Pediatric blood transfusion practices at a regional referral hospital in Kenya

Report of an audit of tranfusion blood use in a large Kenyan hospita

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

Status of blood safetyin the who African region: Ten years after adoption of the regional strategy

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Consequences of centralised blood bank policies in sub-Saharan Africa

Safe and reliable transfusion services remain largely unavailable to the world’s poorest populations, particularly in sub-Saharan Africa. WHO responded to this crisis with a strategy focused on centralising blood transfusion services, the exclusive use of volunteer donors, donor blood testing, and transfusion stewardship. On the basis of our experience in Malawi, we think that this policy has unintentionally decreased the availability of blood products for patients with acute haemorrhage

The contribution of unsafe blood transfusion to human immunodeficiency virus incidence in sub-Saharan Africa:reexamination of the 5% to 10% convention

BACKGROUNDHistorical estimates have attributed 5% to 10% of new human immunodeficiency virus (HIV) infections in sub-Saharan Africa (SSA) to unsafe blood transfusions. Although frequently cited, the validity of this statistic is uncertain or outdated. Recent estimates suggest blood transfusion's contribution to new HIV infections in the region may be much lower. STUDY DESIGN AND METHODSWe searched the peer-reviewed and gray literature for quantitative estimates of the specific contribution of unsafe blood transfusion to the proportion of new HIV infections occurring in SSA. The sources and methods used to generate attribution estimates were evaluated against published country-specific HIV prevalence data. RESULTSDespite multiple secondary citations, a primary published source attributing 5% to 10% of new HIV infections to blood transfusions in SSA could not be established for the current era. The United Nations Programme on HIV and AIDS (UNAIDS) modes of transmission (MOT) reports representing 15 countries suggest that between 0 and 1.1% of new HIV infections per year (median, 0.2% or approx. two out of 1000 new infections each year) may be attributable to blood transfusions. CONCLUSIONRecent modeled estimates suggest that blood transfusions account for a very low proportion of new HIV infections in SSA, likely an order of magnitude lower than 5% to 10%. Direct quantification of risk is challenging given the paucity of data on the variables that impact transfusion-associated HIV. Specifically, data on HIV incidence in blood donors, blood bank laboratory test performance, and posttransfusion surveillance are lacking. Findings suggest an urgent need for improved surveillance and modeling of transfusion-associated HIV transmission in the region

Transfusion complications:Estimate of the residual risk of transfusion-transmitted human immunodeficiency virus infection in sub-Saharan Africa: a multinational collaborative study

Background: Sub-Saharan Africa remains the epicenter of the human immunodeficiency virus (HIV) pan- demic. However, there is a lack of multicenter data on the risk of transfusion-transmitted HIV from blood centers in sub-Saharan Africa.Study design and methods: The incidence of HIV infections in the blood donations collected in the main blood banks of five countries (Burkina Faso, Congo, Ivory Coast, Mali, and Senegal) was determined to estimate the current transfusion risk of HIV infection using the incidence rate/window period model.Results: The risk of transfusion-transmitted HIV infections associated with the window period varied from 1 in 90,200 donations (Senegal) to 1 in 25,600 (Congo). Considering the five participating blood centers as a whole, the incidence rate of HIV-positive donors per 100,000 person-years was 56.6 (95% confi- dence interval [CI], 47.1-67.9); the residual risk (RR) was 34.1 (95% CI, 7.8-70.7) per 1 million donations, which represents 1 in 29,000 donations (95% CI, 1/128,000-1/14,000).Conclusion: RR estimates varied according to the country. This is potentially due to a lower incidence of HIV infection in the general population or to a more efficient selection of blood donors in the countries with the lowest risk. The estimates of the transfusion risk of HIV infection in each country are important, both to assess the impact of current preventative strategies and to contribute data to policy decisions to reinforce transfusion safety