title: Blood transfusion as a major risk factor for HTLV-I infection among hospitalized children in Gabon (Equatorial Africa).
abstract: To study the risk factors for HTLV-I infection of African infants living in a high seroprevalence area, a survey was conducted among hospitalized children and their mothers in Franceville, southern Gabon. A total of 610 children (6 months to 14 years old) from 555 families and 434 mothers participated in the study. HTLV-I seroprevalence was 7.1% in the mothers and 2.8% in the children. No increase by age was observed in the children. Significantly more children with sickle cell anemia (11 of 57, or 19.2%) were infected than others (1%) (Fisher's exact test p < 0.001). Of the 13 seropositive infants (C+) whose mothers were tested, six (43%) had a seropositive mother (M+) [p < 0.001, prevalence ratio (PR) 10.12, 95% CI 3.40-30.35, attributable risk (AR) 0.55]. Risk factors for nonmaternally acquired HTLV-I infection were previous blood transfusion (Fisher's exact test p < 0.001, PR 15.74, CI 5.20-47.60, AR 0.71) and hospital admission. In a hospitalized pediatric population in Gabon mother-to-child transmission and blood transfusion (because of sickle cell disease) were equally implicated in HTLV-I infection. Control of HTLV-I infection in children in Africa requires prevention of both vertical and transfusion-associated transmission, which may be exceedingly difficult in developing countries.
authors.affiliation: International Centre for Medical Research, Franceville, Gabon.
authors.forename: E
authors.initials: E
authors.lastname: Delaporte
authors.forename: M
authors.initials: M
authors.lastname: Peeters
authors.forename: J L
authors.initials: JL
authors.lastname: Bardy
authors.forename: Y
authors.initials: Y
authors.lastname: Ville
authors.forename: L
authors.initials: L
authors.lastname: Placca
authors.forename: I
authors.initials: I
authors.lastname: Bedjabaga
authors.forename: B
authors.initials: B
authors.lastname: Larouzé
authors.forename: P
authors.initials: P
authors.lastname: Piot
mesh_terms: D000293:Adolescent; D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications; D002648:Child; D002675:Child, Preschool; D005260:Female; D005681:Gabon / Q000453:epidemiology; D006679:HIV Seropositivity / Q000150:complications; D015490:HTLV-I Infections / Q000453:epidemiology / Q000635:transmission*; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008297:Male; D008431:Maternal-Fetal Exchange; D008875:Middle Aged; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D012307:Risk Factors; D065227:Transfusion Reaction