. Existing literature shows regional variation in the prevalence of TTIs, with developing countries experiencing higher rates due to inconsistent transfusion protocols and lack of advanced screening technologies. There remains a gap in comprehensive global data assessing the burden of TTIs in thalassemia populations. Objective: This systematic review aims to evaluate the global incidence and distribution of TTIs—specifically HBV, HCV, HIV, and syphilis—among thalassemia patients undergoing multiple blood transfusions, with a focus on identifying geographic disparities and gaps in transfusion safety practices. Methods: A systematic review was conducted following PRISMA guidelines. Literature published between January 2010 and December 2024 was searched across PubMed, Scopus, and Web of Science. Studies were included if they reported prevalence or incidence of TTIs in transfusion-dependent thalassemia patients. Exclusion criteria included case reports, reviews, and non-English articles. Data were extracted using a standardized form and assessed for quality using the Newcastle-Ottawa Scale. Results: Eight studies were included, spanning regions such as Southeast Asia, the Middle East, and Europe. HCV was the most commonly reported infection, with prevalence rates up to 52% in Egypt and 46% in Pakistan. HBV infection ranged between 10–19% in several low-resource settings, while HIV remained less common, especially in countries with established nucleic acid testing (NAT). Co-infections and regional discrepancies in TTI prevalence were prominent, primarily due to varying screening methods and donor selection practices. Conclusion: TTIs remain a significant health concern for thalassemia patients, particularly in low- and middle-income countries where transfusion safety protocols are suboptimal. Although advanced screening techniques like NAT have reduced TTI risks in developed nations, their limited accessibility in resource-poor areas perpetuates infection risks. Standardized global protocols, widespread NAT implementation, and targeted education are essential to improve transfusion safety and patient outcomes. Further longitudinal studies are needed to assess the long-term impact of TTIs in this vulnerable population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.035 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.008 | 0.008 |
| Bibliometrics | 0.015 | 0.017 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".