Impact of Inconsistent Policies for Transfusion-Transmitted Malaria on Clinical Practice in Ghana

Background: Policies concerning the prevention of transfusion transmitted malaria (TTM) are the responsibility of blood transfusion services and malaria control programmes. To prevent spreading drug resistance due to over-use of malaria drugs, recent malaria treatment guidelines recommend prompt parasitological confirmation before treatment is started. In contrast, blood safety policies from the World Health Organisation (WHO) recommend presumptive malaria treatment for recipients of blood in endemic countries but evidence supporting this approach is lacking. Our study documented how these conflicting policies relating to malaria transmission through blood transfusion impact on clinical practice in a teaching hospital in West Africa. Methods/Principal Findings: We randomly selected and reviewed case notes of 151 patients within 24 hours of their receiving a blood transfusion. Transfusion practices including the confirmation of diagnosis and anti-malarial treatment given were compared across three departments; Obstetrics and Gynaecology (O&G), Paediatrics and Medicine. Overall, 66 (44%) of patients received malaria treatment within 24 hrs of their blood transfusion; of which only 2 (3%) received antimalarials based on a laboratory confirmation of malaria. Paediatric patients (87%) received the most anti-malarials and only 7 % and 24 % of recipients in medicine and O&G respectively received anti malarials. In 51 patients (78%), the anti-malarials were prescribed at the same time as the blood transfusion and anti-malarials prescriptions exceeded the number of patient

Challenges in transfusion-transmitted infection screening in Sub-Saharan Africa

International audienceIn Sub-Saharan Africa, high clinical demand for transfusion faces endemic bloodborne infections and limited resources. Blood screening for transfusion-transmitted bloodborne pathogens is the cornerstone of blood safety. Although there have been substantial improvements over the years, challenges in transfusion-transmitted infection screening that have been identified repeatedly long ago still need to be addressed. Affordability and sustainability of state-of-the-art quality assessed serological and molecular assays, and associated confirmation strategies remain of real concern. In addition, limited resources and infrastructures hamper the development of adequate facilities, quality management, and staff qualification, and exacerbate shortage of reagents and equipment maintenance. It is also important to maintain effort in constituting pools of repeat voluntary non-remunerated donors. Alternative strategies for blood screening that take into account local circumstances might be desirable but they should rely on appropriate field evaluation and careful economic assessment rather than dogma established from high-resource settings

Influence of plasmodium Falciparum malaria on sickle cell Vaso-occlusive Crisis in Yaoundé, Cameroon

BackgroundSickle cell disease and malaria infections are common in Cameroon. Malaria infection is thought to influence the occurrence and severity of crisis in sickle cell patients.ObjectiveTo investigate the relationship between malaria infection and vasoocclusive crisis in sickle cell disease patients.MethodsIn order to investigate the clinical severity of painful vaso-occlusive crisis in sickle cell anaemia patients suffering from malaria infection, 60 SS Homozygous patients aged 2 – 35 years (median = 15 years) with painful crisis and 40 SS Homozygous sickle cell patients in ‘steady state’ aged 1 – 38 years (median = 17 years) were recruited into the study. The clinical severity of the crisis was graded as 0.1 and 2 based on an arbitrary scale for increasing pain. For each participant thin and thick blood films were made from capillary blood, stained according to standard methods and examined for malaria parasites. Chi square and student t tests were used for statistical analysis.ResultsOf the 60 patients in crisis, pain in 46.7% was classified as Grade 1, in 46.7% as Grade 2 and in 6.6% as Grade 0. There were 66.6% of them with positive thick films for malaria parasites compared to 35.0% of the patients in ‘steady state’ (p=0.003). All parasites were shown on thin film to be Plasmodium falciparum. More than 50% of the patients in crisis with positive thick films were in Grade 2 of the clinical grading.ConclusionThese findings show that falciparum malaria remains a major cause of morbidity and contributes significantly to the occurrence and severity of painful vaso-occlusive crisis in sickle cell disease patients.Keywords:Plasmodium Falciparum, Malaria, Sickle Cell Diseas

La formation en médecine transfusionnelle reste insuffisante dans les centres d'Afrique subsaharienne francophone: Résultats d'une étude préliminaire

Purpose of the study: To evaluate the needs in staff training in transfusion centres of Sub-Saharan Africa. Material and methods: This preliminary study analyzed the training level of each personnel of four blood banks of Sub-Saharan Africa, their training fields, duration and training structures. Results: The needs remain high in all the fields and are critical regarding the administration of blood transfusion services, equipment maintenance and clinical use of blood. © 2011 Elsevier Masson SAS

Implementation of Blood and Blood Product Regulation Training Workshop, South Africa

The training workshop on Implementation of Blood and Blood Product Regulation was organised and co-hosted by the Paul-Ehrlich -Institut Global Health Protection Program BloodTrain and the Africa Society for Blood Transfusion (AfSBT) from the 20th to the 22nd of August 2019. This was aimed at strengthening the capacity of African countries in developing and implementing regulatory systems for blood. Over thirty participants from countries across the African continent came together in Johannesburg, South Africa and shared knowledge and experiences among themselves and also with experts from the BloodTrain, Africa Society for Blood Transfusion (AfSBT), World Health Organization (WHO) and the New Partnership for Africa`s Development (NEPAD). The workshop addressed a wide range of topics ranging from standards in transfusion, clinical practice, regulatory framework for blood, WHO guidelines related to blood regulation, haemovigilance and regulatory oversight of associated Medical Devices In-vitro Diagnostics. In addition to the context and motivation of the workshop, this report summarises the key content covered throughout the workshop and recommendations for further improvement. French Title: Atelier de Formation sur la Mise en Oeuvre de la Réglementation du Sang et des Produits Sanguins, Afrique du Sud Un atelier de formation portant sur la mise en oeuvre de la réglementation du sang et des produits sanguin s a été co-organisé par le programme de protection de la santé mondiale Paul-Ehrlich-Institut BloodTrain et la Société Africaine de Transfusion Sanguine (SATS) du 20 au 22 août 2019. Il visait à renforcer la capacité des pays africains à élaborer et à mettre en oeuvre des systèmes de réglementation pour le sang. Plus de trente participants de pays du continent africain se sont réunis à Johannesburg, en Afrique du Sud et ont partagé leurs connaissances et leurs expériences entre eux ainsi qu'avec des experts de BloodTrain, de la SATS, de l'Organisation Mondiale de la Santé (OMS) et du Nouveau partenariat pour le développement de l'Afrique (NEPAD). L'atelier a abordé un large éventail de sujets, allant des normes de transfusion, de la pratique clinique, du cadre réglementaire pour le sang, des directives de l'OMS relatives à la régulation du sang, à l'hémovigilance et à la surveillance réglementai re des diagnostics in vitro des dispositifs médicaux associés. En plus du contexte et de la motivation de l'atelier, ce rapport résume le contenu clé couvert tout au long de l'atelier et des recommandations pour de nouvelles améliorations