Screening blood donations for hepatitis C in Central Africa : Analysis of a risk- and cost- based decision tree

International audienceFour screening strategies (no testing, HC Abbott, HC Pasteur, and a combined test) for the detection of hepatitis C virus (HCV) antibody in donated blood were considered ina formal decision tree. Decision criteria included residual risk of infection and overall monetary cost. Tree parameters were determined using data from the Central African Republic. The prevalences observed among blood donors for HIV infection, hepatitis B, syphilis, and hepatitis C varied between 6% and 15%. The current residual risk of transfusion-transmitted infections is very high (8.4%). Screening for HCV would bring that risk down to about 3% with either the HC Pasteur, the HC Abbott, or the combined test. Even though baseline analysis gives preference to the HC Abbott test (the combined test coming out last), Monte Carte sensitivity and uncertainty analyses showed that Abbott's and Pasteur's tests are interchangeable, on the basis or either risk or cost consideration

Facteurs associés à la satisfaction des prescripteurs de produits sanguins labiles au Burkina Faso

INTRODUCTION : Le Centre national de transfusion sanguine, opérateur unique de la transfusion sanguine au Burkina Faso est engagé dans la démarche qualité suivant la norme ISO 9001. Aussi, l’écoute-client constitue-t-il un fondement majeur de son système. Notre étude est construite sur le concept de la « satisfaction client » comme fonction de la qualité du service perçue suivant le modèle SERVQUAL. OBJECTIFS : Identifier les facteurs associés à la satisfaction des prescripteurs de produits sanguins afin de donner aux décideurs des éléments d’aide à la décision pour l’amélioration continue des services. MATÉRIEL ET MÉTHODES : Nous avons conduit une enquête transversale auprès des prescripteurs de la ville de Ouagadougou entre le 27 février et le 30 avril 2015. Nous avons utilisé un questionnaire anonyme, auto-administré comprenant 13 items associés aux 5 dimensions du SERVQUAL. Les différents gaps ou index de satisfaction (ISC) ont été calculés et une régression linéaire a permis de déterminer les associations statistiques avec un seuil significatif à 5 %. RÉSULTATS : Sur 256 questionnaires distribués, le taux de retour était de 94,5 %. Environ 30 % des enquêtés étaient globalement satisfaits à très satisfaits. L’index global de satisfaction des clients était de −5,74. Le délai de livraison des produits, l’efficacité et l’innocuité des produits, le conseil transfusionnel, la pro-activité de la communication, la gestion des demandes de réservation de produits et la couverture des besoins étaient les facteurs associés à la satisfaction des prescripteurs. CONCLUSION : Cette étude, première du genre en transfusion sanguine dans notre contexte, a permis d’évaluer la satisfaction des clients et d’identifier les facteurs sur lesquels cibler les actions à mener dans le but d’utiliser efficacement les ressources disponibles.[Factors associated with the satisfaction of prescribers of blood products in Burkina Faso] BACKGROUND: The National Blood Transfusion Centre, unique operator of blood transfusion in Burkina Faso is engaged into the quality process according to ISO 9001. Therefore, the assessment of customer satisfaction is a main part of its system. Our study conceives "customer satisfaction" as dependant to the perceived service quality based on SERVQUAL model. OBJECTIVES: To identify factors associated with the satisfaction of blood products prescribers in order to help decision-makers for continuous improvement of services. MATERIAL AND METHODS: We conducted a cross-sectional survey among prescribers of blood components in Ouagadougou, between February 27 and April 30, 2015. We used an anonymous self-administered questionnaire, including 13 items associated to the 5 dimensions of SERVQUAL model. The different satisfaction gaps were calculated and linear regression was used to determine statistical associations with a significance level of 5%. RESULTS: The return rate was 94.5% about the 256 questionnaires distributed. A total of 30% of respondents were satisfied to very satisfied. The overall global gap of satisfaction was -5.74. The product delivery time, the efficacy and safety of blood products, the medical and clinical support, the pro-activity of the communication, the management of blood products reservation and the satisfaction of needs in blood products were the factors associated with the prescribers' satisfaction. CONCLUSION: This first study in blood transfusion services in our context was been useful to assess customer satisfaction and identify the main axes on which targeting priority actions in order to effectively use available resources

Transfusion-associated or nosocomial hepatitis G virus infection in patients undergoing surgery

International audienceBACKGROUND: Despite blood donor screening, there are still cases of transfusion-associated hepatitis. From 1988 to 1992, a prospective study was conducted on the incidence of non-A, non-B posttransfusion hepatitis (PTH). STUDY DESIGN: The present investigation was designed to determine if transfusion recipients with PTH who are negative for hepatitis C virus (HCV) were positive for hepatitis G virus (HGV). Patients admitted for surgery who had normal liver tests and no transfusions during the previous 6 months were enrolled. Alanine amino transferase levels were determined monthly for 6 months after surgery and for 1 year in the case of PTH (defined as alanine aminotranferase twice the upper limit of normal in two consecutive assays). HGV RNA and E2 antibodies were tested for in samples from transfusion recipients with or without PTH and from nontransfused patients. RESULTS: Of the 308 blood recipients who were enrolled in the study, 21 (6.8%) had PTH. HGV RNA was detected at the onset of hepatitis in 3 patients with PTH (14%), 2 of whom were also anti-HCV and HCV RNA positive. One patient developed E2 antibodies without detectable HGV RNA. Three (10.7%) of 28 recipients of an allogeneic transfusion without PTH developed HGV infection. HGV RNA was also found in two nontransfused patients, which suggests nosocomial transmission of HGV. CONCLUSION: Some cases of PTH are associated with HGV; most cases of postoperative HGV infection are not associated with liver abnormalities; and most PTH cases are not associated with known hepatotropic viruses

An Examination of Recidivism Among Inmates Released From a Private Reentry Center and Public Institutions in Colorado

In this study, we examine comparative rates of recidivism for Colorado inmates released from a private reentry center and public facilities. Using a sample of 6,102 inmates released from 2008 to 2012, we measure overall recidivism and recidivism for a new crime. Applying a quasi-experimental methodology, we find that overall rates of recidivism are comparable. Prior to matching, 46.8% of the treatment and 61.3% of the comparison group recidivated, and the difference is statistically significant. However, after matching on relevant covariates, the difference was reduced to nonsignificance. In contrast, those released from the private facility are more likely to return to prison for a new offense. Approximately 14% of those in the private facility committed a new crime compared with 9% prematching and 8% postmatching. Despite these modest differences in the rate of recidivism, the overall time to return to prison is comparable between the groups